ObjectiveTo observe the changes of glaucoma optic nerve head (ONH) parameters and macular ganglion cell complex (GCC) structure in preperimetric glaucoma (PPG) patients. Methods Eighteen PPG patients (18 eyes, PPG group), 22 primary open-angle glaucoma (POAG) patients (22 eyes, POAG group), and 20 patients (20 eyes) with physiologic large optic cup (physiological big optic cup group) were included in this study. Seventeen healthy volunteers (17 eyes) were the normal control. The optic nerve head and macular was scanned by fourier-domain optic coherence tomography (FD-OCT) for all subjects. The following 15 parameters, including nerve fiber layer thickness (RNFL), the optic disk rim volume (RV), optic nerve head volume (NHV), optic disc area (ODA), rim area (RA), cup volume (CV), cup/disc area ratio (CDAR), vertical cup/disc ratio (VCDR), horizontal cup/disc ratio (HCDR) and optic cup area (CA), macular GCC, superior GCC, inferior GCC thickness, focal loss of volume (FLV) and global loss of volume (GLV), were measured at 10 different quadrants. The relationship between macular GCC thickness or optic disc RNFL thickness and RA was analyzed by simple linear regression analysis. ResultsThe RNFL thickness of PPG patients was (99.29±19.93) μm (superior quadrant), (97.29±22.86) μm (inferior), (114.61±15.64) μm (superior temporal, ST), (119.22±26.19) μm (inferior temporal, IT), (116.11±39.32) μm (superior nasal, SN), (111.33±37.65) μm (inferior nasal, IN), (77.56±17.22) μm (temporal upper, TU), (76.78±10.34) μm (temporal lower, TL), (88.94± 42.54) μm (nasal upper, NU), and (82.33±43.83) μm (nasal lower, NL) respectively, which was thinner than normal control group and physiologic large cup group, but thicker than POAG patients. Compared to normal controls and physiologic large cup patients, PPG patients also had 4 parameters reduced (RV, NHV, ODA and RA), and 5 parameters increased (CV, CDAR, VCDR, HCDR and CA), the differences are statistically significant (P < 0.05). However, these parameters were similar to POAG patients (P > 0.05). For macular GCC parameters, PPG patients also had 3 parameters reduced (average GCC, superior and inferior GCC thickness), and 2 parameters increased (GLV and FLV) compared to normal control group and physiologic large cup patients (P < 0.05). However, these parameters were similar to POAG patients (P > 0.05).Simple linear regression analysis showed that, with the GCC macular thinning, reducing the number of ganglion cells reduced, optic disc RNFL thickness became thinner (regression coefficient=1.25, P=0.00) and RV reduced (regression coefficient=0.037, P=0.00). ConclusionsPPG patients and normal control had a similar distribution of optic disc RNFL. Five parameters (RV, NHV, ODA, RA, macular GCC thickness) were less than normal control and physiological big optic cup group, but had no significant differences compared with POAG group.
Objective To observe the macular morphological changes of choroidal melanoma with coherence tomography (OCT) after plaque radiotherapy (PRT). Methods A total of 48 patients (48 eyes) with choroidal melanoma who underwent125I PRT were enrolled in this study. All the patients were examined documenting OCT to get the image of macula. The macula of all the patients was not involved. The median visual acuity was 0.4plusmn;0.2, which ranged from 0.02 to 1.0. There were 18 eyes (37.5%) with retinal detachment, 12 eyes (25.0%) with retinal pigment epithelium (RPE) changes, seven eyes (14.6%) with macular edema, epimacular membrane, detachment combined with edema, exudation and RPE changes, 11 eyes (22.9%) with normal macular structure. The median follow-up time was (10.4plusmn;5.9) months, which ranged from one to 24 months. The tumor control situation and visual acuity were observed in follow-up period. The same equipment and methods of OCT were used to return visit in follow-up period. The macular morphological changes at the final visit and its relationship with PRT and visual acuity were contrastively analyzed. Results All the patients had good control of tumor. The vision acuity improved in two eyes (4.2%), unchanged in 10 eyes (20.8%), and decreased in 36 eyes (75.0%). The differences of the visual acuity was statistically significant between before and after treatment (Z=-3.778,P＜0.05). There were 13 eyes (27.1%) with retinal detachment; nine eyes (18.8%) with RPE changes; 17 eyes (35.4%) with macular edema, detachment combined with edema, exudation and RPE changes; six eyes (12.5%) with proliferation, atrophy, detachment combined with edema, exudation and epimacular membrane;three eyes (6.3%) with normal macular structure. There were 15 patients (31.3%) with two or more abnormal macular morphology after PRT. Conclusions Retinal detachment, RPE changes, macular edema and exudation are common abnormal macular morphology after PRT. The incidence rate of abnormal macular morphology is increased. There are 31.3% patients with two or more abnormal macular morphology.
ObjectiveTo observe the changes of retinal thickness in idiopathic macular hole eyes after vitrectomy combined with internal limiting membrane peeling. MethodsThe study included 40 eyes in 40 consecutive patients with idiopathic full-thickness macular holes who underwent vitrectomy and internal limiting membrane peeling. There were 10 males (10 eyes) and 30 female (30 eyes), the average age was (63.60±6.26) years, the average disease duration was (6.00±3.53) months. All patients were examined by spectral-domain optical coherence tomography to measure the foveal retinal thickness, parafoveal retinal thickness and every quadrant in 1, 3, 6 months after surgery. ResultsCompared foveal retinal thickness after 1 month with 3 month, the difference was significant (F=4.527, P=0.013). But foveal retinal thickness were not significantly different in 3 months and 6 months after surgery (F=2.031, P=0.971). The difference of average parafoveal retinal thickness between 1 month, 3 months and 6 months after surgery was not significant (F=2.011, P=0.139). The retinal thickness of the operated eyes were not significantly different from the normal fellow eyes in 1 month after surgery (t=0.651, P=0.519). And the foveal retinal thickness of the operated eyes and the normal fellow eyes are significantly different in 3 months and 6 months after surgery (t=-2.563, -2.524; P=0.015, 0.016). The thickness of temporal were thicker than other quadrant in 1 month, 3months and 6 months after surgery (t=-3.701, -4.612, -4.125; P=0.014, 0.006, 0.009). ConclusionThere is a transient increase in the foveal retinal thickness after macular hole surgery.
PURPOSE:To observe the clinical features of the macular hemorrhage in myopes. METHOD:Twenty-four patients(30 eyes)with myopic macular hemorrhage were examined with slitlamp biomicroscopy,funduscope,A/B ultrasonography,and fundus fluorecein angiography(FFA). The patients were followed up for 3~18 months(average 12 months). RESULTS: Four of 26 eyes with macular hemorrhage examined with FFA were found to be due to choroidal neovaseulature,and they were associated with posterior staphyloma. The other 22 eyes without neovascular change were thought to be simple type,and 19 of them were associated with lacquer cracks. The hemorrhage in simple type cases deminished usually within 1~3 months. CONCLUSION:Myopic macular hemorrhagic eyes of neovascular type resulted usually in recurrent hemorrhage and worse prognosis in visual acuity than those of simple type. （Chin J Ocul Fundus Dis,1996,12: 220-222）
Objective To study the ultrastructure of macular puck er (MP) from the patients with rhegmatogenous retinal detachment (RRD) and the mechanism associated with its development． Methods Twenty specimens of MP surgically removed by vitrectomy from 13 patients were dissected into two layers in each of them．The ultrastructure of two layers,i,e,near the vitreous and near the retina,was studied with electron microscopy． Results Seven sections of the near vitreous ones appeared prodominant collagen deposits and a few of epithelial like cells,and pigment particles might be present in the cytoplasm．While cells with foot processes were found in 13 membrane sections near the retina and increasing number of various types of cells rich in collagen around were observed including fibroblast like cells and glial cells． Conclusion The findings suggest that the MP after surgery of retinal detachment may possess a characteristic lamination,and posterior hyaloid cortex was involved in the developmetn of MP． The adhesion between posterior hyaloid cortex and macular area might be a key factor for forming MP． (Chin J Ocul Fundus Dis, 2001,17:52-54)
Objective To evaluate the clinical application value of ocular fundus photochromy and optical coherence tomography (OCT) in epimacular membrane of traumatic eyes following vitreorential surgery. Methods Ocular fundus photochromy and OCT were used to observe the morphological changes of macula in 139 consecutive patients with unilateral ocular trauma after vitreoretinal surgery between July 2003 and September 2004. Results At the 1st, 2nd, 3rd, 6th, and 12th month postoperatively, epimacular membranes were found in 5, 8, 17, 19, 20 patients, respectively by using photochromy; and in 7, 10, 20, 26, 27 patients, respectively by using OCT. There was no significant difference in epimacular membrane between photochromy and OCT(chi;2＝0.173，Pgt;0.05). The results of OCT showed that epimacular membranes completely adhered to the macular region in 8 patients（29.63%）, and retinal neurosensory layer swelled in 12 patients（44.44%）with the fovea thickness of (290.18plusmn;288.05) mu;m. Conclusion Ocular fundus photochromy and OCT are helpful in observing and discovering the epimacular membrane after virtreoretinal surgery of the patients with traumatic retinal detachment during the early and long-term follow-up period; and OCT can provide important information of the structue and position of these epimacular membranes hence to conduct to appropriate treatment. (Chin J Ocul Fundus Dis, 2006, 22: 236-238)
ObjectiveTo observe the effect of epinephrine in intraocular irrigation solution on retinal vascular caliber and macular thickness. MethodsA prospective control study. 32 eyes of 32 patients with macular hole who underwent vitrectomy were enrolled in this study. The patients including 14 males (14 eyes) and 27 females (18 eyes), with the average age of (64.0±4.5)years. Uncorrected visual acuity, corrected visual acuity, slit lamp biomicroscopy, indirect ophthalmoscopy, fundus color photography and optical coherence tomography were performed in all patients. Retinal vascular caliber located in 0.5-1.0 disc diameter from optic disk was measured from digital fundus photographs and summarized as central retinal artery (CRAE) and vein (CRVE) equivalents in all eyes at baseline and at the 1 month, 3 months follow-up visit. The macular thickness is the distance from retinal interface of inner plexiform layer to retinal pigment epithelium layer. The macula was divided into inner ring ( < 3 mm) and outer ring (3-6 mm) according to the distance from the fovea. The patients were divided into experiment group (include epinephrine in intraocular irrigation solution, 1:1000) and control group (without epinephrine in intraocular irrigation solution), 16 eyes in each group. The difference of CRAE and CRVE between two groups was not significant (P > 0.05). The difference of macular thickness between inner ring and outer ring was not significant (P > 0.05). The average follow-up was 3.5 months. CRAE, CRVE and macular thickness in inner ring and outer ring before and 1 month, 3 months after surgery were comparatively analyzed. ResultsThe differences of CRAE and CRVE before and 1, 3 months after surgery both in experiment group (tCRAE=0.322, 0.148; tCRVE=0.317, 0.005) and control group (tCRAE=0.226, 0.137; tCRVE=0.284, 0.151) were not significant (P > 0.05). The differences of CRAE (t=0.624, 0.424) and CRVE (t=0.015, 0.041) between experiment group and control group also were not significant (P > 0.05). The differences of macular thickness in inner ring and outer ring before and 1, 3 months after surgery both in experiment group (tinner=0.322, 0.148;touter=0.317, 0.005) and control group (tinner=0.226, 0.137;touter=0.284, 0.151) were not significant (P > 0.05). The differences of macular thickness in inner ring (t=1.568, 0.373) and outer ring (t=-1.697, 0.536) between experiment group and control group also were not significant (P > 0.05). ConclusionEpinephrine (1:1000) in intraocular irrigation solution has no effect on retinal vascular caliber and macular thickness in patients with macular hole.
ObjectiveTo observe the changes of foveal avascular zone (FAZ) size before and after surgery in idiopathic macular epiretinal membrane (IMEM) eyes and analyze the correlation of FAZ with metamorphopsia.MethodsA retrospective case series study. From August 2016 to October 2017, 42 eyes of 38 patients affected with IMEM diagnosed in Central Theater Command General Hospital of Chinese People's Liberation Army were enrolled in this study. All the patients underwent a 25G pars plana vitrectomy (PPV) with IMEM removal and ininternal limiting membrane (ILM) peeling. The BCVA was measured using the international standard visual acuity chart, and the results were converted to the logMAR visual acuity. The severity of metamorphopsia was measured using M-charts. The FAZ areas were evaluated with OCT angiography in both the superficial and deep capillary plexus layers. The central macular thickness (CMT) were assessed with spectral-domain OCT before and after surgery. The logMAR BCVA was 0.61±0.21. The M-score was 0.66±0.38. The CMT of fovea was 337.71±57.63 μm. The FAZ areas in superficial and deep capillary plexus were 0.113±0.037 mm2 and 0.202±0.03 mm2, respectively. The differences in BCVA, M-score and FAZ area before and 1, 3, 6, 12 months after surgery were analyzed by ANOVA. The Spearman rank correlation analysis was performed to investigate the relationship between FAZ areas, visual acuity and metamorphopsia.ResultsAt 12 month after surgery, the FAZ areas in superficial and deep capillary plexus were 0.146±0.021 mm2 and 0.240±0.019 mm2, respectively. Compared with baseline, the the FAZ areas in superficial and deep capillary plexus after surgery significantly increased (F=8.484, 14.346; P＜0.001,＜0.001). The postoperative logMAR BCVA 0.47±0.19, M-score 0.12±0.22 and CMT 270.60±33.27 μm were significantly improved compared with baseline (F=5.044, 17.763, 13.545; P=0.001,＜0.001,＜0.001). The preoperative FAZ area in superficial capillary plexus correlated negatively with preoperative M-score (r=－0.816, P＜0.001); the preoperative FAZ area in deep capillary plexus correlated negatively with preoperative BCVA and M-score (r=－0.422, －0.882; P=0.005,＜0.001). The postoperative FAZ area in superficial capillary plexus correlated negatively with preoperative and postoperative M-score (r=－0.791,－0.716; P＜0.001,＜0.001). The postoperative FAZ area in deep capillary plexus correlated negatively with BCVA and preoperative and postoperative M-score (r=－0.343, －0.330, －0.732, －0.694; P=0.026, 0.033,＜0.001,＜0.001).ConclusionsPPV with ILM peeling can effectively restore the FAZ areas in superficial and deep capillary plexus, improve the visual acuity and metamorphopsia in patients with IMEM. Both superficial and deep plexus FAZ areas correlated negatively with metamorphopsia, and deep plexus FAZ area also correlated negatively with BCVA.
ObjectiveTo observe the effect of non-vitrectomy in the treatment of idiopathic macular epiretinal membranes (IMEM).MethodsThis study is a randomized controlled trial. From December 2017 to December 2018, 60 IMEM patients (60 eyes) diagnosed in Weifang Eye Hospital were included in the study. BCVA, intraocular pressure (IOP) and OCT were performed in all patients. The BCVA examination was performed using the international standard visual acuity chart, which was converted to logMAR. The CMT was measured by OCT. According to the surgical methods, the patients were divided into non-vitrectomy group and control group, 30 patients (30 eyes) in each group. The age (t=1.723), logMAR BCVA (t=1.703), CMT (t=-0.956), IOP (t=-1.434) were not significantly different between the two groups (P=0.090, 0.094, 0.343, 0.157). 23G vitreous cutting system was used in all eyes. The macular epiretinal membranes was removed by non-vitrectomy in the non-vitrectomy group and by vitrectomy in the control group. The relevant examination with the same equipment and methods before the operation at 1 week and 1, 3, 6 months after operation. The time of surgery, the changes of BCVA, CMT and postoperative complications in the two groups were observed comparatively. Variance analysis of repeated measurements was performed for the comparison of BCVA, CMT and IOP after surgery in the two groups. Wilcoxon rank sum test of two independent samples was performed for the degree of vision improvement. The incidence of postoperative complications was compared by χ2 test.ResultsAt 6 months after operation, BCVA increased in 24 eyes (80%) and unchanged in 6 eyes (20%) in the non-vitrectomy group. Compared with preoperative BCVA, the difference was statistically significant (P＜0.05). BCVA increased in 25 eyes (83.4%), unchanged in 4 eyes (13.3%) and decreased in 1 eye (3.3%) in the control group. Compared with preoperative BCVA, the difference was statistically significant (P＜0.05). There was no significant difference between the two groups in BCVA improvement degree after operation (Z=－0.26, P＞ 0.05). At 6 months after operation, the average logMAR BCVA was statistically significant compared with the preoperative in the non-vitrectomy group (P=0.002, 0.005) and control group (P=0.004, ＜0.001). Visual stability occurred 1 month after operation in the non-vitrectomy group and 3 months after operation in the control group. The effective operative time of the non-vitrectomy group and control group was 4.50±1.41 and 15.50±2.33 min, respectively. The difference of effective operation time between the two groups was statistically significant (t=－22.12, P＜0.05). After surgery, no significant complications were found in the non-vitrectomy group. In the control group, there were 3 eyes with low IOP and 1 eye with macular hole during operation.ConclusionsNon-vitrectomy and vitrectomy have similar effects on IMEM. Non-vitrectomy has short effective operation time, faster recovery after surgery and no obvious complications.
Objective To evaluate the value of AccuMap multifocal visual evoked potential (mfVEP) objective perimetry in measuring visual function of macular diseases. Methods Forty-six eyes (37 patients) with macular diseases were studied. The mean mfVEP amplitudes of central visual field within radius 2.0deg;, 5.5deg;, 10.0deg;, 15.5deg; and 24.0deg;were measured by AccuMap mfVEP objective perimetry. Automatically calculated AccuMap severity index （ASI） represented the visual field defects. Meanwhile, the mean sensitivity (MS) of central visual field within radius 2.0deg;, 4.0deg;, 6.0deg;, 8.0deg; and 10.0deg; and mean defect (MD) of central visual field within radius 10.0deg; were assessed by MP-1 microperimeter. The correlations among those parameters including logMAR visual acuity, mean mfVEP amplitudes, MS, ASI and MD were analyzed. Results Among 46 affected eyes, AccuMap mfVEP objective perimetry showed abnormal ASI with visual field defects in 43 eyes (93.45%), normal ASI without visual field defects in three eyes (6.55%). The mean mfVEP amplitudes value of the central visual field within radius of 2.0deg;, 5.5deg;, 10.0deg;, 15.5deg; and 24.0deg; were (120.78plusmn;52.91), (134.31plusmn;54.67), (149.99plusmn;52.42), (156.69plusmn;48.30), (157.54plusmn;45.07) nV respectively. The mean ASI value was 74.26plusmn;52.43. MP1 showed that the MS values of central visual field within radius 2.0deg;, 4.0deg;, 6.0deg;, 8.0deg; and 10.0deg; were (10.97plusmn;5.91), (12.71plusmn;5.13), (13.71plusmn;4.53), (14.23plusmn;4.18), (14.48plusmn;3.86) dB respectively. The MD value of central visual field within radius 10deg; was 4.49plusmn;3.07. There was a significant correlation among ASI, the mean mfVEP amplitudes of central visual field with every radius and logMAR best corrected visual acuity （P＜0.05). The mean mfVEP amplitudes of central visual field within radius 2.0deg;, 5.5deg;, 10.0deg; were positively correlated with the MS of central visual field within radius 2.0deg;, 6.0deg;, 10.0deg; (r=0.477, 0.432, 0.433;P=0.001, 0.003, 0.003). Furthermore, ASI was also correlated with MD of central visual field within radius 10.0deg;(r=0.729, P=0.000). Conclusions AccuMap mfVEP objective perimetry can reflect the changes of macular function objectively and can be used to assess the visual function of macular diseases.