Diabetic macular edema is the major cause of vision impairment in patients with non-proliferative diabetic retinopathy. Thickness and pathological alterations in each retina layer of diabetic macular edema (DME) patients can be performed by optical coherence tomography (OCT) device. And retinal light sensitivity at specific retinal point and fixation state can be detected by microperimetry qualitatively and quantitatively. Moreover, OCT can discover pathological anatomical changes in the retina of DME patients, thus facilitating the interpretation of the structure-function relationship in DME with combination of microperimetry results. At present, there are various therapies for DME patients, and the primary method in evaluating therapeutic efficacy is to compare the pathological changes in the retina before and after treatment by OCT. Besides, microperimetry can provide information in visual function restoration. The combined application of OCT and microperimetry has broad prospects in the diagnosis and treatment of DME patients.
ObjectiveTo observe the changes of multifocal electroretinogram(mfERG)and central visual field before and after surgery in patients with rhegmatogenous retinal detachment (RRD) involving the macular area. MethodsThis is a retrospective study. Sixteen patients (16 eyes) with RRD involving the macular area (RRD group) and age-matched normal 20 cases (20 eyes, normal control group) were enrolled in the study. All patients in RRD group underwent scleral buckling surgery. Before surgery and 1, 3, 6 months after surgery, RRD eyes and normal eyes were checked by using mfERG and central visual field examination, and macular reaction wave amplitude density, incubation period and 4° visual field mean sensitivity (MS) were observed. The correlation between amplitude density, incubation period and MS in RRD group and the consistency between mfERG and central visual field examination in normal control group and RRD group were analyzed. ResultsCompared with the normal control group, in RRD group before surgery the macular reaction wave N1 and P1 amplitude density reduced, the incubation period prolonged, the differences were statistically significant (P < 0.05). Postoperative 1, 3, 6 months, in RRD group macular reaction wave amplitude density improved, the incubation period reduced than before surgery, the differences were statistically significant (P < 0.05). Postoperative 1, 3, 6 months, in RRD group macular reaction wave amplitude density reduced, the incubation period prolonged compared with the normal control group, the differences were statistically significant (P < 0.05). Compared with the normal control group, 4° visual field MS significantly reduced in RRD group before surgery reduced, the differences were statistically significant (t=49.752, P < 0.05). Postoperative 1, 3, 6 months, 4° visual field MS significantly increased compared with the preoperative value, the differences were statistically significant (t=-9.580, -16.533, -19.580; P < 0.05); but were lower than that of the normal control group, the differences were statistically significant (t=-6.286, -7.493, -6.366; P < 0.05). Postoperative 1, 3, 6 months, macular reaction wave amplitude density and MS in RRD group showed positive correlation (P < 0.05), and there was no correlation between incubation period and MS (P > 0.05). mfERG and vision consistency in normal control group and RRD group showed good agreement(K=0.886, P < 0.05). ConclusionsCompared with normal control eyes, in RRD eyes involving the macula area before and after surgery, macular reaction wave amplitude density reduced, the incubation period prolonged and MS values reduced; compared with the preoperative mfERG and central visual field, macular reaction wave amplitude density improved, the incubation period reduced and MS values increased.
Objective To observe the clinical characteristics of non arteritic anterior ischemic optic neuropathy (NAION) in patients of different genders. MethodsA retrospective clinical analysis. A total of 183 cases (246 eyes) of NAION with complete diagnosis and treatment confirmed by Departments of Neuro-ophthalmology/Acupuncture and Moxibustion of Eye Hospital, China Academy of Chinese Medical Sciences from June 2018 to December 2023 were included. Among them, 101 cases (138 eyes) were male and 82 cases (108 eyes) were female. Their age was (59.2±9.8) years. The number of right and left eyes were 120 and 126, respectively. The patient's gender, age, disease course, history of hypertension, history of diabetes, history of hyperlipidemia, history of smoking and drinking, best corrected visual acuity (BCVA), intraocular pressure, and peripapillary Retinal Nerve Fiber Layer (pRNFL) thickness were recorded in detail. Visual field defects were classified into diffuse defects, ring scotoma, fan-shaped or wedge-shaped defects, upper and lower half defects, arcuate scotoma, and quadrantanopia. Logistic regression analysis was utilized to determine whether gender was an independent factor affecting the degree of visual field impairment in NAION. ResultsCompared with female patients, male patients showed earlier onset age, a shorter interval between binocular onsets, a higher morbidity rate of hyperlipidemia, and a higher proportion with history of smoking and drinking, with statistically significant differences (P＜0.05). There was no statistically significant difference in disease duration, intraocular pressure, pRNFL thickness, and intraocular perfusion pressure between patients of different genders (P＞0.05). Female patients exhibited better BCVA than male patients, but the difference was not statistically significant (P＞0.05). The degree of visual field impairment in female patients was significantly better than that in males. Males' visual field defects were mostly in the lower half, while females' defects were mostly of arcuate scotoma, with statistically significant differences (P＜0.05). The results of multiple logistic regression analysis showed that the gender of male was an independent risk factor for severe visual field impairment in NAION patients (odds ratio=2.936, 95% confidence interval 1.275-6.763, P=0.011). ConclusionsMale NAION patients have an earlier onset age and a shorter interval between the initial and contralateral eye onset. Male patients exhibit a more severe degree of visual field impairment, which is mostly manifested as lower half visual field defect. While female patients tend to develop arcuate scotoma. After adjusting for other influencing factors, the gender of male remains an independent risk factor for severe visual impairment in NAION patients.
ObjectiveTo evaluate visual field changes in early mild Parkinson's disease. Methods A total of 66 eyes of 33 cases with early mild Parkinson's disease and 72 eyes of 36 age-matched normal individuals were enrolled into the study. Humphrey Field Analyzer II was applied for central visual field test. The visual field indices of mean deviation (MD) and pattern standard deviation (PSD) were analyzed to evaluate the location and the characteristics of visual field defect in this study. ResultsVisual field indices MD (-3.4±2.5) dB was significantly changed in patients with PD when compared to the controls (-0.6±1.7) dB. PSD (4.3±2.6) was significantly higher in patients with PD than that in the control group (2.1±1.8) dB. Glaucoma hemifield test (GHT) assessment was within normal limits in the controls. Of the 33 patients (66 eyes) in PD, GHT showed outside normal limits in 31 eyes, borderline in 8 eyes, and within normal limits in 27 eyes. 31 eyes outside normal limits appeared glaucomatous visual field defects, in which 16 with nasal step and 5 with arcuate defect. ConclusionsVisual field indices including MD and PSD in early mild patients with PD were significantly worse than that in the controls group. GHT abnormalities could be found in early mild PD patients with visual field defects, including pericentral scotoma and nasal step, which mimicked glaucomatous changes.
Objective To observe visual field outcome and refractive status of patients with retinopathy of prematurity (ROP) treated by laser photocoagulation. Method The data of 39 ROP patients (73 eyes) who received laser photocoagulation were retrospectively analyzed and compared with 13 normal control subjects (25 eyes) whose age and sex were matched with ROP group. There were 24 males (45 eyes) and 15 females (28 eyes) in ROP group, with an average age of (7.0±1.28) years. The first laser treatment was carried out at postnatal age (PA) of (38.74±3.82) weeks, the birth weight (BW) of (1402.33±369.61) g and the number of laser burns was (517.86±277.40). The control group included 7 females (13 eyes) and 6 males (12 eyes), with an average age of (7.17±0.96) years. The age (t=0.691) and gender (χ2=1.425) were comparable between the two groups (P=0.491, 0.233). The data of patients and controls were retrospectively analyzed including best corrected visual acuity, refractive examination, automated perimetry test. The differences of the mean deviation (MD) of visual field and the spherical equivalent (SE) between these two groups were comparatively observed. ROP patients were divided into no VF loss group (MD≤2 dB) and VF loss group (MD＞2 dB), mild VF loss group (MD≤6 dB) and moderate VF loss group (MD＞6 dB) according to the results of automated perimetry test, the differences of gestational age (GA), PA, BW, number of laser burns and SE between these groups were comparatively observed. Results The MD in ROP group and control group were 4.87±5.12 dB and 1.27±3.34 dB, respectively; the difference between the two groups was statistically significant (t=–4.01,P＜0.001). The subgroup analysis showed that BW, number of laser burns, and SE were significantly different between no VF loss group and VF loss group (t=2.074, –1.996, –2.162;P=0.042, 0.026, 0.034); while the GA was not significantly different between these two groups (t=1.973,P=0.052). The difference of PA was not statistical significant different between mild VF loss group and moderate VF loss group (t=2.03,P=0.051) and SE was significantly different between the above two groups (t=3.283,P=0.002). For refractive outcomes, the BW and ROP stage correlated with SE significantly (r=–0.304, –0.387;P=0.015, 0.002). The mean BCVA in ROP group was 0.84±0.23, and 59 eyes (91.2%) with BCVA better than 0.5. Conclusion Laser treatment for ROP tends to have less effect on long term refractive status and VF loss, with good visual outcome.
ObjectiveTo evaluate the macular visual function of patients with myopic choroidal neovascularization (MCNV) before and after intravitreal injection of conbercept.MethodsA prospective, uncontrolled and non-randomized study. From April 2017 to April 2018, 21 eyes of 21 patients diagnosed as MCNV in Shanxi Eye Hospital and treated with intravitreal injection of conbercept were included in this study. There were 9 males (9 eyes, 42.86%) and 12 females (12 eyes, 57.14%), with the mean age of 35.1±13.2 years. The mean diopter was −11.30±2.35 D and the mean axial length was 28.93±5.68 mm. All patients were treated with intravitreal injection of conbercept 0.05 ml (1+PRN). Regular follow-up was performed before and after treatment, and BCVA and MAIA micro-field examination were performed at each follow-up. BCVA, macular integrity index (MI), mean sensitivity (MS) and fixation status changes before and after treatment were comparatively analyzed. The fixation status was divided into three types: stable fixation, relatively unstable fixation, and unstable fixation. The paired-sample t-test was used to compare BCVA, MI and MS before and after treatment. The x2 test was used to compare the fixation status before and after treatment.ResultsDuring the observation period, the average number of injections was 3.5. The logMAR BCVA of the eyes before treatment and at 1, 3, and 6 months after treatment were 0.87±0.32, 0.68±0.23, 0.52±0.17, and 0.61±0.57, respectively; MI were 89.38±21.34, 88.87±17.91, 70.59±30.02, and 86.76±15.09, respectively; MS were 15.32±7.19, 21.35±8.89, 23.98±11.12, 22.32±9.04 dB, respectively. Compared with before treatment, BCVA (t=15.32, 18.65, 17.38; P＜0.01) and MS (t=4.08, 3.50, 4.26; P＜0.01) were significantly increased in the eyes 1, 3, and 6 months after treatment. There was no significant difference in the MI of the eyes before treatment and at 1, 3, and 6 months after treatment (t=0.60, 2.42, 2.58; P＞0.05). Before treatment and at 1, 3, and 6 months after treatment, the proportion of stable fixation were 28.57%, 38.10%, 38.10%, 33.33%;the proportion of relatively unstable fixation were 47.62%, 47.62%, 52.38%, 57.14% and the proportion of unstable fixation were 23.81%, 14.28%, 9.52%, 9.52%, respectively. The proportion of stable fixation and relatively unstable fixation at 1, 3 and 6 months after treatment were higher than that before treatment, but the difference was not statistically significant (x2=1.82, 1.24, 1.69; P＞0.05).ConclusionBCVA and MS are significantly increased in patients with MCNV after intravitreal injection of conbercept.
ObjectiveTo investigate the difference in microperimetry between acute and chronic central serous chorioretinopathy (CSC). MethodsCross-sectional cases study. A consecutive series of 208 patients (221 eyes) with CSC diagnosed by fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) were enrolled in the study. The patients were divided into acute group (136 patients, 143 eyes) and chronic group (72 patients, 78 eyes) according to the duration and FFA. There were no statistical difference in sex (χ2=0.012, P=0.912) and mean age (t=-1.492, P=0.137) between two groups. All eyes received the examination of microperimetry and minimum resolution angle in logarithmic (logMAR) best corrected visual acuity (BCVA). The mean retinal sensitivities (MS) and fixation rate in the central 2°(P1) and 4° (P2) were determined. ResultsThe mean value of logMAR BCVA in acute group and chronic group were 0.32±0.23 and 0.48±0.33, there was significant difference (Z=-3.353, P=0.001). In acute group and chronic group, the MS were (21.25±5.06) and (15.82±7.23) dB, P1 were (76.36±25.78)% and (55.01±32.34)%, P2 were (92.21±13.06)% and (79.83±23.11)%. There were statistical differences in MS (Z=-5.456, P < 0.001), P1 (Z=-4.629, P < 0.001) and P2 (Z=-4.265, P < 0.001) between two groups. In acute group, fixation was stable in 98 eyes (68.5%), relative unstable in 30 eyes (21.0%), unstable in 15 eyes (10.5%). In chronic group, fixation was stable in 30 eyes (38.5%), relative unstable in 22 eyes (28.2%), unstable in 26 eyes (33.3%). The difference of fixation between two groups was statistically significant (χ2=23.196, P < 0.001). ConclusionMS, fixation rate and fixation stability in chronic CSC eyes were all decreased compared with acute CSC eyes.
ObjectiveTo observe the correlation between the thickness of foveal ganglion cell-inner plexiform layer (GCIPL) and visual field mean defect before and after gamma knife treatment in patients of sellar region tumors with optic chiasmal compression. MethodsThis was a prospective case series. 72 eyes of 37 consecutive patients suffering from optic chiasmal compression of sellar region tumors treated with gamma knife were enrolled in the study. According to the change of visual field before and after gamma knife treatment, the patients were divided into three groups. There were 13 eyes of 7 patients in group 1 with no vision defect pre-and post-treated, 34 eyes of 17 patients in group 2 with improvement of visual field defect after treatment, 25 eyes of 13 patients in groups 3 with no improvement or reorganization of visual field defect after treatment. Overall average thickness of GCIPL, and of the superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal retina were measured with the Cirrus high-definition spectral domain optical coherence tomography, and mean deviation (MD) with the Humphrey field analyzer before and 6 months after treatment. There was no significant difference in MD values between group 2 and 3 pre-treated (t=1.471, P=0.084). There was significant difference between all the groups in total average value of GCIPL thickness and the 6 quadrant GCIPL thickness values pre-treated (P < 0.05). Logistic regression model was applied to analysis of the correlation between GCIPL thickness and the improvement of visual field after treatment. ResultsThe MD values of the group 1, 2 and 3 were (-2.96 ±0.75), (-10.24 ±1.31), (-20.2 ±5.88) dB at 6 months after treatment. There was significant difference between group 2 and 3 of MD value after treatment (t=6.974, P=0.000). In group 1, there was no significant difference in mean GCIPL thickness and the 6 quadrant GCIPL thickness values between pre-and post-treated (t=0.882, P=0.395).The mean thickness of GCIPL, superonasal and inferonasal GCIPL was increased than pre-treated in group 2, and the difference was statistically significant (t=2.438, 4.630, 4.457; P=0.035, 0.001, 0.001). The mean thickness of GCIPL, superonasal and inferonasal GCIPL was decreased than pre-treated in group 3, and the difference was statistically significant (t=-2.387, -4.603, -4.975; P=0.041, 0.002, 0.001).Logistic regression analysis showed that the greater of the value of average GCIPL thickness of patients with visual field defect pre-treated, the higher of the proportion of patients with improvement of visual field defect post-treated. There was a significant correlation between the value of superonasal or inferonasal GCIPL and the improvement of the visual field post-treated (OR=5.374, 4.693; P=0.000, 0.000). There was no significant correlation between the value of superotemporal or upper or lower or inferotemporal GCIPL and the improvement of the visual field post-treated (OR=1.058, 1.101, 1.074, 1.056; P=0.183, 0.080, 0.162, 0.186). ConclusionsIn patients with optic chiasmal compression of sellar region tumor, the greater of the average GCIPL thickness pre-treated, the higher of the proportion of patients with improvement of visual field defect post-treated. There was a significant correlation between superonasal or inferonasal value of the GCIPL thickness and the improvement of visual field defect post-treated.
Objective To investigate the distribution properties of multifocal pattern visual evoked potential across visual field. Methods Multifocal pattern visual evoked potentials(VEP) of 14 normals were measured with VERIS ScienceTM4.0The visual stimuli were dart board 60 with patterns which consisted of 60 patches arranged in dart board configuration spanning a 26deg; vis ual field. The temporal modulation of each patch was controlled by a special type of pseudorandom sequence called binary m-sequence. The electrodes were placed at equal distances 2 cm inferior to and 2 cm superior to and straddling the inion. The first slice of the second order kernel for each stimulus patch was analysed. The 60 patches were grouped into several sectors. The summed responses of these sectors were analysed and compared. Results Compared with that of the lower hemifield , the polarity of the multifocal VEP of the upper hemifield was reverse, and the latency delayed, the response density decreased. With the eccentricity increased, the response density of the multifocal VEP decreased. The properties of the multifocal VEP of the horizontal sectors were different from that of the vertical sectors. Conclusion VEP of many locations within visual field could be recorded simultaneously in a short time with the method of mutifocal VEP. The multifocal VEP showed different properties in different sectors within visual field. (Chin J Ocul Fundus Dis, 2001,17:280-283)
Objective To investigate the correlation of microperimetric parameters, best-corrected visual acuity (BCVA) and central retinal thickness (CRT) in diabetic macular edema (DME) eyes. Methods It is a prospective, no controlled, open study. Twenty-four consecutive patients (40 eyes) with DME were included. There were 10 males (18 eyes),14 females (22 eyes); aged from 41 to 79 years, with the mean age of (56.84±8.96) years. All the patients were type 2 diabetes, the average duration of diabetes was 8 years. BCVA was evaluated using the international Snellen E vision test chart, and then recorded as logarithm of the minimum angle of resolution (logMAR). CRT was measured by Cirrus HD-OCT4000. MAIA microperimetric parameters were evaluated, including average threshold (AT) of retinal sensitivity, macular integrity index (MI), fixating points within a circle of 1° (P1) and 2° of radius (P2), bivariate contour ellipse area (BCEA) considering 63% and 95% of fixating points (A63,A95), and horizontal and vertical axes of that ellipse (H63,H95,V63,V95). Pearson correlation analysis was performed to evaluate the association between these variables. The independent factor influenced the type of fixation was analyzed by multiple linear regression analysis. Results Strong correlations of logMAR BCVA with CRT (r=0.58,P=0.000), V63 (r=0.44,P=0.004), V95 (r=0.41,P=0.008), MI (r=0.36,P=0.024), AT (r=−0.61,P=0.000), P1 (r=−0.41,P=0.009), P2 (r=−0.38,P=0.015) were found. AT was correlations with P1 (r=0.53,P=0.000), P2 (r=0.51,P=0.001), A63 (r=−0.39,P=0.012), A95 (r=−0.40,P=0.012), V63 (r=−0.53,P=0.000), V95 (r=−0.46,P=0.003), MI (r=−0.50,P=0.001). There was no correlation between AT and CRT (r=−0.21,P=0.190). Forty eyes were included in this study, 8 eyes (20%) had stable fixation,14 eyes (35%) had relatively unstable fixation,18 eyes (45%) had unstable fixation. Multiple linear regression analysis showed that fixation classification was independently affected by P1. Conclusions In DME eyes, logMAR BCVA was positively correlated with CRT, negatively correlated with AT, P1 and P2. There is no correlation between AT and CRT. The fixation classification was independently affected by P1.