PURPOSE:Understanding the characteristics of color vision defects in patients with maculopathy. METHODS:Applying Panel D-15 test and FM 100-hue test to evaluate the color vision of 78 patients (122 eyes) with maculopathy and analyzing the types of color vision defects and the relationship between the color discrimination and the visual acuity. RESULTS:All eyes of the wetform AMT(14 eyes),Stargardt's disease(10 eyes),macular hole (6 eyes)and central exudative retinochoroidopathy(3 eyes)showed color vision defects and high average roots of total error scores of FM 1000-hue test.The abnormal rates of color vision and the average roots of tota error scores in patients with epiretinal membrane (18 eyes)and dry-form AMD(71 eyes)were low.The roots of total error scores in FM 100-hue test was negatively relative with the visual acuity（r-0.8944）. CNCLUSION:The types and severities of color vision defects vary in different maculopathy.The color discrimination was negatively relative with the visual acuity. （Chin J Ocul Fundus Dis,1996,12: 80-82）
Myopic traction maculopathy is a general term for a class of diseases including vitreomacular traction, foveoschisis, and macular hole. Posterior staphyloma plays a vital role in the occurrence and development of myopic traction maculopathy. At present, there is no uniform standard for the timing and method of surgery for myopic traction maculopathy. Based on OCT examination, the classification of traction maculopathy and the degree of visual function damage are important basis for judging the timing of surgery at this stage. Pars plana vitrectomy has been widely used in the treatment of myopic traction maculopathy, but for those with a long axis, the operation is complicated and the effect is not ideal. Macular buckling can effectively alleviate the traction caused by posterior staphyloma, but this surgery has a certain learning curve for clinicians, surgical materials need to be improved and perfected, and more evidence-based medical evidence is needed. We believe that with the continuous clinical understanding of myopic traction maculopathy, surgical treatment will be more rationalized and better treatment results will be achieved.
Maculopathy caused by various fundus diseases in the late stage is a common cause of low vision. Medical technology is difficult to reverse the loss of macular function currently, so interventions that help improve the visual system, utilize residual visual function, and improve quality of life deserve attention. Damage to the fovea of the macula does not mean that the entire retinal function is impaired. There may be one or more retinal regions adjacent to the fovea that can serve as a fixation center. It is possible to form stable paracentral fixation, complete functional remodeling of the visual system, and effectively utilize residual visual function by taking appropriate training on these potential paracentral fixation points for most patients. In 2021, a clinical guideline has been published for low vision rehabilitation in China. In order to strengthen the precise management of diseases and develop a standard operating procedure for visual training specifically for patients with low vision due to macular disease, the National Clinical Research Center for Eye Diseases initiated and organized relevant domestic experts, utilizing the latest research experience at home and abroad, and through repeated discussions, this consensus (International Practice Guideline Registration Number: PREPARE-2023CN199) was formed as a reference for ophthalmologists, optometrists and rehabilitation physicians in their clinical research and practice.
Pathological myopic tractional maculopathy (MTM), as an important type of macular lesions associated with high myopia, play a significant role in the prevention and treatment of myopic macular diseases. With the rapid development of retinal imaging technologies, especially the widespread application of optical coherence tomography, new technical support has been provided for the accurate diagnosis, clinical staging, treatment decision-making, and long-term follow-up of MTM. However, in clinical practice in China, there are still issues such as unclear definitions, inconsistent staging criteria, and significant differences in treatment strategies. To address these challenges, Fundus Diseases Group in Ophthalmology Branch of Chinese Medical Association and Professional Committee of Fundus Diseases in Ophthalmology Branch of Chinese Medical Doctor Association for Ophthalmologists jointly drafted the Expert consensus on management of pathologic myopic tractional maculopathy in China, based on a systematic literature review and the latest clinical evidence. The consensus was revised multiple times by the core expert group and finally finalized. This consensus systematically establishes a standardized diagnostic and therapeutic system for MTM, covering disease definition and staging, diagnostic pathways and follow-up protocols, treatment strategies based on staging, and surgical intervention plans. It aims to provide ophthalmologists at all levels with a scientifically sound and practically applicable clinical guidance. The development of the consensus strictly adheres to the principles of evidence-based medicine, fully considering the actual clinical conditions of medical institutions at different levels in China. It provides principled recommendations with broad guiding significance for the clinical practice of MTM. It is particularly emphasized that when applying this consensus, clinicians should comprehensively consider the patient’s clinical characteristics, treatment accessibility, and socioeconomic factors, and implement personalized and precise treatment strategies to meet the diverse clinical needs of patients with pathological myopia.
ObjectiveTo summarize the clinical features in idiopathic hypotony maculopathy.MethodsA retrospective case series study. Eighteen eyes of 18 patients who were diagnosed with idiopathic hypotony maculopathy were enrolled in the Second Affiliated Hospital of Wenzhou Medical University from August 2012 to December 2017. There were 8 males (8 eyes) and 10 females (10 eyes). All patients underwent examinations including BCVA, optometry, slit lamp microscope, fundus color photography, UBM, B-mode ultrasound, OCT, FFA and axial length (AL). BCVA was recorded with logMAR acuity. The results of affected eyes and contralateral healthy eyes were compared. Paired t test was performed to compare the intraocular pressure (IOP), diopter and AL of the affected eyes and contralateral healthy eyes.ResultsAmong 18 eyes, there were 6 eyes with logMAR BCVA＜1.0, 10 eyes with logMAR BCVA 1.0−2.0, 2 eyes with light perception. The average diopter was +2.32±1.78 D. The average IOP was 5.18±1.38 mmHg (1 mmHg=0.133 kPa). The average AL was 20.92±1.61 mm. The differences of IOP (t=21.6, P＜0.000), diopter (t=5.9, P=0.002) and AL (t=9.13, P＜0.000) between the affected eyes and contralateral healthy eyes were significant. The inflammatory reaction in the anterior segment was observed in 13 eyes (72.22%). In the posterior segment, all the eyes were documented with chorioretinal folds, optic disc swelling and retinal phlebectasia were also demonstrated in 14 eyes, while with macular uplift in 7 eyes. In the UBM and gonioscope examination, the angle chamber was open in all patients with ciliary body cyst in 6 eyes, while no ciliary body detachment was detected. All eyes had been examined with B-scan ultrasound and found the increasing thickness of eye ball in all eyes, and nodular changes in the optic papilla in 5 eyes. The chorioretinal folds were further confirmed by OCT with the appearance of the gear shape, much more obviously in the choroid than that in retina. In the FFA, fluorescein leakage was found around the optic disc in 13 eyes at the late stage, while there was no obvious abnormal leakage in the macular or poster part of retina.ConclusionsIdiopathic hypotony maculopathy could present with various clinical manifestations. The choroiretinal folds is typical clinical sign.
With the tremendous progress in fundus imaging and histopathology over the past decade, the understanding of age-related macular degeneration (AMD) has taken a qualitative leap. AMD is defined as a progressive neurodegenerative disease of photoreceptors and retinal pigment epithelium (RPE) characterized by extracellular deposits under RPE and the retina, including drusen, basal laminar and linear deposits, and subretinal drusenoid deposits, that can evolve to atrophy of the retina, RPE and choroid and neovascularization in the choroid and/or retina. It is the leading cause of blindness and visual impairment in older populations, despite recent advances in treatments. AMD is a multifactorial disease with genetic and environmental factors including advanced age, smoking, high-fat diet, and cardiovascular disorder to enhance the disease susceptibility. The physiopathologic mechanism includes inflammatory processes (complement pathway dysregulation, inflammasome activation), intrinsic (e.g., photo-oxidation) and extrinsic oxidative insult to the retina, age-related metabolic impairment (mitochondrial, autophagic and endoplasmic reticulum stress). Autophagy dysfunction and local inflammation in aged RPE specially result in the extracellular deposits, cell death and AMD. Further investigation of the pathogenesis of AMD will provide with new therapeutic targets and strategy for prevention and treatment of the disease in the early stages.