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Objective:To evaluate and compare the foveal microvascular morphology and central foveal thickness (CFT) after laser retinal photocoagulation and intravitreal injection of anti-vascular endothelial growth factor (VEGF) in patients with retinopathy of prematurity (ROP), and to explore the factors affecting the prognosis of vision.Methods:A cohort study was conducted.Forty children (40 eyes) aged 4-6 years, who had been treated in Peking University People's Hospital for type 1 ROP from January 2019 to December 2020, were enrolled.Optical coherence tomography angiography (OCTA), best corrected visual acuity (BCVA) and refractive status of the patients were examined.The patients were divided into laser retinal photocoagulation group and anti-VEGF group according to they received a single laser retinal photocoagulation therapy or a single intravitreal injection of anti-VEGF drugs (conbercept or ranibizumab 0.25 mg/0.025 mL) after birth.Twenty age-matched full-term healthy children (20 eyes) were enrolled as the normal control group.The FAZ area, superficial and deep foveal vessel density (VD) and CFT of the affected eyes were measured by OCTA at 4-6 years after treatment to investigate the influence of gestational age, birth weight, morphological characteristics of foveal microvessels and CFT on the prognosis of BCVA.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Peking University People's Hospital (No.2017PHB179-01). Written informed consent was obtained from the guardians prior to any medical examination.Results:There were statistically significant differences in FAZ area, superficial foveal VD and deep foveal VD among the three groups ( F=12.321, 8.436, 5.497; all at P<0.05). The FAZ area was smaller, and the superficial and deep foveal VD of the laser photocoagulation group and the anti-VEGF group were greater than those in the normal control group, and the difference was statistically significant (all at P<0.05). The CFT of the laser photocoagulation group was (267.6±11.8)μm, greater than (259.5±12.9)μm of the anti-VEGF group and (242.4±12.3)μm of normal control group, and the CFT value of the anti-VEGF group was greater than that of the normal control group, and the differences were statistically significant (all at P<0.05). There was a strong negative correlation between the superficial foveal VD and FAZ area ( r=-0.713, P<0.05), a moderate negative correlation between the deep foveal VD and FAZ area ( r=-0.565, P<0.05), and a moderate positive correlation between gestational age and FAZ area ( r=0.485, P<0.05). Pearson correlation analysis results showed that gestational age, FAZ, superficial foveal VD, deep foveal VD, CFT were all correlated with BCVA (all at P<0.05). The effects of gestational age and FAZ on BCVA were both statistically significant ( R2=0.615, both at P<0.05). Conclusions:The morphology of microvessels in macular fovea and the prognosis of BCVA in the affected eye is similar at 4-6 years after laser retinal photocoagulation and intravitreal injection of anti-VEGF drugs for type 1 ROP.The CFT of the affected eye after anti-VEGF drug therapy is better than those after laser retinal photocoagulation.Gestational age and FAZ are the influencing factors of visual acuity after treatment in children with type 1 ROP.
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@#AIM: To observe and analyze the changes of macular retina thickness in children with occult high myopia and its influencing factors.<p>METHODS: A prospective, non-randomized, contemporaneous controlled trial. From September 2019 to September 2020, 56 children(110 eyes)who first visited the ophthalmic clinic of the Affiliated Hospital of Chengde Medical College without any myopia correction training were enrolled in this study. According to the clinical manifestations of myopia in children, they were divided into occult high myopia group(27 cases, 52 eyes)and control group(29 cases, 58 eyes, children with common myopia). The retina thickness in each macular area was compared between the two groups, and we will analyze the correlation between macular fovea mean retinal thickness and baseline data in children with occult high myopia. <p>RESULTS: The average retinal thickness of 9 macular regions in the occult high myopia group was thinner than that in the control group, and there were significant differences in the macular fovea, the blow and temporal side of the outer ring area of macular fovea(<i>P</i><0.05). Compared with the control group with the same spherical equivalent, there was significant difference in area that the temporal side of the outer ring of the macular fovea in the occult high myopia of 0.00D to -1.00D and the fovea in the occult high myopia group of >-2.00D to -3.00D(<i>P</i><0.05), but there was no significant difference among the other regions(<i>P</i>>0.05). Pearson correlation analysis results showed that the average retinal thickness under macular fovea in children with secretive high myopia had no significant correlation with gender, age, eye axis, intraocular pressure and corneal curvature(<i>P</i>>0.05), but was negatively correlated with diopter(<i>r</i>=-0.201, <i>P</i><0.05).<p>CONCLUSION: The thickness of macular retinal in children with occult high myopia is thinnest under macular fovea and the thickest above macular fovea in inner ring area. The average retinal thickness in each region of the macular is thinner than that in the common myopia children with the same diopter. The mean retinal thickness of macular fovea is negatively correlated with the diopter.
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@#AIM: To investigate the correlation between glycosylated hemoglobin(HbA1c)level and macular fovea retinal thickness after cataract surgery in diabetic patients. <p>METHODS: By a randomized sampling and retrospective study, from September 2013 to June 2016, a total of 119 cases(119 eyes)of diabetic retinopathy in our hospital were selected and divided into low HbA1c group(HbA1c≤7.0%)of 60 cases(60 eyes)and high HbA1c group(7.0%<HbA1c≤9.0%)of 59 cases(59 eyes)according to preoperative HbA1c levels. All patients underwent phacoemulsification and posterior chamber intraocular lens implantation. Optical coherence tomography(OCT)was used to detect the retinal thickness of the fovea before and after surgery, and its correlation with preoperative HbA1c levels was analyzed. <p>RESULTS: At preoperative 1d, HbA1c in the high HbA1c group and the low HbA1c group were 8.29%±2.19% and 5.38%±1.49% respectively, and the differences between two groups were statistically significant(<i>P</i><0.05); macular foveal retinal thickness in the 5 regions of high HbA1c group were significantly higher than that in the low HbA1c group(<i>P</i><0.05). At postoperative 7d of macular fovea retinal thickness in the 5 regions of the two groups was higher than that at postoperative 1d(<i>P</i><0.05), and the high HbA1c group was also significantly higher than that of the low HbA1c group(<i>P</i><0.05). Linear regression analysis showed that preoperative 1d HbA1c were significant positive correlation with preoperative 1d, postoperative 7d of macular foveal retinal thickness in 5 regions(<i>P</i><0.05).<p>CONCLUSION: HbA1c levels in diabetic patients are significantly correlated with preoperative and postoperative macular foveal retinal thickness. It has important clinical significance for monitoring the occurrence and development of macular edema after cataract surgery.
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@#Recently, although the phacoemulsification of cataract is improving, various complications of surgery still exist. As that most elderly patients are suffering from both cataract and diabetes, complications of cataract surgery in these people become an important issue. In this review, we summarized the recent research on the physiological characteristics of diabetic patients' retinal conditions and the impact from surgery itself, aiming at providing a useful clinical reference.
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Objective To observe the changes of four quantitative indexes of diabetic macular edema by using optical coherence tomography.Methods Eighty-nine patients (155 eyes) with diabetic retinopathy were included in this project and were divided into two groups according to the present of diabetic macular edema:Negative group (56 cases,100 eyes) and positive group(33 cases,55 eyes).In addition,23 cases (42 eyes) of normal volunteers constituted the normal control group.All the objects accepted an optical coherence tomography examination and the indexes including central retinal thickness (CRT),subfoveal choroidal thickness (SFCT) and integrity of external limiting membrane(ELM) as well as inner/outer segment (IS/OS) were measured and analyzed.Results The average CRT of positive group (219.048 ± 16.798) μm was significantly thicker than that of control group(217.775 ± 26.866) μm and negative group (280.418 ±74.187) μm (P ＜0.001).Mean SFCT among control group (312.893 ±140.559) μm,negative group (302.080 ± 125.287) μm and positive group (293.745 ±140.517) μm had no statistical significance (P =0.781).There were 3 eyes with disrupted ELM layer in the negative group and 8 eyes in the positive group.Difference between them was proved to be significant (P =0.019).Similarly,the integrity of IS/OS layer had significant difference between negative group (5 eyes disrupted) and positive group (19 eyes disrupted) (P ＜ 0.001).Conelusion CRT of patients with diabetic macular edema is always increased and the integrity of ELM or (and) IS/OS can be disrupted in many cases.Indexes including CRT and the integrity of ELM or (and) IS/OS can be used to evaluate the severity of diabetic macular edema quantificationally.