Objective To observe the changes of visual acuity、multifocal electroretinogram (mfERG) and optical coherence tomogram（OCT）before and after successful idiopathic macular hole (IMH) surgery, and evaluate the efficiency of the IMH surgery. Methods A total of 28 eyes of 28 patients with IMH who underwent vitrectomy during February 2001 and May 2002 in our hospital were collected. visual acuity, mfERG, and OCT were examined preoperatively and 1, 3, 6, and 12 months postoperatively, respectively. The results were analyzed statistically compared with 33 eyes in control group. Results (1) OCT showed that 27 eyes (96.43%) had anatomic closure of the macular hole 1 month after the surgery without recurrence in 12 months. Just 1 eye (3.57%) failed in the closure within 1 year. (2) The visual acuity was much higher in the eyes 1 year after surgery, especially within 6 months postoperatively, than that before the vitrectomy（P＜0.01）. (3) Before the operation, the mfERG topographies of IMH eyes seem like volcanoes becase the response densities of wave P1 of ring 1 and ring 2 were lower than control group while the other three rings kept in normal. The central peaks of mfERG topographies reappeared little by little during 1 year after the surgery, and the response densities of wave P1 of ring 1 and ring 2 were higher than before, which was still lower than the control group（P＜0.05）. (4) The thickness of neuroepithelial layer (NEL) of fovea measured by OCT of 27 eyes with anatomic closure was no longer varied and kept lower than control group throughout the follow-up time （P＜0.05）. (5) One year after the operation, there were positive correlations among visual acuity, mfERG and NEL（P＜0.05）. Conclusions Vitrectomy is useful for IMH, which could be evaluated by visual acuity mfERG and OCT efficiently. The three factors had consistency. (Chin J Ocul Fundus Dis，2004，20：221-225)
Objective To explore the retinal and choroidal thickness of myopic patients with different diopters, and analyze the change rule and its relation with the diopter. Methods From October 2015 to June 2016, a total of 161 patients (322 eyes) with myopia and 53 normal volunteers (106 eyes) were selected from Department of Ophthalmology, West China Hospital of Sichuan University. Optical coherence tomography (OCT) examination was performed in all the subjects with Macular cube 512×128 and EDI HD-OCT model in Cirrus HD-OCT 5000 of Carl Zeiss Company from Germany, measuring the retinal and choroidal thickness in macular central fovea, and 3 and 6 mm above, below, on the nose side, and on the temporal side of macular central fovea; the data were averaged. According to the different diopters, the subjects were divided into four groups, including emmetropia group with 53 patients (106 eyes), low myopia group (equivalent diopter from –0.25 to –3.00) with 64 patients (128 eyes), moderate myopia group (equivalent diopter from –3.25 to –6.00) with 47 patients (94 eyes), and high myopia group (equivalent diopter <–6.00) with 50 patients (100 eyes). All the subjects’ best corrected visual acuities were ≥0.8. The changes of retinal and choroidal thickness in myopia patients with different diopters were compared and analyzed. Results The average retinal thickness of the patients in the emmetropia group, the low myopia group, the moderate myopia group, and the high myopia group was (242.50±29.86), (238.46±23.85), (224.52±26.01), (211.91±23.07) μm, respectively; the average choroidal thickness of the patients in the emmetropia group, the low myopia group, the moderate myopia group, and the high myopia group was (220.16±66.00), (252.39±79.56), (191.09±103.03), (121.83±92.54) μm, respectively. There was no significant difference in retinal thickness between the moderate myopia group and the high myopia group (P>0.05), while the differences in retinal thickness between the remaining groups were statistically significant (P<0.05); there was no statistically significant difference between the emmetropia group and moderate myopia group (P>0.05), while the differences in choroid thickness between the remaining groups were statistically significant (P<0.05). Conclusion In general, there are decreasing trends of the retinal thickness and choroid thickness with the increase of the diopter, which may be associated with the formation process of myopia.
ObjectiveTo observe the changes of macula in patients with high myopia after phacoemulsification. MethodsIn 20 patients with high myopia with ocular axial length≥27 mm, optical coherence tomography (OCT) was performed on the operative and contralateral eyes 1 week before and after monocular phacoemulsification, respectively, and the OCT images of macula of the operative eyes were observed and compared.ResultsOne week before and after phacoemulsification, the mean macular fovea thickness of the patients with high myopia was (131.6±16.37) μm and (189.75±45.69) μm, respectively, with a significant difference (t=2.805, P=0.01). Simultaneously, the mean macular fovea thickness of the contralateral eyes was (133.5±15.12) μm and (133.5±14.63) μm, respectively, with a non-significant difference (t=1.367, P=0.853). In 20 operative eyes 1 week after phacoemulsification, 3 had vitreous strand around the macula with retinal thickening, 1 had retinoschisis in macular area, and 2 had obvious retinal thickening with slight retinal edema.ConclusionRetinal thickening occurs in the patients with high myopia after phacoemulsification. Traction of retina by vitreous strand or subclinical retinoschisis may occur in some patients.(Chin J Ocul Fundus Dis, 2005,21:90-92)
Objective To evaluate the causes of the metamorphopsia in patients with reattached retina after scleral buckling surgery. Methods Amsler grid test, ophthalmoscopic examination, fundus fluores cein angiography (FFA) and optical coherence tomography (OCT) were performed on 79 patients (79 eyes) with reattached retina at the 2nd week, 2nd, 6th month and 1st year after scleral buckling operation. Results Two weeks after the operation, 51 patients (51 eyes, 64.56%) complained of metamorphopsia,and 44 patients (44 eyes, including 35 with and 9 without metamorphopsia) were examined by OCT and FFA. In patients with metamorphopsia, the results of OCT in 31 (88.57%) revealed abnormal macula with seven kinds consisting mostly of stratum neuroepithelium detachment (74.29%), while of FFA in 6 patients showed abnormal macular (17.14%) including 4 with neuroepithelium detachment (66.67%). In patients without metamorphopsia, abnormal macula could be found in 2 by OCT while nothing special was seen in FFA. Most abnormal macula in patients followed-up 2 months, 6 months and 1 year postoperatively meliorated as time went by, with alleviative or disappeared metamorphopsia; while the patients with persistently existing macular membrane had aggravating metamorphopsia. Conclusions Abnormal macula is the main reason for metamorphopsia after scleral buckling surgery. Neuroepithelium detachment and macular membrane are the main causes of metamorphopsia at the early and terminal stage after operation.(Chin J Ocul Fundus Dis，2004，20：94-97)
Objective To compared the changes of macular microvascular architecture in early stage familial exudative vitreoretinopathy (FEVR) patients with inner retinal layer (IRL) persistence and without IRL persistence. MethodsA retrospective clinical study. From 2017 to 2022, 94 patients with stage 1 FEVR with or without IRL residue and 45 age- and sex-matched healthy volunteers with 45 eyes (normal control group) who were confirmed by ophthalmology examination in Hangzhou Hospital of Optometry Affiliated to Wenzhou Medical University and Zhejiang Provincial People's Hospital were included in the study. According to whether there was IRL residue, the patients were divided into IRL group and non-IRL group, with 22 patients (22 eyes) and 72 patients (72 eyes), respectively. Best corrected visual acuity (BCVA) and optical coherence tomography angiography (OCTA) were performed in all eyes. Superficial vessel density (SCP) and deep vessel density (DCP) of whole image, fovea and parafovea, the area and perimeter of fovea avascular area (FAZ), A-circularity index (AI, perimeter/standard circle perimeter with equal area) and vessel density around the 300 μm width of the FAZ (FD), central macular thickness (CMT) on macular 3 mm × 3 mm scan on OCTA were measured. ResultsSCP and DCP of whole image (F=10.774, 4.583) and parafovea (F=10.433, 3.912), CMT (F=171.940) in IRL group and non-IRL group on macular 3 mm × 3 mm scan on OCTA were significantly lower than that in normal persons (P＜0.05). There were significant differences among three groups of the area of FAZ (F=4.315), AI (F=3.413), FD-300 (F=13.592) (P＜0.05). BCVA were worst in IRL group (P＜0.05). ConclusionsBlood flow density decreased in macular area of FEVR patients. CMT is significantly thicker than normal population. The FAZ area of the foveal IRL residual eyes is small and irregular, with worse BCVA and lower macular blood density.
Diabetic retinopathy (DR) is the main cause of blindness in diabetic patients. Early diagnosis and intervention are essential to improve the quality of life of patients with DR. Choroidal vascularity index (CVI) is the ratio of choroidal luminal area to total area, which can reflect the structure and blood flow of the choroid, and has been used to evaluate the choroidal condition in various eye diseases. CVI has shown great potential in the prediction, early intervention, disease assessment, and prognosis of DR. The relationship between CVI and photoreceptors needs more research, and CVI may be used as a predictive indicator of photoreceptor health and visual prognosis. In addition, the study of CVI at different layers of the choroid is limited by the accuracy of stratification and the repeatability of measurement. Artificial intelligence and other technologies may provide solutions for this. In the future, through more comprehensive study and the help of artificial intelligence, the value of CVI will be further enriched, which is of great significance for the elucidation of the pathogenesis of DR and serving the clinic.
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)
Purpose To investigate the relationship between the changes of the thickness of retina in macula and the abnormalities in multifocal electroretinog rams (mERG) in diabetic retinopathy. Methods mERG and optical coherence tomography (OCT) examination were performed in 38 patients (60 eyes) with DR (phase Ⅲ～Ⅳ). The data were processed with software SPSS and line relation analysis was done. Results The response densities of N1, P1 and N2 in central 5deg; area was significantly negative related to the thickness of neuroretina in macular fovea (correlation efficient -0.252～-0.266，Plt;0.05). The response density of N2 in central 10deg; area was also significantly negative related to the thickness of neuroretina in macular fovea (correlation efficient -0. 332，P=0.01).There was no significant relationship between the latencies of N1 in central 5deg;, 10deg; area and the thickness of macula, whereares the latenc ies of P1 and N2 in central 5deg; were negatively related to the thickness of retinal pigment epithelium in the macular fovea (correlation efficient-0.271～ - 0.322，Plt;0.05). Conclusion The changes of the thickness of neuroretina in macula may affect the local retinal function in macula, which may be revealed by the reduction of response densities in mERG in patients with diabetic retinopathy. (Chin J Ocul Fundus Dis, 2001,17:257-259)
Objective To investigate the characteristics of congenital retinoschisis of optical coherence tomography(OCT) and its clinical application. Methods Eight cases(15 eyes) which were diagnosed as or suspected to retinoschisis in clinic were examined by OCT,direct ophthalmoscopy and color fundus photograph.Three cases(6 eyes) were examined by electroretinogram(ERG) and fundus fluorescein angiography(FFA). Results The typical characteristic OCT images of congenital retinoschisis were cystic maculopathy with tilted and vertical connective filaments,typical split in innner retinal layers in posterior retina and thickening of neurosensory retina with the split of outer retinal layers in membranous remnants. Conclusions OCT can display the characteristics of congenital retinoschisis．It is potentially useful as a new technique for the diagnosis of congenital retinoschisis. (Chin J Ocul Fundus Dis, 1999, 15: 209-211)
Objective To evaluate the correlation between retinal thickness (RT) at the macular area and the axial length (AL) in myopia. Mehtods Optical coherence tomography (OCT) was used to detect the RT at the macular fovea, and at the superior, nasal, inferior, and temporal side of the fovea and parafovea area. The AL of the examined eye was measured by IOL master measuring machine, and the correlation between RT at the macular area and the Al was evaluated. Results The minimum RT in the macular area in the eyes with myopia was (150.90plusmn;22.10)mu;m.The retina at the temporal side of parafovea was the thinnest. The average RT in the areas around the fovea was negatively correlated with the AL, and there was no correlation among the minimum RT, the mean RT at the fovea, and the AL of eye. Conclusions As the AL of eye increases, the RT at the parafovea decreases, while the minimum and the average RT at the fovea remain unchanged. (Chin J Ocul Fundus Dis, 2006, 22: 397-399)