ABSTRACT
Objective To observe the morphological changes of macular capillary in type 2 diabetic mellitus (DM) patients without clinical features of diabetic retinopathy (DR) by optical coherence tomography angiography (OCTA). Methods This is a prospective clinical case-control study. Forty-three eyes of 22 patients with DM without clinical features of DR (case group) and 40 control eyes of 20 age-and sex-matched healthy physical examination subjects (control group) were enrolled in this study. All subjects underwent OCTA examination with mode of retinal blood flow imaging, macular 3 mm×3 mm and 6 mm×6 mm area, signal strength>45. Foveal avascular zone (FAZ) area, foveal capillary density, parafovea capillary non-perfusion, and micro-aneurysm in shallow capillary vessel layer were evaluated. Results In case group, the mean FAZ area was (0.397±0.141) mm2 and the mean foveal capillary density was (44.6±0.62)%. In control group, the mean FAZ area was (0.253±0.112) mm2 and the mean foveal capillary density was (48.6±0.58)%. FAZ area of eyes in case group was larger than that in control group (t=1.017, P0.05). The spider web-like FAZ and normal foveolar avascular zone were observed in eyes of control group. The parafovea capillary non-perfusion, abnormal foveolar avascular zone, micro-aneurysm and tortuosity of vessels were observed in eyes of case group. Parafovea capillary non-perfusion (χ2=4.542), micro-aneurysms (χ2=5.183) were seen more often in case group than control group (P<0.05). Conclusion Type 2 DM patients have abnormal retinal vascular microcirculation before DR using OCTA, including larger FAZ area, parafovea capillary non-perfusion, abnormal foveolar avascular zone, micro-aneurysm and tortuosity of vessels.
ABSTRACT
Objective To observe the clinical characteristics and fundus imaging features of unilateral acute idiopathic maculopathy (UAIM).Methods Retrospective cases series.Six eyes of 6 patients with UAIM were included in this study.There were 4 males and 2 females.All patients underwent best corrected visual acuity (BCVA),fundus color photography,spectral domain optical coherence tomography (SD-OCT) and fundus fluorescein angiography (FFA) examinations.3 patients underwent indocyanine green angiography (ICGA) examination.No intervention was given in all patients after diagnosis.The mean follow-up was 6.3 months.BCVA,fundus color photography,SD-OCT and FFA were performed in follow-up.Results The ocular symptoms included unilateral sudden decreased vision,metamorphopsia and central scotoma.All patients had a yellow-white lesion involving the macular and irregular small bleeding was seen in 3 eyes.Irregular hyperfluorescence in macular area was seen in all patients,some with the hemorrhages showed blocked fluorescence at the early stage of FFA and fluorescence storage at the late stage.ICGA showed that hypo-fluorescence in macular area continually.SD-OCT showed that subretinal fluid in the macular and lost the ellipsoid zone.During the follow-up period,the subretinal fluid was absorbed spontaneously in one month.The ellipsoid zone structure recovered gradually and the visual acuity were normal.At the time of the latest follow-up,the BCVA was 0.8 in 4 eyes,1.0 in 2 eyes.Conclusions UAIM is featured with a unilateral,acute,transient and exudative lesion in the macular,which can be spontaneously resolved;It mainly affects outer retina.
ABSTRACT
Idiopathic parafoveal telangiectasis (IPT) is a retinal vascular disease which is characterized by foveal and parafoveal telangiectasia.The main clinical manifestations are retinal telangiectasis,reduced retinal transparency,retinal venular dilatation,yellow exudation,retinal pigment epithelial lesions,retinal hemorrhage,macular atrophy,macular hole or lamellar hole,subretinal neovascularization and retinal detachment.According to the clinical characteristics and features of fluorescein angiography,IPT can be divided into 3 types and 6 subtypes.Laser photocoagulation,photodynamic therapy,and intravitreal injection of glucocorticoid or anti-vascular endothelial growth factor drugs,can reduce the macular edema and neovascularization.However,due to the unclear etiology of IPT,the existing treatment measures are not specific for its etiology.We need to work hard to understand further the clinical features and pathogenesis of IPT and search the targeted treatments based on its pathogenesis mechanism.
ABSTRACT
Objective To observe the clinical features of acute macular neuroretinopathy (AMN).Methods Six patients (11 eyes) with AMN were included in this study,with every 2-week follow-ups till six months.Among them,five had preceding dengue fever (83.3％),one had history of head trauma (16.7％).All patients received routine examination,fundus photography,infrared reflectance (IR) imaging,spectral-domain optical coherence tomography (SD-OCT) scanning and fluorescein fundus angiography (FFA) initially,and fundus photography,IR,SD-OCT during follow-up.Results Sudden onset of central/paracentral scotoma in one eye or both eyes was the main visual symptom.There were 1 eye with normal fundus,2 eyes with wedge-shape lesions,8 eyes with yellow-white or brown sheet lesion.IR imaging demonstrated localized areas of hypo-reflection in the macula.SD-OCT scanning through these areas revealed hyper-reflection in the photoreceptor layer and disruption of its normal reflective structures.Subsequent SD-OCT demonstrated that the hyper-reflection of the photoreceptor layer regressed gradually,followed by thinning of the outer nuclear layer.The external limiting membrane and ellipsoid zone became continuous;however,the interdigitation zone was not restored.There was no remarkable findings of the AMN lesions on FFA.The scotomas persisted in all 6 patients (11 eyes) by the last visit.Conclusions IR imaging demonstrated localized areas of hypo-reflection in the macula.SD-OCT revealed hyper-reflection in the photoreceptor layer in acute stage and the interdigitation zone was not restored in late stage.AMN has a relative poor prognosis with persistent scotomas through at least 6 months.