Objective To observe the Fourierdomain optical coherence tomography（FD-OCT）characteristic of idiopathic epiretinal membrane (ERM) and its correlation with the patients visual acuity. Methods The 116 eyes (112 patients) with idiopathic epiretinal membrane were included in this study. All the patients had undergone examination of visual acuity (LogMAR chart), ocular fundus (direct ophthalmoscope and fundus pre-set lens), and FD-OCT (Zeiss HD-OCT) with the speed of 27 000 A scan/s,area of 6.0 mmtimes;6.0 mm, and mode of 512times;128. The central fovea thickness (CFT), volume (V), average thickness (AT) were collected from the OCT readings, and the fovea thickness (FT) was measured manually. Data were analyzed using SPSS 16.0. Results The traction on retina caused by ERM can be divided into 3 types according to the OCT findings: no traction (9.48%), tangential traction (84.48%) and tangential traction with anteriorposterior traction (6.04%). A total of 97 eyes (83.62%) had retinal edema (diffuse or cystoid) and the edema located at the outer nuclear layer(ONL), outer plexiform layer(OPL)and inner nuclear layer (INL) . A total of 14 eyes (12.07%) had retinal nerve fiber layer (RNFL) schisis and 27 eyes (23.28%) had inner segment/outer segment junction (IS/OS) impairment. Statistic analysis revealed that BCVA was not related to the age, gender, types of traction, presence of IS/OS damage or RNFL schisis (Pgt;0.05), but was related with CFT(Plt;0.05). Conclusions Idiopathic ERM can exert different types of traction on the macular, and cause different types of retinal lesions. OCT is a useful tool to measure these lesions. CFT reading is closely related to patients' visual acuity.
PURPOSE:To observe the clinical features of the macular hemorrhage in myopes. METHOD:Twenty-four patients(30 eyes)with myopic macular hemorrhage were examined with slitlamp biomicroscopy,funduscope,A/B ultrasonography,and fundus fluorecein angiography(FFA). The patients were followed up for 3~18 months(average 12 months). RESULTS: Four of 26 eyes with macular hemorrhage examined with FFA were found to be due to choroidal neovaseulature,and they were associated with posterior staphyloma. The other 22 eyes without neovascular change were thought to be simple type,and 19 of them were associated with lacquer cracks. The hemorrhage in simple type cases deminished usually within 1~3 months. CONCLUSION:Myopic macular hemorrhagic eyes of neovascular type resulted usually in recurrent hemorrhage and worse prognosis in visual acuity than those of simple type. （Chin J Ocul Fundus Dis,1996,12: 220-222）
Objective To investigate the characteristics of optical coherence to mography (OCT) in eyes with repaired idiopathic macular hole (IMH) after operation and the relation with recovery of visual acuity. Methods The characteristics of OCT images of 24 patients (25 eyes) with repaired IMH after vitrectomy,internal limiting membrane（ILM）peeling and auto-serum healing were analyzed retrospectively. In the patients with IMH, the macular hole was found in 9 eyes at st age II, 13 eyes at stage III, and 3 eyes at stage IV. Examinations of best-corrected visual acuity, slit-lamp biomicroscopy with fundus contact lens, fundus photography, fundus fluorescein angiography(FFA) and OCT were performed on the patients 3 to 24 months after surgery. Results OCT images of the repaired IMH were categorized into 3 patterns: U-type (5 eyes ) with relative normal foveal contour; V-type (7 eyes) with steep foveal contour;W-type (13 eyes) with foveal defect of neurosensory retina, but without warped hem of retinal hole or cystic formation. Postoperative visual acuities were improved in all of the patients and the best ones were in group U-type. Conclusion Characteristics of OCT images of repaired IMH may be related to the postoperative visual acuity. (Chin J Ocul Fundus Dis，2004，20：90-93)
ObjectiveTo observe the different changes of macular microstructure in patients with large idiopathic macular hole (IMH) treated with vitrectomy combined with internal limiting membrane (ILM) transplantation or not. MethodsForty eyes in 40 consecutive patients with giant IMH (≥500 μm) were included in the study. Twenty eyes received vitrectomy with ILM transplantation (ILM transplantation group) and others with ILM peel off (ILM removal group). During the operation, a proper size of the ILM was removed and filled in the bottom of the macular hole. The age, duration of disease and the ocular laterality of the two groups of patients were not statistically significant (P>0.05). Minimum resolution angle in logarithmic (logMAR) best corrected visual acuity (BCVA) and frequency domain optical coherence tomography (SD-OCT) scan were examined. There was no statistically significant difference in logMAR BCVA, average defect diameter of photoreceptor ellipsoid (IS/OS) and average defect diameter of external limiting membrane (ELM) between two groups (t=0.128, 1.452, 1.321; P>0.05). The logMAR BCVA and SD-OCT were examined on 1, 3, 6, 12 months postoperatively. ResultsOn 1 month after the surgery, there was no statistically significant difference in logMAR BCVA, average defect diameter of IS/OS and average defect diameter of ELM between two groups (t=1.226, 1.435, 1.018; P>0.05). On 3, 6, 12 months after the surgery, compared with ILM removal group, the logMAR BCVA (t=2.059, 2.871, 2.415) increased and the average defect diameter of IS/OS (t=2.070, 2.110, 2.121) and ELM (t=2.034, 3.647, 3.556) significantly reduced in ILM transplantation group (P<0.05). On 1 month after the surgery, there was statistically significant difference in CRT between two groups (t=2.113, P<0.05). On 3, 6, 12 months after the surgery, there was no statistically significant difference in CRT between two groups (t=0.428, 0.847, 0.849; P>0.05). ConclusionCompared with vitrectomy combined with ILM peeling surgery, the diameter of IS/OS and ELM defect were significantly decreased after vitrectomy combined with ILM transplantation in the patients with large IMH.
Objective To analyze the correlation of foveal avascular zone (FAZ) size with visual acuity and metamorphopsia in idiopathic macular epiretinal membrane (IMEM) eyes. Methods This is a cross-sectional study, including 43 patients (43 eyes) with IMEM (IMEM group) and 35 health subjects (35 eyes) as control group. The best corrected visual acuity (BCVA) was measured using the international standard visual acuity chart, and the results were converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity. The severity of metamorphopsia was measured using M-charts. The FAZ areas were estimated with optical coherence tomography angiography (OCTA) in both the superficial and deep capillary plexus layers. The central macular thickness (CMT) was assessed with spectral-domain optical coherence tomography. There was no difference of logMAR BCVA and CMT between two groups (Z=?7.379, ?7.560; P＜0.001). The differences of FAZ areas between the two groups were analyzed. The correlative analysis was performed to investigate the relationship between FAZ areas and visual acuity as well as metamorphopsia. Results The FAZ area in superficial and deep capillary plexus in IMEM group were smaller than those in control group (t=?30.316, ?27.606; P＜0.001). In IMEM group, the mean M-score was 0.41±0.32; the horizontal and vertical M-score were 0.49±0.40 and 0.32±0.29, respectively. The horizontal M-score was higher than vertical M-score with the significant difference (Z=?2.000, P=0.046). In IMEM group, the FAZ area in superficial capillary plexus correlated inversely with metamorphopsia (r=?0.709, P＜0.001); the FAZ area in deep capillary plexus correlated inversely with metamorphopsia and BCVA (r=?0.533, ?0.838; P＜0.001). Conclusions The FAZ areas are significantly decreased in IMEM eyes compared with normal eyes. Both superficial and deep FAZ areas are correlated with metamorphopsia, and deep FAZ area is also correlated with BCVA.
Objective To observe the dimensions of the capillary blood vessel arch in central fovea of macula and the foveal avascular area (FAZ), and their relationships with age.Methods Retina in macula of 32 cadavers eyes were isolated . Retinal vessels were immunostained by collagen type IV and examined by confocal laser scanning microscopy. The area and diameter of the FAZ were measured, and the relationship between FAZ and age was analysed. Results The parafoveolar capillary network was observed clearly by confocal laser scanning microscopy. The average area of the FAZ was (0.24±0.13) mm2, and the average diameter was (0.54±0.15) mm. The area and diameter of the FAZ did not show any correlation with age.Conclusions The parafoveolar capillary network could be observed by confocal laser scanning microscopy. The size of the FAZ does not change with age. The dimensions of the parafoveolar capillary network may not be influenced by age. (Chin J Ocul Fundus Dis，2003，19：73-75)
Purpose To investigate the histopathologic changes of macula lutea retinae in the elderly Chinese population,and to provide information for the cause of visiual disturbance in an autopsy study. Methods Two hundred and twelve eyes from 108 consecutive cases of postmortem (mean age of 78.4 years old) sections of the area of macula lutea retinae were studied by histopathology. Results Among the 212 eyes,hard drusen were found in 36.3% of eyes and soft drusen in 19.3% of eyes.The eyes with both of the above mentioned 2 types of drusens were found to be combined with RPE atrophy and RPE detachment;and subretinal neovascularization were found in 5.7% of these eyes and they were associated with obvious RPE atrophy and photoreceptor loss;3.2% eyes had posterior scleral staphyloma showing thinning of the sclera and choroid,RPE atrophy and apparent photoreceptor loss;2.4%eyes showed CME with the history of cataract surgery. Conclusion The macular affections,age-related macular degeneration,myopic macular degeneration and post-perative cystoid macular edema are varying in number in the above mentioned order successively,in elderly Chinese at an autopsy study. (Chin J Ocul Fundus Dis,2000,16:233-235)
ObjectiveTo observe the blood perfusion changes of peripapillary and macular vessels in patients with nonarteritic anterior ischaemic optic neuropathy (NAION).MethodsRetrospective cohort study. Thirty-six eyes (19 affected eyes and 17 fellow eyes) of 19 patients with NAION diagnosed in People’s Hospital of Wuhan University from November 2017 to January 2019 were included in this study. There were 10 males and 9 females, with the mean age of 55.05±7.11 years. Forty eyes of 20 normal subjects matched with NAION patients were included as controls. BCVA, fundus color photography, SD-OCT and OCT angiography were performed in normal controls and repeated in NAION affected eyes at 1-2 weeks, 1-2 months, 3-5 months intervals. OCT quantitative measurements: average retinal nerve fiber layer thickness (aRNFL) of the disc and its superior values (sRNFL) and the inferior values (iRNFL), average ganglion cell complex thickness (aGCC) in macular region and its superior values (sGCC) and the inferior values (iGCC). OCTA quantitative measurements: average radial peripapillary capillary density (aRPC) and its superior values (sRPC) and the inferior values (iRPC), average vascular density of superficial retina (aSVD) in macular region and its superior values (sSVD) and the inferior values (iSVD), average vascular density of deep layer retina (aDVD), areas of foveal avascular zone (FAZ). The differences of OCT and OCTA quantitative measurements between NAION eyes and the fellow eyes and normal controls were comparatively analyzed. Independent sample t test, paired sample t test or nonparametric rank sum test were performed for comparison among three groups. Pearson or Spearman correlation analysis were used to analyze the correlation between RNFL and RPC, GCC and SVD, RNFL and GCC, RPC and SVD.ResultsAt baseline, the aRNFL, aRPC and aDVD of NAION patients were significantly higher than those of normal controls. Compared with the fellow eyes, the aRNFL increased significantly and the aRPC decreased significantly in NAION affected eyes. The overall differences of aRNFL, aRPC, aGCC and aSVD at four intervals within NAION affected eyes were statistically significant (P＜0.05). The average sRNFL, sRPC, sGCC and sSVD at 1-2 months interval were significantly lower than the average iRNFL, iRPC, iGCC and iSVD (P＜0.05). Correlation analysis: at 1-2 months interval, aGCC was positively correlated with aSVD (r=0.482, P=0.037); at 3-5 months interval, aRNFL was positively correlated with aRPC (r=0.631, P=0.037).ConclusionThere is a sectorial reduction of vascular density of peripapillary RPC and macular SVD with the disease progression of NAION.
ObjectiveTo observe the changes of the inner-retinal irregularity index (IRII) of eyes with idiopathic macular epiretinal membrane (IMEM) before and after surgery and its correlation with visual function.Methodsretrospective series of studies. From March 2017 to May 2018, 46 IMEM patients (46 eyes) diagnosed in the Department of Ophthalmology of Central Theater Command General Hospital were included in the study. BCVA, visual deformation degree (M), OCT inspection with swept source were all performed. The BCVA examination was carried out using the international standard visual acuity chart, which was converted into logMAR visual acuity for record. The average IRII was 1.255±0.048, the average logMAR BCVA was 0.63±0.21, the average M value was 0.68±0.38, the average of central macular thickness (CMT) was 353.57±73.92 μm, the average inner retinal layer thickness (IRT) was 181.50±40.91 μm. The complete and incomplete ellipsoid zone (EZ) were 17 and 29 eyes, respectively. All eyes underwent a 25G three-incision closed vitrectomy through the flat part of the ciliary body, and the epiretinal membrane and inner limiting membrane were removed at the same time. The changes of IRII, M value, BCVA, CMT, IRT and EZ were observed at 1, 3, 6, and 12 months after surgery, and the correlation were analyzed between IRII and M value and BCVA before and after surgery. Single-factor repeated measurement data analysis of variance was used for the comparison of BCVA, M value, CMT, and IRT before and after surgery. Spearman rank correlation analysis were adopted for the correlation analysis between IRII and BCVA, M value, CMT, IRT and EZ integrity before and after surgery.ResultsTwelve months after surgery, the average IRII and logMAR BCVA were 1.175±0.032 and 0.47±0.16, respectively. Compared with those before surgery, they were significantly improved, and the difference was statistically significant (F=22.273, 5.453; P＜0.001, ＜0.001). The average M value (F=20.109), CMT (F=14.273), IRN (F=13.665) were significantly lower than those before the operation, and the difference was statistically significant (P＜0.001, 0.001, ＜0.001). The integrity of EZ was significantly improved compared with that before surgery, and the difference was statistically significant (χ2=12.715, P＜0.001). The results of correlation analysis showed that preoperative IRII was positively correlated with preoperative M value and CMT (r=0.951, 0.701; P＜0.001, ＜0.001). It was positively correlated with postoperative M value, logMAR BCVA, CMT and EZ integrity (r=0.650, 0.369, 0.720, 0.293; P＜0.001, ＜0.001, P=0.048). It was not correlated with preoperative logMAR BCVA and EZ integrity (r=0.283, 0.001; P=0.056, 0.996).ConclusionThe IRII of IMEM eyes before surgery is significantly correlated with the BCVA and M values after surgery.
ObjectiveTo observe the effect of non-vitrectomy in the treatment of idiopathic macular epiretinal membranes (IMEM).MethodsThis study is a randomized controlled trial. From December 2017 to December 2018, 60 IMEM patients (60 eyes) diagnosed in Weifang Eye Hospital were included in the study. BCVA, intraocular pressure (IOP) and OCT were performed in all patients. The BCVA examination was performed using the international standard visual acuity chart, which was converted to logMAR. The CMT was measured by OCT. According to the surgical methods, the patients were divided into non-vitrectomy group and control group, 30 patients (30 eyes) in each group. The age (t=1.723), logMAR BCVA (t=1.703), CMT (t=-0.956), IOP (t=-1.434) were not significantly different between the two groups (P=0.090, 0.094, 0.343, 0.157). 23G vitreous cutting system was used in all eyes. The macular epiretinal membranes was removed by non-vitrectomy in the non-vitrectomy group and by vitrectomy in the control group. The relevant examination with the same equipment and methods before the operation at 1 week and 1, 3, 6 months after operation. The time of surgery, the changes of BCVA, CMT and postoperative complications in the two groups were observed comparatively. Variance analysis of repeated measurements was performed for the comparison of BCVA, CMT and IOP after surgery in the two groups. Wilcoxon rank sum test of two independent samples was performed for the degree of vision improvement. The incidence of postoperative complications was compared by χ2 test.ResultsAt 6 months after operation, BCVA increased in 24 eyes (80%) and unchanged in 6 eyes (20%) in the non-vitrectomy group. Compared with preoperative BCVA, the difference was statistically significant (P＜0.05). BCVA increased in 25 eyes (83.4%), unchanged in 4 eyes (13.3%) and decreased in 1 eye (3.3%) in the control group. Compared with preoperative BCVA, the difference was statistically significant (P＜0.05). There was no significant difference between the two groups in BCVA improvement degree after operation (Z=－0.26, P＞ 0.05). At 6 months after operation, the average logMAR BCVA was statistically significant compared with the preoperative in the non-vitrectomy group (P=0.002, 0.005) and control group (P=0.004, ＜0.001). Visual stability occurred 1 month after operation in the non-vitrectomy group and 3 months after operation in the control group. The effective operative time of the non-vitrectomy group and control group was 4.50±1.41 and 15.50±2.33 min, respectively. The difference of effective operation time between the two groups was statistically significant (t=－22.12, P＜0.05). After surgery, no significant complications were found in the non-vitrectomy group. In the control group, there were 3 eyes with low IOP and 1 eye with macular hole during operation.ConclusionsNon-vitrectomy and vitrectomy have similar effects on IMEM. Non-vitrectomy has short effective operation time, faster recovery after surgery and no obvious complications.