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1.
Arq. bras. oftalmol ; 85(4): 339-343, July-Aug. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1383813

ABSTRACT

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.

2.
Arq. bras. oftalmol ; 85(4): 382-388, July-Aug. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1383825

ABSTRACT

ABSTRACT Purpose: In this study, we aimed to show whether a difference exists between retinal and choroidal microcirculation findings between patients with familial Mediterranean fever and healthy controls. Methods: Thirty-two patients with familial Mediterranean fever and 30 healthy controls were included in the study. All the patients underwent a complete ophthalmologic examination, including best-corrected visual acuity and intraocular pressure measurement. The AngioVue optical coherence tomography angiography device (Optovue, Fremont, CA) with split-spectrum amplitude-decorrelation angiography was used to evaluate and examine the retinal microvascular structure. Three-dimensional en face Optical coherence tomography angiography images were obtained by examining the macula using the 3 x 3 mm scanning protocol in the Angio Retina mode and the optic nerve using the 3 x 3 mm scanning protocol in the Angio Disk mode. All the patients' right eyes were examined. Results: A total of 62 subjects were included in the study, of whom 32 (53.3%) were female and 30 (46.7%) were male. No statistically significant difference was found between the two groups in terms of optic nerve head or radial peripapillary capillary vessel density. On examination, the superficial capillary plexuses were statistically similar between the two groups, but the deep capillary plexus vessel density in the parafovea, superior hemi, temporal, and superior areas were significantly lower in the patients with familial Mediterranean fever. Conclusions: We found that the capillary plexus vessel density was significantly lower in the parafovea, superior hemi, temporal, and superior regions in the patients with familial Mediterranean fever than in the control group. Therefore, OCTA, a noninvasive study, may be useful for understanding the systemic effects of familial Mediterranean fever.


RESUMO Objetivos: Este estudo teve como objetivo mostrar se há diferença entre os achados da microcirculação retiniana e coroidal entre pacientes com febre mediterrânica familiar e um grupo controle saudável. Métodos: Trinta e dois pacientes com febre mediterrânica familiar e 30 controles saudáveis foram incluídos neste estudo. Todos os pacientes foram submetidos a um exame oftalmológico completo, incluindo a acuidade visual melhor corrigida e medida da pressão intraocular. O aparelho AngioVue Optical coherence tomography angiography (Optovue, Fremont, CA) com angiografia de correlação de amplitude de espectro dividido foi utilizado para avaliar e examinar a estrutura microvascular da retina. As angiotomografias de coerência ópticas en face tridimensionais foram obtidas examinando o protocolo de varredura macular 3 x 3 mm (modo angio retina) e o nervo óptico com o protocolo de varredura 3 x 3 mm (modo angio-disco). Todos os olhos direitos dos pacientes foram examinados. Resultados: Foram incluídos neste estudo, 62 sujeitos, dos quais 32 (53,3%) eram do sexo feminino e 30 (46,7%) do sexo masculino. Não houve diferença estatisticamente significativa entre os dois grupos quanto à densidade dos vasos da cabeça do nervo óptico ou da densidade dos vasos capilares peripapilares radiais. Durante o exame, os plexos capilares superficiais foram estatisticamente semelhantes entre esses dois grupos, mas a densidade profunda dos vasos do plexo capilar nas areas parafovea, hemi superior, temporal e superior foram significativamente menores nos pacientes com febre mediterrânica familiar. Conclusões: Verificamos que a densidade dos vasos do plexo capilar foi significativamente menor nas regiões parafovea, hemi superior, temporal e superior em pacientes com febre mediterrânica familiar em comparação com o grupo controle. Portanto, pode ser útil usar a angiotomografia de coerência óptica, por tratar-se de um estudo não invasivo, para melhor compreensão dos efeitos sistêmicos da febre mediterrânica familiar.

3.
Arq. bras. oftalmol ; 85(4): 333-338, July-Aug. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1383833

ABSTRACT

ABSTRACT Purpose: To investigate inter-eye retinal vessel density and thickness asymmetry in unilateral pseudoexfoliation syndrome and understand its use for the early detection of glaucoma. Methods: Thirty patients with unilateral pseudoexfoliation syndrome were enrolled in our study. Optical coherence tomography angiography macular scans were used measure the retinal vessel density, and optical coherence tomography scans were used to assess the thickness parameters of the peripapillary retinal nerve fiber layer and the macular ganglion cell complex. Inter-eye asymmetry was determined by taking the absolute value of the difference in the vessel density and thickness parameters between the pseudoexfoliation syndrome eye and fellow eye. Results: The mean patient age was 64.20 ± 7.05 y in the study group. Inter-eye asymmetry in the peripapillary retinal nerve fiber layer thickness and macular ganglion cell complex measurements were significant in the study group (p=0.03 and p=0.001, respectively). The vessel density of the macular superficial inner region was significantly lower in eyes with pseudoexfoliation syndrome than in fellow eyes (p=0.035). However, there was no inter-eye asymmetry in the central and full region macular superficial vessel density of eyes with pseudoexfoliation syndrome and fellow eyes (p>0.05). Conclusion: Retinal vessel density can be evaluated using optical coherence tomography angiography measurements. There was inter-eye asymmetry in the inner region macular superficial vessel density, peripapillary retinal nerve fiber layer, and macular ganglion cell complex thickness of the unilateral pseudoexfoliation syndrome eyes and fellow eyes. Further studies on a larger number of subjects might provide more clarity regarding the relationship between the inter-eye asymmetry of the retinal vessel density and thickness parameters with early detection of glaucomatous damage.


RESUMO Objetivo: Investigar a densidade dos vasos interoculares da retina e assimetria na espessura na síndrome de pseudoexfoliação unilateral e o seu uso para a detecção precoce de glaucoma. Métodos: Trinta pacientes com síndrome de pseudoexfoliação unilateral foram incluídos no estudo. As varreduras maculares de angiografia por tomografia de coerência óptica mediram a densidade dos vasos da retina, e as varreduras por tomografia de coerência óptica obtiveram parâmetros de espessura da camada de fibras nervosas da retina peripapilar e do complexo macular de célula ganglionar. A assimetria interocular foi determinada tomando o valor absoluto da diferença entre o olho da síndrome de pseudoexfoliação e o olho oposto nos parâmetros de densidade e espessura dos vasos. Resultados: A média de idade foi 64,20 ± 7,05 anos no grupo de estudo. A assimetria interocular na espessura da camada de fibra nervosa da retina peripapilar e as medidas do complexo macular de célula ganglionar foram estatisticamente significativas no grupo de estudo (p=0,03 e p=0,001, respectivamente). Para os olhos com síndrome de pseudoexfoliação, a densidade do vaso da região macular superficial interna foi significativamente menor do que em olhos opostos (p=0,035). No entanto, não houve assimetria interocular estatisticamente significativa na densidade macular dos vasos superficiais da região central e completa entre os olhos da síndrome de pseudoexfoliação e os olhos opostos (p>0,05). Conclusões: A densidade dos vasos da retina pode ser avaliada por medidas de angiografia por tomografia de coerência óptica. Houve assimetria interocular na densidade macular do vaso superficial da região interna, camada de fibra nervosa da retina peripapilar e espessura do complexo macular de célula ganglionar entre olhos com síndrome de pseudoexfoliação unilateral e olhos opostos. Novos estudos com um número maior de indivíduos podem fornecer a relação entre a assimetria interocular da densidade do vaso da retina e os parâmetros de espessura com detecção precoce de dano glaucomatoso.

4.
International Eye Science ; (12): 673-676, 2022.
Article in Chinese | WPRIM | ID: wpr-922875

ABSTRACT

@#AIM:To observe the imaging features of optical coherence tomography angiography(OCTA)in the macular hemorrhage of pathologic myopia.METHODS:Designing a retrospective analysis collected clinical data of 100 patients(108 eyes)diagnosed as macular hemorrhage of pathological myopic in Nanjing Medical University Affiliated Eye Hospital from June 2016 to December 2020. All patients underwent refraction, eye axis,fundus photography, spectral-domain optical coherence tomography(SD-OCT), fundus fluorescein angiography(FFA), indocyanine green angiography(ICGA)and OCTA examination. All patients were divided into macular hemorrhage only with lacquer cracks and macular hemorrhage with choroidal neovascularization(CNV). All patients followed-up for more than 3mo by OCTA. RESULTS:There were 40 patients(42 eyes)diagnosed as macular hemorrhage only with lacquer cracks, OCTA showed bleed obscured by choroidal capillaries. After hemorrhage was being absorbed, lacquer cracks showed linear or stellate reflection completely in the choroidal capillary layer. B-scan image showed discontinuous retinal pigment epithelium(RPE), thinner choroid and an increased light. Penetrance into deeper tissues. After all macular hemorrhage only with lacquer cracks were absorbed, follow-up mode of OCTA found that 2 eyes(4.8%)without lacquer cracks, 28 eyes(66.7%)were linear and 12 eyes(28.6%)were stellate under the original hemorrhage. Follow-up mode also showed that 8 eyes of 8 patients(19.0%)relapsed macular hemorrhage only with lacquer cracks, and 4 eyes of 4 patients(9.5%)suffered secondary macular hemorrhage with CNV. There were 60 patients(66 eyes)diagnosed as macular hemorrhage with CNV,OCTA showed bleed obscured choroidal capillaries, the outer retinal and choroidal capillary layer also showed the shape of CNV around hemorrhage. B-scan showed CNV breaked through the RPE layer and blood flow signal in it. The area of CNV decreased after anti-vascular endothelial growth factor(VEGF)intravitreal injection treatment. Around all macular hemorrhage with CNV, OCTA found that 48 eyes(72.7%)had lacquer cracks, 28 eyes(42.4%)were linear and 20 eyes(30.3%)were stellate.CONCLUSION:OCTA has a great significance in the diagnosis of macular hemorrhage of pathological myopia, fast and non-invasive is the biggest advantage. Choroidal capillary layer can clearly observe the shape and location of hemorrhage,lacquer cracks and CNV. The follow-up mode can intuitively comprehend the changes of disease. To some extent, it can replace fundus angiography to directly judge the classification, and time to treat in the clinic.

5.
International Eye Science ; (12): 666-668, 2022.
Article in Chinese | WPRIM | ID: wpr-922873

ABSTRACT

@#AIM: To analyze the changes of the epiretinal membrane(ERM)stage, macular status and best corrected visual acuity(BCVA, LogMAR)in cataract patients with idiopathic macular epiretinal membrane(IERM)before and after cataract surgery.METHODS:We conducted a single center retrospective observational case series of patients that underwent sequential cataract and idiopatic ERM surgeries from March 2016 to May 2019 in Anyang Eye Hospital. Full data were obtained for 51 patients(54 eyes).Preoperative and postoperative 1mo ERM stage, central macular edema(CME), central macular thickness(CMT), macular volume(MV), ellipsoid zone disruption, occurrence of neurosensory detachment(NSD)and BCVA were analyzed.RESULTS:In this group of patients, 5 eyes(9%)had ERM grade 1, 23 eyes(43%)had ERM grade 2, 21 eyes(39%)had ERM grade 3, and 5 eyes(9%)had ERM grade 4 before surgery; ERM graded 1mo after surgery were keeping steady. Compared with before operation(0.45±0.16),there was no significant change in BCVA(0.47±0.17)at 1mo after operation(<i>P</i>>0.05), but the incidence of CME, ellipsoid band interruption and NSD were significantly higher than those before operation(<i>P</i><0.05). CONCLUSION: We suggest that phacoemulsification did not significantly accelerate ERM progression and affect BCVA, but patients underwent cataract surgery in the presence of epiretinal membranes need tight follow up to treat and control eventual macular infammatory changes and eventual prompt vitrectomy if BCVA was threatened.

7.
International Eye Science ; (12): 95-98, 2022.
Article in Chinese | WPRIM | ID: wpr-906739

ABSTRACT

@#AIM: To investigate the difference of the optic vessel density in early primary open angle glaucoma(POAG), ocular high tension subjects and healthy subjects. <p>METHODS: A cross-sectional study. From January 2019 to April 2021, patients were selected in the Department of Glaucoma in Fuzhou Southeast Eye Hospital. There were 45 patients(70 eyes)of early POAG group, including 32 males(49 eyes)and 13 females(21 eyes)with age of 48.50(26.75, 64.50)years. There were 37 patients(65 eyes)of ocular high tension group, including 17 males(29 eyes)and 20 females(36 eyes)with age of 37.00(27.00, 47.00)years. There were 51 patients(94 eyes)of healthy group, including 23 males(39 eyes)and 28 females(55 eyes)with age of 46.00(34.50, 56.50)years. Ophthalmic examinations including best-corrected visual acuity(BCVA), intraocular pressure, central corneal thickness(CCT), mean deviations(MD), retinal nerve fiber layers thickness(RNFL)were measured in three groups. The center area, the inner circle area, the outer circle area, and the whole area of the optic vessel density in three groups were measured <i>via</i> optical coherence tomography angiography(OCTA)device.<p>RESULTS: The difference of the intraocular pressure in early POAG group-ocular high tension group was not significant(<i>H</i>=146.876,<i>P</i><0.001), while significantly in early POAG group-healthy group and ocular high tension group-healthy group(all <i>P</i><0.01). Significant differences in BCVA, MD, and RNFL were observed in early POAG group-ocular high tension group(<i>P</i>=0.005, <i>P</i>=0.01, <i>P</i><0.01)and early POAG group-healthy group(<i>P</i>=0.013, <i>P</i><0.01, <i>P</i><0.01), while the difference was not found in ocular high tension group-healthy group(<i>P</i>=1.000, <i>P</i>=0.660, <i>P</i>=1.000). There was no difference of CCT in early POAG group-healthy group(<i>P</i>=0.074), and significant differences were observed in early POAG group-ocular high tension group and ocular high tension group-healthy group(<i>P</i>=0.006, <i>P</i><0.01). The optic vessel density comparison in the center area, the inner circle area, and the whole area were significantly different in early POAG group-ocular high tension group(all <i>P</i><0.01)and in early POAG group-healthy group(all <i>P</i><0.01), which indicated that the optic vessel density was obviously less in the early POAG group than the other two groups. The optic vessel density had no significant difference in ocular high tension group-healthy group in these areas(all <i>P</i>=1.000). In the outer circle area, there were no significant differences of the optic vessel density in early POAG group-ocular high tension group and early POAG group-healthy group(<i>P</i>=0.067, <i>P</i>=0.877), while significant difference was observed in early POAG group-healthy group(<i>P</i>=0.001).<p>CONCLUSION: The optic vessel density was decreased in early POAG comparing with ocular high tension subjects and healthy subjects, which was agree with the changes of MD, RNFL. The optic vessel density decreased firstly from the center area and the inner circle area for early POAG.

8.
International Eye Science ; (12): 53-56, 2022.
Article in Chinese | WPRIM | ID: wpr-906729

ABSTRACT

@#Microglial activation is one of the main pathogenic factors to cause retinal neuroinflammation. Recently, with the advancement of retinal imaging technologies, hyperreflective foci(HRF), as a novel biomarker in optical coherence tomography(OCT)imaging, have received more attention in retinal neuroinflammation. Current research demonstrated that HRF are the aggregates mainly derived from the activated microglia in retina or mononuclear phagocyte-macrophage from the blood. HRF were defined as discrete and well-circumscribed hyperreflective dot-shaped lesions with the maximum diameter between 20-50μm in retina and choroid imaged with OCT. Under pathological conditions, the number of HRF increases significantly. Under pathological condations, the number of HRF was obviously increased, which might be related to the severity of some retinal diseases. However, the research on the source and function of HRF is still in its infancy. This review is aimed to describe the basic characteristics of HRF and their roles in both retinal inflammatory diseases and neurodegenerative diseases of the central nervous system. HRF are expected to be a potential and novel biomarker of inflammation for early diagnosis and prognosis of neuroinflammation in both retinal and central nervous system diseases.

9.
International Eye Science ; (12): 1-8, 2022.
Article in English | WPRIM | ID: wpr-906720

ABSTRACT

@#AIM: To investigate for any detectable change in sub-foveal choroidal thickness following intravitreal injections of Ranibizumab or Aflibercept in patients with central involving diabetic macula edema(DME), evidenced by optical coherence tomography(OCT).<p>METHODS: Totally 17 patients with central involving DME who required and agreed to intravitreal anti-VEGF injection were invited to be the subject of this study. These injection-naive subjects were undergone three loading doses of monthly intravitreal anti-VEGF(Ranibizumab 0.5 mg/0.05 mL for 9 patients or Aflibercept 2 mg/0.05 mL for 8 patients)injection, and a clinic review appointment 1mo after the third injection. The changes of foveal choroidal thickness, visual acuity and central retinal thickness at 1mo were observed before and after treatment in 2 groups by enhanced depth image-optical coherence tomography(EDI-OCT). <p>RESULTS: We recorded a significant sub-foveal choroidal thinning and vision improvement after three loading doses of anti-VEGF(all <i>P</i><0.05). The thinning effect between Ranibizumab and Aflibercept group was insignificant(all <i>P</i>>0.05). There was no significant correlation between pre-treatment sub-foveal choroidal thickness and vision improvement(<i>r<sub>s</sub></i>=-0.269, <i>P</i>=0.296). There was also no significant correlation between choroidal thickness changes with vision improvement, central retinal thickness change and age of subjects(all <i>P</i> >0.05).<p>CONCLUSION: Intravitreal Ranibizumab and Aflibercept injections both leads to significant sub-foveal choroidal thinning in DME subjects. It was accompanied with significant vision improvement with no evidence of immediate detrimental effect of choroidal thinning. Future research with a longer study duration would help in establishing the duration and long term effect of choroidal thinning.

10.
International Eye Science ; (12): 438-442, 2022.
Article in Chinese | WPRIM | ID: wpr-920425

ABSTRACT

@#Diabetic retinopathy(DR)is a common clinical condition caused by hyperglycemia, leading to retinal microvascular damage and neurodegeneration. With the development of advanced technologies, handheld electrophysiology(RETeval), optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA)have been extensively studied and applied in early diagnosis of DR. These technologies are non-invasive and quantifiable, assisting in DR diagnosis in a fast and convenient manner. In this review, the principles and applications of RETeval, OCT and OCTA will be discussed in detail.

11.
International Eye Science ; (12): 327-330, 2022.
Article in Chinese | WPRIM | ID: wpr-913047

ABSTRACT

@#AIM: To investigate the application value of optical coherence tomography angiography(OCTA)in observing retinal microvasculature in patients with diabetic retinopathy(DR). METHODS: Prospective research. The 84 patients(98 eyes)with DR admitted to our hospital during 2017-06/2019-12 were selected as the study group, and were further divided into non-proliferative DR group and proliferative DR group according to the degree of DR. Another 60 cases(68 eyes)with simple diabetes mellitus who underwent physical examination in our hospital during the same period were selected as the control group. The OCTA was used to quantitatively analyze the microvessels in the retinal macular area of the subject, and the built-in analysis software was used to obtain the blood flow density(SCP, DCP)of the superficial and deep parafoveal retina, the area and circumference of the foveal avascular zone(FAZ), the roundness index, full-thickness retinal blood flow density(FD-300). The differences of quantitative indexes, the correlation between OCTA parameters and DR severity and the diagnostic value of DR were compared.RESULTS: The study group's FD-300, SCP and DCP were lower than those of the control group(<i>t</i>=6.476, 8.907, 5.078; all <i>P</i><0.05), while the FAZ circumference and the roundness index were higher than those of the control group(<i>t</i>=4.380, 10.542; all <i>P</i><0.05). The FD-300, SCP and DCP of the proliferative DR group were lower than those of the non-proliferative DR group(<i>t</i>=2.668, 3.408, 3.103; all <i>P</i><0.05), while the FAZ circumference and the roundness index were higher than those of the non-proliferative DR group(<i>t</i>=2.550, 5.563; all <i>P</i><0.05). Pearson correlation analysis shows that FD-300, SCP, DCP were negatively correlated with disease severity(<i>r</i>= -0.485, -0.546, -0.522; all <i>P</i><0.05), FAZ circumference and morphological index were positively correlated with disease severity(<i>r</i>=0.426, 0.443; all <i>P</i><0.05). ROC curve analysis showed that the area under the curve for FD-300, SCP, DCP, FAZ circumference, and FAZ morphological index to diagnose DR were 0.835(95%<i>CI:</i> 0.722-0.947), 0.806(95%<i>CI</i>: 0.701-0.911), 0.849(95%<i>CI</i>: 0.770-0.928), 0.768(95%<i>CI</i>: 0.641-0.896), 0.742(95%<i>CI</i>: 0.633-0.850), respectively. CONCLUSION: OCTA can clearly monitor the morphology of superficial and deep capillaries in the macular area of patients with DR. The quantitative index of blood flow density is negatively correlated with the severity of the disease, which has high clinical value for the diagnosis of DR.

12.
International Eye Science ; (12): 287-292, 2022.
Article in Chinese | WPRIM | ID: wpr-913039

ABSTRACT

@#AIM:To quantitatively evaluate the macular microvasculature and visual function in patients with macular edema secondary to retinal vein occlusion(RVO)by optical coherence tomography angiography(OCTA)combined with microperimetry. <p>METHODS: Totally 36 patients(36 eyes)with monocular RVO complicated with macular edema were enrolled, including 15 patients(15 eyes)in central retinal vein occlusion(CRVO)group and 21 patients(21 eyes)in branch retinal vein occlusion(BRVO)group(all with superior temporal vein occlusion), 15 age-matched healthy subjects(24 eyes)were included as controls. OCTA was used to scan macular retina in the range of 3mm×3mm in all three groups and measure the vascular density(VD)of superficial capillary plexus(SCP)and deep capillary plexus(DCP), the area of foveal avascular zone(FAZ)and the central retinal thicknes(CRT); the retinal mean sensitivity(RMS)at 10°was measured by MP-3 microperimetry. VD and RMS in BRVO group were further divided into lesion area(superior), non-lesion area(inferior)VD and RMS. The lesion area and non-lesion area of the control group were divided according to corresponding regions of the BRVO group. The changes of above indexes in CRVO group and BRVO group were compared with control group respectively, and the correlation between RMS and VD, CRT and FAZ areas in CRVO group and BRVO group was analyzed.<p>RESULTS:The overall VD(SCP and DCP)in CRVO group were lower than those in control group(<i>t</i>= -2.536, <i>P</i>=0.016; <i>t</i>= -8.834, <i>P</i><0.001); the area of FAZ was larger than that in control group(<i>t</i>=3.354, <i>P</i>=0.002); the CRT was thicker than that in control group(<i>t</i>=13.888, <i>P</i><0.001); the overall RMS was significantly lower than that in control group(<i>t</i>= -6.250, <i>P</i><0.001). The overall VD(SCP and DCP)in BRVO group were decreased compared to those in control group(<i>t</i>= -5.186, <i>P</i><0.001; <i>t</i>= -5.238, <i>P</i><0.001); the VD of SCP and DCP in the affected sector were decreased compared to those in the corresponding sector of the control group(<i>t</i>= -5.611, <i>P</i><0.001; <i>t</i>= -6.940, <i>P</i><0.001); the VD in the unaffected sector was significantly less than that in the corresponding sector of the control group only in DCP, but not in SCP(<i>t</i>= -3.047, <i>P</i>=0.004; <i>t</i>= -1.459, <i>P</i>=0.156); the area of FAZ was larger than that in control group(<i>t</i>=2.722, <i>P</i>=0.011); the CRT was thicker than that in control group(<i>t</i>=7.764, <i>P</i><0.001); the overall RMS was significantly lower than that in control group(<i>t</i>= -10.931, <i>P</i><0.001); the RMS in both the affected sector and the unaffected sector were lower than those in the corresponding sector of the control group(<i>t</i>= -13.183, <i>P</i><0.001; <i>t</i>= -8.074, <i>P</i><0.001). In CRVO group,the overall VD of SCP and DCP was positively correlated with the overall RMS(<i>r</i>=0.571, <i>P</i>=0.026; <i>r</i>=0.813, <i>P</i><0.001)and the area of FAZ and CRT was negatively correlated with the overall RMS(<i>r</i>= -0.621, <i>P</i>=0.014; <i>r</i>= -0.533, <i>P</i>=0.041). In BRVO group,the overall VD of SCP and DCP was positively correlated with the overall RMS(<i>r</i>=0.465, <i>P</i>=0.034; <i>r</i>=0.611, <i>P</i>=0.003), and the CRT was negatively correlated with the overall RMS(<i>r</i>= -0.547, <i>P</i>=0.01), while there was no correlation between the area of FAZ and the overall RMS(<i>r</i>= -0.421, <i>P</i>=0.057).<p>CONCLUSION: The combined application of OCTA and microperimetry can corresponding quantitatively evaluate the structure and function of macular area in patients with macular edema secondary to retinal vein occlusion, providing more detailed information for clinical decision makers to explain the disease well.

13.
International Eye Science ; (12): 280-286, 2022.
Article in Chinese | WPRIM | ID: wpr-913038

ABSTRACT

@#AIM: To quantitatively analyze the microcircular and structural changes of the macular and peripapillary area in patients with diabetic kidney disease(DKD), exploring non-invasive effective monitoring indexes that can predict the occurrence and development of diabetic kidney disease used optical coherence tomography angiography(OCTA).<p>METHODS: A cross-sectional study. The diabetic patients(52 cases)and healthy subjects(20 cases)who came to Shanxi Provincial People's Hospital from January 2020 to January 2021 were collected, and the diabetes mellitus(DM)patients were further divided into DKD group(23 cases)(complicated with diabetic kidney disease)and non-DKD group(29 cases)(not complicated with diabetic kidney disease). All patients underwent slit-lamp microscopy, best corrected visual acuity(BCVA), OCTA and fundus color photography. OCTA was used to scan the macula and peripapillary area of all participants, measuring the shallow and deep blood flow density, the area and circumference of the fovea(FAZ), vascular density in the 300μm area around FAZ(FD300), retinal thickness, peripapillary-VD, retinal nerve fiber layer(RNFL)thickness, and ganglion cell complex(GCC)thickness. The correlation between the changes of these parameters in OCTA, DR staging and DKD staging was analyzed. <p>RESULTS: Parafoveal SCP-VD, perifoveal DCP-VD, peripapillary-VD, and FD300 showed a decreasing trend among the healthy group, non-DKD group, and DKD group(<i>P</i><0.05). The foveal DCP-VD was decreased only in the DKD group(<i>P</i><0.05), and there was no significant difference in the SCP-VD of fovea among the three groups(<i>P></i>0.05). FAZ area and GCC thickness were gradually increased among healthy group, non-DKD group and DKD group(<i>P</i><0.05). DR staging was positively correlated with DKD staging(<i>rs</i>=0.648, <i>P</i><0.05). Parafoveal SCP-VD, parafoveal DCP-VD, and perifoveal DCP-VD were negatively correlated with DKD staging(<i>rs</i>= -0.535, <i>P</i>=0.009; <i>rs</i>= -0.712, <i>P</i><0.001; <i>rs</i>= -0.641, <i>P</i>=0.001). Compared with non-DKD group, DKD group had higher SBP, lower eGFR, and higher UACR(<i>P</i><0.05). <p>CONCLUSION: OCTA can detect retinal microcirculation and structural changes in patients with DKD, including decreased vessel density in the macular and peripapillary area, increased FAZ area and GCC thickness. More importantly, we found that retinal vessel density decreased with renal function impairment, suggesting that retinal vessel density may be a noninvasive and effective predictor in the severity of DKD.

14.
International Eye Science ; (12): 235-239, 2022.
Article in Chinese | WPRIM | ID: wpr-913029

ABSTRACT

@#Diagnosis of early keratoconus(KC)contributes to identifying potential patients before typical clinical symptoms. It also contributes to timely intervention of the progress of disease and improvement of long-term prognosis. Hence, it is crucial to prevent iatrogenic corneal ectasia and reduce the burden of keratoplasty. There are diverse kinds of early KC diagnosis techniques, including corneal topography, corneal aberrations, epithelial and corneal thickness measurement, corneal confocal microscopy, corneal biomechanics, and genetic examination. Since it is often difficult to ensure sufficient sensitivity and specificity with single technique, multiple techniques are beneficial to evaluate the cornea comprehensively, which may become the development tendency of early KC diagnosis in the future.

15.
International Eye Science ; (12): 205-210, 2022.
Article in Chinese | WPRIM | ID: wpr-913023

ABSTRACT

@#AIM: To discuss the measurement of retinal thickness in each macular region, fixation property, best corrected visual acuity(BCVA), eye axis and equivalent spherical power and treatment time for the children with hyperopia anisometropic amblyopia before and after treatment.<p>METHODS: This study was a prospective longitudinal controlled trial. The subjects were 40 hyperopia anisometropia children aged 4-8 years with monocular amblyopia who had not been treated with amblyopia before diagnosis in our hospital(20 cases of central fixation and 20 cases of paracentral fixation)from August 2018 to August 2019. Atropine mydriatic optometry, fundus macular fixation quality, ocular axis and optical coherence tomography(OCT)retinal thickness were used in the initial diagnosis and 6mo and 1a follow-up. Statistical analysis was used to analyze whether the macular retinal thickness of hyperopia amblyopia had changed in the treatment and the related factors, and whether had differences between different fixation properties.<p>RESULTS: There were significant differences in foveal retinal thickness and nasal retinal thickness of inner ring between central fixation group and paracentral fixation group at different measurement times(before treatment, 6 and 12mo after treatment)(<i>P</i><0.01). There were no significant changes in the other retinas in macular area(<i>P</i> >0.05). With the extension of treatment time, the foveal retinal thickness and the nasal retinal thickness of the inner ring in the central fixation group and the paracentral fixation group became thinner(all <i>P</i><0.05). At the same measurement time, the thickness of fovea and inner ring nasal retina in the central fixation group was thinner than that in the paracentral fixation group(all <i>P</i><0.05), and there were no significant differences in the thickness of other retinas in the macular region(all <i>P</i>>0.05). There were significant differences in ocular axis, BCVA and equivalent spherical power of amblyopia before and after treatment(all <i>P</i><0.05); With the extension of treatment time, the length of ocular axis and BCVA had increased and the degree of equivalent spherical mirror had decreased. The macular retinal thickness of hyperopia amblyopia was thicker than that of contralateral normal eyes, and the length of ocular axis was shorter than that of contralateral normal eyes(all <i>P</i><0.01). The axial length of amblyopia and normal eyes had changed significantly before and after treatment(all <i>P</i><0.01). The axial length of amblyopia was shorter than that of normal eyes. With the extension of treatment time, the axial length of amblyopia and normal eyes had become longer.<p>CONCLUSION:The thickness of macular retina in moderate and high amblyopic eyes was greater than that in contralateral normal eyes, and the ocular axis was shorter than that in contralateral normal eyes. After treatment, with the improvement of best corrected visual acuity, the retinal thickness of fovea and nasal side of inner ring in central fixation group and paracentral fixation group had decreased.

16.
International Eye Science ; (12): 200-204, 2022.
Article in Chinese | WPRIM | ID: wpr-913022

ABSTRACT

@#AIM: To explore the value of corneal epithelial thickness parameters in the diagnosis of early keratoconus by Fourier domain optical coherence tomography(FD-OCT).<p>METHODS: Retrospective control study. Patients with early keratoconus who were admitted to the Department of Ophthalmology of the First Affiliated Hospital of Soochow University from January 2015 to October 2020 and patients who received laser refractive surgery for myopia during the same period were included in this study. Using FD-OCT to measure the cornea in circle centralized by the pupil and with diameter of 9mm in the early-keratoconus group and the control group. This was to obtain the thickness parameter of corneal epithelium with diameter of 7mm, the respective averaged thickness value of corneal epithelium and the respective averaged thickness value of the full corneal layer on each of the 25 divisions. The parameter value differences between the early-keratoconus group and the control group were compared, and the diagnosis value of parameters that hold difference was analyzed. <p>RESULTS: The Min-e value in early-keratoconus group was significantly lower than that of the control group. On contrary, the value of Std.Dev, Max-Min-e, and Max-e were significantly higher in early-keratoconus group than that in latter one(all <i>P</i><0.001). The value of Std.Dev and Max-Min-e hold a greater diagnostic efficiency on diagnosis of early keratoconus(AUC=0.937, 0.928), while Max -e value and Min-e value performed a medium diagnostic efficiency(AUC=0.871, 0.797). Analysis on thickness of corneal epithelium on the 25 divisions found that the thickness of corneal epithelium at infratemporal region of inner ring(EIT1)became thinner most obviously in early-keratoconus group, with greatest diagnostic efficiency(AUC=0.827). The average corneal thickness of the 25 zones of the early keratoconus group was significantly thinner than that in the normal control group. Averaged corneal thickness at infratemporal region of inner ring(CIT1)hold a relatively high diagnostic efficiency among the 25 divisions(AUC=0.903).<p>CONCLUSION: The parameter values of corneal epithelium thickness including Std.Dev, Max-Min-e, Max-e, Min-e, the averaged thickness value of corneal epithelium at infratemporal region of inner ring, and the thickness value of full corneal layer at infratemporal region of inner ring can all be used for diagnosis of early keratoconus.

17.
International Eye Science ; (12): 182-188, 2022.
Article in English | WPRIM | ID: wpr-913019

ABSTRACT

@#AIM:To figure out the sequence of vessel density(VD)changes in the retina and deformation induced by mechanical force in the optic nerve head(ONH)tissue during intraocular pressure(IOP)elevation.<p>METHODS: This prospective study tested 34 eyes from 34 healthy volunteers. Group A had 23 subjects. Their testing protocol included a baseline phase, two elevated IOP phases(15 mmHg and 30 mmHg respectively for 2min), and a recovery phase. Group B had 11 subjects, and their protocol included an IOP elevation of 15 mmHg for 10min. In each phase the deformation in the ONH and macular region were scanned by optical coherence tomography(OCT), and Bruch's membrane opening(BMO)distance, the optic nerve head surface depth(ONHSD), the subfoveal choroidal thickness(SFCT)were measured, the VD was measured by OCTA.<p>RESULTS: After the first IOP elevation in group A, the VD in the ONH decreased(superficial capillary plexuses, from 67.39±7.65% to 43.78±5.89%, <i>P</i><0.05), the BMO distance, the ONHSD, the VD in the macula and the SFCT did not change. After the second IOP elevation, the VD in the ONH and in the macular region both decreased, the BMO distance and ONHSD increased(all <i>P</i><0.05). After the IOP elevation in group B, the VD in the ONH and in the macular region decreased significantly, the BMO distance increased, the SFCT did not change. ONH VD reduction is not associated with BMO distance increment(<i>r</i>=0.050, <i>P</i>>0.05).<p>CONCLUSION:The ONH tissue is more sensitive to hemodynamics than to morphological change. Hemodynamics during IOP elevation differs in the ONH and the macular tissue.

18.
International Eye Science ; (12): 175-181, 2022.
Article in English | WPRIM | ID: wpr-913018

ABSTRACT

@#AIM: To evaluate the differences of macular vascular network measured by optical coherence tomography angiography(OCTA)between severe non-proliferative diabetic retinopathy(S-NPDR)eyes and health eyes, and explore the changes of these OCTA characteristics in patients with S-NPDR before and after panretinal photocoagulation(PRP).<p>METHODS: This was a prospective study including 31 eyes from 18 consecutive patients with S-NPDR and 31 eyes of healthy subjects. We measured macular vascular density and foveal avascular zone(FAZ)area and volume by an OCTA device.<p>RESULTS: Compared to the normal control group, in superficial retinal capillary plexus(SCP), macular vascular density decreased in S-NPDR group, except foveal vascular density unchanged. Consistently, in deep retinal capillary plexus(DCP), macular vascular density was also lower in S-NPDR group. In addition, FAZ area and volume expanded in S-NPDR eyes. At 6mo post-PRP in S-NPDR eyes, foveal SCP and DCP densities increased significantly, while FAZ area and volume decreased. At 3mo post-PRP, only foveal vascular density in DCP increased. The changes of foveal SCP and DCP densities as well as FAZ area and volume were not statically significant at 1mo post-PRP.<p>CONCLUSION: Macular vascular network was impaired in S-NPDR assessed by OCTA. Although OCTA parameters were not significantly affected by PRP in 1 and 3mo period, at 6mo follow-up parameters became significant after PRP.

19.
Article in English | WPRIM | ID: wpr-927640

ABSTRACT

OBJECTIVE@#We wanted to investigate the radial peripapillary capillary (RPC) network in patients with Bietti crystalline dystrophy (BCD).@*METHODS@#We compared RPC densities in the disk and different peripapillary regions, obtained using optical coherence tomography angiography in 22 patients with BCD (37 eyes) and 22 healthy subjects (37 eyes). The BCD group was then divided into Stage 2 and Stage 3 subgroups based on Yuzawa staging, comparing the RPC densities of the two.@*RESULTS@#The disk area RPC density was 38.8% ± 6.3% in the BCD group and 49.2% ± 6.1% in the control group ( P < 0.001), and peripapillary region RPC density was significantly lower in the BCD group than in the control group (49.1% ± 4.7% and 54.1% ± 3.0%, respectively, P < 0.001). There were no significant RPC density differences between the tempo quadrant and inside disk of Stages 2 and 3 subgroups; the other areas showed a significantly lower RPC density in Stage 3 than in Stage 2 BCD.@*CONCLUSION@#The BCD group RPC density was significantly lower than the control group. The reduction of RPC density in the tempo quadrant occurred mainly in the Stage 1 BCD. In contrast, the reduction of RPC density in superior, inferior, and nasal quadrants occurred mainly in Stage 2.


Subject(s)
Adult , Aged , Angiography , Corneal Dystrophies, Hereditary/physiopathology , Female , Humans , Male , Microvascular Density , Microvessels/physiopathology , Middle Aged , Retinal Diseases/physiopathology , Retinal Vessels/physiopathology , Tomography, Optical Coherence
20.
Article in Chinese | WPRIM | ID: wpr-927371

ABSTRACT

OBJECTIVE@#To observe the effect of acupuncture on visual acuity, intraocular pressure, visual field, retinal and choroidal thickness on optic disc and macular area in patients with optic atrophy.@*METHODS@#A total of 33 patients with optic atrophy were treated with acupuncture. Acupuncture was given at Chengqi (ST 1), Shangjingming (Extra), Qiuhou (EX-HN 7) and Fengchi (GB 20) etc., 30 min each time, once a day, for 14 days. The visual acuity, intraocular pressure, visual field indexes (mean deviation [MD], pattern standard deviation [PSD] and visual field index [VFI]), optic disc retinal nerve fiber layer thickness, macular retinal thickness and choroidal thickness of optic disc and sub-foveal were compared before and after treatment.@*RESULTS@#Compared before treatment, the visual acuity was increased (P<0.05), the MD value was decreased (P<0.05), the thickness of nerve fiber layer on the upper temporal side of optic disc was thinner (P<0.05), and the choroidal thickness of average, nasal side and lower temporal side of optic disc was increased (P<0.05). There was significant correlation between visual field MD and retinal nerve fiber layer thickness in different quadrants before and after treatment (P<0.01).@*CONCLUSION@#Acupuncture could improve visual acuity, increase choroidal thickness in part of optic disc area in patients with optic atrophy.


Subject(s)
Acupuncture Therapy , Humans , Optic Atrophy/therapy , Optic Disk/diagnostic imaging , Retina/diagnostic imaging , Tomography, Optical Coherence
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