ObjectiveTo compare and observe the fundus imaging characteristics of eyes with glucocorticoid-related central serous chorioretinopathy (CSC). MethodsA retrospective clinical study. A total of 149 CSC patients with 166 eyes diagnosed at Department of Ophthalmology of The First Affiliated Hospital of Zhengzhou University from March 2021 to October 2024 were included in the study. The duration of the disease from the appearance of symptoms to treatment was less than 3 months. All affected eyes underwent best-corrected visual acuity (BCVA), fundus color photography, swept-source optical coherence tomography (SS-OCT), and fundus fluorescein angiography (FFA) examinations. BCVA was tested using an international standard vision chart and converted into logarithm of the minimum angle of resolution (logMAR) visual acuity for statistical analysis. The SS-OCT instrument measured subfoveal choroidal thickness (SFCT), central macular thickness (CMT), choroidal vascular volume (CVV), and the width and height of flat irregular pigment epithelial detachment (FIPED). FIPED, subretinal fibrin, and choroidal layer strong reflective spots were identified from SS-OCTA B-scan images; multiple leakages (leak points >3) were identified from FFA images. Based on the presence or absence of a clear history of glucocorticoid administration before the onset, patients were divided into glucocorticoid-related and non-glucocorticoid-related groups, comprising 41 patients with 53 eyes and 108 patients with 113 eyes, respectively. Clinical and fundus imaging characteristics of the two groups were compared. The comparison of quantitative data between the two groups was performed using independent samples t test or non-parametric independent samples Wilcoxon test; the comparison of qualitative data was performed using χ2 test. ResultsCompared with the non-glucocorticoid-related group, the glucocorticoid-related group had a smaller male-to-female ratio and a higher bilateral incidence, and the differences were statistically significant (χ2=4.925, 17.849; P＜0.05). The logMAR BCVA for the glucocorticoid-related and non-glucocorticoid-related groups were 0.45±0.33 and 0.21±0.21, respectively; SFCT were (644.43±131.91) and (507.26±121.79) μm; CMT were (389.51±233.45) and (362.59±140.85) μm; CVV were (4.44±1.07) and (3.67±0.82) mm3; FIPED incidence were 58.49% (31/58) and 20.35% (23/113), respectively; FIPED width and height were (1 122.01±533.98) and (742.90±388.79) μm, and (99.13±92.17) and (33.01±15.99) μm; subretinal fibrin were observed in 24 (45.28%, 24/53) and 15 (13.27%, 15/113) eyes; choroidal strong reflections were found in 38 (71.70%, 38/53) and 45 (39.82%, 45/113) eyes; multiple leak points were identified in 35 (66.03%, 35/53) and 40 (35.40%, 40/113) eyes, respectively. Compared with the non-glucocorticoid-related group, the glucocorticoid-related group had worse BCVA (Z=−4.984), thicker SFCT (t=6.586), larger CVV (t=5.160), higher incidence of FIPED (χ2=23.908), and greater width and height of FIPED (t=2.895, Z=−3.703). The glucocorticoid-related group also had a significantly increased incidence of subretinal fibrin, choroidal strong reflections, and multiple leak points, with all differences being statistically significant (χ2=20.565, 14.663, 13.675; P＜0.05); however, the comparison of CMT showed no statistically significant difference (Z=−0.651, P＞0.05). ConclusionCompared with non-glucocorticoid-related CSC, glucocorticoid-related CSC patients have poorer vision, are more likely to affect both eyes, show no gender bias; choroidal vascular dilation is more significant, and damage to the outer retina and retinal pigment epithelium is more severe.
Objective To observe macular vascular density and structural characteristics in children with transfusion-dependent β-thalassemia (TDT). MethodsA retrospective clinical study. From October 2022 to December 2023, 29 TDT children (58 eyes) diagnosed and examined at the Department of Hematology, Affiliated Hospital of Guangdong Medical University were included in the TDT group, along with 29 age- and gender-matched healthy children (58 eyes) as the control group. All participants underwent optical coherence tomography and angiography. Measurements included central macular thickness (CMT), subretinal choroidal thickness (SFCT), choroidal thickness (ChT), choroidal vascularity index, blood flow density in the superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris layer (CC), and choroidal layer of the macular region, as well as the foveal avascular zone (FAZ) area of the SCP and DCP. A generalized estimating equation was used to compare differences in the above parameters between the two groups. Pearson correlation analysis was employed to examine the relationships between fundus structural parameters, blood flow density, and blood indices. ResultsCompared with the control group, the TDT group showed significantly thinner CMT (χ2=6.044) and ChT at 3.0 mm nasal (χ2=4.451) and temporal (χ2=4.767) to the fovea (P＜0.05). The TDT group also demonstrated reduced blood flow density in the inferior DCP (χ2=5.254), whole CC (χ2=3.996), and superior CC (χ2=5.094), as well as enlarged FAZ area in DCP (χ2=4.286) (P＜0.05). Correlation analysis revealed a negative correlation between SFCT and disease duration (r=−0.357, P=0.006). ConclusionsIn children with TDT, CMT and ChT become thinner and the area of FAZ expands. The blood flow densities of DCP and CC in the macular area decreased.
ObjectiveTo observe the center retinal thickness (CRT) and subfoveal choroidal thickness (SFCT) in eyes with central retinal artery occlusion (CRAO) before and after treatment.MethodsA total of 34 patients (34 eyes) diagnosed with CRAO by fundus fluorescence angiography (FFA) were retrospectively analyzed. There were 18 males (18 eyes) and 16 females (16 eyes). The average age was (61.42±14.09) years. The mean onset time was (2.64±3.73) days. The mean hospitalization time was (11.92±4.95) days. The mean axial length (AL) was (23.53±2.04) mm. The best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, indirect ophthalmoscopy, fundus color photography, fundus fluorescein angiography, spectral domain optical coherence tomography (OCT) and AL measurement were performed. BCVA was converted to the logarithm of the minimum angle of resolution (logMAR). According to FFA, visual loss and the results of OCT, patients were divided into 3 groups: incomplete CRAO (15 eyes) , subtotal CRAO (8 eyes), total CRAO (11 eyes). SFCT and CRT in affected and the fellow eye were measured by OCT for enhanced deep imaging. Follow up lasted for 1 month after treatment, with an average follow-up of (34.71±6.82) days. The changes of SFCT, CRT, and BCVA before and after treatment were observed. The correlation between BCVA after treatment and pretreatment CRT was also analyzed.ResultsAfter 1 month of follow-up, the logMAR BCVA in incomplete group, subtotal group and total group were significantly higher than before treatment (t=3.74, 3.61, 3.26; P=0.004, 0.009, 0.017). Before treatment, the average CRT of the contralateral eyes in the total, subtotal and incomplete group were (215.00±19.85), (224.00±22.79), (214.00±8.21) μm, and the mean SFCT were (264.54±121.71), (266.50±58.17), (261.86±90.95) μm. The average CRT of the affected eyes were (353.18±60.26), (280.14±11.08), (266.63±19.65) μm, and the average SFCT were (233.72±111.35), (237.75±53.30), (259.86±98.14) mm. Compared with the fellow eyes, the average CRT in the 3 groups were thickened, and the difference were statistically significant (t=8.274, 3.694, 11.577; P＜0.001, 0.008, ＜0.001); the average SFCT in the total group was decreased, the difference was statistically significant (t=−2.138, P=0.048). The mean CRT among the 3 groups of eyes was statistically significant (F=12.02, P＜0.001). There was no significant difference in the average SFCT (F=0.178, P=0.838). After 1 month follow-up, the mean CRT in the total, subtotal and incomplete group were (231.18±49.28), (219.16±21.34), (217.86±24.98) μm, and the average SFCT were (239.81±109.57), (241.86±42.81), (260.57±91.67) μm. Compared with before treatment, the average CRT in the three groups of eyes were decreased, the difference were statistically significant (t=13.032, 3.711, 4.970; P＜0.001, 0.008, 0.003); the difference in mean SFCT were not statistically significant (t=−0.785, −0.202, −0.078; P=0.466, 0.845, 0.940). Correlation analysis showed that BCVA after treatment was positively correlated with pretreatment CRT (odds ratio=0.578, P=0.002).ConclusionCRAO resulted in CRT in the preliminary stage and became thinner after receiving treatments. There exists a positive correlation between visual outcome and CRT before receiving treatments.
ObjectiveTo obverse the changes of macular choroidal thickness (CT) in patients with mild to moderate Alzheimer’s disease (AD).MethodsThis was a case-control study. Twenty-one patients with mild to moderate AD confirmed by Neurology Department of Jinhua Central Hospital from November 2016 to June 2018 and 21 age-matched control subjects were concluded in the study. There was no significant difference in age (t=0.128), intraocular pressure (t=0.440) and axial length (t=1.202) between the two groups (P＞0.05). There was significant difference in mini-mental state examination score (t=8.608, P＜0.05). CT was measured by OCT with enhanced depth imaging technique in the subfoveal choroid, at 0.5 mm and 1.0 mm from the center of the fovea nasal (NCT0.5, 1.0 mm), temporal (TCT0.5, 1.0 mm), superior (SCT0.5, 1 .0 mm), and inferior (ICT0.5, 1.0 mm). Independent-samples t test was used to compare the results obtained from these two groups.ResultsSFCT (t=2.431), NCT0.5, 1.0 mm (t=3.341, 2.640), TCT0.5, 1.0 mm (t=3.340, 2.899), SCT0.5, 1.0 mm (t=3.576, 3.751) and ICT0.5, 1.0 mm (t=2.897, 2.903) were significantly thinner in AD eyes than those in control eyes.ConclusionCompared with healthy subjects, patients with mild to moderate AD showed a significant reduction in CT.
ObjectiveTo observe the changes of chorioidal thickness (ChT) in patients with central serous chorioretinopathy (CSC) in different mode of vortic venous dilation. MethodsA prospective cross-sectional observational study. A total of 80 patients with 89 eyes (CSC group) diagnosed in Department of Ophthalmology, General Hospital of Central Theater Command from April to October 2023 were included in the study. Among them, 64 males had 71 eyes and 17 females had 18 eyes. A total of 15 healthy volunteers matched in age and sex were selected as the control group. Among them, 14 men had 26 eyes and one woman had two eyes. The macular region was examined by ultra-wide-angle scanning frequency source optical coherence tomography (OCTA) with BM400K BMizar made by TowardPi (Beijing) Medical Technology Co., LTD. Scanning rate 1 536 A scanning×1 280 B scanning, scanning range 24 mm×20 mm. The accompanying software delineated nine subfields (superotemporal, upper, superonasal, temporal, central, nasal, inferotemporal, lower, inferonasal regions) to record ChT. En-face OCTA mode was utilized to observe the anatomy and functional anastomosis of the vortex veins above and below the choroidal blood layer. Eyes in the CSC group were further categorized into upper-dominant, symmetrical, and lower-dominant groups based on the difference in vortex vein expansion shown in the choroidal layer of the en-face image, with 36, 35, and 18 eyes respectively. Statistical analysis included the use of independent samples t-test or Mann-Whitney test for comparison between two groups, one-way analysis of variance or Kruskal-Wallis H test for comparison between multiple groups, and the χ test or Fisher test for categorical variables. ResultsCompared with the control group, ChT in the CSC group was thickened in the foveal area and different areas of the macula, with the greatest difference in the fovea, and the differences were statistically significant (t=3.345, 5.018, 2.902, 4.667, 7.276, 3.307, 3.868, 4.795, 2.583; P＜0.05). Compared with the ChT of the control group, there was no statistically significant difference in the superotemporal, region of the upper-dominant group (t=1.510, P＞0.05); in other regions, the differences were statistically significant (t=3.207, 5.163, 2.526, 4.310, 6.285, 2.656, 3.812, 2.173; P＜0.05). The differences in the foveal area and other areas in the symmetrical group were statistically significant (t=4.488, 5.554, 3.457, 5.314, 7.256, 3.507, 5.584, 6.019, 2.994; P＜0.05). In the superotemporal, and superonasal, regions of the lower dominant group, the differences were not statistically significant (t=1.150, 1.465; P＜0.05); in other regions, the differences were statistically significant (t=2.278, 4.168, 5.244, 2.783, 5.040, 3.432, 2.095; P＜0.05). ConclusionThe dilated distribution of vortex veins on en-face ultra-wide-angle OCTA has a corresponding relationship with ChT. In eyes with CSC, the superior vortex vein drainage system may be the primary route for choroidal drainage.
ObjectiveTo observe the clinical characteristics and risk factors associated with pachydrusen in eyes affected by central serous chorioretinopathy (CSC). MethodsA retrospective clinical study. From July 2021 to June 2024, 144 cases and 158 eyes of CSC patients diagnosed through ophthalmological examination at Department of Ophthalmology of The First Affiliated Hospital of Zhengzhou University were included. All affected eyes underwent a series of assessments, including refraction, intraocular pressure measurement, fundus color photography, fluorescein fundus angiography (FFA), and swept-source optical coherence tomography (OCT). Additionally, 58 eyes underwent indocyanine green angiography (ICGA). Cross-sectional (en-face) OCT was utilized to observe the colocalization of pachydrusen with areas of dilation of large choroidal vessels and attenuation of the choriocapillaris layer. The device was used for OCT included software for calculating subfoveal choroidal thickness (SFCT). FFA fluorescein leakage was categorized into “ink stain”, “cooking smoke”, and “diffuse point leakage”. Patients were classified into groups of CSC patients complicated by pachydrusen and groups of CSC patients without pachydrusen. Comparisons between the groups were performed using the χ2 test, and factors associated with the presence of pachydrusen were analyzed using logistic regression. ResultsAmong 158 eyes, 72 eyes (45.6%, 72/158) were complicated by pachydrusen. In en-face OCT images, pachydrusen were co-located with dilated large choroidal vessels in 59 eyes (81.94%, 59/72) and corresponded to choroidal capillary layer blood flow holes in 61 eyes (84.72%, 61/72). Among the 58 eyes that underwent ICGA examination, pachydrusen corresponded to punctate strong fluorescence in 46 eyes (79.31%, 46/58) and were located in areas of choroidal hyperpermeability in 43 eyes (74.14%, 43/58). Compared with the CSC group without pachydrusen, the incidence of choroidal neovascularization, flat irregular pigment epithelial detachment, diffuse punctal leakage and multiple leakage points increased in the CSC group, and the differences were statistically significant (χ2=6.217, 8.455, 5.363, 17.749; P＜0.05). Logistic regression analysis indicated that age [odds ratio (OR)=1.116, 95% confidence interval (CI) 1.060-1.176, P＜0.001], chronic CSC [OR=2.628, 95%CI 1.250-5.526, P=0.011] were independent risk factors for the occurrence of pachydrusen. ConclusionsThe incidence of pachydrusen in eyes with CSC is 45.6%, with age and chronic CSC identified as independent risk factors for their occurrence. Pachydrusen correspond to dilated choroidal vessels and areas of choroidal hyperpermeability, which may serve as potential risk factors for CSC activity or development.
Objective To quantitatively evaluate the changes of choroidal biomarkers in patients with central serous chorioretinopathy (CSC) and preliminarily explore its pathogenesis. MethodsClinical cross-sectional study. From July 2021 to December 2022, 74 eyes of 65 patients with CSC (CSC group) confirmed by ophthalmic examination at the First Affiliated Hospital of Zhengzhou University were included in the study. Among them, 46 patients (51 eyes) were male, 19 patients (23 eyes) were female. The duration from the onset of symptoms to the time of treatment was less than or equal to 3 months. A control group consisted of 40 healthy volunteers (74 eyes) matched in age and gender. Among them, 26 patients (50 eyes) were male, and 14 patients (24 eyes) were female. Using VG200D from Microimaging (Henan) Technology Co., Ltd., macular scanning source light coherence tomography angiography was performed, with scanning range 6 mm × 6 mm. According to the division of the diabetes retinopathy treatment research group, the choroid within 6 mm of the macular fovea was divided into three concentric circles centered on the macular fovea, namely, the central area with a diameter of 1 mm, the macular area with a diameter of 1-3 mm, and the surrounding area of the fovea with a diameter of 3-6 mm. The device comes with software to record the three-dimensional choroidal vascular index (CVI), choroidal vascular volume (CVV), perfusion area of the choroidal capillary layer (CFA), choroidal thickness (CT), and three-dimensional CVI, CVV, and CT in the upper, temporal, lower, and subnasal quadrants within 6 mm of the fovea. Quantitative data between the two groups were compared using an independent sample t-test. Qualitative data comparison line χ2 inspection. The value of receiver operating curve (ROC) analysis in predicting the occurrence of CSC, including CVI, CVV, CFA, and CT. ResultsCompared with the control group, the CVI (t=3.133, 4.814), CVV (t=7.504, 9.248), and CT (t=10.557, 10.760) in the central and macular regions of the affected eyes in the CSC group significantly increased, while the CFA (t=－8.206, －5.065) significantly decreased, with statistically significant differences (P＜0.05); CVI (t=7.129), CVV (t=10.020), and CT (t=10.488) significantly increased within 6 mm of the central fovea, while CFA (t=－2.548) significantly decreased, with statistically significant differences (P＜0.05). The CVI (t=4.980, 4.201, 4.716, 8.491), CVV (t=9.014, 7.156, 7.719, 10.730), and CT (t=10.077, 8.700, 8.960, 11.704) in the upper, temporal, lower, and lower nasal quadrants within 6 mm of the central fovea were significantly increased, with statistically significant differences (P＜0.05). In the CSC group, the maximum CVI and CVV were (0.39±0.10)% and (1.09±0.42) mm3, respectively, on the nasal side of the affected eye. Upper CT was (476.02±100.89) μm. The nasal side CVI, CVV, and CT have the largest changes. The ROC curve analysis results showed that the area under the curve of CT, CVV, and CVI within 6 mm of the central region, macular region, and fovea was over than 0.5. Subcentral CT was the most specific for the diagnosis of CSC. ConclusionChoroidal biomarkers CVI, CVV, and CT in CSC patients increase, while CFA decreases. Central CT is the most specific for the diagnosis of CSC.
ObjectiveTo investigate the changes of choroid thickness in adolescents with different types of non-pathological high myopia (HM). MethodsA retrospective observational study. From January 2021 to April 2022, 179 eyes of 101 adolescents with myopia in Liaocheng Aier Eye Hospital were collected and analyzed. According to the spherical equivalent (SE) and corneal curvature, subjects were divided into mild myopia or emmetical eye group (control group), HM group, occult HM group (OHM group) and super HM group (SHM group). There were 52 eyes in 30 cases, 47 eyes in 26 cases, 42 eyes in 24 cases and 38 eyes in 21 cases, respectively. Medical optometry, intraocular pressure, optical coherence tomography (OCT), axial length (AL) and corneal curvature were measured. The macular foveal choroidal thickness was analyzed by using spectral-domain OCT. The diopter was expressed in SE. The thickness of choroid in the fovea of macular region was measured by enhanced deep imaging with frequency domain OCT. The thickness of choroid was measured in 9 regions within 1 mm, 3 mm from the fovea, including the upper, lower, nasal and temporal regions. Generalized estimating equation was used to compare the data among groups, and the least significant difference t-test was used to compare the data among groups. The correlation between AL, corneal curvature, intraocular pressure and choroidal thickness was analyzed by Pearson correlation. ResultsThe choroidal thickness in the foveal macula and the areas 1 mm and 3 mm away from the fovea were compared among the control group, HM group, OHM group and SHM group, the difference were significant (χ2=76.646, 36.715, 27.660, 35.301, 24.346, 38.093, 36.275, 33.584, 36.050; P＜0.05). Compared with the control group, the choroidal thickness of the fovea and the choroidal thickness in each area within 1 and 3 mm from the fovea in the HM group, the OHM group and the SHM group were significantly thinner than those in the control group, and the difference was statistically significant (P＜0.05). There were statistically significant differences in choroidal thickness in each region between the group and the SHM group, and between the OHM group and the SHM group (P＜0.05). The results of correlation analysis showed that AL was negatively correlated with choroidal thickness in various regions (P＜0.05); SE was positively correlated with choroidal thickness in various regions (P＜0.05); corneal curvature and intraocular pressure had no significant correlation with choroidal thickness in various regions (P＞0.05). ConclusionsThe choroidal thickness of SHM is significantly lower than that of OHM and HM; OHM patients have lower SE. However, the choroidal thickness is significantly thinner. AL and SE are the influencing factors of choroidal thickness.
Retinal vein occlusion (RVO) is a serious retinal vascular disease, often accompanied by systemic cardiovascular and cerebrovascular diseases, the eye changes include macular edema, retinal ischemia, and even neovascularization, etc. As a common chronic disease of the fundus, it seriously affects patients' vision and quality of life. With the development of optical coherence tomography, the role of choroid in the occurrence and development of RVO has become a research hotspot. The research on the changes of the choroid layer of the eye with RVO has expanded from a simple two-dimensional thickness analysis to a more comprehensive multidimensional observation index such as three-dimensional volume, blood flow density and velocity. In addition, some cutting-edge research combines artificial intelligence algorithm techniques to improve the accuracy and depth of analysis. In the future, it is still necessary to further improve the data of the choroid layer of the eye with RVO, enhance the overall understanding of RVO, and provide new ideas for clinical prevention and treatment of RVO.
ObjectiveTo observe the changes of retinal and choroidal blood flow density and thickness in macula of different myopic dioptre eyes, and to analyze the correlation between retinal and choroidal blood flow density and axial length (AL). MethodsA retrospective clinical study. From October 2022 to May 2023, 86 eyes of 56 myopic patients scheduled for refractive surgery in Department of Ophthalmology, PLA Central Theater CommandGeneral were included into the study. According to the equivalent spherical specular degree (SE), 19, 21, 27 and 19 eyes of low myopia group (group A), moderate myopia group (group B), high myopia group (group C) and super high myopia group (group D) were observed. Optical coherence tomography angiography (OCTA) and AL measurement were performed in all patients. The diopter was expressed in SE. AL was measured by ultrasonic bio-meter. OCTA scanner was used to scan the macular region in the range of 3 mm × 3 mm. The software automatically divided the macular region into two concentric circles with the fovea as the center, which were 1 mm in diameter respectively, the paracentric fovea of 1-3 mm was divided into 5 regions: superior, nasal, inferior and temporal. The superficial capillary plexus (SCP), deep capillary plexus (DCP), choroidal capillary plexus (CC), choroidal blood flow density, retinal and choroidal thickness were measured. The correlation between AL and blood flow density and thickness was analyzed by Pearson correlation analysis. ResultsThere was no significant difference in SCP blood density and DCP blood density in the fovea in groups A, B, C and D (P＞0.05) .There were significant differences in DCP flow density among superior, nasal, inferior and temporal areas (P＜0.05), the difference was significant (P＜0.05). There was no significant difference in the fovea area between the four groups (P＞0.05), but there was significant difference in the superior, nasal, inferior and temporal areas (P＜0.05). Different macular regions: there were statistically significant among group A, group B, and group C, group D (P＜0.05). Results of correlation analysis, AL was negatively correlated with DCP blood flow density (r=−0.504, −0.500, −0.460, −0.465), retinal thickness (r=−0.348, −0.338, −0.312, −0.230), macular subarea CC (r=−0.633, −0.666, −0.667, −0.710, −6.82), choroidal layer (r=−0.635, −0.687, −0.659, −0.703, −0.680) and choroidal thickness (r=−0.665, −0.605, −0.656, −0.648, −0.643) (P＜0.05). ConclusionsAL is negatively correlated with DCP, CC, CDF, retinal and choroidal thickness in the eyes with myopia. SCP, DCP and retinal thickness in fovea did not change significantly, and temporal choroidal thickness changed earlier than other areas.