Objective To investigate the early influences of laser photocoagulation on macular retinal thickness in diabetic retinopathy(DR). Methods Optic coherence tomography examination was performed in 30 eyes with DR(phase Ⅲ~Ⅳ) before, and on the 3rd day and the 7th day after photocoagulation respectively. The thickness of neuroretina and pigment epithelium were measured in the areas of fovea macula and 750 μm from fovea macula. Results Three days after photocoagulation, significant thickening of neuroretina was observed in the fovea macula, which is positively related with age, fasting blood sugar and duration of DR. There was no significant changes in the thickness of pigment epithelium in macula and in the thickness of neuroretina 750 μm from fovea macula. Conclusion Significant thickening of neuroretina in fovea macula in DR early after photocoagulation reveals progressed macular edema induced by photocoagulation which is positively related with age, fasting blood sugar and duration of DR. (Chin J Ocul Fundus Dis, 2002, 18: 31-33)
ObjectiveTo investigate the course of the idiopathic macular hole (IMH) clinically diagnosed as at stage Ⅰ-Ⅳ by optical coherence tomography (OCT), and analyze the relationship between the posterior vitreous detachment (PVD) and the course of IMH. MethodsHadn′t undergone any operation, periodical OCT were performed on 72 eyes of 58 patients with IMH at stage Ⅰ-Ⅳ confirmed by Gass standard and the features of OCT images.ResultsThe longest follow-up period was 43 months (average 13.4 months), and the examine times of OCT on each eye were between twice to 10 times (average 4.7 times). During the followup period, 23 eyes were in stage I in which 9 (39.1%) developed to stage II and 2 had recovered normal curve of fovea after PVD; 19 were in stage II in which 13 (68.4%) developed to Ⅲ-Ⅳ and 1 had closed hole after PVD; 11 were in stage III in which 5 (45.5%) developed to stage IV and 1 had partly closed hole 12 months later. The images of OCT showed that the process of macular hole was consistent with the course that vitreous depart from retina from the circumference of fovea till entire posterior detachment.Fifteen affected eyes in this series of patients had undcrygong surgical treatment due to serious progression of IMH in follow-up period. ConclusionsThere is a close relationship between the formation and development of macular hole and the occurrence of PVD. OCT can show the progress of the macular hole directly and offer an important technique in diagnosis, classification and surgical treatment of IMH. (Chin J Ocul Fundus Dis, 2005,21:79-82)
Objective To evaluate the application value of optical coherence tomography angiography (OCTA) in obstructive sleep apnea syndrome (OSAS). Methods A comprehensive search of both domestic and international databases was conducted to identify clinical studies on the use of OCTA in OSAS, from the establishment of the databases to May 2024. A meta-analysis was performed using Revman 5.4 software. Results A total of 134 studies were initially identified, with 14 studies meeting the inclusion criteria, encompassing 999 subjects (739 in the OSAS group and 260 in the healthy group). Meta-analysis results indicated that the superficial capillary plexus (SCP) density in the fovea (MD=–2.05, 95%CI –3.75 to –0.35, P=0.02) and parafovea (MD=–1.56, 95%CI –2.44 to –0.68, P=0.000 5) was significantly lower in the OSAS group compared with the healthy group. In the mild to moderate OSAS group, SCP density was significantly lower in the fovea (MD=–2.41, 95%CI –4.32 to –0.49, P=0.01), parafovea (MD=–1.17, 95%CI –2.01 to –0.32, P=0.007), and perifovea (MD=–1.73, 95%CI –2.69 to –0.77, P=0.000 4) compared with the healthy group. In the severe OSAS group, SCP density in the perifovea (MD=–1.33, 95%CI –2.53 to –0.13, P=0.03) was significantly lower than that of the healthy group. SCP density in the whole area (MD=0.36, 95%CI 0.05 to 0.68, P=0.02) was significantly higher in the mild to moderate OSAS group compared with the severe OSAS group. In the deep capillary plexus (DCP) density, the OSAS group showed significantly lower densities in the whole area (MD=–2.16, 95%CI –3.51 to –0.81, P=0.002), fovea (MD=–2.38, 95%CI –4.38 to –0.37, P=0.02), and parafovea (MD=–2.33, 95%CI –3.93 to –0.73, P=0.004) compared with the healthy group. The mild to moderate OSAS group also showed significantly lower densities in the whole area (MD=–2.02, 95%CI –3.33 to –0.72, P=0.002) and parafovea (MD=–1.65, 95%CI –3.04 to –0.26, P=0.02) compared with the healthy group. The severe OSAS group had significantly lower DCP density in the whole area (MD=–2.26, 95%CI –3.85 to –0.66, P=0.006) and parafovea (MD=–1.47, 95%CI –2.31 to –0.62, P=0.000 7) compared with the healthy group. DCP density in the whole area (MD=0.54, 95%CI 0.02 to 1.07, P=0.04) was significantly higher in the mild to moderate OSAS group compared with the severe OSAS group. Regarding the retinal nerve fiber layer (RNFL) thickness, the inferior quadrant (MD=4.01, 95%CI 0.69 to 7.32, P=0.02) and temporal quadrant (MD=4.35, 95%CI 1.88 to 6.82, P=0.000 6) were significantly thicker in the mild to moderate OSAS group compared with the severe OSAS group. In terms of the foveal avascular zone (FAZ) area, the severe OSAS group showed a significantly larger FAZ area (MD=0.06, 95%CI 0.03 to 0.08, P<0.000 01) compared with the healthy group. Conclusion OCTA-related ocular biomarkers may be associated with the occurrence and progression of OSAS and have potential applications in the diagnosis and treatment of OSAS.
ObjectiveTo observe alterations of macular outer retinal reflectivity (ORR) and the associations with macular vessel density in patients with nonproliferative diabetic retinopathy (NPDR). Methods A retrospective cross-sectional study. From August 2021 to March 2022, a total of 63 NPDR patients with 63 eyes (NPDR group) diagnosed by Department of Ophthalmology of Guangdong Provincial People's Hospital were included in the study. There were 39 males with 39 eyes and 24 females with 24 eyes. Age was 60 (52, 68) years. A total of 66 eyes of 66 healthy volunteers matching age and sex were selected as the control group. Among them, 40 men had 40 eyes and 26 women had 26 eyes. Age was 58 (52, 67) years. Optical coherence tomography (OCT) and OCT angiography (OCTA) were performed in all affected eyes. Image J software was used to calculate ORR, including the optical density of ellipsoid zone (EZ), photoreceptor outer segment (OS), photoreceptor inner segment (IS) and outer nuclear layer (ONL) by OCT examination. The sampling sites were horizontal and vertical scanning of the fovea of the macula on 500 μm (nasal500, temporal500, superior500, inferior500), 1 000 μm (nasal1 000, temporal1 000, superior1 000, inferior1 000) and 2 000 μm (nasal2 000, temporal2 000, superior2 000, inferior2 000). The software automatically divided the retina within 6 mm of the macular fovea into the fovea with a diameter of 1 mm, the parafovea with a diameter of 1-3 mm, and the perifovea with a diameter of 3-6 mm by macular OCTA examination. The blood density of superficial capillary plexus and deep capillary plexus in different zones in the macular area were measured by the built-in software of the device. Spearman correlation analysis was used to analyze the correlation between ORR and blood flow density. ResultsCompared with the control group, retinal reflectivity of EZ in NPDR group was significantly decreased at other sites except the fovea, retinal reflectivity of OS was significantly decreased at nasal2 000, temporal2 000, superior2 000 and superior1 000; retinal reflectivity of IS was significantly decreased at superior1 000, superior500 and inferior500. The retinal reflectivity of ONL in macular fovea was significantly decreased, and the differences were statistically significant (P＜0.05). The ORR was positively correlated with blood flow density, and the correlation coefficient in NPDR group was lower than that in control group. The results of multifactor linear regression analysis showed that the superior and temporal ORR were correlated with blood flow density (P＜0.05). ConclusionsCompared with the control group, ORR is reduced and less correlated with vessel density in NPDR patients. ORR is more affected by retinal blood flow density in temporal and superior parts.
Objective To observe the characteristics of the images of optical coherence tomography (OCT) performed on the patients with macular edema, and investigate relationship between the retinal thickness at the central fovea and the best corrected visual acuity. Methods Fourty-seven patients (54 eyes) with macular edema diagnosed by direct and indirect ophthalmoscopy, three mirror contactlens, or fundus fluorescein angiography (FFA) underwent OCT which was also performed on 50 healthy individuals as the control. The examination focused on the horizontal and vertical planes crossing the central fovea to measure the thickness of the fovea. The correlation between retinal thickness at the central fovea and best-corrected visual acuity was analyzed, and the images of OCT in the patients with macular edema were classified according to the macular configuration. Results Significant difference of the macular configuration and best-corrected visual acuity was found between the control and macular edema group. Three characteristics were found in the images of OCT in the patients with macular edema: sponge-like retinal swelling in 20 eyes (37.1%), macular cystoid edema in 26 eyes (48.1%), and serous retinal detachment in 8 eyes (14.8%). The statistical analysis showed that there was a negative correlation between the thickness at the central fovea and best-corrected visual acuity of affected eyes (r=-0.569, P=0.000). Conclusions The images of OCT in macular edema include 3 types: sponge-like retinal swelling, macular cystoid edema, and serous retinal detachment. The retinal thickness at the central fovea of the eyes with macular edema was thicker than that of the normal ones, and the thicker the fovea is, the poorer the visual acuity will be. (Chin J Ocul Fundus Dis，2004，20：152-155)
Purpose To evaluate the surgical effect of idiopathic macular hole (IMH)，with optical coherence tomography (OCT)． Methods To measure the diameter of holes and hole halos，the thickness of hole in edge，the changes of hole pattern in 19 cases (19 eyes) with IMH using OCT． Results By quantitatively measuring，OCT showed that after surgery the mean hole diameter lessened from （570．95plusmn;264．59 ）mu;m to （337．05plusmn;335．95）mu;m．The mean diameter of hole halo lessened from （1043．53plusmn;278．80）mu;m to （695．00plusmn;483．00）mu;m and the mean thickness of the hole edge thinned from （389．78plusmn;60．58）mu;m to （298．78plusmn;109．80）mu;m．In 17 eyes the holes become closed or reduced in size or the hole halo，and thinned in hole edge．The anatomic successful rate of the surgery is 89%． Conclusion OCT can objectively，accurately and effectively judge the anatomic effect of IMH surgery． (Chin J Ocul Fundus Dis，2000，16：71-138)
ObjectiveTo use flash electroretinogram (F-ERG) and optical coherence tomography (OCT) to examine patients with primary retinitis pigmentosa (RP), and analyze the specificity of the disease on F-ERG and OCT. MethodsThirty-seven patients (74 eyes) diagnosed with primary retinitis pigmentosa in the Department of Ophthalmology, West China Hospital between September 2013 to October 2014 and 38 normal volunteers (76 eyes) were included in this study. F-ERG and OCT examinations were performed on all the patients. Then, we analyzed the differences between the two groups of subjects. ResultsFor RP patients undergoing P-ERG examination with the dark adaptation of 0.01 ERG, the latency of b wave was (73.24±6.42) ms and the amplitude of b wave was (22.87±22.48) μV; when dark adaptation of 3.0 ERG was adopted, the latency of a wave was (24.57±6.30) ms, the amplitude of a wave was (35.45±25.54) μV, the latency of b wave was (48.19±8.18) ms, and the amplitude of b wave was (119.47±50.89) μV; with the light adaptation of 3.0 ERG, the latency of a wave was (21.01±4.86) ms, the amplitude of a wave was (12.59±13.43) μV, the latency of b wave was (38.43±5.00) ms, and the amplitude of b wave was (27.19±38.12) μV. For normal volunteers undergoing F-ERG examination with the dark adaptation of 0.01 ERG, the latency of b wave was (72.63±3.49) ms and the amplitude of b wave was (86.36±21.57) μV; when the dark adaptation was 3.0 ERG, the latency of a wave was (22.88±1.62) ms, the amplitude of a wave was (210.74±43.57) μV, the latency of b wave was (42.59±2.60) ms, and the amplitude of b wave was (398.29±62.42) μV; when the light adaptation of 3.0 ERG was adopted, the latency of a wave was (16.61±0.87) ms, the amplitude of a wave was (54.26±19.64) μV, the latency of b wave was (33.29±1.11) ms, and the amplitude of b wave was (176.98±63.44) μV. There were no significant differences between the two groups when dark adaptation ERG was 0.01 (P=0.48), but for other adaptations, there were significant differences in the latency and amplitude of a and b wave between the two groups (P<0.05). The results of OCT showed that the retinal thickness of the RP patients with a range of 1 mm diameter centered on macular center concave was (218.66±74.14) mm, 3 mm diameter was (275.03±47.85) mm, and 6 mm diameter was (247.37±46.44) mm. For normal volunteers, OCT showed that the retinal thickness with a 1 mm range centered on macular center concave was (250.38±15.79) mm, 3 mm was (323.64±17.26) mm, and 6 mm was (283.44±12.50) mm. The differences between the two groups were statistically significant for each range (P<0.01). ConclusionFor patients with RP, F-ERG shows latency delay and amplitude decrease for each response, while OCT displays a thinning thickness of macular fovea. Therefore, F-ERG and OCT can not only effectively evaluate the functions of macular and the surrounding retina, but can also be used as an effective method for the diagnosis of RP.
Objective To observe and analyze the imaging features of pathologic myopic paravascular abnormalities (PVA) and macular retinoschisis (MRS) and their relationship with clinical features. MethodsA retrospective case series study. A total of 371 eyes of 224 patients with pathological myopia with PVA and/or MRS diagnosed by examination in Department of Ophthalmology of the First Affiliated Hospital of Zhengzhou University from September 2021 to December 2023 were included in the study. There were 74 eyes in 48 males and 297 eyes in 176 females. Age were 54 (49, 61) years; equivalent spherical lens (SE) was −13.375 (−18.00, −10.00) D. Axial length (AL) was 29.84 (28.27, 31.24) mm. According to the features of ultra-wide-angle sweep source optical coherence tomography, PVA morphology was divided into blood vessels and paravascular microfolds, paravascular retinal cysts, paravascular retinal splits and paravascular lamellar macular holes. MRS was divided into inner layer, outer layer and mixed layer according to splitting level, and grouped accordingly. The presence of dome-shaped macula (DSM), internal and external lamellar macular hole, and full lamellar macular hole (FTMH) were recorded. According to whether PVA combined with MRS or not, the affected eyes were divided into PVA group and PVA combined with MRS group. According to whether MRS involved the fovea, the affected eyes were divided into two groups: MRS not involved the fovea group and MRS involved the fovea group. Mann-Whitney U test was used to compare age, SE and AL among different groups. Qualitative data were compared by χ2 test. ResultsIn 371 eyes, there were 120 eyes in the simple PVA group; in the MRS group, there were 251 eyes, of which 208 eyes were in the PVA combined with MRS group. There were 33, 27, 3, 14, 12, 56, 28, and 7 eyes with or without retinal detachment, choroidal neovascularization, DSM, preretinal membrane, and simple superficial detachment of neuroepithelium in inner lamina, outer lamina, and FTMH, respectively. In 328 eyes with PVA, blood vessels and paravascular microfolds, paravascular retinal cysts, paravascular retinal splits and paravascular lamellar macular holes were 151, 236, 202 and 72 eyes, respectively. There were 142 eyes with single lesion (43.29%, 142/328). There were 186 eyes with 2 or more lesions (56.71%, 186/328). There were 34 eyes in the inner MRS group, 92 eyes in the outer MRS group and 125 eyes in the mixed MRS group, respectively. It involved 155 eyes in the fovea group; 96 eyes in the fovea group were not involved. There were significant differences in the number of PVA eyes between the outer MRS group, the inner MRS group and the mixed MRS group (χ2=30.614, 28.379; P＜0.001). Compared with PVA group, PVA group combined with MRS group was more likely to have two or more PVA lesions, the difference was statistically significant (χ2=30.535, P＜0.001). Compared with the inner MRS group and mixed MRS group, the age of the simple PVA group was younger, and the age of the outer MRS group was older, and the differences were statistically significant (P＜0.05). Compared with the inner MRS group and the outer MRS group, the simple PVA group had short AL, less myopia and better optimal corrected visual acuity (BCVA), while the mixed MRS group had long AL, more myopia and worse BCVA, and the differences were statistically significant (P＜0.05). Compared with the PVA group and the inner MRS group, the fovea was more involved in the outer MRS group and the mixed MRS group, and the difference was statistically significant (χ2=3.906, 10.836; P＜0.05). Those with MRS involved in fovea were older, AL was longer, myopia was more severe, and BCVA was worse (P＜0.001). DSM-associated splits were less likely to involve macula (P＜0.001). ConclusionPVA and MRS exhibit a variety of presentations, and their imaging features correlate with clinical features.
ObjectiveTo observe the histopathological changes in peripheral retinal lesions under intraoperative optical coherence tomography (iOCT). Methods A retrospective case series study. Eighty-eight patients (194 eyes) who underwent vitreoretinal surgery in the Department of Ophthalmology at the East Ward of the First Affiliated Hospital of Zhengzhou University from October 2021 to May 2022 in 94 eyes were included in the study. Among them, 49 cases were male and 39 cases were female, with the mean age of (50.93±17.55) years. Ninety-four eyes included 32 eyes with retinal detachment, 6 eyes with proliferative diabetic retinopathy, 28 eyes with vitreous hemorrhage, 8 eyes with ocular trauma, 14 eyes with the macular lesion, 1 eye with uveitis, 1 eye with family exudative vitreoretinopathy (FEVR), 1 eye with acute retinal necrosis (ARN), and 3 eyes with lens dislocation. All affected eyes were examined with iOCT during vitreoretinal surgery. The iOCT scanning of the peripheral retina was performed with the help of episcleral pressure. The pre-equatorial and serrated edge anterior and posterior of retinas were scanned according to the characteristics of different fundus diseases. Various abnormal fundus manifestations were recorded. Results In 94 eyes, 53 eyes (56.38%, 53/94) have different types of retinopathy in the peripheral retina. Of these, 7 eyes (7.45%) have retinal cystoid degeneration; 19 eyes (20.21%) have lattice degeneration; and 8 eyes (8.51%) have pigment degeneration; 9 eyes (9.57%) have pavement-like degeneration; 7 eyes (7.45%) have small occult holes; 1 eye (1.06%) has familial exudative vitreoretinopathy (FEVR) serrated edge "dyke-like" proliferative degeneration; 4 eyes (4.26%) have vitreous and retinopathy adhesions; and one eye (1.06%) has ARN. Conclusion With clear refractive media, iOCT can provide clear scans of different peripheral retinal lesions.
ObjectiveTo observe the clinical features of collateral circulation in different types of retinal vein occlusion. MethodsA retrospective clinical study. A total of 360 patients with monocular retinal vein occlusion diagnosed by ophthalmic examination in Department of Ophthalmology of Yunnan University Affiliated Hospital from December 2021 to December 2023 were included in the study. Among them, 157 males had 157 eyes and 203 females had 203 eyes. Age were (61.0±5.9) years. The duration of the disease from the onset of symptoms to the time of treatment was 3 days to 6 months. Macular branch vein occlusion (MBRVO), retinal branch vein occlusion (BRVO) and central retinal vein occlusion (CRVO) were observed in 67, 187 and 106 eyes, respectively. 210 eyes were with macular edema. All patients with macular edema were treated with anti-vascular endothelial growth factor (VEGF) by intravitreal injection. All eyes were examined by scanning source optical coherence tomography. The incidence, location, morphological characteristics, formation time of retinal collateral circulation and the effect of anti-VEGF drug on the formation of collateral circulation were observed. A short circuit in which blood vessels originating from the optic disc in the form of a blood loop return to the optic disc after the disc has been deformed for some time is defined as a short-circuited collateral circulation of the ciliary vessels of the optic disc. ResultsAfter 1 week of disease course, MBRVO and collateral circulation of BRVO affected eye were established. By 1 to 2 months, a relatively abundant and stable collateral circulation had been established. In the course of 2 to 3 months, the short-circuit collateral circulation of ciliary vessels in the optic disc of the affected eye gradually formed. At 6 months, collateral circulation was established in 36 eyes (53.7%, 36/67) in 67 MBRVO patients. Collateral circulation was observed in 187 eyes of BRVO patients (100.0%, 187/187). In 106 eyes with CRVO, collateral circulation was established in 29 eyes (18.1%, 29/106). In 36 eyes with MBRVO, collateral circulation was established at the vertical horizontal slit between the blocked area and the non-blocked area. In 187 eyes of BRVO patients, collateral circulation was established in the vertical horizontal slit between the blocked and non-blocked areas in 102 eyes; 54 eyes were blocked the most central bypass to the collateral circulation on normal blood vessels. The collateral circulation of 19 eyes was established through nasal and temporal side. Collateral circulation through the fovea was established in 12 eyes. Its morphology is straight out of shape, spiral sinuous and flower cluster. CRVO established collateral circulation in 29 eyes, all of which had short-circuit collateral circulation of ciliary vessels. In 210 eyes treated with anti-VEGF drugs, collateral circulation was established in 160 eyes. Among them, 32 eyes were MBRVO (50.7%, 32/63), BRVO 119 eyes (100.0%, 119/119), CRVO 9 eyes (32.1%, 9/28). ConclusionsThe incidence of collateral circulation of MBRVO, BRVO and CRVO is 53.7%, 100.0% and 18.1%, respectively. The forms of MBRVO were varied and the course of disease is about 2 months. Anti-VEGF therapy did not inhibit the establishment of collateral circulation.