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AIM: To investigate the relationship between blood biochemical parameters and choroidal thickness(CT)in na&#xEF;ve-treatment of patients with nonproliferative diabetic retinopathy(NPDR).METHODS: Prospective cross-sectional study. A total of 92 patients(92 eyes)with na&#xEF;ve-treated NPDR were selected in the Affiliated Eye Hospital of Nanchang University from July 2021 to July 2022. All of the patients included in this study were subjected to ophthalmologic examination including enhanced depth imaging optical coherence tomography(EDI-OCT), best corrected visual acuity(BCVA), fundus fluorescence angiography, intraocular pressure, slit lamp and fundus examination. At the same time, they were also underwent hematological examination including blood glucose, glycosylated hemoglobin(HbA1c), serum creatinine, uric acid, urea, β2 microglobulin, high density lipoprotein(HDL), low density lipoprotein(LDL), serum calcium, serum potassium and other tests. According to the glomerular filtration rate(eGFR)and CT, the patients were divided into normal, mild and moderate to severe renal function group, pachychoroid group and the leptochoroid group. The blood biochemical indexes, CT differences and theirs correlation were analyzed in na&#xEF;ve-treated NPDR patients.RESULTS: A total of 92 cases(92 eyes)were included in this study, with 51 males(51 eyes), 41 females(41 eyes), 45 right eyes and 47 left eyes. There was no significant difference in age, axial length and disease duration among the three groups(all P>0.05). There were significant differences in nasal 0.5, 1.5mm, subfoveal and temporal 0.5, 1.5mm CT among three groups(all P<0.05). There was no statistical significance in age, axial length and the course of disease between the pachychoroid and leptochoroid groups(all P>0.05). There were significant differences in creatinine, eGFR, uric acid, urea, potassium and β2-microglobulin between the pachychoroid group and the leptochoroid group(all P<0.05). There were no significant differences in total cholesterol, triglyceride, HDL, LDL, HbA1c, serum calcium and glucose between the two groups(all P>0.05). CT was negatively correlated with creatinine, urea, uric acid and β2-microglobulin, and positively correlated with eGFR. Multiple regression analysis showed that the thicker the nasal 0.5mm CT, the higher the eGFR(B=0.292, P<0.001). CT affected creatinine, eGFR, urea, uric acid and β2-microglobulin(B=16.5, 64.6, 24.1, 18.1, 20.3; P=0.008, <0.001, <0.001, 0.004, 0.001), while there were no significant effects on total cholesterol, triglyceride, glucose, serum calcium, HDL and LDL(all P>0.05).CONCLUSION: In patients with na&#xEF;ve-treated NPDR, the thicker the CT, the better the renal function. The decrease of CT in newly diagnosed NPDR patients is an important hint to pay attention to the renal function.
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High myopia is a state of refractive error with myopia over -6.00D. High myopia is typically accompanied by multiple fundus lesions, thus making patients with high myopia suffer from varying degrees of impairment in visual function. As an emerging auxiliary way in ophthalmology, optical coherence tomography angiography(OCTA)can efficiently and non-invasively obtain microvascular stratified images of the retina and choroid and quantitatively analyze blood flow signals. Since the advent of OCTA, there have been numerous studies observing fundus changes in those with high myopia through OCTA. In this paper, some studies in which OCTA is applied to obtain retinal and choroidal thickness from patients with high myopia are reviewed, with a view to revealing the correlation between high myopia and the parameters such as retinal thickness, choroidal thickness, vessel density and the area of the foveal avascular zone and providing novel ideas to deeply investigate the mechanism of high myopia and delay the occurrence and development of high myopia.
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ABSTRACT Purpose: To investigate the effect of hemoglobin A1c level on central macular thickness and central, nasal, and temporal choroidal thickness in patients with gestational diabetes mellitus. Methods: This retrospective study included 41 patients who had been diagnosed with gestational diabetes mellitus and undergone a 75-g oral glucose tolerance test between 24 and 28 weeks of gestation. They were divided into two groups based on their hemoglobin A1c level (group 1: hemoglobin A1c <6.0% and group 2: hemoglobin A1c ≥6.0%). All patients underwent a complete ophthalmologic examination. The central macular thickness and central, nasal, and temporal choroidal thickness were measured using optical coherence tomography. Results: Of the 3,016 pregnant women screened, 7.5% (n=228) were diagnosed with gestational diabetes mellitus during the study period and 41 of these patients were included in the study. Group 1 comprised 48 eyes from 24 patients and Group 2 consisted of 34 eyes of 17 patients. The average body mass index values were 30.8 ± 3.3 and 35.1 ± 9.0, respectively (p=0.002). The insulin use rates were 29.2% and 76.5%, respectively (p=0.000). Mean central macular thickness values were 250.8 ± 14.3 µm and 260.9 ± 18.1 µm, respectively, and the difference was significant (p=0.008). Conclusions: Although the body mass index and central macular thickness values were significantly higher in Group 2, there was no difference in the central, nasal, and temporal choroidal thickness between the two groups.
RESUMO Objetivos: Investigar o efeito do nível de hemoglobina A1c (HbA1c) na espessura macular central e na espessura da coróide central, nasal e temporal em pacientes com diabetes mellitus gestacional. Métodos: Este estudo retrospectivo incluiu 82 olhos de 41 pacientes diagnosticadas com diabetes mellitus gestacional, as quais fizeram um teste de tolerância oral à glicose de 75 g entre 24 e 28 semanas de gestação. As pacientes foram divididas em dois grupos de acordo com o nível de hemoglobina A1c (hemoglobina A1c <6,0% e hemoglobina A1c ≥6,0%). Todas as pacientes foram submetidas a exame oftalmológico completo e, a espessura macular central, a espessura central, nasal e temporal da coroide foram mensuradas por tomografia de coerência óptica. Resultados: Durante o período do estudo, das 3.016 gestantes triadas, 7,5% (n=228) foram diagnosticadas com diabetes mellitus gestacional. Destas, 41 pacientes foram analisadas de acordo com os critérios do estudo. Houve 48 olhos de 24 pacientes no primeiro grupo com hemoglobina A1c <6,0% e 34 olhos de 17 pacientes no segundo grupo com hemoglobina A1c ≥6,0%. Os valores médios do índice de massa corporal foram de 30,8 ± 3,3 e 35,1 ± 9,0, respectivamente (p=0,002). As taxas referentes ao uso de insulina foram de 29,2% e 76,5%, respectivamente (p=0,000). Os valores médios da espessura macular central foram medidos em 250,8 ± 14,3 µm e 260,9 ± 18,1 µm, respectivamente e a diferença foi significativa entre os dois grupos (p=0,008). Conclusões: Embora os valores do índice de massa corporal e da espessura macular central tenham sido significativamente maiores no Grupo 2 com hemoglobina A1c alta, não houve diferenças nas medidas de espessura coroidal central, nasal e temporal entre os dois grupos.
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Myopia is the most common ametropia. High myopia, especially pathological high myopia, is often accompanied by a series of fundus pathological changes, such as Fuchs spot and choroidal neovascularization(CNV), etc, which can lead to serious damage of visual function. In recent years, it has been found that the changes of choroidal thickness and blood flow play a considerable role in the progression of high myopia. The change of choroidal thickness can directly reflect the abnormality of its structure and function. The choroidal thickness in high myopia is significantly thinner than that in normal people, and the thinning degree varies in different regions. At the same time, the choroid is the main source of blood supply to the eyes, and its blood flow directly determines whether the blood supply is sufficient to the eyes. Therefore, observing the changes of choroidal thickness and blood flow in high myopia is of great significance to explore the progress of myopia or observe its pathological changes. This review illustrates the choroidal structure, thickness and choroidal blood flow changes of high myopia. At the same time, it analyzes and discusses the new research progress and main existing problems in recent years, the new challenges and future research directions, hoping to provide help for clinical monitoring of the occurrence and progression in high myopia.
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@#Amblyopia is a common eye disease in children. If not corrected and treated in time, it will cause irreversible damage to children's vision, resulting in loss of vision in one or both eyes. The pathogenesis of amblyopia is complex, and the specific pathogenesis is not clear at present, mainly focusing on the central theory and peripheral theory. Traditionally, there was no obvious organic change in the fundus of amblyopia patients. In recent years, optical coherence tomography(OCT)technology has developed rapidly. As a convenient and intuitive ophthalmic examination method, OCT has been increasingly used in retinal examination of amblyopia patients due to its advantages of safety, non-invasive, non-contact and rapid and clear. The abnormal anatomy structures of the amblyopia patients in fundus structure are also gradually been found. Providing some evidence and basis for peripheral theory of pathogenesis of amblyopia, amblyopia examine, postoperative evaluation and prognosis. In this article, the applications of OCT in retinal thickness, choroid thickness and vessel density are reviewed.
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@#AIM: To analyze the effects of vitrectomy and macular epiretinal membrane dissection combined with or without internal limiting membrane(ILM)peeling on choroid thickness, vision and metamorphopsia in patients with idiopathic macular epiretinal membrane(IMEM).<p>METHODS: Totally 88 patients(88 eyes)with IMEM admitted to the hospital were selected between January 2016 and January 2020. They were divided into group A and group B by random number table method with 44 eyes in each group. Patients in group A were treated with vitrectomy and macular epiretinal membrane dissection combined with ILM peeling, while patients in group B were treated with vitrectomy and macular epiretinal membrane dissection. The choroid thickness, vision, metamorphopsia, central macular thickness(CMT), ellipsoid zone(EZ)continuity were compared between the two groups.<p>RESULTS: Compared with preoperative, the sub-foveal choroidal thickness(SFCT), choroidal thickness 1 000μm from nasal side central of fovea(NFCT)and choroidal thickness 1 000μm from temporal side central of fovea(TFCT)were significantly reduced in the two groups at 3mo and 6mo after operation(<i>P</i><0.05), but there was no statistically significant difference between the groups(<i>P</i>>0.5). Compared with preoperative, the best corrected visual acuity(BCVA)LogMAR was reduced, while mean sensitivity(MS)was increased in the two groups. The number of scotoma points(SP)increased in group A and decreased in group B. Group A had significantly lower MS and higher SP than group B at 1mo, 3mo, and 6mo after operation(<i>P</i><0.05). Compared with preoperative, the M scores(Angle of view when horizontal and vertical variability begins to disappear)and average M scores of the two groups were significantly reduced at 3mo and 6mo after operation, without statistically significant differences between the groups(<i>P</i>>0.05). Compared with preoperative, CMT was significantly reduced in the two groups at 1, 3 and 6mo after operation. The ratio of EZ continuity in group A at 1mo after operation was significantly lower than that before operation. The CMT of group A was larger than that of group B at 3mo and 6mo after operation(<i>P</i><0.05). No statistically significant differences were found in the ratio of EZ continuity and the incidence of complications between the groups(<i>P</i>>0.05).<p>CONCLUSION: Vitrectomy and macular epiretinal membrane dissection combined with or without ILM peeling both can improve vision and metamorphopsia in patients with IMEM, with similar effects on choroid thickness and safety. However, combined use of ILM peeling will lower MS and increase SP as well as CMT. Therefore, it has no significant advantages in the treatment of patients with IMEM.
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@#AIM: To use spectral domain optical coherence tomography(SD-OCT)to measure macular subfoveal choroid thickness(SFCT)in patients with diabetic retinopathy(DR), observe the changes of SFCT, and to explore the relationship between SFCT and diabetes mellitus and diabetes retinopathy.<p>METHODS: A total of 152 patients with type 2 diabetes(T2DM)were collected and grouped according to their fundus conditions. There were 72 cases in the NDR group and 80 cases in the DR group. Eighty-five healthy subjects were used as the control group. Follow-up according to the clinical stage of DR, where the DR components were mild NPDR, moderate NPDR, severe NPDR and PDR. According to the United Nations World Health Organization, the age group was divided into three age groups: 18-44 years old(youth group), 45-59 years old(middle-aged group), and 60-75 years old(old group). Analyzed and compared the SFCT between each group.<p>RESULTS:There was no statistically significant difference in SFCT between the T2DM group and the control group(<i>P</i>>0.05). The SFCT of the all group was not significantly correlated with age and course of disease(<i>P</i>>0.05); the SFCT of the control group was negatively correlated with age(<i>P</i><0.05), and the SFCT of the elderly group was thinner than that of the middle-aged group and the young group(<i>P</i><0.05). There was no significant difference between young and middle-aged(<i>P</i>>0.05). The SFCT of the T2DM group was thinner than the control group(<i>P</i><0.001), and the SFCT of the NDR group and the DR group were thinner than the control group(<i>P</i><0.001); the difference in SFCT between DR staging was statistically significant(<i>P</i><0.001).<p>CONCLUSION: Age is a related factor that affects SFCT. Diabetic SFCT becomes thinner than normal people, and SFCT thickens with the severity of DR lesions.
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@#Rheumatic immune disease, as a group of recurrent systemic diseases, involves the vascular system through inflammatory factors. Eye reaction can be used as a sign of rheumatic immune reactivation or disease aggravation, together with the first systemic manifestation of rheumatic immune disease. As a part of the most abundant blood flow in the eyes, choroid is an excellent evaluation index for ocular involvement, and it is greatly affected by systemic vascular diseases. And optical coherence tomography provides a scientific and accurate measuring tool for the observation of choroid thickness. However, whether changes in choroid thickness can be utilized as markers of disease activity, and progression, our results require further research. In this paper, the changes of choroid thickness in rheumatic immune diseases are analyzed.
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@#AIM: To explore changes of choroidal blood flow post vitrectomy in idiopathic macular hole(IMH), and to discuss the role of choroidal microstructure changes abnormality in macular hole formation.<p>METHODS: Totally 56 eyes of 56 patients diagnosed with unilateral IMH were included(2014-05/2015-12). All patients received pars planar vitrectomy, indocyanine green assisted inner limiting membrane peeling combined with intraocular +12%C3F8 tamponade. Patients with cataract received phacoemulsification and intraocular lens implantation. Choroidal thicknesses were measured at 9 points before and at 1, 3 and 6mo after the surgery, namely the fovea, 1mm and, 3mm above, below, nasal and temporal to the fovea.<p>RESULTS: Preoperative SFCT value was 233.43±84.638μm, and at 1, 3, 6mo follow-up SFCT were 242.46±88.199μm, 238.97±89.252μm, and 236.71±88.661μm, respectively. SFCT at 1mo after surgery was significantly increased compared to preoperative thickness(<i>P</i><0.05). 1, 3, and 6mo after the surgery the choroidal thickness at 3mm below the fovea(ICT3mm)(179.63±62.941μm, 179.74±65.981μm, 180.80±58.379μm)gradually increased compared with those before the surgery(170.89±57.040μm). However, there was no significant difference between ICT3mm values at each time point. 1, 3, and 6mo after the surgery the choroidal thickness at 1mm below the fovea(ICT1mm)(216.31±80.297μm, 214.54±75.693μm, 205.69±68.697μm)compared with those before the surgery(207.37±67.502μm)have statistical significance. Compared 6mo after the surgery with 1mo after the surgery have statistical significance with ICT1mm values at each time point(<i>P</i><0.05).<p>CONCLUSION: SFCT of the study eyes showed a transient increase at 1mo follow up, then gradually returned to the base line. As the macular hole successfully closed, the choroidal thickness didn't not show difference compared with baseline, indicating that the decreasing in choroidal thickness is possibly the cause to the formation of the macular hole, not the results. IMH postoperative choroidal thickness values change by location, which may be due to the oppression by the injected gas in the macular hole surgery.
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AIM: To investigate the choroidal thickness changes in macular area and facular area of patients with diabetic retinopathy ( DR) after panretinal photocoagulation (PRP). METHODS: Totally 40 cases (78 eyes) of DR patients with PRP in our hospital from January 2015 to January 2017 were selected, and optical coherence tomography (OCT) was conducted for preoperative and postoperative choroidal thickness in macular area and facular area. RESULTS: At 1mo after PRP, the subfoveal choroidal thickness (SFCT), nasal choroidal thickness (NCT), the temporal choroidal thickness (TCT), superior choroidal thickness (SCT),inferior choroidal thickness(ICT) were sharply higher than those before operation, the difference was statistically significant(t=2.016,t=2 017, t=2.001, t=2.264, t=2.229;P<0.05). SFCT,NCT,TCT, SCT and ICT at postoperative 3mo sharply decreased when compared to those before operation, showing statistical significance (t=2.048, t=2.051, t=2.092, t=2 010, t=2.273; P<0.05). Postoperative baseline level average choroidal thickness in facular area of 227. 6士44 9μ m was evidently higher than that at postoperative 1mo (207.1士41.6μ m),the difference had statistical points (t=2.118, P<0.05). The mean thickness at postoperative 3mo (206. 5士41. 3μ m) was apparently lower than the baseline level mean choroidal thickness 227.6士44.9μ m, the difference showed statistical significance(t=2.188,P<0.05). CONCLUSION: The choroid thickness at macular region rises obviously for short term after PRP, while that in facula area reduces markedly, which shows choroidal blood flow redistribution after operation.
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AIM:To determine whether there was a significant relationship between eye iris color with axial length, intraocular pressure, retinal nerve fiber layer (RNFL) thickness, macular thickness and choroidal thickness.METHODS:A prospective cross-sectional study involving 92 eyes of 92 healthy volunteers.These were divided into dark colored-eye (DCE) and light-colored eye (LCE) groups according to iris color.The RNFL and macular thicknesses were analysed with standard optical coherence tomography (OCT) protocol while choroidal thickness was analysed with electronic data interchange (EDI) protocol in all subjects.Choroidal thickness was measured at the fovea, 1500 μm nasal and 1500 μm temporal to the fovea in a horizontal section.RESULTS:Of the 92 eyes included, 62 (67.4%) were dark-colored while 30 (32.6%) were light-colored.The mean age was 29.22±5.86y in the subjects with DCE and 28.86±6.50y in those with LCE.No significant difference was detected in mean age, axial length, macular thickness, choroidal thickness and intraocular pressure (IOP) between the groups (P>0.05).However, RNFL thicknesses varied depending on the quadrant measured, and were lower in both global and the nasal and temporal quadrants for individuals with LCE (P≤0.022).CONCLUSION:No significant differences were found in IOP, macular thickness and choroid thickness between individuals with DCE and LCE.Meanwhile, the RNFL thickness is lower.
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Objective To investigate choroid thickness at horizontal meridian with optical coherence tomography (OCT) and compare the choroid thickness difference between first visit myopia children with those children who wear orthokeratology lens for more than 1 year.Methods This retrospective study enrolled 68 myopia children with low to moderate myopia (-1.00--6.00 D) who visited our hospital and took choroid images by OCT.The total subjects were divided into 2 groups.The subjects of 34 children in group 1 visited for myopia initially and wear spectacles.The other one group wear orthokeratology lens more than 1 year.Only the data of right eye were analyzed.Scans through the fovea at horizontal meridian were acquired with OCT.Choroid images were detected by custom software with 500 μm intervals up to 3.5 mm around fovea.Choroid thickness (CT) was calc~ated based on the average of the 7 zones.Statistical analysis was performed to evaluate choroid thickness at each zone.ANOVA was used to compare choroid thickness differences between various zones in each group.Paired t test was used to compare choroid thickness difference at the same zone between two groups.Results The mean age of OK lens group was (12.3 ± 1.8) years old,and the spectacles group was (11.8 ± 1.4) years old,there was no statistical difference.From temple to nasal choroid,the mean CT of the orthokeratology lens group were (296.7 ± 61.8) μm (T3),(290.7 ± 58.9) μm (T2),(285.7 ± 57.4) μm (T1),(278.5 ±57.7) μm (M),(262.2 ±57.9) μm (N1),(239.8 ±59.7) μm (N2),(214.7 ±59.0) μm (N3);And the mean CT of the spectacles group were (294.2 ± 45.4) μm (T3),(292.0±44.0) μm (T2),(283.6 ±45.5) μm (T1),(272.0 ±51.6) μm (M),(255.2 ± 56.3) μm (N1),(236.5 ±58.1)μm (N2),(212.8 ±57.7) μm (N3),respectively.The thicknesses were significantly thicker in temple zones than that in nasal zones in each group (all P ＜ 0.05),but the CT was not significantly different between the two groups in each zone (all P ＞ 0.05).Conclusion The choroid thickness has regional deference in myopia children,the thickest is in the temple and the thinnest in the nasal region.There is no significant difference between the children who initially corrected by spectacles and those who wear OK lens more than 1 year.