ABSTRACT
AIM: To observe the macular retina vascular density of patients with acute central retinal artery occlusion(CRAO)by optical coherence tomography angiography(OCTA)and to analyze the relationship with retinal circulation time of these patients on fundus fluorescein angiography(FFA).METHODS: Retrospective case analysis. A total of 43 patients(43 eyes)from January 2019 to March 2021 admitted to Shaanxi Eye Hospital with clinical diagnosis of acute CRAO(course of disease ≤7d)were included. All patients underwent FFA, OCTA, best corrected visual acuity(BCVA)examination and thrombolytic therapy. The patients with enhanced or unchanged retinal blood flow signal in the affected eye showed on OCTA before treatment compared with the contralateral healthy eye were assigned to group A, and the patients with retinal blood flow signal of the affected eye was lower than that in the contralateral healthy eye by OCTA were assigned to group B. Image J software was used for OCTA image processing to evaluate the macular retina vascular density before treatment, and FFA examination was performed to record the affected retinal circulation time before treatment.RESULTS: The retinal vascular density of patients in the affected eye and the contralateral healthy eye in group A was higher than that in group B(25.08%±4.40% vs 12.24%±3.41%, 25.72%±2.70% vs 17.89%±4.55%, all P<0.001), the filling time(FT)of retinal artery trunk to terminal in group B [96(20.50, 193.50)s] was longer than that in group A [11(5.00, 19.50)s](P<0.001). The course of disease, the retinal vascular density of contralateral healthy eye and FT were related factors of retinal vascular density of the affected eye(all P<0.05), and the influence strength order was FT, course of disease and the retinal vascular density of contralateral healthy eye, in which the course of disease and FT was negatively correlated with the retinal vascular density.CONCLUSION: OCTA retinal vascular density was correlated with FFA retinal circulation time in CRAO patients.
ABSTRACT
Objective To observe the changes in retinal structure after shortpulse laser technique and conventional laser surgery.Methods Oburg fundus photography,spectral domain optical coherence tomography (SD-OCT) and fundus autofluorescence (FAF) examination were performed in 16 patients (22 eyes) receiving shortpulse laser surgery,following 19 patients (25 eyes) undergoing conventional laser surgery to observe the spot situation with the time for postoperative 1 h,1-2 weeks,1-3months,＞3-6 months,＞ 6-12 months.Results After 1 h of short-pulse laser,fundus color displayed light spot of the center was white and gray,which surrounded by gray dizzy;SD-OCT images showed spot ellipsoid area formed a ring out of band,but the inner retina and retinal pigment epithelium (RPE) had no significant change.FAF showed multiple spontaneous fluorescence signals to reduce the circular area;at 1-2weeks after laser surgery,fundus photography showed spot center for white and gray,and the surrounded gray dizzy became larger,and FAF spontaneous fluorescence signal in light spot center was enhanced,while SD-OCT showed that the outer nerve sensory layer was pulled to the photocoagulation spot center.From 1 month to 3 months,some of the epithelial layers of the nerves were restored to normal,and ＞ 3-6 months,the epithelial layer of the nerve was basically restored to normal;and ＞ 6-12 months,the nerve epithelium was back to normal.As for conventional laser surgery,1 h later,fundus photography and FAF performance were similar to the short-pulse laser,and the SD-OCT showed that the whole retinal layer had dropsy in the spot place;after 1-2 weeks,the spot center was gray and white,and the surrounded gray halo turned enlargement,and FAF spontaneous fluorescence signal in light spot center was enhanced,while SD-OCT showed that the outer nerve sensory layer was pulled to the spot center with adhesion;after 1-3 months,fundus photography and FAF performance were similar to those of short-pulse laser,while SD-OCT presented the RPE cells hyperplasia and ring atrophy around the spot,and the RPE atrophy around the spot was gradually enlarged,plus the whole layer of the nerve epithelium was adhesion ＞ 3-6 months after surgery.＞6-12 months later,the results showed the RPE layer atrophy and nerve epithelium layer adhesion.The results of FAF in all follow-up groups were consistent with that of OCT results.Conclusion OCT and FAF are the important methods to observe the postoperative retinal laser structure changes,which can provide objective basis for the confirmation that short-pulse laser has less damage than the conventional laser treatment,and this provides a new research idea to optimize the laser parameters.