ABSTRACT
Background In previous study,peripheral retinal nerve fiber layer (RNFL) thickness is considered to be the earliest structural changes which can be detected.3D-OCT can measure the thickness of macular ganglion cell complex (mGCC),which makes the detection of primary glaucoma possible in the early stage.Objective This study was to measure the thickness of mGCC and disc-peripheral RNFL in early stage of primary glaucomous eyes by 3D-OCT and assess the anatomic basis of glaucoma-induced optical nerve damage.Methods 3D-OCT images from 10 patients with advanced stage primary glaucoma in one lateral eye and early stage glaucoma in fellow eye from December 2010 to December 2012 were prospectively analyzed in China-Japan Friendship Hospital.The patients were diagnosed based on the recommended standard of National glaucoma group (1987 version) and received routine eye examination.3D-OCT scanning was performed using 3D-macular mode,3D-macular Wide mode and 3D-disc mode with TOPCON 3D-OCT 2000 system,and the images at macular 6 mm×6 mm area were analyzed.The posterior pole area was divided into 5 concentric rings from fovea toward periphery and equally subdivided into 100 small checks,with the area of 0.6 mm×0.6 mm for each.The probable values in each check were calculated as the ratio of each figure and corresponding normal value.The probable values were expressed as red color (P＜ 1％),yellow color (P＜5％) and gray color (P≥ 5％).Then the disc-periphery RNFL thickness and disc cup were evaluated.Results No evident abnormality was found in the thicknesses of photoreceptors layer and bipolar cell layer in both advanced glaucomous eyes and the early stage of glaucomous eyes in the 10 patients.Serious damage of visual field was seen in the advanced glaucomous eyes and presented with red color in the parapapillary RNFL area,mGCC area and macular RNFL area,showing an evidently attenuation of the thicknesses of parapapillary RNFL,mGCC and RNFL.However,the visual field was close normal in the early stage glaucomous eyes,and mGCC and macular RNFL showed yellow color,while green or yellow color was exhibited in the parapapillary RNFL area,indicating mGCC and macular RNFL thickness was reduced,but parapapillar RNFL thickness was near normal.Conclusions The change of mGCC thickness is earlier than that of peripheral RNFL at optic disc in primary glaucomaous eyes,which may imply that the disappear of macular ganglion cell body is earlier than that of the axon.
ABSTRACT
Pan-retinal photocoagulation (PRP) and macular photocoagulation (MPC) are the gold standard treatments for proliferative diabetic retinopathy (DR) and diabetic macular edema. With the development of equipment and technology advancement, photocoagulation has been gradually applied in many Eye Centers all over China. However, there are still several problems such as no standardized guideline and undesirable therapeutic effects. In this article we will summarize the indications and techniques of photocoagulation, and when and how to apply drug treatments for retinal diseases; aim at improving the criterion and clinical effects of photocoagulation.
ABSTRACT
39 cases (49 eyes) with retinal periphlebitis (Eales' disease) were treated by laser photocoagulation and followed up for 3～64 months, averaging 17 months. The visual acuity improved in 29 eyes (59.1％), remained unaltered 15 eyes (30.7％),and diminished in 5 eyes (10.2％). The results showed that laser photocoagulation was effective and safe for the treatment of Eales' disease. The importance of early diagnosis, early treatment, periodical follow-up and the use of corticosteroids were discussed.
ABSTRACT
Objective To investigate the effects of krypton laser photocoagulation for diabetic macular edema(DMO).Design Retrospective cases series.Participants 58 patients(110 eyes)with DMO.Methods Average 18.9 months follow-up was performed af- ter grid pattern and/or focal laser photocoagulation in patients with DMO.Examination of visual acuity,ophthalmoscope or color fundus photography were performed at follow-up.Fluorescein angiography(FFA)and optical coherence tomography(OCT)were performed in some patients.Main Outcome Measures The changes of DMO and visual acuity.Results In 110 eyes of all patients with DMO,there was a marked reduction or disappearance of macular edema(that is satisfactory for laser therapy)in 83.6%(92 eyes),verified with FFA or/and OCT.Unsatisfactory for laser therapy was only in 16.4%(18 eyes).Visual acuity improved and unchanged in 78.2%(86 eyes), decreased in 21.8%(24 eyes).Conclusions Krypton laser grid pattern or/and focal photocoagulation is an effective and safe first-line therapy techniques for DMO.But the result is affected by many factors.