Alterations of macular ganglion cell layer thickness and optic disc parameters in patients with early diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the changes of optic disc parameters, peripapillary retinal nerve fibers layer(pRNFL)thickness and macular ganglion cell layer(mGCL)thickness among patients with early diabetes retinopathy and healthy controls by Cirrus HD-optical coherence tomography(OCT).METHODS: In this cross-sectional comparative study, 45 non-diabetic retinopathy(NDR), 52 mild nonproliferative diabetic retinopathy(NPDR), 55 moderate NPDR with type 2 diabetes mellitus(T2DM)and 64 age-matched healthy controls were included. The fasting blood glucose(FBG), duration of diabetes, glycosylated hemoglobin(HbA1c)and past history of the patients were collected in detail. Optic disc parameters(i.e., binocular RNFL thickness symmetry percentage, rim area, optic disc area, cup-to-disc ratio, cup volume), pRNFL thickness and mGCL thickness were measured by Cirrus HD-OCT. The comparison of different groups was performed by one-way analysis of variance.RESULTS: Compared with the control group, the binocular RNFL thickness symmetry percentage and rim area were significantly decreased, while the average C/D and vertical C/D were significantly increased in the NDR group, mild NPDR group and moderate NPDR group(all P<0.05). Compared with the control group, the peripapillary RNFL thicknesses(superior, temporal, inferior, nasal)and macular GCL thickness(average, minimum, superior, supero-temporal, infero-temporal, inferior, supero-nasal, and infero-nasal)became thinner in the NDR group, mild NPDR group, and moderate NPDR group(all P<0.05).CONCLUSION: Patients with early DR have significantly decreased binocular RNFL thickness asymmetry, rim area, pRNFL and mGCL thickness, while they have significantly increased cup-to-disc ratio when compared to healthy controls. The results support the statement that DM causes inner retinal neurodegenerative changes even in T2DM patients without overt microangiopathy.

Repeatability and Reproducibility of Tear Meniscus Evaluations Using Two Different Spectral Domain-optical Coherence Tomography

PURPOSE: To evaluate the repeatability and reproducibility of inferior tear meniscus measurements using two different spectral domain-optical coherence tomography (OCT), and to compare the inter-device agreements between these devices. METHODS: Two examiners evaluated the tear meniscus depth (TMD) and tear meniscus height (TMH) of 20 eyes in 20 normal subjects using Cirrus OCT and Spectralis OCT with the examiners calculating the TMD and TMH. We analyzed intra-examiner repeatability, inter-examiner reproducibility, and inter-device agreement. RESULTS: The average TMD measurements using the Cirrus OCT and Spectralis OCT devices were 151.25 ± 41.53 µm and 139.10 ± 40.56 µm by examiner 1, respectively, and 152.03 ± 42.77 µm and 138.35 ± 39.70 µm by examiner 2, respectively. The TMHs were 291.90 ± 100.19 µm and 245.43 ± 66.44 µm by examiner 1, respectively, and 288.25 ± 98.72 µm and 244.23 ± 60.69 µm by examiner 2, respectively. The TMDs and TMHs measured using these OCT devices were not statistically significant for intra-examiner and inter-examiner measurements (all, p > 0.05). These devices showed high repeatability (intraclass correlation coefficient ≥ 0.991) for intra-examiner TMD and TMH measurements and the inter-examiner coefficient of variation ranged from 2.04% to 4.32%. The 95% limits of agreement between the two devices were −66.13 to 91.95 µm for TMD and −127.18 to 217.68 µm for TMH. CONCLUSIONS: Both OCT devices are useful for conducting inferior tear meniscus measurements. The inter-device agreement was poor, and the devices were not interchangeable.

Correlation of macular ganglion cell-inner plexiform layer thickness with myopia / 眼科新进展

Objective To analyze the correlation of the macular retinal ganglion cells-inner plexiform layer (GCIPL) thickness and the axial length and refractive power in myopia,thereby providing guidance for GCIPL thickness analysis in myopic glaucoma patients.Methods A total of 95 patients (190 eyes) with different degrees of myopia were recruited from October 2015 to September 2016 in Shenyang HE Eye Hospital,with age ranging from 18 to 36 years.Variables including gender,age,axial length,medical optometry diopter (spherical equivalent),GCIPL thickness (the mean,minimum,superior,inferior,temporal superior,temporal inferior,nasal inferior and nasal superior parameter) were recorded.According to diopter,all patients were divided into A group (-0.25 to-3.00D),Bgroup (-3.25 to-6.00 D),C group (＞-6.00 D);moreover,according to the axial length,they were assigned into A1 group (22 to 24 mm),B1group (＞24 to 26 mm) and C1 group (＞26 mm),and all above variables were compared.Single factor analysis of variance was used to analyze the differences in GCLIP thickness parameters between the 3 groups and Pearson correlation analysis was used to analyze the correlation of GCIPL thickness with different diopters and axial length.Results There was no significant difference in gender and age,but there were significant differences in the mean diopter and axial length among the 3 groups (F =523.963,P =0.000;F =57.452,P =0.000).And a negative correlation was presented between axis length and refractive power (r =-0.707,P =0.000) in all patients.There were significant differences in GCIPL thickness (the mean,minimum,superior,inferior,temporal superior,temporal inferior,nasal inferior and nasal superior parameter) among A,B and C group (F =3.231-16.500,all P ＜ 0.05) as well as among A1,B1 and C1 group (F =5.234-19.999,all P ＜ 0.05).The thickness of GCIPL was negatively correlated with refraction power (r =-0.419 to-0.153,all P ＜ 0.05),and the axial length(r =-0.407 to-0.241,all P ＜ 0.05).Conclusion With the increase of diopter and axial length,the thickness of GCLIP gets thinner in myopic patients.The effect of axial length should be taken into consideration when the GCLIP thickness of myopic glaucoma patients is evaluated.

Corneal Thickness Measurements Using 2 Kinds of Spectral Domain Optical Coherence Tomography, Pentacam, Ultrasound Pachymetry

PURPOSE: To compare the measurements of central corneal thickness (CCT) obtained using two kinds of spectral domain optical coherence tomography (OCT), Pentacam®, and ultrasound pachymetry (USP). METHODS: CCT was measured by Cirrus OCT®, Spectralis OCT®, Pentacam®, and USP in 32 eyes from 32 subjects without ocular disease of the anterior segment. RESULTS: The average CCT measurements using Cirrus OCT®, Spectralis OCT®, Pentacam®, and USP were 549.2 ± 28.7 µm, 545.2 ± 25.4 µm, 554.0 ± 27.8 µm, and 548.4 ± 27.9 µm respectively. The measurements were significantly highly correlated with each other (Pearson's correlation coefficient r > 0.9, all p-values < 0.001), but were significantly different (p < 0.001). The CCT 95% limits of agreement between Cirrus OCT® and Spectralis OCT®, Cirrus OCT® and Pentacam®, Cirrus OCT® and USP, Spectralis OCT® and Pentacam®, and Spectralis OCT® and USP were 27.70 µm, 26.1 µm, 26.97 µm, 22.91 µm, 35.59 µm, and 32.15 µm, respectively. CONCLUSIONS: The CCT values measured using the four devices were highly correlated with each other, but the measurement using Pentacam® was significantly thicker than that using USP. The measurements of the two kinds of spectral domain OCT were similar to those using USP. Therefore, these differences should be considered in clinical use, and measurements cannot be considered interchangeable.

Prognostic Factors in Vitrectomy for Macular Epiretinal Membrane

PURPOSE: To identify prognostic factors associated with a favorable outcome after vitrectomy for patients with macular epiretinal membrane (ERM). METHODS: The authors retrospectively reviewed the records of 63 patients (64 eyes) with macular ERM, who were treated by vitrectomy between 2003 and 2008, and followed for more than 6 months. RESULTS: The mean follow-up period was 13.21 +/- 9.11 months and the mean best corrected visual acuity after vitrectomy was log MAR 0.32 +/- 0.34. Univariate analysis revealed the patients in the group with a postoperative log MAR of 0.3 or better had better preoperative visual acuity and shorter symptom duration; multivariate analysis revealed the same results. In 24 eyes, intraretinal structures which contained pseudoholes, intraretinal cysts, retinal folds and vitreoretinal traction were analyzed with Cirrus HD-OCT, however, there was no correlation with visual acuity after vitrectomy. CONCLUSIONS: The present study demonstrated vitrectomy for macular ERM resulted in favorable visual improvement. The preoperative visual acuity and symptom duration were a significant prognostic factor.

The Measurements of Macular Thickness and Volume with SD-OCT in Normal Eyes

PURPOSE: We investigated reproducibility and repeatability of average macular thickness and volume measurements in normal eyes with Cirrus HD OCT (optical coherence tomography). METHODS: Fifty normal eyes from twenty-five subjects without medical and ocular histories were included. Macular cube 512 x 128 combination scanning using the Cirrus HD OCT was performed for a total of three times on the same visit by an experienced technician. Then other two technicians performed one more macular scanning respectively. Within-results, the intraclass correlation coefficient (ICC) was calculated for each parameter studied to evaluate repeatability and reproducibility. The correlation between macular measurements and demographic variables (age, gender, and spherical equivalent) were also investigated. RESULTS: The ICCs for intraoperator reproducibility were 0.99 on the average macular thickness and 0.96 on the macular volume. And the ICCs for interoperator repeatability were found to be 0.98 and 0.96, respectively. The ICCs for measurements of nine regional retinal thickness also were higher than 0.90. The retinal thickness was correlated with age, gender and refractive error. However, neither age nor refractive error affected to reproducibility and repeatability. CONCLUSIONS: The retinal thickness and macular volume measurements using Cirrus HD OCT in healthy volunteers showed excellent reproducibility and repeatability. Therefore, Cirrus HD OCT has been recognized as an useful tool for diagnosis and mornitoring of variable maculopathies.

Glaucoma Diagnostic Performance of Macular and Retinal Nerve Fiber Layer by Spectral-Domain Optical Coherence Tomography

PURPOSE: To compare the performance of glaucoma diagnosis according to the macular and peripapillary retinal nerve fiber layer (RNFL) thicknesses, as determined by spectral domain optical coherence tomography (OCT). METHODS: Ninety-six normal, 63 early glaucoma and 37 moderate to advanced glaucomatous eyes were imaged by Cirrus OCT. The areas under the receiver operating characteristics curves (AUCs) of macular and RNFL thicknesses were calculated for discrimination of normal and glaucomatous eyes. The sensitivity and specificity of normative classification of each parameter were assessed. RESULTS: The glaucoma diagnostic capability determined by AUC was greater when based on the peripapillary RNFL than the macular thickness (0.914, 0.775, p<0.001). Both the early and the moderate-to-advanced group showed higher AUCs in peripapillary RNFL thickness (early glaucoma group; 0.870, 0.670, p<0.001, moderate to advanced glaucoma group; 0.990, 0.954, p=0.03). The inferior outer sector of macular thickness showed highest sensitivity among the parameters (58%). CONCLUSIONS: Although Cirrus OCT applied to determine macular thickness did not outperform that applied to determine peripapillary RNFL thickness in glaucoma diagnosis, applying Cirrus OCT to determine both thicknesses in diagnosis may help in understanding a patient's status.

Comparison of Time Domain OCT and Spectrum Domain OCT for Retinal Nerve Fiber Layer Assessment

PURPOSE: To compare retinal nerve fiber layer (RNFL) thickness obtained with Stratus optical coherence tomography (OCT) and Cirrus OCT. METHODS: Sixty-one normal eyes were evaluated with Stratus and Cirrus OCT on the same day, and the RNFL thicknesses measured by the two OCT machines were compared. The correlation between the two data sets was obtained using Pearson's correlation coefficient. The correlation between RNFL thickness and the difference in data measured by the two OCT machines was then assessed. RESULTS: The average RNFL thickness was significantly higher with Stratus OCT by 6.54+/-4.48 micrometer (p=0.0008). A strong correlation was present between the two RNFL thickness data sets (r=0.883), and the difference between Stratus and Cirrus values tended to increase as RNFL thickness increased. CONCLUSIONS: RNFL thickness measurements in normal eyes scanned with Cirrus OCT correlate well with Stratus OCT measurements. Average RNFL thickness was significantly higher with Stratus OCT, and as the RNFL thickness increased, the difference between Stratus and Cirrus values increased.