Quantitative analysis of macular retinal thickness and volume in patients with different degrees of Parkinson's disease / 中华眼底病杂志

Objective To observe the macular retinal thickness and volume in patients with different degrees of Parkinson's disease (PD).Methods Thirty eyes of 30 patients with primary PD and 20 eyes of 20 healthy subjects (control group) in Xuanwu Hospital of Capital Medical University from October 2016 to October 2017 were enrolled in this study.There were 17 males and 13 females,with the mean age of 63.2±6.4 years and disease course of 3.9± 2.4 years.The patients were divided into mild to moderate PD group (15 eyes of 15 patients) and severe PD group (15 eyes of 15 patients).The macular area was automatically divided into 3 concentric circles by software,which were foveal area with a diameter of 1 mm (inner ring),middle ring of 1 to 3 mm,and outer ring of 3 to 6 mm.The middle and outer ring were divided into 4 quadrants by 2 radiations,respectively.The changes of retinal thickness and macular volume of the macular center and its surrounding quadrants were analyzed.SPSS 16.0 software was used for statistical analysis.One-way ANOVA were used to analyze all data.Results Compared with the control group,the retinal thickness and volume in macular center and each quadrant of the mild to moderate PD group and severe PD group were reduced.Compared with the mild to moderate PD group,the retinal thickness and volume in macular center and each quadrant of the severe PD group were reduced.The differences of retinal thickness and macular volume among 3 groups were significant (F=5.794,5.221,5.586,5.302,5.926,5.319,5.404,5.261,5.603;P=0.001,0.007,0.003,0.005,0.000,0.004,0.004,0.006,0.002).In inner ring of the mild to moderate PD group and the severe PD group,the retinal thickness and macular volume in the upper and the nasal were the largest,the inferior was followed,and the temporal was the smallest.In outer ring of the mild to moderate PD group and the severe PD group,the retinal thickness and macular volume in the nasal was the largest,the upper was the second,the temporal and the inferior were the smallest.Conclusions The retinal thickness and volume of the macular central fovea and its surrounding areas in PD patients are significantly thinner than that in the healthy subjects.And with the increase of the severity of PD,the macular structure changes obviously,showing macular center and its surrounding macular degeneration thin,macular volume reduced.

Maculopatia viteliforme polimorfa exudativa aguda: um relato de caso / Acute exsudative polymorphous vitelliform maculopathy: a case report

Resumo A maculopatia viteliforme polimorfa exsudativa aguda é um distúrbio retiniano extremamente raro, que tem sido considerado como uma forma de retinopatia paraneoplásica, encontrada em pacientes com um tumor primário subjacente. Os sintomas de maculopatia viteliforme polimorfa exsudativa aguda incluem dor de cabeça precedente seguida de perda aguda da visão. O fundo de olho de um paciente com essa condição demonstra geralmente depósitos bilaterais, branco-amarelados na região macular. O relato de uma doença rara e que tem uma forte associação com neoplasia oculta é de extrema relevância, pois ajuda a conhecer melhor a sua historia natural, possíveis complicações e prognóstico.

Abstract Acute exudative polymorphous vitelliform maculopathy is an extremely rare retinal disorder, that has been considered as a form of paraneoplasic retinopathy, found in patients with a underlying primary tumor. Symptoms of acute exudative polymorphous vitelliform maculopathy include preceding headache followed by acute onset of vision loss. The fundus of a patient with this condition typically demonstrates bilateral, subretinal white-yellow deposits in the macular region. The report of a rare disease which has a strong association with underlying neoplasia is extremely relevant whereas it helps better comprehend its genuine history, possible complicacy and prognosis.

Macular morphology and circumpapillary retinal nerve fiber layer thickness in Parkinson's disease ;evaluated by spectral-domain optical coherence tomography / 中华眼底病杂志

Objective To observe the macular morphology and circumpapillary retinal nerve fiber layer thickness (RNFL) in Parkinson's disease (PD) evaluated by spectral-domain optical coherence tomography (SD-OCT). Methods A total of 37 patients (74 eyes) with PD were in the PD group, 32 age-and sex-matched healthy subjects (64 eyes) in the control group. All subjects underwent SD-OCT examination with 5 line scanning, macular cube 512×128 scanning and optic disc volume 200×200 scanning. The retinal thickness, central foveal thickness (CFT), macular volume and thickness of circumpapillary, superior, inferior, nasal, and temporal of RNFL between two groups were comparatively analyzed. The relationship between SD-OCT parameters and age, disease duration, scores of Hoehn-Yahr and unified PD rating scale (UPDRS) in PD patients was analyzed by Pearson correlation analysis. Results Both of the retinal thickness and macular volume in PD group were significantly reduced than those in control group (t=?2.546,?3.410;P=0.012, 0.001). There was no difference of CFT (t=?0.463, P=0.644) and the thickness of circumpapillary (t=?1.645, P=0.102), superior (t=?0.775, P=0.439), inferior (t=?1.844, P=0.067), nasal (t=?0.344, P=0.732) and temporal (t=?0.541, P=0.590) of RNFL between two groups. The retinal thickness, macular volume, CFT and the thickness of circumpapillary, superior, inferior, nasal, temporal of RNFL had no relationship with age, disease duration and scores of Hoehn-Yahr and UPDRS in PD patients (P>0.05). Conclusions In PD patients, the retinal thickness and macular volume are decreased, however, the circumpapillary RNFL have no obvious alterations.

Characteristics of macular optical coherence tomography changes before and after silicone oil removal in patients with rhegmatogenous retinal detachment involving the macular area / 中华眼底病杂志

Objective To observe the characteristics of macular optical coherence tomography (OCT) changes before and after silicone oil removal in patients who had undergone pars plana vitrectomy with silicone oil tamponade for macula-off rhegmatogenous retinal detachment (RRD).Methods Thirty-nine eyes that underwent silicone oil removal were enrolled in this retrospective study.The patients included 24 males and 15 females,with an average age of (53.05±4.03) years,the duration of silicone oil tamponade ranged from 3 to 7 months.Best-corrected visual acuity,intraocular pressure,slit lamp microscope and prelens,indirect ophthalmoscopy and fourier domain OCT were measured for all patients before and at months 1,3 and 6 after silicone oil removal.The macular microstructure were observed before and after silicone oil removal.Results Submacular fluid was detected in 6 eyes (15.38％),at the last time of follow-up,submacular fluid resolved completely in 2 eyes with disrupted ellipsoid zone,and resolved partly in 2 eyes.Disrupted ellipsoid zone were observed before silicone oil removal in 16 eyes (41.02％),6 eyes showed simultaneous disrupted ellipsoid zone and disrupted external limiting membrane,and there were 2 eyes that external limiting membrane was not identified,at the last time of follow-up,disrupted ellipsoid zone restored in 2 eyes and the extent of disrupted ellipsoid zone became reduced in 4 eyes.Cystoids macular edema were found in 2 eyes (5.12％),it resolved completely in 1 eye and resolved partly in 1 eye at the last time of follow-up.Macular epiretinal membrane was detected in 10 eyes (25.64％),and macular epiretinal membrane was found before silicone oil removal in 5 eyes,at the last time of follow-up,the membrane became thickened in 2 eye;5 eyes developed macular epiretinal membrane after silicone oil removal,at the last time of follow-up,the membrane became thickened in 1 eye.Secondary macular hole were noted in 2 eyes.Microcystic macular changes were observed in 9 eyes (23.07％),it was observed in 7 eyes before silicone oil removal,and was observed in 2 eyes after silicone oil removal,at the last time of follow-up,the cysts reduced in 1 eye.Conclusion Submacular fluid,disrupted ellipsoid zone and microcystic macular are the main macular ultrastructural changes that developed in patients with RRD before and after silicone oil removal.

Benign concentric annular macular dystrophy

The purpose of the authors is to show clinical findings of a patient with benign concentric annular macular dystrophy, which is an unusual condition, and part of the “bull’s eye” maculopathy differential diagnosis. An ophthalmologic examination with color perception, fluorescein angiography, and ocular electrophysiology was performed.

O objetivo dos autores é detalhar o quadro clínico de um paciente com distrofia macular anular concêntrica benigna, quadro raro, que compõe o diagnóstico diferencial das maculopatias em alvo. Realizou-se avaliação oftalmológica com auxílio de testes de percepção de cores, angiofluoresceinografia e eletrofisiologia ocular.

Anatomic and functional outcome of eyes with massive submacular hemorrhage secondary to retinal macroaneurysm submitted to vitrectomy

Purpose: To report the anatomic and functional outcome in patients with severe visual loss after acute massive submacular hemorrhage secondary to retinal arterial macroaneurysm submitted to vitrectomy and subretinal recombinant tissue plasminogen activator injection. Methods: Retrospective, observational, case-series of 4 eyes of 4 patients submitted to pars plana posterior vitrectomy (ppV) combined with internal limiting membrane (ILM) removal and subretinal recombinant tissue plasminogen activator (rtPA-12.5 mg/0.1 ml) injection with dilute (20%) sulfur hexafluoride (SF6) gas in the vitreous cavity of eyes with recent onset (≤7 days) massive macular hemorrhage due to retinal arterial macroaneurysm (RAMA). Optical coherence tomography (OCT) was obtained both at presentation and during follow up. Results: Patients ranged in age from 63 to 78 years and all had systemic arterial hypertension. Visual acuity at presentation ranged from hand motions to count fingers at 50 cm. All eyes showed extensive retinal hemorrhage involving more than two-thirds of macular area. The time between the onset of symptoms and the surgery ranged from 3 to 7 days. After a mean postoperative follow-up of 15.5 ± 5.19 months (range, 10-22 months), all eyes showed visual acuity improvement and final visual acuity ranged from 20/30 to 20/80. All had complete displacement of the subretinal hemorrhage from the fovea after the surgery. OCT images showed neurosensory retina thinning and disruption of the reflective line that represents the junction between inner and outer photoreceptors segments (IS/OS line) beneath the macular area and absence of the external limiting membrane (ELM). Conclusions: ppV associated with subretinal rtPA injection with intravitreal gas seems to be a safe and effective technique to promote visual improvement in patients with multilevel macular hemorrhage secondary to RAMA. Despite functional improvement, OCT images demonstrate that...

Objetivo: Relatar os resultados anatômicos e funcionais em uma série de pacientes com perda visual grave por hemorragia submacular maciça aguda secundária a macroaneurisma arterial de retina (MAR) e descrever a técnica cirúrgica utilizada. Métodos: Este é um estudo retrospectivo, observacional, série de casos, incluindo 4 olhos de 4 pacientes que foram submetidos à cirurgia de vitrectomia posterior (VP), associada a peeling da membrane limitante interna (MLI) e injeção sub-retiniana de ativador do plasminogênio tecidual recombinante (rtPA-12,5 mg/0.1 ml) por hemorragia submacular maciça recente (≤7 dias) secundária MAR. Em todos os casos, o exame de tomografia de coerência óptica (OCT) foi obtido na consulta inicial e nas subsequentes para avaliação das alterações estruturais da retina. Resultados: A idade dos pacientes variou entre 63 a 78 anos e todos apresentavam hipertensão arterial sistêmica. A acuidade visual inicial nos olhos afetados variou de movimento de mãos a conta dedos a 50 cm. Todos os olhos apresentaram hemorragia retiniana extensa ocupando mais do que dois terços da região macular. O tempo decorrido entre a perda visual e a cirurgia variou entre 3 a 7 dias. Após um seguimento médio de 15.5 ± 5.19 meses (variando entre 10 a 22 meses), a acuidade visual pós-operatória variou entre 20/30 e 20/80. Todos os olhos apresentaram um deslocamento completo da hemorragia subretiniana da região macular central no pós operatório. As imagens seccionais da retina obtidas pela OCT revelaram um afilamento da retina neurossensorial e interrupções na linha refletiva que representa a junção entre os segmentos internos e externos dos fotorreceptores na região macular, além de falhas na membrane limitante externa em todos os casos. Conclusão: De acordo com os resultados do presente estudo, a VP associada à injeção sub-retiniana de rtPA parece ser uma técnica segura e eficaz em promover melhora visual em pacientes com hemorragia submacular...

Histopathological and cytological study on inner limiting membrane in idiopathic macular hole / 中华实验眼科杂志

Background Researching the pathological characteristics and components of cells in internal limiting membrane of idiopathic macular hole (IMH) has an important clinical significance for the prevention of IMH.However,the study results are still disputable.Objective This study was to investigate the histopathological features of internal limiting membrane of IMH and the types of cells inside it, and explore the pathomechanism of IMH.Methods Seven specimens of internal limiting membrane were obtained during the vitrectomy with IMH patients in the Second Affiliated Hospital of Guangzhou Medical University from February 2012 to August 2013 under the informed consent of patients.The histopathological examination was performed for the structural observation and cellular identification of internal limiting membrane.The expression and location of glial fibrillary acidic protein (GFAP), CD45 and CD44 in internal limiting membrane were examined by using immunochemistry and immunofluorescence technology.Results All the seven specimens showed continuous undulating membrane with red staining.Two specimens appeared to be uniform in thickness and few cells were distributed in the specimens.The internal limiting membranes were uneven in thickness in the other specimens with retinal pigment epithelial cells,neuroglia cells,fibrocytes,macrophages and lymphocytes in them.Immunochemistry showed the positive expression of GFAP in the outer layer of the specimens.CD45 positive cells were detected in the internal limiting membranes, and CD44 was detected in the inner layer of the specimens.Conclusions Few cells exist in the internal limiting memranes of IMH.However,neuroglia cells and CD45 positive cells emerge in the internal limiting memranes of stage 3 or above IMH eyes, indicating the proliferation of cells and immuno-inflammation response exist during the IMH development.The up-regulation of CD44 expression promotes inflammatory response of internal limiting memranes.

Investigation of the association between the macular volume and thickness by optical coherence tomography, with refraction state and axial length in children / 中华眼底病杂志

Purpose To investigate the association between the macular volume and thickness,as assessed by optical coherence tomography(OCT),with refraction state and axial length(AL)in children.Methods A total of 100 normal children whose right eyes were randomly selected were divided into five groups due to their refraction,comprising hyperopia,emmetropia,low myopia,moderate myopia,high myopia.The AL of the eyes was measured by IOL master measuring machine.Then the macular volume and thickness were measured bv OCT.Results Children with high myopia have smaller macular volume and thinner parafoveal retinal thickness(especially out-ring macular).The minimum thickness and average thickness of the fovea were not significantly different among the five groups.The macular volume ,total average macular thickness and quadrant-specific macular thickness(except the nasal inner quadrants)were positively associated with refraction and negatively associated with AL,while there were no correlation between minimum foveal thickness,the average foveal thickness and refraction or AL.Conclusions In Chinese children,increasing axial length was associated with reduced maeular volume and thickness(except the foveal region and the nasal inner quadrant).

Clinical observation of macular epiretinal membrane / 中华眼底病杂志

Objective To investigate the clinical features, etiological classification and staging of epiretinal macular membrane(MEM). Methods Clinical materials of 194 cases of MEM diagnosed by fundus fluorescein angiography in outpatient department of eye clinic in this hospital from 1983 to 2000 were retrospectively analyzed. Results There were typical clinical symptoms and signs of MEM in all of this 222 eyes of 194 patients. Etiological classification revealed that 4 cases were congenital(2.12%), 22 cases were secondary(11.34%), and 168 cases were idiopathic(86.60%). Staging of course of disease indicated that 119 eyes were in early stage(53.60%), 72 eyes were in middle stage(32.43%), and 31 eyes were in late stage(13.96%). Conclusion MEM may be classified as congenital, secondary and idiopathic type according to its pathogenesis, as early, middle and late stage according to the clinical course of disease. This can be helpful in treating the disease.