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Objective:To quantitatively assess the macular and choroidal capillary vessel density and foveal avascular zone (FAZ) variables in untreated central serous chorioretinopathy (CSC), polypoidal choroidal vasculopathy (PCV) patients and healthy people using optical coherence tomography angiography (OCTA), and to investigate their correlation with retinal thickness and choroidal thickness.Methods:A cross-sectional study was adopted.Fifty-five eyes of 55 Chinese adults, including 20 eyes with untreated unilateral CSC, 16 eyes with untreated unilateral PCV and 19 eyes of healthy controls, were enrolled from January 2018 to June 2021 in Shenzhen Aier Eye Hospital Affiliated to Jinan University.The 6 mm×6 mm scanning of Optovue OCTA was carried out in all the subjects.The superficial retinal vessel density (SRVD), deep retinal vessel density (DRVD), outer retinal vessel density (ORVD) and choroidal capillary vessel density (CCVD), FAZ area, FAZ perimeter and vessel density in a 300-μm-wide annular region around FAZ were measured by ReVue software of Optovue OCTA.Central foveal thickness (CFT) and subfoveal choroidal thickness (SFCT) were assessed by Optovue OCTA HD scan.Correlation between CFT, SFCT and OCTA variable, FAZ variables were evaluated by Pearson liner correlation analysis.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Shenzhen Aier Eye Hospital Affiliated to Jinan University (No.AIERKY6236-1). Written informed consent was obtained from each subject prior to entering the cohort.Results:There were significant differences in the foveal, parafoveal and perifoveal SRVD among the three groups ( F=6.344, 9.006, 5.617; all at P<0.01). Compared with healthy control group, the foveal, parafoveal and perifoveal SRVD in CSC group as well as the foveal SRVD in PCV group were significantly increased (all at P<0.01). Compared with CSC group, the parafoveal and perifoveal SRVD were significantly decreased in PCV group (both at P<0.01). There were significantly differences in the parafoveal DRVD among the three groups ( F=3.383, P<0.05). Compared with healthy control group, the parafoveal DRVD of CSC and PCV groups was increased significantly (both at P<0.05). There were significant differences in the ORVD and CCVD among the three groups ( F=16.931, 19.412; both at P<0.001). Compared with healthy control group, the ORVD and CCVD in CSC group and the CCVD in PCV group were decreased significantly (all at P<0.001). Compared with the PVC group, the ORVD was significantly decreased in CSC group ( P<0.001). A significantly difference was found in CFT among the three groups ( F=20.495, P<0.001). Compared with healthy control and PCV group, the CFT was significantly increased in CSC group (both at P<0.001). No significant difference was found in SFCT, FAZ area, FAZ perimeter and vessel density of the 300-μm-wide annular region around FAZ among the three groups ( F=1.083, 0.906, 0.819, 1.530; all at P>0.05). Negative correlations were found between parafoveal DRVD, ORVD and CFT in CSC eyes ( r=-0.555, -0.516; both at P<0.05), and a significant negative correlation was found between ORVD and CFT in PCV eyes ( r=-0.585, P<0.05). No significant correlation was found between OCTA variables (SRVD, DRVD, ORVD, CCVD), FAZ parameters (FAZ area, FAZ perimeter and vessel density of the 300-μm-wide annular region around FAZ) and SFCT in the three groups (all at P>0.05). Conclusions:Hyperaemia in the superficial capillary of macular fovea and atrophy of choroidal capillaries may be the same pathogenesis between CSC and PCV.The vessel density of outer retinal layer is a common independent influencing factor of CFT between the two diseases.
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Pachychoroid disease is a relatively novel concept proposed in ophthalmology in recent years, which describes a series of pathological conditions including chronic persistent choroidal thickening and choroidal vasodilatation, with choroid blood capillary layer capacity attenuation, choroidal vasodilation, focal or disseminated choroidal thickening, progressive retinal pigment epithelial dysfunction and choroid retinal neovascularization as characteristic symptoms.Nowadays, the definition of pachychoroid disease has gradually changed from the previous emphasis on the simple thickening of choroid to the morphological description of complex pathological conditions.The clinical manifestations of certain pachychoroid diseases have been clearly described including central serous chorioretinopathy (CSC), pachychoroid neovasculcularization (PNV), polypoid choroidal vasculopathy (PCV), focal choroidal excavation (FCE), peripapillary pachychoroid syndrome (PPS). These entities have certain characteristic choroidal vasculopathy, which may represent different clinical manifestations of the same type of pachychoroid diseaseor indicate that they have similarpathogenesis .In this article, the existing literature and recent findings about pachychoroid disease, as well as the classification and treatment of pachychoroid diseases spectrum were summarized and discussed.
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Objective To analyze the results of diagnostic pars plana vitrectomy (PPV) in patients with uveitis of unknown cause.Methods This is a retrospective case series study.Sixty-five patients (67 eyes) with uveitis of unknown cause were enrolled in this study.There were 31 males (32 eyes) and 34 females (35 eyes).The ages were from 6 to 84 years,with the mean age of (55.00± 18.56) years.All eyes were received PPV.Examination of vitreous samples consisted of microbial stains and culture,microbial DNA and antibody detection,cytokine measurement,cytology,flow cytometry and gene rearrangement detection.Results Vitreous analysis was positive in 40 of 67 eyes (59.7％).Positive results indicated bacterial endophthalmitis in 20 of 40 eyes (50.0％),lymphoma in 11 eyes (27.5％),viral IgM and IgG increased significantly in 3 eyes (7.5％),fungal endophthalmitis in 3 eyes (7.5％),IgG of toxocara increased significantly in 2 eyes (5.0％),IgG of toxoplasma Gondii increased significantly in 1 eye (2.5％).Conclusion The diagnostic yield of vitreous samples in uveitis eyes of unknown cause is 59.7％.
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Objective To analyze the clinical characteristics of fundus changes in systemic lupus erythematosus (SLE) patients.Methods Color fundus and FFA were performed in 27 SLE patients (54 eyes) with fundus abnormalities.Clinical characteristics were analyzed.SLE disease activity index (SLEDAI) was evaluated in the patients.SLEDAI was analyzed by SPSS 19.0 Student-t test.Results Four clinical types were found in 27 patients.Capillary obstruction was found in 28 eyes of 14 patients,retinal artery occlusion in 11 eyes of 6 patients,retinal vein occlusion in 7 eyes of 6 patients,choroidal vessel obstruction in 2 eyes of 1 patient.SLEDAI was evaluated in 24 patients.SLEDAI in 5 patients with retinal artery occlusion was (25.6 ± 2.2) scores,which was significantly higher than other patients(18.2 ± 2.9)scores (P ＜0.05).Conclusion This clinical typing scheme may help to know fundus abnormalities in SLE patient,and it may be related to SLE activity.SLEDAI in patients with retinal artery occlusion is higher than other patients.
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Background Takayasu arteritis is a non specificity inflammation of aorta and its branch.The incidence of Takayasu arteritis is low and its ocular secondary disease is rare.The correct diagnosis of Takayasu arteritis is very important for its early treatment in clinic.Objective This study is to analyze the fundus findings and characteristic of fundus fluorescein angiography (FFA) of Takayasu retinopathy.Methods The FFA and clinical data of 12 patients (24 eyes) with Takayasu arteritis were retrospectively reviewed.Written informed consent was obtained from all the patients before and initiation of any study protocol.Results In 12 patients,chronic ischemic retinopathy was found in 15 eyes of 9 patients.The arm to retina circulation time(A RCT) prolonged to (19.20±2.95) s in 5 eyes,and the retinal circulation time (RCT) delayed to 10.62±6.15 s in 5 eyes.Peripapillary arteriovenous anastomosis was found in 2 eyes of 2 patients.Macular arch ring was incomplete in 6 eyes of 4 patients.Eight patients (14 eyes) had telangiectasis and microaneurysm,and 2 eyes of 2 patients presented neovascularization on the disc or elsewhere.In 12 patients,hypertensive retinopathy was found in 4 eyes of 3 patients,showing narrow retinal artery,arteriosclerosis,hemorrhage,cotton wool spots and hard exudates.Ten patients were diagnosed as Takayasu arteritis before FFA examination,and 2 patients were determinedly diagnosed after FFA was performed.Conclusion The main features of Takayasu retinopathy are hypertensive retinopathy and chronic ischemic retinopathy.It is important for ophthalmologist to correctly recognize the clinical features of TA.
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Objective To summarize the clinical outcome of direct trans-scleral drainage by puncture with 25G needles in the external-route surgeries for primary retinal detachment. Methods Fifty-four consecutive cases of primary retinal detachment were treated by external-route surgeries. The subretinal fluid of 23 cases was drained by direct scleral puncture with 25G needles (25GND group), the other 31 cases underwent the conventional scleral incision and drainage(CD group). Postoperative complications, the single-operation retinal reattachment rate and functional outcome were recorded.Results Subretinal fluid was adequately drained in all cases. there was no significant difference in the single-operation retinal reattachment rate between 25GND and CD groups. In comparision to CD, 25GND significantly decreased postoperative complication rate (?2=4.729,P
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Objective To explore differentiation in vitro of rat adipose-derived stem cells into photoreceptor cells and RPE cells.Methods The ADSCs were cultured by adhering to the flask surface and purified by continual passaging.Surface antigens including CD45、CD90、CD49d、CD106 were indentified by flow cytometry.ADSCs were induced to differentiate by EGF,activin A,taurine,retinoic acid(RA) and extracted liquid of retina respectively.Meanwhile,ADSCs were induced by EGF+taurine,EGF+RA,taurine + RA,EGF+taurine+RA respectively.Immunofluorescence was used for detecting the expression of rhodopsin,CK and S-100,and flow cytometry was used for quantification.Results For primary culture,the phenotypes of ADSCs were: CD45,CD90,CD49d and CD106,with a positive percentage of 1.6%,71.3%,7.8% and 3.5%,respectively.From passage 1 to 5,these phenotypes were: CD45(0.8%～9.3%),CD90(84.7%～94.8%),CD49d(16.8%～31.0%)and CD106(8.3%～22.2%).There was a higher CD49d percentage than CD106 in all the passages.The induction efficacy of ADSCs was 17.5%～46.0% for rhodopsin,19.7%～79.3% for CK and 27.3%～50.7% for S-100.Conclusion It is suggested that ADSC has potential to differentiate into photoceptors and RPE cells as evidenced by thepresence of the specific markers of photoceptors(rhodopsin) and RPE markers(CK and S-100).