Association of the occurrence of reticular macular diseases with chronic kidney disease based on estimated glomerular filtration rate / 中华实验眼科杂志

Objective:To analyze the relationship between reticular macular disease (RMD) and chronic kidney disease (CKD) by estimated glomerular filtration rate (eGFR).Methods:A cross-sectional study was conducted.Thirty-six consecutive patients (71 eyes) with subretinal drusenoid deposits in at least one eye in optical coherence tomography (OCT) images were enrolled as the RMD group, and 29 consecutive patients (50 eyes) with age-related macular degeneration (AMD) in at least one eye were identified as the non-RMD group at the First Affiliated Hospital of Guangzhou Medical University from February to September 2019.In the same period, 32 healthy volunteers (64 eyes) without eye disease were included as the healthy control group.Serum was collected to calculate the estimated creatinine clearance (eCcr) and the eGFR.The choroidal thickness of macular fovea and the flow density of choroidal capillary layer were measured by OCT.The related factors of RMD and the correlation between CKD and RMD were analyzed by multiple logistic regression analysis.The relationship between eGFR and choroidal capillary blood flow density and foveal choroidal thickness in RMD patients was analyzed by Pearson linear correlation analysis.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the First Affiliated Hospital of Guangzhou Medical University (No.2022-50)Results:The eGFR value of the RMD group was (66.40±27.58)ml/(min·1.73 m 2), which was significantly lower than (84.40±20.91)ml/(min·1.73 m 2) of the non-RMD group and (87.64±22.32)ml/(min·1.73 m 2) of the healthy control group (both at P<0.01). eGFR was significantly correlated with the occurrence of RMD ([odds ratio, OR]=0.973, 95%[confidence interval, CI]: 0.954-0.992, P=0.005). Subgroup analysis showed that this correlation was significant in the CKD stage (eGFR<60 ml/[min·1.73 m 2]) ( OR=6.482, 95% CI: 1.543-27.236, P=0.011). The choroidal thickness of the macular fovea in the RMD group was significantly lower than that of the non-RMD grup and healthy control group (both at P<0.01). In the RMD group, no significant correlation was found between the choroidal thickness of the macular fovea and eGFR ( r=0.138, P>0.05), and the flow density of choroidal capillary layer was moderately positively correlated with eGFR ( r=0.457, P<0.05). Conclusions:There is a correlation between the occurrence of CKD and RMD, which may be due to the confounding effect of the systemic microcirculation disorder.

Research progress in the clinical features of reticular macular disease / 中华实验眼科杂志

Reticular macular disease (RMD) is a novel, independent macular disease closely related to age-related macular degeneration (AMD). It is currently available to identify RMD through a variety of new imaging techniques.The infrared imaging in the confocal scanning laser ophthalmoscopy and spectral domain optical coherence tomography have the highest sensitivity and specificity for the diagnosis of RMD, and the imaging characteristics are significantly different from those of the common drusen.The cause of RMD has a certain correlation with genes, environment, gender, age and systemic diseases, but the specific pathogenesis is still inconclusive.Many studies showing that choroid vascular lesions are closely related, and Bruch membrane lesions may also be the cause of the first appearance of reticular pseudodrusen in some studies.RMD is closely related to advanced AMD, especially geographic atrophy, and some develop advanced wet-AMD.Early intervention may prevent its progression to advanced AMD.In recent years, it has been found to be associated with cardiovascular diseases and some malignant tumors, and may even become a warning sign.Therefore, research on RMD is of increasing importance in clinical implications.In this article, the characteristics of RMD, its clinical and imaging manifestations, changes of visual function and its relationship with fundus and systemic diseases were reviewed.

Application and related study of Hirudo and extract thereof in ophthalmic diseases / 国际眼科杂志(Guoji Yanke Zazhi)

@#Hirudo is highly effective in promoting blood circulation and removing blood stasis, a vital medicine for breaking blood and removing blood stasis in ophthalmopathy. Presently, Hirudo is commonly used in ophthalmology for age-related macular degeneration, diabetic retinopathy, cataract, retinal vein occlusion and other ophthalmic diseases, with the mechanism thereof possibly being related to anti-VEGF, improvement of microcirculation and anti-apoptosis. Further, although new functions have been found in Hirudo extract, such as transdifferentiation and inhibition of WERI-RB-1, these studies remain in the basic exploratory stage, and the specific molecular mechanism requires further verification. This paper concisely describes the application and research status of Hirudo and the extract thereof in ophthalmic diseases, so as to provide a new direction for further research on the treatment of ophthalmopathy using Hirudo and the extract thereof.

An observational study of macular optical density in patients with obstructive sleep apnea hypopnea syndrome / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the change of macular pigment optical density(MPOD)in the patients of obstructive sleep apnea-hypopnea syndrome(OSAHS). <p>METHODS: Totally 70 OSAHS patients as observation group and 32 healthy subjects as control group with their right eyes were enrolled from Chongqing Emergency Medical Center during January to December of 2019. All the subjects used Visucam 200 to measure the mean/max MPOD. <p>RESULTS: Both mean/max MPOD(0.0916±0.0149, 0.2675±0.0419Log unit)of OSAHS group are significantly lower than the control group(0.1193±0.0159, 0.3235±0.0400Log unit, <i>P</i><0.001).There are significant difference of mean/max MPOD between mild(<i>n</i>=12)/moderate(<i>n</i>=17)/severe(<i>n</i>=41)groups divided by AHI(<i>P</i><0.001). The increasing severity of OSAHS lead to lower mean/max MPOD.Furthermore there is negative correlation between mean/max MPOD and AHI(<i>r</i>=-0.685, -0.492; <i>P</i><0.001).<p>CONCLUSION: Our study results suggest that the mean/max MPOD were reduced in the patients of OSAHS. Moreover, the decreased degree of mean/max MPOD is positively related to the severity of OSAHS. It shows that the MPOD of OSAHS have already changed before they feel the significant syndrome. The reducing of MPOD may cause dysfunction of macular and finally rise up to macular disease.

The evaluation of assistant effect of intraoperative optical coherence tomography in vitreous retinal surgery for macular disease / 中华眼底病杂志

Objective To evaluate the assistant effect ofintraoperative OCT (iOCT) in vitreous retinal surgery for macular disease.Methods A retrospective case study.A total of 71 patients (71 eyes) with macular disease who underwent vitrectomy in Eye Hospital of Wenzhou Medical University at Hangzhou from June 2015 to September 2016 were collected.There were 24 males (24 eyes) and 47 females (47 eyes),aged from 25 to 78 years,with the mean age of 63.35± 10.01 years.Among 71 eyes,there were 26 eyes with idiopathic macular hole,42 eyes with idiopathic epiretinal membrane,3 eyes with vitreomacular traction syndrome.The examination of iOCT was performed on the patients during 23G minimally invasive vitreoretinal surgery combined with internal limiting membrane peeling.Use observational method to compare the difference between result of iOCT and observation under the microscope,record the change of treatment strategy.Results Eight eyes (11.27％) iOCT results were different from the surgeon's observation,which including 5 eyes (62.50％) with idiopathic macular hole,2 eyes (25.00％) with idiopathic epiretinal membrane,1 eye (12.50％) with vitreomacular traction syndrome.The treatment strategy was changed in 8 eyes (11.27％) based on iOCT result,which including 5 eyes (62.50％) with idiopathic macular hole,2 eyes (25.00％) with idiopathic epiretinal membrane,1 eye (12.50％) with vitreomacular traction syndrome.Conclusions iOCT can help the surgeon find some subtle morphological changes which can hardly be seen by eyes.The surgeon can change and optimize the treatment strategy based on the result of iOCT.

The research progress of macular telangiectasia type 2 / 中华实验眼科杂志

Macular telangiectasia type 2 (MacTel type 2) is a kind of disease that characterized by the dilation of capillary in temporal macula lutea and the degeneration of neurosensory retina.It usually affects both eyes in patient aged 50 to 60.The pathophysiology of MacTel type 2 was not understood very well.With the rapid development of imaging technic and the genomic research,we have illuminated some secrets of this disease.In this article,the development of classification,fundus fluorescein angiography (FFA) and histology feature,and the characteristic of optical coherence tomography (OCT),optical coherence tomographic angiography (OCTA),macular pigment,genome about MacTel type 2 were reviewed.

Research advances in low-vision rehabilitation by means of microperimeter biofeedback examination in patients with different macular diseases / 眼科新进展

In macular diseases,there is a typical development of a central scotoma which is responsible for the central visual acuity loss,reading speed reduction and changing in fixation stability.The prevention and treatment of degenerative macular disease have not yet received satisfying functional results.Effectiveness of biofeedback treatment in visual rehabilitation has been evidenced in several studies.The microperimeter can improve their visual abilities and lay the basis for new,more manageable visual aids by using cerebral plasticity and neurosensorial adaptation to the central scotoma of patients with macular diseases.The purpose of this review is to summarize key fmdings on characteristics of central scotoma,the plasticity of human visual system and visual rehabilitation via microperimetry.

Value of 3D-OCT in the diagnosis of macular disease before cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the value of 3D-optical coherence tomography (OCT) in the diagnosis of macular disease before phacoemulsification.METHODS:Clinical records of 423 cataract patients (512 eyes) who underwent phacoemulsification combined with intraocular lens implantation in our hospital from June to December in 2015 were retrospectively analyzed.In addition to preoperative routine examination of fundus, Topcon 3D-OCT 2000 was used to examine the macula, the detection rate of macular disease was compared, risk factors of cataract combined with macular disease were analyzed.RESULTS:The OCT image results of 305 cases (384 eyes, 72.1%) were successfully obtained, 133 cases showed macular disease (146 eyes), the detection rate was 28.5% (95%CI:27.64%-29.40%);the macular disease of 35 cases (37 eyes) were detected by routine examination of fundus before operation, the detection rate was 7.2% (95%CI:6.72%-7.74%);the detection rate of 3D-OCT was significantly higher than routine examination of fundus for macular disease (χ2=79.05, P<0.01).Female, over 65 years old, surgical history of diseased eye, and high myopia were risk factors of cataract combined with macular disease, the relative risk was 1.705 (95%CI:1.091,2.664), 1.893 (95%CI:1.219,2.939), 6.593 (95%CI:2.027,21.447) and 95%CI:5.130 (2.841,9.263) respectively, the risk of cataract combined with macular disease showed an increasing trend with rising age.CONCLUSION:In preoperative examination of cataract patients, 3D-OCT has higher sensitivity in the detection of macular disease, especially for women, over 65 years old, high myopia and surgical history of diseased eye, 3D-OCT can be used as a routine preoperative examination.

Complicaciones de la triamcinolona intravítrea en pacientes con afecciones maculares secundarias a neovascularización / Complications of intravitreal triamcinolone in patients with macular disorders secondary to neovascularization

Se realizó un estudio descriptivo y retrospectivo en 109 pacientes con enfermedades maculares, atendidos en el Centro Oftalmológico del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, desde septiembre de 2011 hasta julio de 2012, a los cuales se les administró 4 mg de triamcinolona intravítrea (vía pars plana), en dosis única, a fin de describir las complicaciones presentadas después del tratamiento. En la casuística predominaron el sexo femenino (64,3 %), el grupo etario de 65-84 años (49,5 %) y la degeneración macular asociada a la edad (húmeda) como antecedente oftalmológico (76,1 %). Entre las complicaciones más frecuentes figuraron: hipertensión ocular secundaria (13,7 %) y catarata (11,9 %).

A descriptive and retrospective study in 109 patients with macular diseases, assisted in the Ophthalmological Center of "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba was carried out from September, 2011 to July, 2012, to whom 4 mg of triamcinolone intravitreal (via pars plana) were administered in unique dose, in order to describe the complications presented after the treatment. Female sex (64.3%), the age group 65-84 years (49.5%) and macular degeneration associated with age (wet) as ophthalmological history (76.1%) prevailed in the case material. Among the most frequent complications there were: secondary ocular hypertension (13.7%) and cataract (11.9%).

Clinical Usefulness of Binocular Multifocal Electroretinography in Patients with Monocular Macular Disease

PURPOSE: To evaluate the clinical usefulness of binocular multifocal electroretinography (mfERG) by comparing results with conventional monocular mfERG in patients with monocular macular disease. METHODS: mfERG testing was conducted on 32 patients with monocular macular disease and 30 normal subjects. An initial mfERG was simultaneously recorded from both eyes with two recording electrodes under binocular stimulation. A second mfERG was subsequently recorded with conventional monocular stimulation. Amplitudes and implicit times of each ring response of the binocular and monocular recordings were compared. Ring ratios of the binocular and monocular recording were also compared. RESULTS: In the macular disease group, there were no statistical differences in amplitude or implicit time for each of the five concentric rings between the monocular and binocular recordings. However, with binocular simulation, the ring ratios (ring 1 / ring 4, ring 1 / ring 5) were significantly reduced in the affected eye. In the normal control group, there were no statistical differences in any parameters between the monocular and binocular recordings. CONCLUSIONS: Binocular mfERG could be a good alternative to the conventional monocular test. In addition, given that the test needs stable fixation of the affected eye during the binocular test, the reliability of the test results could be improved, especially for patients with monocular macular disease.

Analysis of Various Artifacts Produced by Spectral-Domain Optical Coherence Tomography Based on Macular Pathologies

PURPOSE: To report the frequency, severity and various types of artifacts associated with spectral-domain optical coherence tomography (SD-OCT) based on macular pathologies. METHODS: Data was collected retrospectively from 116 eyes of 116 subjects. SD-OCT (3D-1000, Topcon Corp., Japan) imaging was performed in 40 healthy eyes, 45 eyes with intraretinal pathology (IRP) and 31 eyes with subretinal pathology (SRP). The scan protocol was 12x6 mm radial scan. The frequency and types of artifacts were investigated in each scan and were analyzed based on macular disease. Additionally, the effect of artifacts on the measurement of macular thickness was studied. RESULTS: Errors occurred in 77 eyes (66.38%). Inner retinal boundary misidentification (IRBM) was the most common error (25.86%), with the frequencies of other types of artifacts being 10.34% for off-center fixation, 15.52% for degraded image and 8.6% for outer retinal boundary misidentification (ORBM). The overall error rate of SD-OCT in the retinal pathology group was much higher than that in the normal group. Macular thickness was underestimated in the IRP group because the outer retinal boundary of the IRP group tended to be misidentified toward the inner retina (p<0.01). CONCLUSIONS: SD-OCT can frequently cause various types of artifacts in patients with macular disease. When interpreting OCT images, the artifacts of SD-OCT should be considered in order to obtain accurate macular thickness and to prevent erroneous clinical decisions.

Distrofias del epitelio pigmentario de la retina en patrón / Pattern dystrophies of the retinal pigment epithelium

Las distrofias en patrón son patologías de la retina genéticamente determinadas que se caracterizan por anormalidades en el epitelio pigmentario que se visualizan en el fondo de ojo conformando diversos patrones de puntos o líneas. Realizamos una revisión detallada de las diversas variedades de presentación y sus características más importantes, e incluimos una secuencia fotográfica de las más representativas.

Pattern dystrophies are defined as a group of diseases genetically determined and characterized by pigment epithelium changes that are seen on fundus examination, such as various line and dot patterns. We present a review of these pathologies including a comparative table reporting the main characteristics as well as some representative figures of each one in order to facilitate diagnosis.

Application of Optical Coherence Tomography in Traumatic Macular Disease / 中国康复理论与实践

@#Objective To investigate the application of optical coherence tomography (OCT) in traumatic macular disease.MethodsOCT examination was carried out and analyzed in 56 eyes of 56 cases with traumatic macular disease.ResultsThe OCT examination showed that there were 23 cases of whole macular hole, 3 cases of lamellar macular hole, 3 cases of epi-macular membrane, 8 cases of macular hemorrhage, 5 cases of serous neuroretinal detachment, 4 cases of hemorrhagic retinal pigment epithelium detachment, 4 cases of macular edema and 6 eyes of macular neuroretinal thinning.ConclusionOCT plays an important role in diagnosis, monitoring and investigation of pathogenic mechanisms for traumatic macular disease.

Laser in situ keratomileusis and macular hemorrhage / 中国基层医药

Objective To evaluate the relationship between lasar in situ keratomileusis(LASIK) and macular hemorrhage after the operation.Methods 1840 patients(3430 eyes) treated by LASIK in our hospital were reviewed for macular hemorrhage in the past four years(July,2001 to 2005).Results The rate of macular hemorrhage was 0.26%(9/3430) after LASIK.The shortest period of time from the LASIK to the occurrence of macular hemorrhage was 20 days and the longest was 8 months 2 patients(2 eyes) with the history of macular hemorrhage suffered hemorrhage again after the LASIK,among the 65 cases with Fuchs spot in macula,there were 4 cases(6.15%) with macular hemorrhage.Conclusions We think there is no direct cause-effect relation between LASIK and macular hemorrhage.LASIK will not increase the rate of macular hemorrhage,but these cases with the history of macular hemorrhage,pathological changes with Fuchs,or fluorescence leaks in checking of FFA cannot receive LASIK.

Clinical characteristics and features of images of optical coherence tomography in vitreomacular traction syndrome / 中华眼底病杂志

Objective To observe the characteristics of the images of optical coherence tomography (OCT) performed on the patients with vitreomacular traction syndrome and its clinical significance. Methods The clinical data of 25 patients with vitreomacular traction syndrome diagnosed by OCT, fundus fluorescein angiography, and B-scan ultrasonography and confirmed by surgical treatment were retrospectively analyzed. The features of images of OCT in vitreomacular traction syndrome were observed. Results Five types were found in the images of OCT in the patients with vetreomacular traction syndrome. The main characteristic of the images of OCT in the patients with vitreomacular traction was the highly reflective band of the vitreous posterior cortex inservion at fovea. In 25 patients, vitreomacular traction associated with macular edema was found in 10, macular hole in 3, macular epiretinal membrane in 6, retinoschisis in 1, and retinal detachment in 5. Conclusion OCT is a potential powerful toll for detecting and monitoring vitreomacular traction syndrome.