Objective To observe the characteristics of multiple evanescent white dot syndrome (MEWDS) with modern multimodal imaging modalities. Methods This was a retrospective case study. Eleven patients (11 eyes) diagnosed with MEWDS were enrolled. There were 10 females and 1 male, mean age was 27.6 years (range 15-41 years). The period between disease onset and visiting to the hospital was between 2 to 13 days, the average time was 4.7 days. All the patients underwent examinations of best corrected visual acuity, slit-lamp biomicroscope, indirect ophthalmoscope, fundus color photography, fundus autofluorescence (FAF), fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and spectral domain optical coherence tomography (SD-OCT). The mean follow up duration was 3.2 months. The imaging characteristics were compared. Results Fundus color photography showed foveal orange-red granularity in all eyes. FAF showed strong autofluorescence with a vague boundary. FFA showed a variable number of highly fluorescent fine needle-like dots arranged in a ring in the early stage, and fluorescence remained in the late stage. ICGA showed advanced lesions of vague boundary merged into a large plaque of deep retinal hypofluorescence. SD-OCT showed the hyperreflectant material deposit over the retinal pigment epithelium and extending anteriorly through the interdigitation zone, ellipsoid layer, and toward the external limiting membrane. At the site of extrafoveal lesions, SD-OCT revealed the presence of discontinuities or disruptions centered on the ellipsoid zone to include the interdigitation. Conclusions In MEWDS patients, fundus photography showed foveal orange-red granularity; FFA showed early fluorescent dots distributed in a ring pattern; ICGA showed hypofluorescent lesions in the later stage; SD-OCT showed disruption of the interdigitation zone and ellipsoid zone and accumulations of hyperreflective material that was of variable size and shape; FAF showed strong autofluoresce areas that correlated to spots observed with FFA and ICGA.
Objective To observe the choroidal thickness and its relationship with age and refraction status in Chinese population. Methods 180 healthy volunteers (360 eyes) were enrolled in this study. Based on the age, the volunteers were divided into A (20-29 years old), B (30-39 year old), C (40-49 years old), D (50-59 year old), E (60-69 year old), and F (70-85 year old) group, with 33, 31, 29, 30, 31, 26 volunteers respectively. And the volunteers were divided into ＜60 years old group with 123 volunteers and ge; 60 years old group with 57 volunteers. Enhanced depth imaging (EDI) choroidal scans were obtained in all eyes by using spectraldomain optical coherence tomography. Subfoveal choroidal thickness (CT) and CT at 1 mm/3 mm temporal, nasal, superior, inferior to the fovea (S 1 mm, I1 mm, T1 mm, N 1 mm, S, I3 mm, T3 mm, N3 mm) were measured. The differences of CT between different quadrants, genders, eyes and ages were comparatively analyzed. The correlations between age, refraction status and CT in the volunteers of ＜60 years old and ge; 60 years old group were analyzed. Results The subfoveal CT was (262.78plusmn;84.38) mu;m. The differences were significant between subfoveal CT and all the quadrants CT (P＜0.05) except for S1 mm and T1 mm (P＞0.05 ). There was no difference between genders or eyes in subfoveal CT (P＞0.05 ). There was no difference between A, B, C, D group in subfoveal CT (P＞0.05 ). The subfoveal CT of E and F group were thinner than A, B, C, D group (P＜0.05). In the ＜60 years old group, there was a positive correlation between refraction status and CT (r=0.147,P＜0.05); but no correlation between age and CT (r=－0.055, P＞0.05 ). In the ge; 60 years old group, there was a significant negative correlation between CT and age (r=－0.543, P＜0.05), but no correlation between refraction status and CT (r=-0.008, P＞0.05). Conclusions The average subfoveal CT in Chinese population was (262.78plusmn;84.38) mu;m. The refraction status is the main influence factors in subjects ＜60 years old, while the age is the main influence factors in subjects ge;60 years old.
Objective To compare the findings of posterior vitreous detachment (PVD) with B-mode ultrasonography and spectral-domain optical coherence tomography (SD-OCT), and to find the best way for clinical diagnosis of PVD. Methods This is a prospective case series study based at our hospital between May and September 2012. Patients aged 50 years or older with no obvious ocular pathology, no history of intraocular operation and refractive power within ±3 Diopter were recruited and examined with B-mode ultrasonography and SD-OCT. Posterior hyaloid status were assessed by two experienced technicians respectively. Patients with idiopathic macular pucker and macular hole indicated for vitrectomy were also included, and preoperative findings of posterior vitreous cortex status were compared with intraoperative findings. SPSS software was used for statistical analyses. Results Two hundreds and four eyes of 102 patients met the criteria were examined, in which 10 eyes of 10 patients received 23G vitrectomy. There were 31 males and 71 females. Mean age was (63.2±7.2) years old (ranged from 50 to 80 years old). Status of posterior vitreous cortex were measured by SD-OCT in 70 eyes (34.3%), 56 eyes (27.5%) of which manifested different stages of PVD and 14 eyes (6.8%) with attached posterior vitreous cortex (N-PVD). The other 134 eyes (65.7%) had no findings of posterior vitreous cortex with SD-OCT. B-mode ultrasonography showed 98 eyes (48.0%) with C-PVD. Combining the results detected by both ultrasound and SD-OCT, altogether 145 eyes (71.1%) were found with different stages of PVD. Comparison of B-mode ultrasonography and SD-OCT to intraoperative findings in 10 operated eyes showed that: seven eyes with no findings in SD-OCT actually had C-PVD; three eyes with PVD in SD-OCT were proved having PVD during operation; five eyes manifested N-PVD in B-mode ultrasonography, only one of which was proved having N-PVD; five eyes with C-PVD in B-scan were observed having C-PVD. Only one eye had a matched result of C-PVD with three detecting ways. Conclusions B-mode ultrasonography provides a significant higher detection rate of PVD than SD-OCT; SD-OCT has more advantages than ultrasound in detecting the earlier stage of PVD. Combining Bmode ultrasonography and SD-OCT can significantly improve the PVD detection rate and provide considerably more information of PVD.
ObjectiveTo investigate the change of subfoveal choroidal thickness (SFCT) and the relationship between SFCT and the severity of the diabetic retinopathy using enhanced depth imaging optical coherence tomography (EDI-OCT). MethodsA total of 164 eyes (93 patients) of type 2 diabetes mellitus (DM) were included in this study. The patients included 34 males and 59 females, with an average age of (59.3±5.6) years, with an average diabetes duration of (5.11±4.64) years. The patients were divided into 4 groups according to international classification standards of DR, including non-diabetic retinopathy (NDR) group (64 eyes), mild non-proliferative diabetic retinopathy (NPDR) group (33 eyes), moderate NPDR group (37 eyes), and severe NPDR group (30 eyes). The control group included 25 normal subjects (42 eyes). All patients underwent visual acuity, intraocular pressure, slit lamp microscope, indirect ophthalmoscope, A/B-type ultrasound scan, frequency domain optical coherence tomography (SD-OCT) examination, as well as fasting blood glucose and mean arterial blood pressure measurement. The mean axial length was (23.04±0.78) mm, mean fasting blood glucose was (8.88±2.59) mmol/L, mean arterial pressure was (100.44±9.63) mmHg. SFCT of all eyes were measured by EDI-OCT. The relationship between SFCT and the severity of the diabetic retinopathy, DM duration, fasting blood glucose, the mean arterial pressure, axial length was analyzed by one-way ANOVA. ResultsThe mean SFCT was (224.24±42.10) μm in DM group and (276.77±48.07) μm in normal control group, the difference was statistically significant (F=23.86, P < 0.05). The mean SFCT was also statistically significant between all DM groups (P < 0.05). There were negative linear correlation between SFCT of all patients and the severity of retinal lesions (r=-0.555, P=0.000), and between SFCT and DM duration (r=-0.332, P < 0.05). But SFCT was independent of fasting plasma glucose (r=-0.123, P > 0.05), mean arterial pressure (r=-0.116, P > 0.05), and axial length (r=-0.018, P > 0.05). ConclusionsSFCT in DM eyes is thinner than that in normal controls. SFCT is different in the NDR, mild NPDR, moderate NPDR, severe NPDR patient. Severe DR patients have much thinner SFCT.
ObjectiveTo observe the characteristics of indocyanine green angiography (ICGA) and optical coherence tomography angiography (OCTA) in polypoidal choroidal vasculopathy (PCV). Methods17 patients (17 eyes) with PCV referred to Peking Union Medical College Hospital from November 2014 to February 2015 were included in this cross-sectional study. There were 9 males (9 eyes) and 8 females (8 eyes), aged from 55 to 79 years, with the mean of (68.24±6.80) years. There were 10 right eyes and 7 left eyes. All patients were examined by fundus fluorescein angiography combined with ICGA, and OCTA was performed within 1 hour. ResultsICGA showed 5 eyes with branching vascular network (BVN), 7 eyes with polyps, only 1 eye with both BVN and polyps. 4 eyes showed no positive findings, 3 of them with large hemorrhage. 5 eyes with BVN shared the similar location and range of the lesions in ICGA and OCTA. 7 eyes with polyps showed hot spot in OCTA, 5 of them shared the similar lesions with ICGA, the other 2 eyes showed slightly different in ICGA and OCTA. 1 eye showed both BVN and polyps, OCTA and ICGA were consistent for this. In the 3 eyes with large hemorrhage, 2 of them showed hot spot below pigment epithelial detachment, 1 eye show no positive findings in both ICGA and OCTA. ConclusionsPCV patients with BVN shared similar findings in ICGA and OCTA, PCV patients with polyps showed highlight spot in OCTA. OCTA can visualize BNV and polyps of choroidal capillary, and it can showed the similar site and range of lesions in ICGA.
ObjectiveTo observe the imaging characteristics of fundus choroidal nodules in patients with neurofibromatosis type 1 (NF1). MethodsA retrospective clinical study. From January 2018 to August 2022, 20 eyes of 10 patients with NF1 combined with choroidal nodules who were diagnosed by ophthalmology examination at the Affiliated Hospital of Yunnan University were included in the study. Among them, there were 6 male cases with 12 eyes and 4 female cases with 8 eyes; both eyes were affected. Age was (28.0±6.9) years old. Both eyes were involved. All patients underwent color fundus photography, infrared fundus photography (IR), fundus autofluorescence (FAF), fluorescein fundus angiography (FFA), and optical coherence tomography (OCT). Nine eyes underwent multi-wavelength color imaging (MC) and 5 eyes underwent OCT angiography (OCTA). ResultsIn 20 eyes, fundus color photography showed "spiral-like" changes in the small retinal blood vessels on the surface of the choroidal nodules in 1 eye. FAF and FFA examination showed no abnormalities in all affected eyes. On IR examination, choroidal nodules appeared as strong reflective lesions of varying sizes and numbers, in the form of spots and/or sheets, and were partially fused. In the 9 eyes that underwent MC examination, patchy red signals was observed in standard MC images. OCT examination showed that all affected eyes had strong choroidal reflective mass lesions under the retinal pigment epithelium, which were flat patchy or slightly raised “dome-like”, corresponding to IR strong reflective lesions. The choriocapillaris layer was squeezed and thinned, and the large choroidal vessels show weak reflection. Five eyes underwent OCTA examination, there was no loss of blood flow density at the choroidal nodules and the of the superficial an deep retinal capillary plexus in 3 eyes. The choroidal capillary blood flow density was reduced in 2 eyes. ConclusionIR of choroidal nodules is characterized by strong reflection lesions of varying sizes and numbers, which appear in spots and/or sheets. OCT shows enhanced reflection of the choriocapillaris layer corresponding to the strong IR reflection lesions.
ObjectiveTo assess and classify the features of fundus autofluorescence (FAF) with optical coherence tomography (OCT) in clinically significant diabetic macular edema according to the criteria reported by ETDRS. Methods Eighty-four eyes of 47 diabetic patients with untreated clinically significant macular edema (CSME) diagnosed by OCT/FAF examination were enrolled in this study. The mean BCVA was 0.38±0.26, CRT was (360.23±139.40) μm and volume was (9.59±1.97) mm3. According to the FAF patterns, the CSME patients were divided into normal group (30 eyes), single-spot group (20 eyes), and multiple-spot group (22 eyes). There were 44, 18 and 22 eyes with diffuse edema, cystoid edema and serous retinal detachment, respectively. The correlation of visual acuity with central retinal thickness and total volume of macular was analyzed between different groups. ResultsIn the normal group and the single-spot group, the prevalence of the diffuse type was highest in the OCT (83.3%, 60.0%). In the multiple-spot group, the prevalence of the SRD type was highest in the OCT (50.0%). In the three FAF pattern groups, the BCVA were 0.47±0.26, 0.43±0.30, 0.28±0.19; the CRT were (272.41±48.62), (402.84±134.89), (505.67±135.20) μm; the total volume was (8.67±1.03), (8.94±1.63), (10.79±2.20) mm3. The BCVA were 0.43±0.25, 0.45±0.30, 0.22±0.14; the CRT were (272.41±48.62), (402.84±134.89), (505.67±135.20) μm; the total volume was (8.58±0.95)、(9.22±1.33)、(12.03±2.01) mm3 in eyes with diffuse edema, cystoid edema and serous retinal detachment, respectively(r=-0.31, -0.34; P > 0.05). Correlation analysis showed CRT positively correlated to volume (r=0.85, P < 0.05), BCVA negatively correlated to CRT and volume(r=-0.31, -0.34; P > 0.05). ConclusionThere are more diffuse edema eyes in normal group and single-spot group, while serous retinal detachmen in multiple-spot group. FAF correlates better with visual acuity than OCT patterns.
ObjectiveTo evaluate the repeatability and reproducibility of macular ganglion cell-inner plexiform layer (GCIPL) thickness measurement using spectral-domain optical coherence tomography (Cirrus HD-OCT). MethodOne hundred and eight eyes of 54 normal subjects (26 males and 28 females) between 19 and 75 years of age were included. Each eye underwent macular scanning using Cirrus HD-OCT Macular Cube 512×128 protocol by two operators. Three scans of each eye were obtained by each operator. For the right eye of each subject, three extra scans were obtained using Macular Cube 200×200 protocol by one operator. The average, minimum, superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal GCIPL thickness was analyzed and the repeatability of GCIPL thickness measurement was evaluated with intra-operator, inter-operator, intra-protocol, and inter-protocol intraclass correlation coefficients (ICC). Ten extra scans were obtained from the left eyes of 10 randomly selected subjects for reproducibility assessment with coefficients of variation (CV). ResultsThe intra-operator ICC of macular GCIPL measurement using Macular Cube 512×128 protocol by two operators were 0.959-0.995 and 0.954-0.997, respectively; and the inter-operator ICC were 0.944-0.993. All intra-and inter-operator ICC were > 0.800 with the highest and lowest records of the average and minimum GCIPL thickness, respectively. The intra-protocol ICC of Macular Cube 512×128 protocol and Macular Cube 200×200 protocol were 0.986-0.996 and 0.927-0.997, respectively; and the inter-protocol ICC were 0.966-0.994. All intra-and inter-protocol ICC were > 0.800. CV of GCIPL thickness measurement using Macular Cube 512×128 protocol were (0.70±0.31)%-(1.35±0.86)%. ConclusionCirrus HD-OCT can measure macular GCIPL thickness in normal eyes with excellent repeatability and reproducibility.
ObjectiveTo determine the retinal thickness of normal children 3-6 years old and its relationship with the age and gender. MethodsIn a cross-sectional study, 480 eyes of 240 normal preschool children including 115 male and 125 female, ages 3 to 6 years in the urban of Beijing, China were included. The average age was (4.93±0.77) years old. The visual acuity, slit-lamp microscopy and frequency domain optical coherence tomography (FD-OCT, Optvue, Inc. USA) were examined. The retinal thickness of the macular fovea and 500, 750, 1500 μm from temporal and nasal side around the fovea were measured. 32 eyes were excluded from the study because they couldn't cooperate. Pearson correlation analysis was used to determine the correlation between age and macular retinal thickness. Independent samples group t-test was used to compare the differences between boys and girls. ResultsThe mean thickness of macular fovea was (169.10±20.587) μm. The mean macular thickness of boys was significantly higher than girls (t=-4.549, -6.167, -5.492, -5.163, -6.749, -7.494, -6.874; P≤0.001). The mean thickness of 500 μm and 750 μm from nasal side of macular fovea were significantly higher than temporal side (t=5.594, 15.778, 7.678, 18.180; P < 0.001). There was no significant relevance between macular thickness and age. ConclusionsThe mean macular thickness of boys is significantly higher than girls in normal children in the urban of Beijing. There is no significant relevance between macular thickness and age.