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Objective:To explore the microvasculature changes in macular area of central retinal vein occlusion (CRVO) patients with macular edema (ME).Methods:A cross-sectional study was conducted.Fifteen patients with monocular ME secondary to CRVO (30 eyes) and 15 age- and gender-matched normal subjects (15 eyes) were enrolled in The Second Affiliated Hospital of Chongqing Medical University from November 2017 to March 2019.Best corrected visual acuity (BCVA), intraocular pressure, slit lamp microscope with pre-set lens, color fundus photography and optical coherence tomography (OCT) were performed in all subjects.The central macular thickness (CMT), foveal avascular zone (FAZ) area, FAZ perimeter, acircularity index (AI), vessel density of superficial retinal capillary plexus (SCP) and deep retinal capillary plexus (DCP) in 3 mm×3 mm macular area were measured by optical coherence tomography angiography instrument and compared between different groups.The correlation between BCVA, CMT and microvascular structural parrameters in ME eyes of CRVO patients was analyzed by Pearson linear correlation test.This study protocol adhered to the Declaration of Helsinki and was approved by the Ethics Committee of The Second Affiliated Hospital of Chongqing Medical University (No.2018-211).Written informed consent was obtained from each subject before any medical examination.Results:Compared with contralateral eyes, the FAZ area and FAZ perimeter of ME eyes were significantly increased, and AI, the vessel density of SCP and DCP were significantly decreased (all at P<0.01).Compared with normal control eyes, the FAZ area and FAZ perimeter of contralateral eyes of CRVO patients were significantly increased, and AI, the vessel density of DCP were significantly decreased (all at P<0.05).In ME eyes, the BCVA LogMAR was positively correlated with FAZ area and FAZ perimeter ( r=0.614, 0.609; both at P<0.05), and was negatively correlated with AI and vessel density of SCP ( r=-0.517, -0.593; both at P<0.058).In ME eyes, CMT was positively correlated with FAZ area and FAZ perimeter ( r=0.523, 0.610; both at P<0.05), and was negatively correlated with AI and the vessel density of SCP ( r=-0.537, -0.608; both at P<0.05). Conclusions:The characteristic microvascular change in ME secondary to CRVO eyes is the decrease of blood flow caused by the decrease of capillaries in fovea, and the same change in blood flow also exists in their contralateral eyes.The degree of ME and visual function damage are correlated with the degree of foveal damage and the blood flow in fovea.
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Objective:To systematically evaluate the diagnostic value of optical coherence tomography angiography (OCTA) and fluorescein fundus angiography (FFA) for choroidal neovascularization (CNV) in central serous chorioretinopathy (CSC).Methods:PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Internet (CNKI), VIP database and Wanfang Database were searched for literature published from January 1991 to March 2020 with CSC patients as subjects and OCTA and FFA as diagnostic methods of CNV.The quality of the included literature was evaluated with Australian JBI tool.A meta-analysis was performed using Review Manager 5.3 software.The source of heterogeneity was identified by age and total number of samples subgroup analysis.Results:Nine studies with a total sample size of 374 eyes were enrolled.The quality score of 8 studies was greater than 14.The detection rate of CNV in CSC by OCTA was higher than that by FFA [odds ratio( OR)=3.99, 95% confidence interval( CI): 1.44-11.07, P<0.001].Studies with sample size >40 showed no heterogeneity ( I2=49%, P=0.14), suggesting that sample size might be a source of heterogeneity.Publication bias was found by funnel plot. Conclusions:OCTA has a higher detection rate of CNV secondary to CSC than FFA, and it can be used as a routine inspection method.
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As the increasing population aging,the incidence of age-related macular degeneration is increasing,blinding rate also increasing,so it is very important for the early diagnosis and treatment of age-related macular degeneration.There are many methods to check the aging macular degeneration,such as fundus angiography,optical coherence tomography (OCT),visual field and multifocal electroretinogram (mfERG).In recent years,many emerging ophthalmic methods have emerged and are gradually applied to clinical diagnosis,including optic coherence tomography angiography (OCTA).The function of these methods has its unique advantages,but there are also limitations.This paper will review these existing methods.
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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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Optical coherence tomography angiography (OCTA) is a new technology of angiography in recent years.In addition to the advantages of traditional OCT,it can observe blood flow in different retinal and choroidal segmentation slab.By using the pseudo-color,abnormal vascular structure can be distinguished from normal vascular structure of the retina.Dye injection is not needed with OCTA,which is different from fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA).OCTA provides more and more accurate blood flow information.However,like other biometric technology,OCTA has its limitations and shortcomings.This review will analyze and summarize the operating principle of OCTA,its application in ophthalmology,as well as its advantages and limitations.
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Objective To observe the characteristics of spectral-domain optical coherence tomography (SD-OCT) for leakage point in acute central serous chorioretinopathy (CSC).Methods A total of 21 acute CSC patients (21 eyes) were enrolled in this retrospective study,including 17 men (17 eyes) and 4 women (5 eyes).The mean age was (47.3±8.8) years (range 35-66 years).The mean duration was (1.6±0.8) months (range 0.5-3.0 months).All patients were underwent mydriatic fundus photography,SD-OCT examination and fluorescein fundus angiography (FFA).SD-OCT and FFA images were carefully compared to observe the SD-OCT examination characteristics of fluorescence leakage point.Results 21/21 eyes had one fluorescein leakage point.In addition to serous retinal detachment,leakage point in the SD-OCT examination showed retinal pigment epithelium (RPE) protrusion in 10 eyes (47.6 ％),RPE detachment in 7 eyes (33.3 ％),highly reflective areas suggesting fibrinous exudate in the subretinal space in 3 eyes (14.3 ％),and RPE defect in 1 eye (4.8 ％).Conclusion The SD-OCT characteristics of acute CSC include RPE protrusion,RPE detachment,highly reflective areas suggesting fibrinous exudate in the subretinal space and RPE defect.
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AIM:To analyze the characteristics of optical coherence tomography ( OCT ) in diabetic optic neuropathy ( DON ) retrospectively. ●METHODS:Retrospective study. A total of 175 cases of type ll diabetes with fundus lesions from Dec. 2013 to Dec. 2015 were selected and the clinical information was collected. These cases were diagnosed by consultation between Departments of Ophthalmology and Endocrinology in the Second Affiliated Hospital of Xi′an Jiao Tong University. The results of body examination were recorded and cases were examined by color fundus photography, fluorescein fundus angiography ( FFA) and OCT. All these data were analyzed. ●RESULTS: A total of 49 cases ( 90 eyes, 25. 7%) were diagnosed DON through FFA which manifested abnormal fluorescence in optic papilla. Results of OCT showed:among 90 eyes of DON patients, 15 eyes ( 16. 7%) had normal optic nerve form; 20 eyes(22. 2%) of excavation of optic disc became smaller or disappeared, with prelaminar tissue and peripapillary retinal nerve fiber layer (RNFL) swelling;26 eyes (28. 9%) manifested optic cup deep and cup/disc ratio increasing;18 eyes (20. 0%) had tissue hyperplasia in the hollow or on the surface of optic disc; 11 eyes(12. 3%) had symptoms including vitreous traction optic papilla and optic disc rim rising. DON eyes which had similar fluorescence features could manifest different tissue morph by OCT. ●CONCLUSION: FFA defines DON by change of blood circulation in optic nerve. However, OCT can show differences of tissue morph of optic nerve that FFA fails to do. So OCT can manifest the causes and sites of optic neuropathy more clearly and also provide basis for treatment. The advantages of OCT are conducive to reviews and curative effect tracking among DON patients and these advantages including noninvasive, convenient, inexpensive and repeatable.
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Abstract?AlM:To analyze of the clinical features of acute retinal pigment epitheltis ( ARPE) .?METHODS: The clinical data of 36 ARPE patients ( 40 eyes) attending this center from January 2008 to January 2014 were reviewed retrospectively. Of them, 21 patients (58.3%) were male (male :female=1:0. 71). The mean age was 40. 92±7. 13 years old (range:17~60y). The mean best-corrected visual acuity (BCVA) was 0. 50±0. 26 with a range of 0. 3 ~ 1. 0. Thirty-two patients were unilateral cases. All the patients were examined for BCVA, funds photography, fluorescein fundus angiography ( FFA ) , optical coherence tomography ( OCT) . FFA was shown as three types: type ▏ to multiple black light or grape variety fluorescent spot; Type II for l lesions visible fluorescence leakage; Type Ⅲ lesions with choroid neovascularization ( CNV ) . OCT was the following three forms: multiple RPE lesions layer reflection intermittent, proliferation ( type ▏); pigment epithelial detachment with limitations neural epithelium ( typeII);types l and ll with CNV ( type Ⅲ) .?RESULTS: Ocular fundus showed that the lesions were multiple dark-gray spots with a dark circumscribed area at the macular or nearby in all 40 eyes. FFA showed:21 eyes were type ▏, 17 eyes were type II and 2 eyes were typeⅢ, BCVA between type ▏ and type II was statistically significant (P0. 05). OCT showed 21 eyes wwere type ▏, 17 eyes were type II and type Ⅲ 2 eyes. BCVA average between type▏ andIIwas statistically significant (P0. 05).?CONCLUSlON:ARPE fundus demonstrated the multiple dark gray discrete lesions, the degree of visual impairment related with the presence of pigment epithelial barrier and lesion location. OCT and FFA characterized three types. FFA is shown asblack light orgrape variety fluorescent spot, and is the basis of diagnosis. OCT can display the lesions organization form of each layer clearly. lt plays a more and more important role in the diagnosis and differential diagnosis of ARPE.
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Radiation retinopathy (RR) is a known complication after radiotherapy for Nasopharyngeal Carcinoma (NPC). This study aims to relate the relationship of RR and radiation dose in patients with NPC through assessment with clinical funduscopy and fundus fluorescein angiogram (FFA). A cross sectional study was conducted on patients with NPC who had completed radiotherapy treatment in the Oncology Clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Eighty two eyes of 42 patients were examined and the prevalence of RR was found to be 35.4%. The severity of RR is strongly associated with the dose of radiation to the retina (Spearman correlation value=0.48; p<0.001). The common features of RR assessed by FFA were telangiectatic vessels (26.2%) and capillary non-perfusion (14.3%). Retinal neovasularization occurred in 10.7% of eyes. The level of visual deterioration correlated with the severity of RR with 26% of eyes experiencing a visual acuity of 6/18 or worse. More than one third of patients developed RR, with radiation maculopathy being the commonest cause for significant visual loss. FFA is a useful tool in detecting early signs of radiation retinopathy and maculopathy. Keywords:
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Nasopharyngeal CarcinomaABSTRACT
The pictures of 78 cases (86 eyes) of central serous choroidoretinopathy taken by fluorescein fundus angiography were anslyzed in this article. The results based on the observation of leaking shape showed that the jet type was more during the early period of illness, whereas the spread type was more during the late period of illness. It is significant to diagnose and treat central serous choroidoretinopathy with fluorescein fundus angiography.