ABSTRACT
Conventional contrast-enhanced T1WI is a useful tool for evaluating the choroid but can not be used to evaluate the retina due to its small blood supply. Contrast-enhanced T2 fluid-attenuated inversion recovery imaging(CE-T2FLAIR)is sensitive to low-concentration MRI contrast;however,its role in the diagnosis of macular edema has not been described. A patient with macular edema caused by retinal vein occlusion was diagnosed by CE-T2FLAIR in the Hainan Branch of Chinese PLA General Hospital from July 20,2017 to August 4,2017,and our findings confirmed that CE-T2FLAIR could provide valuable imaging evidence for the diagnosis and evaluation of macular edema.
ABSTRACT
The diagnosis of the recurrent optic neuritis is commonly established clinically, and sometimes it could be challenging because the involved optic nerve does not always show significant enhancement on conventional contrast enhanced-T1 weighted imaging (CE-T1WI). In this paper, we reported a middle-aged female with early diagnosis of recurrent optic neuritis using contrast-enhanced T2 fluid-attenuated inversion recovery imaging (CE-T2FLAIR). The involved optic nerve presented evident enhancement on CE-T2FLAIR and no enhancement on CE-T1WI. This case suggested that the CE-T2FLAIR may be a useful diagnostic tool specifically for the recurrent optic neuritis in clinical practice.
ABSTRACT
AIM:To investigate the effects and mechanism of anti-vascular endothelial growth factor ( VEGF) assisted pars plana vitrectomy ( PPV) in the treatment of proliferative diabetic retinopathy ( PDR) . ·METHODS: A total of 92 patients ( 92 eyes ) with PDR treated by PPV were divided into the simple PPV group (41 patients with 41 affected eyes) and the combined treatment group ( 51 patients with 51 affected eyes ) according to whether the patient underwent intravitreal injection of Ranibizumab ( IVR) . The combined treatment group was treated with IVR at 5-7d before PPV. The surgical time, times of electrocoagulation, silicone oil filling rate, the incidence of postoperative complications, LogMAR BCVA of affected eyes, levels of VEGF and pigment epithelium derived factor ( PEDF ) in aqueous humor and vitreous body were compared between the two groups. ·RESULTS:The surgical time was shorter, the times of electrocoagulation was less, the silicone oil filling rate and the incidence rates of iatrogenic retinal hole and vitreous body hematocele were lower in the combined treatment group than in the simple PPV group (P<0. 05). Levels of VEGF and PEDF in aqueous humor and vitreous body of the combined treatment group during PPV were lower than those in the simple PPV group (P<0. 05). The LogMAR BCVA of the affected eyes of the combined treatment group in 3mo after surgery was better than that of the simple PPV group (P<0. 05). ·CONCLUSION:IVR combined with PPV can reduce the perioperative levels of VEGF and PEDF, reduce the times of electrocoagulation and the incidence of iatrogenic retinal hole and vitreous body hematocele, and improve the visual acuity of patients with PDR.
ABSTRACT
Background Researches documented that retinal nerve fiber layer thickness (RNFLT) in unaffected carriers of Leber hereditary optic neuropathy (LHON) becomes thickened in different quadrants to different degrees.But the change of their macular thickness is still unclear.Objective This study was to clarify RNFLT and macular thickness by optical coherence tomography (OCT) in unaffected female carriers of LHON families.Methods Five female LHON patients (5 eyes) from 5 LHON families,eighteen unaffected female carriers (18eyes) from 18 LHON families and twenty-five age-matched healthy female controls (25 eyes) were included in this study.The patients and genetic carriers were diagnosed in PLA General Hospital from 2011 September to 2012 October.Regular ocular examination were performed followed by OCT measurement of retinas.The Optic Disc Cube 200×200 and Macular Cube 200×200 protocols were used during the OCT measurement.Average (360°) RNFLT,RNFLT at four quadrantic sections,cube average macular thickness and macular thickness of nine Early Treatment Diabetic Retinopathy Study (ETDRS) sub-areas were compared among the LHON genetic carriers,LHON patients and normal controls.Results Compared to the normal control group,significant reduced values were seen in temporal,superior,nasal and inferior side of sub-area macular thickness in the LHON female carriers (P=0.022,0.046,0.024,0.008).In addition,but no significant differences were found in cube average thickness,central subarea macular thickness,temporal,superior,nasal and inferior side of lateral sub-area macular thickness,average RNFLT,and temporal,superior,nasal and inferior quadrant RNFLT between the LHON female carriers and normal controls (P=0.102,0.051,0.238,0.663,0.1 10,0.104,0.419,0.371,0.158,0.063,0.563).Compared to the unaffected female carrier group,female patients showed significant reductions in cube average macular thickness,temporal,superior,nasal and inferior side of sub-area macular thickness,temporal,superior,nasal and inferior side of lateral sub-area mac ular thickness,average R NFLT and temporal,superior,and inferior quadrant RNFLT (P =0.000,0.000,0.000,0.007,0.002,0.002,0.000,0.000,0.040,0.000,0.016,0.000,0.000) except for the central subarea macular thickness and nasal quadrant RNFLT (P=0.388,0.580).Conclusions Unaffected LHON female carriers show a normal peripapillary RNFLT,but the macular thickness at medial sub-area is thinner.This first report offers an information of macular structure change in unaffected LHON female carriers,which suggest that macular damage appears prior to RNFLT change.