Alterations of macular ganglion cell layer thickness and optic disc parameters in patients with early diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the changes of optic disc parameters, peripapillary retinal nerve fibers layer(pRNFL)thickness and macular ganglion cell layer(mGCL)thickness among patients with early diabetes retinopathy and healthy controls by Cirrus HD-optical coherence tomography(OCT).METHODS: In this cross-sectional comparative study, 45 non-diabetic retinopathy(NDR), 52 mild nonproliferative diabetic retinopathy(NPDR), 55 moderate NPDR with type 2 diabetes mellitus(T2DM)and 64 age-matched healthy controls were included. The fasting blood glucose(FBG), duration of diabetes, glycosylated hemoglobin(HbA1c)and past history of the patients were collected in detail. Optic disc parameters(i.e., binocular RNFL thickness symmetry percentage, rim area, optic disc area, cup-to-disc ratio, cup volume), pRNFL thickness and mGCL thickness were measured by Cirrus HD-OCT. The comparison of different groups was performed by one-way analysis of variance.RESULTS: Compared with the control group, the binocular RNFL thickness symmetry percentage and rim area were significantly decreased, while the average C/D and vertical C/D were significantly increased in the NDR group, mild NPDR group and moderate NPDR group(all P<0.05). Compared with the control group, the peripapillary RNFL thicknesses(superior, temporal, inferior, nasal)and macular GCL thickness(average, minimum, superior, supero-temporal, infero-temporal, inferior, supero-nasal, and infero-nasal)became thinner in the NDR group, mild NPDR group, and moderate NPDR group(all P<0.05).CONCLUSION: Patients with early DR have significantly decreased binocular RNFL thickness asymmetry, rim area, pRNFL and mGCL thickness, while they have significantly increased cup-to-disc ratio when compared to healthy controls. The results support the statement that DM causes inner retinal neurodegenerative changes even in T2DM patients without overt microangiopathy.

Correlation of macular ganglion cell-inner plexiform layer thickness with myopia / 眼科新进展

Objective To analyze the correlation of the macular retinal ganglion cells-inner plexiform layer (GCIPL) thickness and the axial length and refractive power in myopia,thereby providing guidance for GCIPL thickness analysis in myopic glaucoma patients.Methods A total of 95 patients (190 eyes) with different degrees of myopia were recruited from October 2015 to September 2016 in Shenyang HE Eye Hospital,with age ranging from 18 to 36 years.Variables including gender,age,axial length,medical optometry diopter (spherical equivalent),GCIPL thickness (the mean,minimum,superior,inferior,temporal superior,temporal inferior,nasal inferior and nasal superior parameter) were recorded.According to diopter,all patients were divided into A group (-0.25 to-3.00D),Bgroup (-3.25 to-6.00 D),C group (＞-6.00 D);moreover,according to the axial length,they were assigned into A1 group (22 to 24 mm),B1group (＞24 to 26 mm) and C1 group (＞26 mm),and all above variables were compared.Single factor analysis of variance was used to analyze the differences in GCLIP thickness parameters between the 3 groups and Pearson correlation analysis was used to analyze the correlation of GCIPL thickness with different diopters and axial length.Results There was no significant difference in gender and age,but there were significant differences in the mean diopter and axial length among the 3 groups (F =523.963,P =0.000;F =57.452,P =0.000).And a negative correlation was presented between axis length and refractive power (r =-0.707,P =0.000) in all patients.There were significant differences in GCIPL thickness (the mean,minimum,superior,inferior,temporal superior,temporal inferior,nasal inferior and nasal superior parameter) among A,B and C group (F =3.231-16.500,all P ＜ 0.05) as well as among A1,B1 and C1 group (F =5.234-19.999,all P ＜ 0.05).The thickness of GCIPL was negatively correlated with refraction power (r =-0.419 to-0.153,all P ＜ 0.05),and the axial length(r =-0.407 to-0.241,all P ＜ 0.05).Conclusion With the increase of diopter and axial length,the thickness of GCLIP gets thinner in myopic patients.The effect of axial length should be taken into consideration when the GCLIP thickness of myopic glaucoma patients is evaluated.

Prognostic Factors in Vitrectomy for Macular Epiretinal Membrane

PURPOSE: To identify prognostic factors associated with a favorable outcome after vitrectomy for patients with macular epiretinal membrane (ERM). METHODS: The authors retrospectively reviewed the records of 63 patients (64 eyes) with macular ERM, who were treated by vitrectomy between 2003 and 2008, and followed for more than 6 months. RESULTS: The mean follow-up period was 13.21 +/- 9.11 months and the mean best corrected visual acuity after vitrectomy was log MAR 0.32 +/- 0.34. Univariate analysis revealed the patients in the group with a postoperative log MAR of 0.3 or better had better preoperative visual acuity and shorter symptom duration; multivariate analysis revealed the same results. In 24 eyes, intraretinal structures which contained pseudoholes, intraretinal cysts, retinal folds and vitreoretinal traction were analyzed with Cirrus HD-OCT, however, there was no correlation with visual acuity after vitrectomy. CONCLUSIONS: The present study demonstrated vitrectomy for macular ERM resulted in favorable visual improvement. The preoperative visual acuity and symptom duration were a significant prognostic factor.

The Measurements of Macular Thickness and Volume with SD-OCT in Normal Eyes

PURPOSE: We investigated reproducibility and repeatability of average macular thickness and volume measurements in normal eyes with Cirrus HD OCT (optical coherence tomography). METHODS: Fifty normal eyes from twenty-five subjects without medical and ocular histories were included. Macular cube 512 x 128 combination scanning using the Cirrus HD OCT was performed for a total of three times on the same visit by an experienced technician. Then other two technicians performed one more macular scanning respectively. Within-results, the intraclass correlation coefficient (ICC) was calculated for each parameter studied to evaluate repeatability and reproducibility. The correlation between macular measurements and demographic variables (age, gender, and spherical equivalent) were also investigated. RESULTS: The ICCs for intraoperator reproducibility were 0.99 on the average macular thickness and 0.96 on the macular volume. And the ICCs for interoperator repeatability were found to be 0.98 and 0.96, respectively. The ICCs for measurements of nine regional retinal thickness also were higher than 0.90. The retinal thickness was correlated with age, gender and refractive error. However, neither age nor refractive error affected to reproducibility and repeatability. CONCLUSIONS: The retinal thickness and macular volume measurements using Cirrus HD OCT in healthy volunteers showed excellent reproducibility and repeatability. Therefore, Cirrus HD OCT has been recognized as an useful tool for diagnosis and mornitoring of variable maculopathies.