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Objective To observe the changes ofchoroidal capillary flow area (CBFA) and density in patients with idiopathic macular hole (IMH) before and after surgery.Methods A prospective clinical study.Thirty patients (60 eyes) with unilateral IMH diagnosed in Department of Ophthalmology of The Second Hospital of Hebei Medical University from February 2017 to March 2018 and 30 age-and sex-matched normal controls were included in this study.All eyes were divided into group A (30 affected eyes),group B (30 fellow eyes) and group C (30 normal eyes of controls).Among 30 eyes in group A,there were 5,14,11 eyes with hole in stage Ⅱ,Ⅲ,Ⅳ,respecitvely.The eyes in group A were divided into two subgroups according to the diameter of the holes:group D:hole diameter less than or equal to 500 μm (11 eyes),group E:hole diameter over than 500 μm (19 eyes).All eyes in group A underwent vitrectomy.Spectral-domain OCT was used to observe the diameter size of macular hole and the closure of the hole after vitrectomy in eyes of group A.The CBFA and blood flow density of superticial choroidal capillaries were measured by OCT angiography before and 3 months after vitrectomy in groups A,B and C.Univariate analysis of variance and t test were used for statistical analysis.Results Before surgery,in group A,B and C,the CBFA were 2.84± 0.35,3.19± 0.23,3.26±0.24 mm2,the blood flow density were (20.74 ± 8.26)％,(35.18 ± 5.20)％,(35.20± 6.49)％,respectively.The CBFA and blood flow density in group A were significantly lower than those in group B and C (F=19.768,45.583;P =0.000,0.000),but there was no significant difference between group B and C (F=19.768,45.583;P=0.332,0.994).The CBFA and blood flow density in group D were higher than those in group E (t=2.230,2.202;P=0.034,0.036).The diameter of macular hole was negatively correlated with CBFA and blood flow density (r=-0.377,-0.477;P=0.044,0.009).Three months after surgery,the macular holes in group A were closed;CBFA and blood flow density in macular area were significantly higher than before surgery (t=-4.126,-4.912;P=0.000,0.000).Conclusions CBFA and blood flow density decreased in the macular area ofIMH.CBFA and blood flow density can be recovered after vitrectomy.
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Objective@#To observe the changes of choroidal capillary flow area (CBFA) and density in patients with idiopathic macular hole (IMH) before and after surgery.@*Methods@#A prospective clinical study. Thirty patients (60 eyes) with unilateral IMH diagnosed in Department of Ophthalmology of The Second Hospital of Hebei Medical University from February 2017 to March 2018 and 30 age-and sex- matched normal controls were included in this study. All eyes were divided into group A (30 affected eyes), group B (30 fellow eyes) and group C (30 normal eyes of controls). Among 30 eyes in group A, there were 5, 14, 11 eyes with hole in stage Ⅱ, Ⅲ, Ⅳ, respecitvely. The eyes in group A were divided into two subgroups according to the diameter of the holes: group D: hole diameter less than or equal to 500 μm (11 eyes), group E: hole diameter over than 500 μm (19 eyes). All eyes in group A underwent vitrectomy. Spectral-domain OCT was used to observe the diameter size of macular hole and the closure of the hole after vitrectomy in eyes of group A. The CBFA and blood flow density of superficial choroidal capillaries were measured by OCT angiography before and 3 months after vitrectomy in groups A, B and C. Univariate analysis of variance and t test were used for statistical analysis.@*Results@#Before surgery, in group A, B and C, the CBFA were 2.84±0.35, 3.19±0.23, 3.26±0.24 mm2, the blood flow density were (20.74±8.26)%, (35.18±5.20)%, (35.20±6.49)%, respectively. The CBFA and blood flow density in group A were significantly lower than those in group B and C (F=19.768, 45.583; P = 0.000, 0.000), but there was no significant difference between group B and C (F=19.768, 45.583; P=0.332, 0.994). The CBFA and blood flow density in group D were higher than those in group E (t=2.230, 2.202; P=0.034, 0.036). The diameter of macular hole was negatively correlated with CBFA and blood flow density (r=-0.377, -0.477; P=0.044, 0.009). Three months after surgery, the macular holes in group A were closed; CBFA and blood flow density in macular area were significantly higher than before surgery (t=-4.126, -4.912; P=0.000, 0.000).@*Conclusions@#CBFA and blood flow density decreased in the macular area of IMH. CBFA and blood flow density can be recovered after vitrectomy.
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Objective To observe the subfoveal choroidal thickness (SFCT) and choriocapillary blood flow area (CBFA) in the patients with idiopathic macular hole (IMH).Methods This is a prospective clinical study.Thirty-two patients with unilateral IMH (4 in stage 2,17 in stage 3,11 in stage 4) and 32 age-and sexmatched normal controls were enrolled in this study.All eyes were divided into three groups,including group A (32 affected eyes),group B (32 fellow eyes) and group C (32 normal eyes of controls).There was no significant difference in age (t=0.865) and gender (x2=0.000) in IMH patients versus normal control subjects (P＞0.05).There was no significant difference in refraction (F=0.957) and ocular axial length (F=0.562) between group A,B and C.The SFCT was detected by enhanced depth imaging of spectral-domain optical coherence tomography (OCT).The CBFA was detected by OCT angiography.The differences of SFCT and CBFA in three groups were analyzed by Kruskal-Wallis and non-parametric test.Results The mean SFCT was (182.53 ±64.52) μtm in group A,(199.21 t73.07) μtm in group B and (254.21 ±56.85) μtm in group C respectively.The SFCT was thinner in group A and B than that in group C (Z=-4.362,-3.190;P＜0.05),but was the same in group A and B (Z=-1.171,P＞0.05).The mean CBFA was (5.09±0.31) mm2 in group A,(5.41 ±0.20) mm2 in group B and (5.39±0.15) mm2 in group C respectively.The CBFA was reduced in group A than that in group B and C (Z=-4.467,-4.048;P＜0.05),but was samc in group B and C (Z=0.420,P＞0.05).Conclusion SFCT and CBFA are both reduced in IMH eyes.
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Objective To observe the diameters of macular hole and destroyed boundary line between inner and outer segment (IS/OS) of the photoreceptors and the correlation with the visual acuity in patients with idiopathic macular hole(IMH). Methods The clinical data of 39 eyes (37 patients) with IMH were retrospective analyzed. All the patients had undergone the examinations of visual acuity (Snellen chart), intra-acular pressure, ocular fundus (indirect ophthalmoscope), and Fourier-domain optical coherence tomography (FD-OCT) whose speed was 27 000 A scan/s, area was 6.0 mm×6.0 mm, and the mode was 512×128. The diametres of macular hole and destroyed IS/OS, and the correlations with visual acuity were detected. Results The mean IogMAR was 0.99±0. 44 (ranged from 0. 15 to 2.00), the mean diameter of macular holes was (942.0± 348. 4)μm(ranged from 171 to 1491 μm), and the mean diameter of IS/OS disruption was (1870. 35±673.2) μm(range from 463 to 3176 μm). There was a significant correlation among the diameter of the macular hole, the diameter of the IS/OS disruption, and IogMAR in IMH (P= 0. 038, 0. 002, 0. 000). In eyes with closed macular hole after surgery, the IogMAR and the diameter of the IS/OS disruption had a significant decrease. Conclusion Using FD-OCT the photoreceptor changes can be visualized in vivo. The abnormality in the IS-OS boundary line appears to be involved for a much larger area beyond the macular hole itself, and persists there with small size even after the maeular hole closure surgery.
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Objective To test the hypothesis that the macular pigment may be a marker of foveal cone function and consequently the structural integrity of foveal cones. Methods Sixteen patients (32 eyes) diagnosed to have Stargardt dystrophy and three patients with full thickness macular holes by clinical criteria were studied with a scanning laser ophthalmoscopy (SLO) comparing argon laser blue and infra-red images for the presence or absence of macular pigment (MP) in the fovea. An C ++ computer based program was used to evaluate the density of MP. Eyes were graded into three categories: those without foveal macular pigment, those with partial pigment and those with normal amounts of macular pigment. These categories were compared with visual acuity determined by the Snellen chart. Results Thirteen eyes with a visual acuity of 20/200 or worse had no macular pigment in the fovea. Eleven eyes with visual acuity of 20/40 or better had a normal amount of macular pigment in the fovea and 1 eye had partial macular pigment. Eleven eyes with partial macular pigment had intermediary acuity value. Conclusions Foveal macular pigment is closely related to foveal cone acuity and therefore may be a marker for the presence of foveal cones. Infrared light is a sensitive indicator of early macular diseases