ABSTRACT
Myopia is the most common ametropia. High myopia, especially pathological high myopia, is often accompanied by a series of fundus pathological changes, such as Fuchs spot and choroidal neovascularization(CNV), etc, which can lead to serious damage of visual function. In recent years, it has been found that the changes of choroidal thickness and blood flow play a considerable role in the progression of high myopia. The change of choroidal thickness can directly reflect the abnormality of its structure and function. The choroidal thickness in high myopia is significantly thinner than that in normal people, and the thinning degree varies in different regions. At the same time, the choroid is the main source of blood supply to the eyes, and its blood flow directly determines whether the blood supply is sufficient to the eyes. Therefore, observing the changes of choroidal thickness and blood flow in high myopia is of great significance to explore the progress of myopia or observe its pathological changes. This review illustrates the choroidal structure, thickness and choroidal blood flow changes of high myopia. At the same time, it analyzes and discusses the new research progress and main existing problems in recent years, the new challenges and future research directions, hoping to provide help for clinical monitoring of the occurrence and progression in high myopia.
ABSTRACT
AIM:To investigate the value of 3D-optical coherence tomography (OCT) in the diagnosis of macular disease before phacoemulsification.METHODS:Clinical records of 423 cataract patients (512 eyes) who underwent phacoemulsification combined with intraocular lens implantation in our hospital from June to December in 2015 were retrospectively analyzed.In addition to preoperative routine examination of fundus, Topcon 3D-OCT 2000 was used to examine the macula, the detection rate of macular disease was compared, risk factors of cataract combined with macular disease were analyzed.RESULTS:The OCT image results of 305 cases (384 eyes, 72.1%) were successfully obtained, 133 cases showed macular disease (146 eyes), the detection rate was 28.5% (95%CI:27.64%-29.40%);the macular disease of 35 cases (37 eyes) were detected by routine examination of fundus before operation, the detection rate was 7.2% (95%CI:6.72%-7.74%);the detection rate of 3D-OCT was significantly higher than routine examination of fundus for macular disease (χ2=79.05, P<0.01).Female, over 65 years old, surgical history of diseased eye, and high myopia were risk factors of cataract combined with macular disease, the relative risk was 1.705 (95%CI:1.091,2.664), 1.893 (95%CI:1.219,2.939), 6.593 (95%CI:2.027,21.447) and 95%CI:5.130 (2.841,9.263) respectively, the risk of cataract combined with macular disease showed an increasing trend with rising age.CONCLUSION:In preoperative examination of cataract patients, 3D-OCT has higher sensitivity in the detection of macular disease, especially for women, over 65 years old, high myopia and surgical history of diseased eye, 3D-OCT can be used as a routine preoperative examination.
ABSTRACT
Keratorefractive surgery changes the central corneal thickness (CCT) and corneal curvature, which could influence the Goldmann applanation tonometer (GAT) and non-contact tonometer (NCT) measurements of intraocular pressure (IOP), but not dynamic contour tonometer(DCT). During the procedure of LASIK, there is a transient rise of IOP, which increases the risks of optic nerve damage. Meanwhile, the presence of functioning filtering blebs may affect the choice and outcome of refractive surgery, or even becomes a contraindication of surgery. Steroids are typically used after keratorefractive surgery, which could lead to IOP elevation. Hence it is important to monitor IOP after LASIK and to be aware of inaccurate IOP readings due to corneal flap interface fluid. Treating patients with postoperative elevated IOP after keratorefractive surgery is similar to that for patients with glaucoma. This review will address the issues surrounding the safety, relevant complications and implications of keratorefractive surgeries on glaucoma and relevant diagnostic tests.