Maculopatía paracentral aguda media y neurorretinopatía macular aguda

La neurorretinopatía macular aguda es una condición rara con patogenia microvascular. Se presenta con un inicio agudo con escotomas paracentrales correspondientes a lesiones paramaculares evidentes. Los avances en las imágenes multimodales permitieron caracterizar este trastorno de retina y crear nuevos conceptos. Serraf, en el 2013, identificó dos formas por medio de la tomografía de coherencia óptica dominio espectral: el tipo 1 conocido como maculopatía paracentral aguda media en la cual se observa una banda hiperreflectiva en la capa nuclear interna, y el tipo 2 en el cual la banda hiperreflectiva se ubica en la capa nuclear externa, que involucra la zona elipsoide y la zona de interdigitación con el epitelio pigmentario de la retina. Hasta el momento no existe cura; pero se puede actuar sobre los factores de riesgo. Por ser una condición rara y por no existir reportes hasta el momento en Cuba es que se presentan a continuación dos pacientes con cuadros clínicos similares de estas dos variantes; concluyendo la importancia que presentan las imágenes multimodales como medio auxiliar diagnóstico.

Acute macular neuroretinopathy is a rare condition with complex pathogenesis and microvascular cause. It appears with acute onset, with paracentral scotomas corresponding to obvious paramacular lesions. Advances in multimodal imaging made it possible to characterize this retinal disorder and to create new concepts. Serraf, in 2013, identified two forms by spectral domain optical coherence tomography: type 1, known as paracentral acute middle maculopathy, in which a hyperreflective band is observed in the inner nuclear layer; and type 2, in which the hyperreflective band is located in the outer nuclear layer, involving the ellipsoid zone and the zone of interdigitation with the retinal pigment epithelium. Up to this moment, there is no cure; but it is possible to act on the risk factors. Because it is a rare condition and because there are no reports so far in Cuba, two patients with similar clinical pictures of these two variants are presented; concluding the importance of multimodal images as an auxiliary diagnostic tool.

Scleral thickness in normal Indian eyes measured using spectral domain anterior segment optical coherence tomography

Purpose: To establish normative data on anterior scleral thickness using the spectral domain anterior segment optical coherence tomography (AS?OCT). Methods: In total, 200 eyes of 100 healthy subjects underwent AS?OCT scans in the temporal and nasal quadrants. The scleral + conjunctival complex thickness (SCT) was measured by a single examiner. Mean SCT was analyzed for differences across age groups, gender, and location (nasal versus temporal). Results: Mean age was 46.4 ± 18.3 (21–84) years; male to female ratio was 54:46. Mean SCT (nasal + temporal) of the right eye (RE) was 682.3 ± 64.2 ?m in males and 660.6 ± 57.1 ?m in females. In the left eye (LE), it was 684.6 ± 64.9 ?m in males and 661.8 ± 49.3 ?m in females. These differences between male and female for both eyes were statistically significant (P = 0.006 and P = 0.002). The mean SCT of temporal and nasal quadrants in the RE was 678.54 ± 57.50 and 666 ± 66.2 ?m, respectively. In the LE, the temporal mean SCT quadrant was 679.6 ± 55.8 ?m, and the nasal was 668.6 ± 63.6 ?m. Age had a negative correlation with SCT (?0.62 ?m/year; P = 0.03), and males had a higher temporal SCT than females (22 ?m higher; P = 0.03). After adjusting for age and gender in a multivariate analysis, temporal SCT was significantly (P < 0.001) higher than nasal SCT. Conclusion: In our study, mean SCT decreased with age and males had a higher temporal SCT. This is the first study to evaluate scleral thickness in the Indian population, and the data can be used as a baseline for comparing variations in scleral thickness in disease.

Síndrome uveomeningoencefálico Vogt Koyanagi-Harada con desprendimiento de la capa bacilar de la retina / Vogt Koyanagi-Barada uveomeningoencephalic syndrome with detachment of the bacillary layer of the retina

Introducción: El síndrome de Vogt-Koyanagi-Harada pertenece a los síndromes uveomeníngeos y es una de las principales enfermedades que amenazan la visión. Se caracteriza por una uveítis bilateral que se asocia frecuentemente con manifestaciones neurológicas, auditivas y tegumentarias. Recientemente un fenotipo particular de engrosamiento macular se ha descrito como desprendimiento bacilar asociado a esta enfermedad. Objetivo: Describir el desprendimiento bacilar de la retina mediante la tomografía de coherencia óptica de dominio espectral en un caso de Vogt Koyanagi Harada en fase uveítica. Presentación de caso: Paciente femenina de 46 años de edad atendida en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" con disminución de agudeza visual en ambos ojos y panuveitis bilateral. Fue diagnosticada con síndrome de Vogt-Koyanagi-Harada en su fase uveítica aguda con presencia de manifestaciones neurológicas y desprendimiento de la capa bacilar de la retina identificado mediante la tomografía de coherencia óptica de dominio espectral. Conclusiones: El síndrome de Vogt-Koyanagi-Harada aguda y el desprendimiento bacilar de la capa de la retina pueden diferenciarse de otros signos mediante la tomografía de coherencia óptica de dominio espectral. Su desaparición pudiera tener una relación con la mejoría de la agudeza visual(AU)

Introduction: Vogt-Koyanagi-Harada syndrome belongs to the uveomeningeal syndromes and is one of the major vision-threatening diseases. It is characterized by bilateral uveitis, which is frequently associated with neurological, auditory and integumentary manifestations. Recently a particular phenotype of macular thickening has been described as bacillary detachment associated with this disease. Objective: To describe bacillary retinal detachment using spectral domain optical coherence tomography in a case of Vogt Koyanagi Harada in uveitic phase. Case presentation: 46-year-old female patient attended at the Cuban Institute of Ophthalmology "Ramón Pando Ferrer" with decreased visual acuity in both eyes and bilateral panuveitis. She was diagnosed with Vogt-Koyanagi-Harada syndrome in its acute uveitic phase with presence of neurological manifestations and detachment of the bacillary layer of the retina identified by spectral domain optical coherence tomography. Conclusions: Acute Vogt-Koyanagi-Harada syndrome and bacillary retinal layer detachment can be differentiated from other signs using spectral-domain optical coherence tomography. Their disappearance could be related to the improvement of visual acuity(AU)

Myopia, axial length, and optic coherence tomography characteristics of the macula in Indian children

Background: Myopia is a common condition affecting a significant proportion of the pediatric population in Asian countries. Aim and Objectives: This study was undertaken to investigate the associations of optical coherence tomography measurements of macular volume and macular thickness with refractive error and axial length in Indian children. Materials and Methods: The prospective observational study was carried out at MRA Medical College, Ambedkar Nagar, Uttar Pradesh. We enrolled 300 consecutive cases (190 cases and 110 controls) of pediatric age group (6–18 years) between January 2015 and December 2018. Pearson’s correlation was performed with refractive errors, axial length, macular thickness, and volume. Results: Children with myopia (SE ?0.5–?4.57 D) tended to have smaller total macular volume and thinner macular thickness as, compared to control. The correlation of macular thickness and macular volume was analyzed with spherical equivalent (SE) and axial length. Macular thickness had negative correlation with SE and positive with axial length, correlation coefficients being observed as (r = ?0.886 and 0.880, P ? 0.001). Total macular volume correlated negatively with SE, (r= ?0.771, P ?0.001) and positively with axial length (r = 0.764, P ?0.001). Conclusion: Increasing axial myopia was associated with increased macular volume and thickness. It establishes the importance of the fact that refractive error should be considered in the interpretation of macular thickness.

Features of Henle fiber layer by spectral domain optical coherence tomography in central serous chorioretinopathy / 中华实验眼科杂志

Objective:To observe the features of Henle fiber layer (HFL) in eyes with central serous chorioretinopathy (CSC) using spectral domain optical coherence tomography (SD-OCT).Methods:A cross-sectional study was conducted.Thirty-five CSC patients (35 eyes) treated in the Third People's Hospital of Qingdao from January 2017 to November 2021 were enrolled.The subjects included 23 males (23 eyes) and 12 females (12 eyes), aged 24 to 60 years old, with an average age of (41.14±8.19) years, and had a CSC duration ranged from 1 day to 6 months.SD-OCT was performed on all eyes with a line scan through the central fovea horizontally.The features of HFL over subretinal fluid (SRF) area were analyzed and summarized.The study protocol adhered to the Declaration of Helsinki and was approved by the Ethics Committee of the Third People's Hospital of Qingdao (No.2022Y0403001).Results:In 26 eyes with regular dome-shaped neurosensory retinal detachment, HFL appeared to be delimited type 1 in 25 eyes, accounting for 96.15%, delimited type 2 in 7 eyes, accounting for 26.92%, bright in 17 eyes, accounting for 65.38% over SRF area.In 21 eyes with CSC duration≤21 days, HFL all showed delimited type 1 and some presented bright or delimited type 2 at the same time.In 5 eyes with CSC duration>21 days, HFL all showed bright and some were delimited type 1 or delimited type 2 in the meantime.In 15 eyes with symmetrical nasal and temporal retinal detachment, HFL showed symmetrical reflectivity over SRF area in horizontal OCT images in 6 eyes, and showed brighter reflectivity over nasal SRF in nasal elevated OCT images in 3 eyes and over temporal SRF in temporal elevated OCT images in 6 eyes.In 11 eyes with asymmetrical nasal and temporal retinal detachment, HFL showed brighter reflectivity over temporal SRF with larger retinal detachment range on temporal side in horizontal OCT images in 3 eyes.Of the 4 eyes with nasal elevated OCT images, the retinal detachment range was larger on temporal side and HFL showed symmetrical reflectivity over SRF area in 3 eyes, and HFL was brighter over nasal SRF area with larger retinal detachment range on nasal side in 1 eye.Of the 4 eyes with temporal elevated OCT images, the retinal detachment range was larger on nasal side and HFL showed symmetrical reflectivity over SRF area in 3 eyes, and HFL was brighter over nasal SRF area with larger retinal detachment range and higher height on nasal side in 1 eye.In 9 eyes with irregular neurosensory retinal detachment, HFL appeared to be delimited type 1 in 7 eyes, accounting for 77.78%, delimited type 2 in 5 eyes, accounting for 55.56%, bright in 6 eyes, accounting for 66.67%, dark in 4 eyes, accounting for 44.44%, and indistinct in 2 eyes, accounting for 22.22%.The detached neurosensory retina was not smooth in 7 eyes, and the phenotypes of HFL changed with the directions of detached neurosensory retina.In 2 eyes with only low neurosensory retinal detachment, HFL reflectivity on the raised side was slightly weaker than that on the lowered side.Conclusions:HFL appears to be delimited type 1 and bright mostly over SRF area in CSC in SD-OCT images.The phenotypes of HFL vary regularly with the tilt directions of OCT images, CSC duration, and the symmetry, range, height, directional characteristics of detached neurosensory retina.

Value of spectral domain-optical coherence tomography parameters on evaluating visual acuity improvement after internal limiting membrane peeling of macular hole / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the application value of spectral domain-optical coherence tomography(SD-OCT)parameters on evaluating visual acuity improvement after internal limiting membrane peeling of macular hole.METHODS: The retrospective analysis was performed on the clinical data of 82 patients(82 eyes)with idiopathic macular hole(IMH)who underwent vitrectomy + internal limiting membrane peeling + long-acting gas tamponade in the hospital between May 2019 and February 2021. The correlation between IMH closure and SD-OCT parameters at 3mo after surgery was analyzed, and the risk factors for poor postoperative visual acuity improvement were evaluated.RESULTS: Spearman rank correlation coefficient analysis showed that IMH closure at 3mo after operation was positively correlated with preoperative external limiting membrane(ELM)defect diameter(rs=0.308, P&#x003C;0.05), and it was negatively correlated with preoperative macular hole index(MHI; rs=-0.266, P&#x003C;0.05). Logistic regression analysis revealed that preoperative MHI≥0.5 was a protective factor affecting poor postoperative visual acuity improvement(OR=0.691, P&#x003C;0.05).CONCLUSION: SD-OCT can predict the surgical efficacy by detecting the preoperative MHI and ELM defect diameter, and it is beneficial to judging the improvement of visual function.

Punctate inner choroidopathy in a young Filipino female: A case report

@#A 30-year-old, monocular myopic female consulted for new onset scotoma on her left eye. Best corrected visual acuity was 20/20 for the left eye. Fundus exam revealed a hypopigmented lesion in the inferior juxtafoveal area with no overlying vitreous reaction/opacity. Spectral domain optical coherence tomography (SD-OCT) showed focal disruption and elevation of the inner choroid and retinal pigment epithelium (RPE), indicating punctate inner choroidopathy (PIC). OCT angiography (OCT-A) revealed the presence of a choroidal neovascular membrane (CNV) on RPE-RPE fit segmentation. The CNV and lesion resolved upon treatment with one intravitreal bevacizumab injection and oral prednisone 60 mg (1.2 mg/kg body weight) per day tapering over 2 months. This is the first reported case of PIC in a Filipino that was diagnosed and treated with the guidance of high-resolution SD-OCT and OCT-A. These diagnostic tests proved useful in identifying the lesions based on cross-sectional views of the retina, RPE and choroid.

Comparison of spectral-domain optical coherence tomography parameters between the eyes of anisometropic amblyopia children and normal eyes / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the thickness of retina in macular area and retinal nerve fiber layer(RNFL)around optic disc between the eyes of monocular anisometropic amblyopia children and normal eyes.METHODS: A total of 62 children(124 eyes)with monocular anisometropic amblyopia who were treated in Chengdu Women's and Children's Central Hospital from January 2021 to October 2022 were selected as the experimental group, and 60 children(60 eyes; right eye)with normal vision who were treated in the same period were selected as the control group. Spectral-domain optical coherence tomography(SD-OCT)was used to detect the retinal thickness in macular region and the RNFL thickness around optic disc in the two groups, and comparative analysis was performed.RESULTS: The retinal thickness and perioptic RNFL thickness of amblyopic children in experimental group were thicker than those in control group, and most of them had significant differences(P&#x003C;0.05). The retinal thickness and perioptic RNFL thickness of contralateral non-amblyopic children in experimental group were thinner than those in control group, but there were no significant differences in most of them(P&#x003E;0.05).CONCLUSIONS: There are differences in the retinal thickness of the macula and perioptic RNFL in the amblyopic eye and the contralateral non-amblyopic eye of monocular anisometropic amblyopic children compared with normal eyes, and the contralateral non-amblyopic eye is not completely equal to the normal eye.

Increase in anterior chamber angle depth after topical pilocarpine measured by spectral domain optical coherence tomography: A possible additional indicator for laser peripheral iridotomy in primary angle-closure suspects in an opportunistic set-up

Purpose: Indication of laser peripheral iridotomy (LPI) is often conjectural due to dependency on gonioscopy and strict dichotomous classification of occludability. Indentation gonioscopy is the gold standard but is under?utilized for various reasons. The prevalence of primary angle closure disease (PACD) in eastern India is 1.5–1.9%, with a 22% five?year progression rate. Many angle closure patients may go blind without timely diagnosis and iridotomy. General ophthalmologists need alternate, validated methods for diagnoses. Pilocarpine eye drop causes miosis, and flattens the iris, producing angle changes detectable by spectral domain optical coherence tomography (SD?OCT). We hypothesized that the amount of angle change may be a suitable indicator for iridotomy. Methods: Our prospective cross?sectional single?masked observational study evaluated pilocarpine?induced changes in angle parameters detected by SD?OCT. Out of 372 patients enrolled, 273 patients (539 eyes) remained, with a mean age of 48.6 years (SD = 10.36). All eyes were graded by the Van Herick (VH) method, gonioscopy, and anterior segment (AS) SD?OCT and reassessed after pilocarpine drops. Results: The sensitivity and specificity of tomography measurements against gonioscopy grades were 61% and 85%, respectively. The receiver operating characteristic (ROC) curve was 0.85. Pilocarpine?induced angle widening was significant in gonioscopically narrower angles. Low Van Herick grades (217 eyes), narrow gonioscopy grades (238 eyes), and a narrow OCT angle value (165 eyes) were candidates for iridotomy. Conclusion: Our study results showed that pilocarpine?induced angle widening detected by SD?OCT could be a strong objective indicator for LPI

External Limiting Membrane, Photoreceptor Ellipsoid Zone Disruption, and Retinal Pigment Epithelium Alterations in Diabetic Retinopathy

Objective?Diabetic retinopathy (DR), a microvascular complication of diabetes, is a leading cause of preventable blindness. Spectral domain optical coherence tomography (SD-OCT) provides cross-sectional and topographical imaging of the retina. SD-OCT resolves outer retinal layers into three hyperreflective bands—external limiting membrane (ELM), ellipsoid zone (EZ), and retinal pigment epithelium (RPE). In this article, we have studied the role of these outer retinal layers in structural and molecular changes taking place in DR. Materials and Methods?Articles with clinical features, pathogenesis, diagnosis, and treatment of DR were thoroughly studied. Articles were searched on PubMed, MEDLINE, and Cochrane Library from 2000 to 2020. Studies focusing on the role of ELM, EZ, and RPE in pathogenesis of DR based on SD-OCT were included. Results?The long-standing hyperglycemia leads to protein glycosylation resulting in formation of advanced glycation end products (AGEs). AGEs have an impact through their effect on retinal microvasculature, vascular endothelial growth factor (VEGF), intercellular adhesion molecule-1, nitrosative and oxidative stress, and vitamin D and calcium metabolism. All these factors have been linked with disruption of outer retinal layers. AGEs lead to vascular endothelial dysfunction and release of proangiogenic factors by increasing the expression of VEGF in retinal pericytes and RPE cells. This leads to leakage and fluid accumulation resulting in diabetic macular edema (DME). In DME, there is sequential disruption of ELM and EZ and decrease in visual acuity (VA). The RPE alterations have been reported to be associated with the severity of DR and decrease in VA. Anti-VEGF therapy, most common treatment of DME, leads to restoration of barrier effect of ELM, it was found to be restored first followed by EZ restoration. Newer anti-AGEs agents and their receptor blockers are being developed which have a positive effect on maintaining the health of RPE. Conclusion?A complex molecular association exists between the structural changes in ELM, EZ, and RPE in DR. SD-OCT is an indispensable tool to study these changes as integrity of these outer layers of retina is essential for maintaining visual function of retina in DR.

Postoperative microstructural re-modelling and functional outcomes in idiopathic full thickness macular hole

Purpose: To analyze the effect of various macular hole indices and postoperative microstructural changes of all retinal layers on postoperative functional outcomes in patients with idiopathic full?thickness macular hole (FTMH). Methods: In this prospective study, pre and post?operative optical coherence tomography (OCT) scans of 36 eyes with idiopathic FTMH were analyzed. Hole indices and microstructural changes of all retinal layers such as ellipsoid zone (EZ), external limiting membrane (ELM) integrity, outer and inner retinal defects, and cystoid resolution were studied on follow?up visits. Results: Out of 36 eyes, type?1 closure was achieved in 23 eyes (65.7%) and type?2 closure in 11 eyes (31.42%), one eye showed persistent hole, and one eye was lost to follow?up. The mean minimum diameter of hole (P = 0.026), mean MHI (P = 0.001), DHI (P = 0.158), THI (P = 0.001), and HFF (P < 0.001) showed statistical significance with the type of hole closure. Postoperatively, eyes with intact ELM and EZ had better BCVA at the final visit. The BCVA was better by logMAR 0.73 ± 0.38 (P < 0.001) in patients with absent outer retinal defects. There was a significant difference in BCVA of 0.52 ± 0.35 at 1 month and 0.64 ± 0.34 at 6 months in eyes without inner retinal defects (P < 0.001). At 6 months, cystoid resolution was observed in 28 (80%) eyes. BCVA was significantly better at 1 month (P < 0.001) and at 6 months (P = 0.001) in eyes with no DONFL. Conclusion: Macular hole indices determine the closure type. Postoperative regeneration of outer retinal layers and resolution of retinal defects significantly influence the final visual outcomes. ELM recovery is seen as a prerequisite for EZ regeneration with no new IRD after a period of 3 months

Corneal and corneal epithelial thickness distribution characteristics in healthy North Indian eyes using spectral domain optical coherence tomography

Purpose: To determine the pattern of corneal thickness and epithelial thickness distribution in healthy North Indian eyes by using spectral domain optical coherence tomography (SD?OCT). Methods: The observational study measured total corneal and epithelial thickness in the central 2 mm zone and eight sectors each in paracentral 2�mm (ring 1) and midperipheral 5�mm (ring 2) zones on SD?OCT. Results: The study included 67 eyes of 67 subjects with a male:female ratio of 32:35 and mean age of 25.04 � 4.54 years. The mean central corneal and epithelial thicknesses were 505.97 � 30.12 ?m and 60.48 � 8.37 ?m, respectively. The epithelium of inferior and infero?nasal sectors in ring 1 and inferior sector in ring 2 was significantly thicker than the radially opposite sectors of the respective rings (P = 0.001; P = 0.01 and P = 0.02, respectively). Sector?wise analysis did not reveal any significant correlation between the total corneal thickness and epithelial thickness (all P > 0.05) except in the outer superior sector where there was a weak positive correlation (r = 0.28, P = 0.02). Central epithelial thickness in males (60.59 � 9.28 ?m) and females (60.37 � 7.58 ?m) was comparable (P = 0.91). Pachymetry was thinnest in the inferior, inferonasal, and inferotemporal sectors in 44.79% of eyes (n = 30), while thinnest epithelium was seen in the superior, superonasal, and superotemporal quadrants in 50.75% of eyes (n = 34). Conclusion: The epithelial thickness distribution in this sample of topographically normal healthy North Indian eyes was nonuniform and independent of the underlying corneal thickness. Epithelium was thinner in the superior cornea, whereas total corneal thickness was minimum in the inferior part

Macular microstructural changes in patients with rhegmatogenous retinal detachment after silicone oil tamponade evaluated by SD-OCT / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To evaluate the macular microstructural changes in patients with rhegmatogenous retinal detachment(RRD)after silicone oil tamponade by spectral-domain optical coherence tomography(SD-OCT).METHODS:From November 2019 to July 2021, 27 patients with 27 eyes in RRD who underwent vitrectomy combined with silicone oil tamponade in Cangzhou Aier Eye Hospital were enrolled in this study as the observation group, other 30 healthy volunteers with 30 eyes were included in the control group. The best corrected visual acuity(BCVA)of patients before and after operation were observed, and quantified evaluation of the postoperative macular microstructural changes were performed by SD-OCT.RESULTS: The BCVA(LogMAR)of the observation group at 1wk and 3mo after operation(0.61±0.23, 0.69±0.34)were improved compared with those before operation(1.43±0.77)(all P<0.01). The cube volume and average cube thickness in the macular area at 3mo after operation in the observation group were lower than those at 1wk and 1mo after operation in the control group(all P<0.05). There were no differences in the average ganglion cell-inner plexiform layer(GCIPL)thickness, minimum GCIPL thickness, average macular retinal nerve fiber layer(mRNFL)thickness and minimum mRNFL thickness at 1wk, 1 and 3mo after operation in the observation group, but all decreased compared with the control group(all P<0.01). There were 9 eyes with subretinal fluid(SRF)in the observation group during postoperative follow-up, SRF had a tendency to be gradually absorbed, but 1 eye had a secondary macular hole; 3 eyes had ellipsoid zone disruption, which had a tendency to be gradually repaired; 2 eyes had submacular perfluorocarbon liquid; 2 eyes had macular edema.CONCLUSION: SD-OCT can show the microstructure and morphological changes very well in macular area in patients with RRD after silicone oil tamponade, and has important clinical value for the preoperative and postoperative follow-up evaluation of RRD.

Multimodal imaging analysis of congenital optic disc pit / 中华实验眼科杂志

Objective:To analyze the characteristics of eyes with congenital optic disc pits (ODPs) through multimodal imaging.Methods:A cross-sectional study was conducted.Thirty-eight patients (38 eyes) diagnosed with congenital ODPs in the Second Hospital of Hebei Medical University from January 2009 to January 2020 were enrolled.A comprehensive summary analysis of the imaging results including fundus photography, spectral domain-optical coherence tomography (SD-OCT), infrared imaging, fundus autofluorescence (FAF), fluorescein fundus angiography (FFA) and indocyanine green angiography (ICGA) was performed.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of The Second Hospital of Hebei Medical University (No.2021-P011). Written informed consent was obtained from each subject prior to any medical examination.Results:Among the 38 eyes, there were 32 eyes with ODPs located in or below the temporal side of optic disc, 4 eyes with ODPs located above the temporal side of optic disc, and 2 eyes with ODPs located at the center of optic disc, which were round or quasi-circular pale depression, and dark red eminences with clear or unclear boundaries between milk spots were found in 29 eyes with optical-disc macular degeneration (ODP-M) by fundus photography.SD-OCT examination showed that the structure of lamina cribrosa in the lesion area in all ODPs patients was incomplete, which presented a dark area with no tissue reflection, and the fissure led to the deep optic nerve.Fluid was found in the outer nuclear layer in all ODP-M patients, and there were 27 eyes with fluid in the inner nuclear layer, 13 eyes in the ganglion cell layer, and 4 eyes under the inner limiting membrane.Among the 29 eyes with ODP-M, there were 21 eyes with retinoschisis in outer layer, 27 eyes with neuroepithelial detachment.In the 27 eyes with neuroepithelial detachment, spot-like high reflection and reduced or disappeared ellipsoid band reflectance were seen above the neuroepithelium in 18 eyes.In infrared images, there were circular or quasi-circular low-reflection areas in the temporal side of the optic disc, and the lesion of ODP-M eyes presented low-reflection areas.FAF examination showed that in 27 eyes with ODP-M, there was a hypofluorescent region at the posterior pole consistent with the lesion range, among which, there was a granular or sheet-like hyperfluorescence at the center of the hypofluorescent region in 18 eyes.FFA showed that the optic disc depression in the arterial phase of patients was in a localized hypofluorescence state.During the venous phase, fluorescein dye extravasation along the temporal side of the optic disc could be found.A strong fluorescent arc with unclear boundaries at the temporal edge of the optic disc was formed in the late stage of angiography.Among the 29 eyes with ODP-M, the area of the macular lesion showed hyperfluorescence during the late stage of angiography in 27 eyes with neuroepithelial detachment, and no extension of dye toward the macula was found.ICGA showed that the optic disc depression of ODPs patients presented a localized hypofluorescence, and the lesion showed hyperfluorescence in 27 of the 29 ODP-M eyes with neuroepithelial detachment.Conclusions:Multimodal imaging can be helpful to realize the early diagnosis, etiology analysis of ODPs and make treatment plan.

Quantitative assessment of choroidal vascular sublayers in patients with pre-eclampsia compared to healthy pregnant women / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To quantitatively assess choroid vascular sublayers in women with pre-eclampsia(PE)compared to healthy pregnant women.<p>METHODS: This cross-sectional observational study enrolled 100 subjects, including 40 healthy non-pregnant women, 23 healthy pregnant women, and 37 women with PE. Spectral-domain optical coherence tomography(SD-OCT)was used to measure the choroidal thickness(CT)at the fovea and four additional sites that were 750 μm nasal/temporal or 1 500 μm nasal/temporal to the fovea, and designated as subfoveal choroidal thickness(SFCT), N750, T750, N1500, and T1500, respectively. The thickness of two choroidal vessel layers, Sattler's and Haller's layers, also were quantitatively assessed. <p>RESULTS: No significant differences in mean age or spherical equivalent were observed among the three groups(<i>P</i>=0.240, 0.338). No difference was observed in gestational ages between the healthy pregnant women and PE patients(<i>P</i>=0.783). Significant differences were observed in large choroidal vessel thickness(LCVT), medium choroidal vessel thickness(MCVT), and SFCT at the five sites among the three groups(<i>P</i><0.05). Compared with normal non-pregnant women, a significant increase in LCVT, MCVT, and SFCT was detected at the five sites in healthy pregnant women(<i>P</i><0.05). LCVT and SFCT in PE patients were significantly greater at the five sites compared to normal pregnant women(<i>P</i><0.05), while MCVT was not different(<i>P</i>=0.709).<p>CONCLUSION: This study demonstrated that the vascular sublayer thickness of the choroid was significantly increased in pregnancy and PE. Moreover, the increase in CT thickness might be due to the thickening of Haller's layer. We also observed that the nasal CT increased more than the temporal CT in PE patients and normal pregnant women. We suggest that parasympathetic and sympathetic mediated regulation and nonvascular smooth muscle cells might play a role in the choroidal vascular sublayer thickness variations observed in pregnancy and PE.

Choroidal thickness in primary angle-closure disease / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To measure the macular and peripapillary choroidal thickness(CT)in primary angle-closure disease(PACD)with enhanced depth imaging optical coherence tomography(EDI-OCT). To explore the characteristics of CT in each subtypes of PACD and to evaluate its role in the pathogenesis of PACD.<p>METHODS: This was a prospective clinical study. A total of 155 PACD eyes(82 patients)were enrolled in the study, including 24 PACS eyes(24 patients), 35 APAC eyes(28 patients), 38 CPAC eyes(30 patients), 58 eyes PACG(38 patients). 87 normal eyes(87 patients)were set up as control. The EDI-OCT was used to measure the macular and peripapillary choroidal thickness in all study patients. <p>RESULTS: PACD eyes exhibited thicker choroid than the control eyes at all macular locations(<i>P</i><0.05). Choroidal thickness of PACG was thinner than other PACD eyes in area except for 3mm nasal from the fovea(<i>P</i><0.05). Subfoveal choroidal thickness(SFCT)of APAC was thickest(357.17±61.49μm), followed by PACS group(318.04±56.52μm). PACG group presented the thinnest SFCT(263.55±67.87μm). The average macular CT at 1mm centered at the fovea was thinner than SFCT(<i>P</i><0.05)in all subgroups except for CPAC. The average macular CT at 3mm as well as 1mm centered at the fovea was thinner than SFCT in all subgroups(<i>P</i><0.05). There was no statistical differences in CT at peripapillary locations between PACD and controls groups(<i>P</i>>0.05).<p>CONCLUSION: In PACD and controls groups, the CT of subfoveal location was the thickest with decreasing thickness when moving eccentrically from the fovea. The thicker CT might be another anatomic characteristic of PACD. Increased CT in macular location might be a contributing factor of acute attacks. There was no characteristic distinction in the peripapillary CT of PACD when compared with normal controls.

Efficacy of internal limiting membrane insertion in the treatment of refractory macular holes evaluated by SD-OCT / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the efficacy of pars plana vitrectomy combined with internal limiting membrane(ILM)insertion for the treatment of refractory macular holes(MH)by spectral-domain optical coherence tomography(SD-OCT). <p>METHODS: Retrospective analysis was conducted in 17 patients(17 eyes)with refractory MH from July 2019 to December 2020. All patients were treated with pars plana vitrectomy combined with ILM insertion. Preoperative and postoperative best corrected visual acuity(BCVA)were compared. Quantified evaluation of the postoperative macular restoration was performed by SD-OCT. <p>RESULTS: The widths of ellipsoid zone disruption were 839.00-1577.50μm, with an average of 1182.90±226.68μm. During the follow-up period(3-12mo), 17 cases achieved successful closure(100%), and no recurrence was seen. Postoperative BCVA was significantly improved compared with preoperative(<i>P</i><0.01). The widths of external limiting membrane disruption and ellipsoid zone disruption were smaller gradually at 1wk and 3mo after surgery compared with preoperative(all <i>P</i><0.01). But the continuity was still not restored. The thickness of the central fovea of macula(within 1mm diameter range)at 1wk and 3mo after surgery decreased significantly compared with preoperative(all <i>P</i><0.01).<p>CONCLUSION: Pars plana vitrectomy combined with ILM insertion proves to be effective to achieve anatomical and functional improvement in the treatment of refractory MH. SD-OCT has important clinical value in the diagnosis and postoperative follow-up evaluation of refractory MH.

A preliminary study of choroidal vascular index in patients with diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the differences of the choroidal vascularity index between type 2 diabetes with diabetic retinopathy and non-diabetes patients.<p>METHODS: A retrospective cross-sectional study was performed at Beijing Friendship Hospital. Enhanced depth imaging spectral-domain optical coherence tomography(EDI-OCT)scans of 68 eyes of 68 type 2 diabetes who with diabetic retinopathy were compared with those of right eyes of 34 age- and gender-matched healthy controls. The choroidal images were binarized into luminal areas(LA)and stromal areas(SA). CVI was defined as the ratio of LA to total circumscribed subfoveal choroidal area. Mean choroidal thickness, mean retinal thickness and mean CVI between patients and controls were compared using <i>t</i>-test. <p>RESULTS: There were no significant differences in total circumscribed subfoveal choroidal area(0.53±0.14mm2 <i>vs</i> 0.49±0.15mm2), LA(0.35±0.09mm2 <i>vs</i> 0.32±0.10mm2), SA(0.17±0.05mm2 <i>vs</i> 0.17±0.06mm2), or subfoveal choroidal thickness(347.9±76.9μm <i>vs</i> 325.9±92.9μm)between patients with DR and controls(<i>P</i>>0.05). However, there was a significantly lower CVI in patients with diabetes as compared to controls(64.33%±3.25% <i>vs</i> 67.04%±2.46%, <i>P</i><0.001). The critical value was 63.59%.<p>CONCLUSION: CVI is a kind of biological indicators which can directly reflect the changes of choroidal internal structure, and it is more stable and reliable than SFCT. For type 2 diabetic patients who with diabetic retinopathy, CVI is lower than that of healthy people.

Structure-function correlation of juxtapapillary choroidal thickness with visual field analysis of patients suspected with glaucoma

Purpose@#To conduct an evaluation of juxtapapillary choroidal thickness of patients suspected with glaucoma obtained through spectral domain optical coherence tomography (SD-OCT) and correlate it with perimetry results.@*Methods@#Design: Cross-sectional Study. Population: 175 eyes diagnosed as “glaucoma suspect” had standard automated perimetry (SAP) to document the presence of functional glaucomatous damage using optimal near-point correction using the Humphrey Visual Field Analyzer II, 30-2 or 24-2 SITA-standard program. SD-OCT imaging of the retinal nerve fi ber layer (RNFL) was also done to look for structural glaucomatous damage and in using enhanced depth imaging of the optic nerve and the Cirrus caliper tool, choroidal thickness was measured at fi ve predetermined points temporal and nasal from the optic nerve. The population was classifi ed into two groups: Group 1 are those with structural or functional glaucomatous damage (n=68) and Group 2 were those without (n=107).@*Results@#One-Way Multivariate Analysis of Covariance was used in comparing the mean temporal and nasal choroidal thickness scores of the two groups. There are no statistical differences in terms of the mean temporal choroidal thickness (p=0.856) and mean nasal choroidal thickness (p=0.734) between patients with and without glaucomatous damage. The mean temporal and nasal choroidal thickness scores of the two groups at different juxtapapillary locations: 0 μm, 250 μm, 500 μm, 750 μm and 1000 μm away from the disc were also not statistically different.@*Conclusion@#Results show that from this present cohort of glaucoma suspect patients, juxtapapillary choroidal thickness is not correlated with structural and functional glaucomatous damage.