Diagnostic performance of isolated-check visual evoked potential versus perimetry with blue-yellow in patients with open angle glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the diagnostic performance of the isolated-checked visual evoked potential(IC-VEP)in the detection of open angle glaucoma and compared it to the blue-yellow perimetry(B/YP)and optical coherent tomography(OCT).<p>METHODS: In a retrospective analysis, IC-VEP, perimetry and OCT were performed on 101 subjects(<i>n</i>=35, normal; <i>n</i>=30, early glaucoma; <i>n</i>=36, moderate and advanced glaucoma)from China. The sensitivity of IC-VEP, perimetry and OCT for detection of glaucoma, as well as the agreement within these 3 methods, were calculated to evaluate their clinic performance.<p>RESULTS: In the early primary open angle glaucoma(POAG)group the sensitivity of IC-VEP, blue-yellow perimetry and OCT were 70.00%, 70.00% and 63.33%, respectively. In the moderate advanced POAG group, the sensitivity of IC-VEP, OCT and blue-yellow perimetry were 86.11%, 88.89% and 91.67%, respectively. The specificity of IC-VEP was 91.43%. The results of IC-VEP were highly consistent with OCT and blue-yellow visual field tests(kappa: 0.721-1.000, <i>P</i><0.05).<p>CONCLUSION:As an objective examination of visual function, IC-VEP can be used for early diagnosis of glaucoma. It may be a useful tool for monitoring the function of RGCs in suspected glaucoma patients.

Recovery Course of Macular Structure after Macular Hole Surgery: Using a Spectral Domain Optical Coherence Tomography Image

PURPOSE: To analyze the recovery course of foveal microstructures and evaluate the important structures for visual improvement after vitrectomy for full thickness macular hole (MH) using optical coherence tomography (OCT). METHODS: We retrospectively reviewed the medical records of 34 cases with idiopathic macular hole. We investigated the healing process of foveal microstructures and visual acuity pre- and post-operatively at 1, 3, 6, 12 months after surgery. We evaluated the integrity of four factors by OCT image: existence of MH (Hole, H(1,3,6,12)), recovery of outer nuclear layer (ONL, O(1,3,6,12)), recovery of external limiting membrane (ELM, E(1,3,6,12)), and recovery of inner segment-outer segment (IS/OS) line of the photoreceptor (Photoreceptor, P(1,3,6,12)). We compared the recovery course and visual acuity of the four groups based on postoperative 12 months. RESULTS: The mean observed period was 1.85 ± 2.59 months at recovery of ONL, 3.78 ± 3.83 months at recovery of ONL and ELM, and 7.40 ± 3.56 months at recovery of ONL, ELM and IS/OS line. At postoperative 12 months, the best corrected visual acuity (BCVA) of Groups E and P were better than that of Groups H and O (p < 0.05). Except for group H, all groups had improved BCVA at postoperative 12 months compared to preoperative BCVA (p < 0.05). CONCLUSIONS: Recovery sequences of foveal microstructures were ONL, ELM and IS/OS line after vitrectomy for idiopathic MH. The most important structures for visual acuity were restorations of both ELM and IS/OS line.

Association between Microperimetric Parameters and Optical Coherent Tomographic Findings in Various Macular Diseases

PURPOSE: To analyze the correlation between microperimetric parameters and optical coherent tomographic findings in the eyes of patients with macular diseases. METHODS: A total of 64 eyes were included in this retrospective cross-sectional study. Differences in the macular integrity index and microperimetric parameters were analyzed according to types of outer retinal band defects. Correlations between average threshold values and retinal thickness in the corresponding areas were analyzed. Finally, microperimetric parameters were compared between inner and outer retinal lesions. RESULTS: Measures of best-corrected visual acuity, macular integrity index, and average threshold values were significantly worse in eyes with defects in the ellipsoid portion of the photoreceptor inner segment (ISe), the cone outer segment tip (COST), and the external limiting membrane (ELM) than in eyes without ISe, COST, and ELM defects. Also, visual functionality is more significantly impacted by ELM defects than by other hyper-reflective band defects. There was a significant negative correlation between retinal thickness and the average threshold of the corresponding area in the Early Treatment Diabetic Retinopathy Study grid. Microperimetric parameters in the eyes of patients with inner retinal lesions were better than in the eyes of patients with outer retinal lesions. CONCLUSIONS: The macular integrity index may be a useful factor for reflecting the functional aspects of macular diseases. Specifically, ELM, ISe, and COST defects are significantly associated with poor retinal sensitivity and macular integrity index values that suggest abnormalities. Among eyes with these particular defects, the visual functionality of patients is most sensitively impacted by ELM defects. This finding suggests that microperimetric parameters are sensitive and useful for evaluating functional abnormalities in the eyes of patients with macular disease, particularly in patients with outer retinal pathology.

Analysis of features on prolonged central serous chorioretinopathy by optical coherent tomography / 国际眼科杂志(Guoji Yanke Zazhi)

AlM:To investigate the features on prolonged central serous chorioretinopathy ( CSCR ) by optical coherent tomography ( OCT ) and to provide the basis of deciding the pathogenetic condition and prognosis. METHODS: Eighty - five patients who had been diagnosed with CSCR were grouped by suffering time as below: 32 patients suffered longer than 6mo as the prolonged and 53 patients with CSCR cured within that time. The imaging features of OCT were compared between the above groups.RESULTS:The incidence rate of neuroepithelial serous detachment extent above 500μm associated with pigmentary epithelial detachment in suffering eye and pigmentary epithelial damage in contralateral eye was significantly different between two groups. However, the incidence rate of neuroepithelial serous detachment extent above 4 000μm was not significant difference.CONCLUSlON:OCT could display clearly the change of every layer of retina with simplicity and visibility, which supplies us a new horizon to diagnose and trace CSCR. We could decide the pathogenetic condition and prognosis in accordance with the features of OCT, to provide references for the diagnosis and treatment of CSCR.

Enhanced Depth Imaging Optical Coherence Tomography of Choroidal Nevus : Comparison to B-Scan Ultrasonography

PURPOSE: To evaluate the characteristics of choroidal nevus using the enhanced depth imaging spectral domain optical coherence tomography (EDI SD-OCT), with a comparison to the B scan ultrasound (BUS) findings. METHODS: Medical records of 124 eyes of 124 choroidal nevus patients were reviewed retrospectively. All patients underwent fundus photography (FP), EDI SD-OCT, and BUS. RESULTS: Of 124 eyes with choroidal nevus examined by EDI SD-OCT, 43 eyes (35%) displayed good images to study. The most common EDI-OCT imaging features included choroidal shadowing, choriocapillary thinning, retinal pigment epithelial changes, and overlying subretinal fluid. The mean nevus thickness was 817 microm (120-1850 microm) by EDI-OCT compared 1295 microm (780-2400 microm) by BUS. The mean difference in the tumor thickness between two techniques was 475 microm (27-1319 microm) (p < 0.05). CONCLUSIONS: These results have suggested that imaging of choroidal nevus with EDI-OCT shows superior measurement of its characteristics compared with ultrasonography. The clinical utility of this modality is emerging. EDI-OCT is useful in distinguishing suspicious nevi from other chorioretinal lesions, detecting tumor re-growth along the treatment margin, and demonstrating retinal or choroid tumor location.

Correlation between measurement of tear meniscus by anterior segment module of OCT with dry eye signs and symptoms / 中华实验眼科杂志

Background Dry eye is the most common ocular surface disease.Anterior segment pattern of optical coherent tomography (OCT) is able to be used to assess the tear meniscus directly and accurately.Objective This study was to evaluate the correlation between measuring outcomes of tear meniscus by anterior segment module of OCT with signs and symptoms of dry eye.Methods A retrospective serial cases-observational study was designed.Thirty-six patients who completed Ocular Surface Disease Index (OSDI) and got a score more than 20 were enrolled in the First Hospital of Peking University from September to October,2010 under the informed consent.The upper and lower tear meniscus height (U/LTMH,μm),depth (U/LTMD,μm) and cross sectional area (U/LMA,mm2) were measured with the anterior segment module of OCT (RTVue.pitch).A series of clinical tests were performed,including tear film interferometry,break-up time (BUT),fluorescein corneal staining,lissamine green conjunctival staining and Schirmer Ⅰ test (S Ⅰ t).The correlations of measuring outcomes of tear meniscus by anterior segment module of OCT with dry eye-related examinations were analyzed with Spearman correlation coefficients.Results The values of UTMH,UTMD,UMA were (232±56) μm,(156±53) μm,(0.021 ±0.008) mm2,respectively,and the values of LTMH,LTMD,LMA were (222 ± 72) μm,(163 ± 65) μm,(0.020 ± 0.006) mm2,respectively.No significant differences were found in the measuring values between the upper and the lower tear meniscus (all at P＞0.05).The quantitative values of tear meniscus were not significantly correlated with the OSDI scores or tear film interferometry grade.Significant correlations were seen between UTMH,UTMD,UMA and BUT (r=0.46,P=0.01 ;r=0.40,P=0.02;r=0.43,P=0.01).LTMH,LTMD,LMA were positively correlated with BUT (r=0.61,P=0.00;r=0.64,P=0.00;r=0.64,P=0.00) and S Ⅰ t (r=0.54,P=0.02 ;r=0.46,P=0.01;r=0.55,P=0.01) as well as negatively correlated with fluorescein cornealstaining (r=-0.37,P=0.04;r=-0.37,P=0.04;r=-0.41,P =0.05) and lissamine green conjunctival staining (r =-0.56,P =0.01 ; r =-0.37,P =0.04 ; r =-0.47,P =0.00).Conclusions Anterior segment module of OCT is an effective approach to the measurement of tear meniscus.The measuring outcomes of anterior segment of OCT are associated with dry eye-related signs.

Dynamic observation on children's anisometropic amblyopic macular at area A1 by OCT / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To analyze relevancy between the changes of the retinal thicknesses of children's anisometropic amblyopic macular at Area A1 before and at the end of amplyopia cure and amplyopia cure effect. METHODS: Through randomly selecting 30 cases ( 60 eyes) of anisometropic amblyopic children as test group and 29 cases ( 58 eyes ) of children with normal vision after the vision correction as control group, the changes of the retinal thicknesses of macular of the test group and the control group at Area A1 by OCT-3 was observed dynamically and analyzed. RESULTS: Compared with first diagnosis, the comparative difference of retinal thicknesses of macular at Area A1 in control group at 3, 6mo has statistical significance. The test group was divided into amblyopia group and non-amblyopia group. There has statistical significance for the comparative difference between the retinal thicknesses of macular centre at 3, 6mo and the first diagnosis in the non - amblyopia group, the amblyopia group was divided into the invalid cure group, progress group and the cured group according to amblyopic cure effect. Compared with first diagnosis, there is no statistical significance of macular at Area A1 in invalid cure group and progress group at 3, 6mo, and in the cured group at 3mo, but in the cured group at 6mo has statistical significance. CONCLUSION: There is a certain relationship between the changes of retinal thicknesses of macular of children with anisometropic amblyopic at Area A1 before and at the end of amblyopia treatment and amblyopia cure effect. OCT is a kind of objective auxiliary test method and provides new clues for amblyopia research.

Segmentação do lúmen em imagens de IOCT usando Fuzzy Connectedness e Reconstrução Binária Morfológica / Lumen Segmentation in IOCT images using Fuzzy and Binary Morphological Reconstruction

No ano 2010, doenças cardiovasculares (CVD) causaram 33% do total das mortes no Brasil. Tomografia Ótica Coerente Intravascular (IOCT) é uma tecnologia que oferece imagens in vivo para detecção e monitoramento da progressão de CVD. O exame de IOCT permite mais precisão no diagnóstico; contudo, ainda é pequena a variedade de métodos quantitativos aplicados a IOCT na literatura, em comparação à outras modalidades relacionadas. Portanto neste trabalho é proposto um método de segmentação do lúmen, baseado em uma combinação de Fuzzy Connectedness, com múltiplas funções de afinidade, e Operações Morfológicas. As funções de afinidade usadas neste trabalho são: (I) Clássica, (II) Pesos Dinâmicos e (III) Bhattacharyya. Esta última é baseada no coeficiente de Bhattacharyya, utilizado habitualmente para speckle tracking. Primeiro, características não desejadas da imagem são atenuadas. Depois, informações da parede do vaso são obtidas utilizando Fuzzy Connectedness e um processo de binarização dinâmico. Finalmente, operações morfológicas são realizadas para melhorar o lúmen segmentado. Para avaliar o método proposto, um conjunto de 130 imagens advindas de humanos, porcos, e coelhos foram segmentadas e comparadas com seus respectivos "Gold Standards" feitos por especialistas. Uma média de verdadeiros positivos (TP%) = 98,08 e de falsos positivos (FP%) = 2,34 foram obtidas. Com isso, o método proposto resultou em uma maior eficácia do que os estudos publicados anteriormente, encorajando seu uso.

In 2010 cardiovascular disease (CVD) caused 33% of the total deaths in Brazil. Intravascular Optical Coherent Tomography (IOCT) is an imaging technology that provides in vivo detection and monitoring of the progression of coronary heart disease. IOCT exam allows more accurate diagnoses; nonetheless, the set of quantitative methods applied to IOCT in the literature is small compared to other related modalities. Therefore, the proposed approach presents a lumen segmentation method, based on a combination of Fuzzy Connectedness, with multiple affinity functions, and Morphological Operations. The affinity functions used in this work are: (I) classical, (II) Dynamic weights (III) Bhattacharyya. The latter is based on the Bhattacharyya coefficient, commonly used for speckle tracking. Firstly, unwanted features of the image are attenuated. Then, vessel-wall information is obtained using Fuzzy Connectedness and dynamic binarization process. Finally, morphological operations are performed to improve the segmented lumen. To evaluate the proposed method, a set of 130 images from humans, pigs and rabbits were segmented and compared to their corresponding gold standard made by experts. An average of true positive (TP%) = 98.08, and false positive (FP%) = 2.34 were obtained. Hence, the use of the proposed method is suggested since it has yielded higher efficiency than previously published studies.

Surgical Outcome According to Morphology in Epiretinal Membrane Based on Optical Coherence Tomography (OCT)

PURPOSE: To determine the influence of morphologic classification based on optical coherence tomography (OCT) on epiretinal membrane (ERM) surgery outcomes. METHODS: We retrospectively reviewed the medical records of 77 eyes with ERM treated by vitrectomy with ERM peeling. By using OCT, the preoperative ERM was classified into four types: diffuse (DIF), cystoids macular edema (CME), pseudolamellar hole (PLH), and vitreomacular traction (VMT). The postoperative changes of central macular thickness (CMT) and best-corrected visual acuity (BCVA) were compared. RESULTS: Approximately six months postoperatively, the DIF type had the best BCVA for both idiopathic and secondary ERM, followed by the PLH, CME, and VMT types. On the other hand, regarding the mean BCVA improvement, the VMT type was the best, followed by the DIF, PLH, and CME types. When comparing the difference in BCVA improvement by each type, idiopathic ERM showed a clearer distinction when the inner segment/outer segment (IS/OS) junction was not disrupted. CONCLUSIONS: BCVA improvement was significantly different depending on the morphologic classification of ERM by using OCT. Especially in cases of ERM with an intact IS/OS junction, the morphologic classification can help predict surgical outcomes.

Spontaneously Resolved Purtscher's Retinopathy within 24 Hours: Case Report and OCT Review

PURPOSE: To report a case of unilateral Purtscher's retinopathy that spontaneously resolved within 24 hours. CASE SUMMARY: A 54-year-old man presented with decreased visual acuity in his left eye after a vehicle accident. When the accident occurred, his chest region was compressed by the safety belt. The case was diagnosed with Purtscher's retinopathy based on fundus examination, flourescein angiography (FAG) and optical coherent tomography (OCT). At presentation, the best corrected visual acuity (BCVA) was 0.3 in the affected eye. Tiny Purtscher-flecken and macular edema were observed but there was no sign of retinal hemorrhage. Immediately after the trauma, OCT detected abnormally increased hyperreflectivity in the nerve fiber layer and ganglion cell layer, severe cystoid edema and serous foveal detachment. Without any treatment, BCVA was improved to 1.0 within 12 hours. Recovery of visual acuity was followed by improvement of abnormal hyperreflectivity in the nerve fiber layer, cystoid macular edema and serous foveal detachment. CONCLUSIONS: The authors of the present study report a dramatically resolved unilateral Purtscher's retinopathy after blunt chest trauma.

Quantitative measurement of laser-induced choroidal neovascularization with spectral-domain optical coherent tomography / 中华实验眼科杂志

Background The neovascular form of the disease usually causes severe vision loss in a number of eye diseases.Special-domain optical coherence tomography (SD-OCT) provides high-quality in retinal imaging and the possibility of the measurement in vivo.Objective This study aimed to investigate the feasibility of SD-OCT dynamically measuring choroidal neovascularization (CNV).Methods CNV was induced in 30 left eyes of 30 clean Brown Norway(BN)rats by retinal photocoagulation with the laser parameter as follows: wavelength 532 nm,exciting power 200 mW,spot diameter 100 μm and irradiating time 50 ms.Bubble or less retinal bleeding was thought as Brunch membrane breakage and CNV model establishment.Fundus fluorescein angiography(FFA) was performed to determine the establishment of CNV model and scored based on the fluorescein leakage on 3,7,14,21 days after photocoagulation.Meanwhile,CNV memberane thickness (CMT) was dynamically measured in vivo as the maxiume value from retinal inner limiting membrane through choroidal vessel layer in various time points.Histopathologic examination was used in the 14th day to evaluate and verify the result of SD-OCT.The right eyes were as controls.Results FFA examination showed that disc-like leakage of fluorescein appeared in 7 days and extended in 14 days after photocoagulation with the scores of 1.6±0.4,2.5±0.6 and 2.4±0.5 in 7,14 and 21 days,showing a significant difference among them(F=13.11,P＜0.01).The fluorescein leakage score was significantly higher in 14 and 21 days than that of 7 days(both P＜0.05).CMT measured by SD-OCT was(76.33±10.09),(102.03±14.21)and(98.03±13.76) μm in 7,14 and 21 days after photocoagulation respectively,with a significant difference among 3 time points (F=23.25,P＜0.01),and that in 14 and 21 days was significantly declined in comparison with 7 days(both P＜0.05).The results of SD-OCT showed a consistent tendency with that of FFA.Histopathological examination showed CNV formation in 14 days after photocoagulation.Conclusions Experimental CNV model was successfully induced by laser photography.SD-OCT technology allows excellent visualization of CNV in vivo.

Long-term Clinical Outcomes of Femtosecond LASER-Assisted Descemet's Stripping Endothelial Keratoplasty

PURPOSE: To evaluate the long-term clinical outcomes of femtosecond LASER-assisted Descemet's stripping endothelial keratoplasty (DSEK). METHODS: The clinical results of endothelial keratopathy from 11 consecutive patients who were followed up for at least 12 months after femtosecond LASER-assisted DSEK were retrospectively analyzed. The best corrected visual acuities (BCVA), manifest refractions, intraocular pressures, and perioperative complications were evaluated preoperatively and up to 24 months after the femtosecond LASER-assisted DSEK. RESULTS: The average follow-up period was 18 months. Postoperative visual acuity had significantly improved from 1.26 (logMAR) to 0.80 (logMAR) at 3 months (p < 0.05) and this change was maintained during postoperative follow-up. All eyes underwent successful transplantation and the donor discs were well-attached. The mean endothelial cell density continued to decrease during the follow-up period. The donor-recipient stromal interface was the area where varying degree of haziness and birefringent particles were found. CONCLUSIONS: The femtosecond LASER-assisted DSEK was effective in creating an endothelial donor disc which resulted in rapid visual recovery and low surgically-induced astigmatism. However, the operation caused rapid decrease in endothelial cell density which requires continuing further consideration by the physician.

A Case Report of Acute Zonal Occult Outer Retinopathy Showing Acute Idiopathic Blind Spot Enlargement

PURPOSE: To present a case of acute zonal occult outer retinopathy (AZOOR) with acute idiopathic blind spot enlargement (AIBSE) investigated using indocyanine green angiography (ICGA), multifocal electroretinography (multifocal ERG) and spectral domain-OCT (SD-OCT). CASE SUMMARY: A healthy 31-year-old female with photopsia and a five-day visual field defect in her left eye showed no abnormal findings in ocular examinations such as slit lamp and fundus examination, fluorescein angiography (FAG), or full field ERG as well as in the systemic neurologic examination. In the late phase of ICGA, there were multiple hypofluorescent spots around the optic disc and scattered through the posterior pole. The patient showed an amplitude decrease of multifocal ERG and the destruction of the boundary between the inner and outer segments of the photoreceptors in the SD-OCT examined in the retinal area corresponding to the visual field defect. The patient was diagnosed with AZOOR and was followed-up without treatment. After three months, no abnormal SD-OCT or visual field test findings were observed and no symptoms remained; however, a slightly depressed response on multifocal ERG was present. CONCLUSIONS: ICGA, multifocal ERG and SD-OCT could be useful methods to detect AZOOR with EBS.

Visual field analysis in primary open angle glaucoma with high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the relationship between damages of visual field and retinal nerve fiber layer (RNFL) thickness in primary open angle glaucoma (POAG)with highly myopia. POAG with highly myopia group (21 eyes of 17 cases), POAG with non-highly myopia group (17 eyes of 16 cases), highly myopia without POAG group (25 eyes of 20 cases) and normal control group (19 eyes of 17 cases).automated perimeter and thickness of RNFL was measured by optical coherent tomography(OCT). Main outcome mean deviation (MD), pattern standard deviation (PSD) and mean sensitivity at superior, inferior, nasal and temporal sectors in total deviation probability plots. Thickness of RNFL at superior, inferior, nasal and temporal sector.total deviation probability plots of the early POAG with highly myopia than that of POAG without highly myopia,and the early visual field defects of glaucoma in pattern deviation probability plots of this group. MD of POAG with highly myopia was more than those of others (P＜0.05).The differences of MD, PSD and mean sensitivity between POAG with highly myopia and others were significant(P＜0.05).Mean sensitivities in each sector of POAG without highly myopia were similar to those of highly myopia(P＞0.05). The thickness of RNFL of POAG with highly myopia was thinner than that of others and the thickness of RNFL of normality was thicker than that of others. The relationship between mean sensitivity and the thickness of RNFL in each quadrant was significant(P＜0.05).judgment of the visual field changes in POAG with highly myopia. The relationship between RNFL thickness by OCT and visual field damage may provide clinically relevant information in diagnosis of POAG with highly myopia. Field; optical coherent tomography

Analysis of the Maular Change in Optical Coherent Tomography after Internal Limiting Membrane Peeling

PURPOSE: To analyse the postoperative anatomical changes of maculae using optical coherent tomography after internal limiting membrane peeling during vitrectomy. METHODS: A retrospective review of 22 patients (22 eyes) who underwent vitrectomy with internal limiting membrane peeling was performed. Age, sex, fundus findings, BCVA, operation methods, complications, and postoperative OCT findings were recorded. RESULTS: Of 22 eyes, 12 eyes had epiretinal membranes, 5 eyes had macular holes, and 5 eyes had diffuse diabetic macular edemas. Eighteen of 22 eyes underwent internal limiting membrane peeling using ICG, with 1 eye treated with triamcinolone and 3 eyes treated with nothing. The postoperative improvement of BCVA was statistically significant in epiretinal membrane and diffuse macular edema patients (p0.05). Postoperative OCT findings of 17 eyes showed that they had returned to normal shape and thickness. However, among the 18 eyes that underwent ICG dye-assisted ILM, 3 eyes showed irregular macular thinning and 1 eye showed macular cystic changes. One eye treated with triamcinolone presented with a recurrent cytoid macular edema. No postoperative complications or recurrences were reported by epiretinal membrane patients. CONCLUSIONS: Changes to macular shape did not significantly affect the final BCVA after internal limiting membrane peeling, but they can cause changes to the microstructure of maculae. Therefore, caution during surgery and close follow-up are necessary.

Clinical Manifestation and Result of Vitrectomy of Vitreomacular Traction Syndrome

PURPOSE: To investigate the clinical manifestation and the result of vitrectomy in patients with vitreomacular traction syndrome. METHODS: Optical coherent tomography (OCT) was used to evaluate the clinical manifestation and the results of vitrectomy for 26 eyes with vitreomacular traction syndrome. RESULTS: Spontaneous relief of vitreomacular traction was achieved in 3 of 8 eyes after a mean follow-up duration of 9 months. One eye recovered visual acuity, but the other 2 eyes could not attain better visual acuity because of persistent sponge-like macular edemas. Six of 13 eyes (46%) improved by two or more lines of visual acuity after vitrectomy. The presence of simple macular cysts without sponge-like macular edemas or tractional retinal detachment seemed to be related to good results after vitrectomy. CONCLUSIONS: Vitrectomy is a preferable way to treat vitreomacular traction syndrome. Preoperative OCT could predict the surgical prognosis.

Analysis of Clinical Types and Retinal Nerve Fiber Layer According to Optic Disc Appearances

PURPOSE: To evaluate the clinical characteristic of retinal nerve fiber layer (RNFL) and The clinical types of glaucoma according to optic disc appearances. METHODS: Sixty eyes in 60 patients with glaucoma were evaluated retrospectively. Complete ophthalmologic examination, optical coherent tomography (OCT), automated perimetry, stereoscopic optic disc photography and RNFL photography were performed. We classified optic disc pattern into focal, myopic, generalized enlargement, senile sclerotic, and normal appearance types. RESULTS: In 60 eyes with glaucoma, 15 eyes were adult-onset primary open-angle glaucoma (Adult-onset POAG), 22 eyes were normal-tension glaucoma (NTG), 10 eyes were juvenile-onset open-angle glaucoma (JPOAG), and 13 eyes were secondary glaucoma. JPOAG patients were significantly more detected in association with myopic optic disc type (P<0.05). OCT- measured temporal RNFL thickness in focal optic disc pattern were significantly lower than that in myopic optic disc pattern (P<0.05). Age was significantly correlated with temporal RNFL thickness in our study subjects (P<0.036, r=-0.272). CONCLUSIONS: Our study revealed that JPOAG patients may have a relationship with myopic optic disc type. OCT-measured RNFL thickness of glaucoma patients particularly in the temporal quadrant may be related to age.

Ananlysis of visual field in primary open angle glaucoma with high myopia / 眼科

Objective To evaluate the relationship between damages of visual field and retinal nerve fibre layer(RNFL)thickness in primary open angle glaucoma(POAG)with high myopia.Design Retrospective,case-controlled study.Participants POAG group with high myopia(21 eyes of 17 cases),POAG group with non-high myopia(17 eyes of 16 cases),high myopia group without POAG(25 eyes of 20 cases)and normal control group(19 eyes of 17 cases).Methods The static central visual fields were tested with Humphrey 750 automated perimetry and thickness of RNFL was measured with optical coherent tomography(OCT).Main Outcome Measures Mean deviation(MD),pattern standard deviation(PSD)and mean sensitivity at upper,lower,nasal and temporal quadrants in total deviation probability plots.Thickness of RNFL at upper,lower,nasal and temporal quadrants.Results There were more obvious general depression of sensitivity in total deviation probability plots of the early POAG with high myopia than those of POAG without high myopia,and the early visual field defects of glaucoma in pattern deviation probability plots of this group.MD of POAG with high myopia was more than those of others(P＜0.05).The differences of MD,PSD and mean sensitivity between POAG with high myopia and others were significant(P＜0.05).Mean sensitivities in each quadrant of POAG without high myopia were similar to those of high myopia(P＞0.05).The thickness of RNFL of POAG with high myopia was thinner than those of others and the thickness of RNFL of normality was thicker than that of others.The correlationship between mean sensitivity and the thickness of RNFL in each quadrant was significant(P＜0.05).Conclusion Pattern deviation probability plots is an important favor for judgement of the visual field changes in POAG with high myopia.The relationship between RNFL thickness with OCT and visual field damage may provide clinically relevant information in diagnosis of POAG with high myopia