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）
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.
Objective To investigate the clinical features, etiological classification and staging of epiretinal macular membrane(MEM)． Methods Clinical materials of 194 cases of MEM diagnosed by fundus fluorescein angiography in outpatient department of eye clinic in this hospital from 1983 to 2000 were retrospectively analyzed． Results There were typical clinical symptoms and signs of MEM in all of this 222 eyes of 194 patients． Etiological classification revealed that 4 cases were congenital(2．12%), 22 cases were secondary(11．34%), and 168 cases were idio pathic(86．60%)． Staging of course of disease indicated that 119 eyes were in early stage(53．60%), 72 eyes were in middle stage(32．43%), and 31 eyes were in late stage(13．96%)． Conclusion MEM may be classified as congenital, secondary and idiopathic type according to its pathogenesis , as early, middle and late stage according to the clinical course of disease．This can be helpful in treating the disease． (Chin J Ocul Fundus Dis, 2001,17:210-213)
ObjectiveTo observe the changes of macular vascular density of hypertensive patients without obvious hypertensive retinopathy (HRP).MethodsTwenty-three patients (hypertension group) diagnosed as grade 2 or grade 3 essential hypertension in Cardiology Department of Renmin Hospital of Wuhan University from January to April 2019 were enrolled in the study. Among them, there were 13 males and 10 females. The mean age was 61.6 ± 5.6 years, and the mean BCVA was 0.74 ± 0.16. The course of hypertension was more than 7 years; Keith Wagener (K-W) grade was 0 or 1. Fifteen age-matched people without hypertension were selected as the control group, among which included 8 males and 7 females. Their average age was 59.7 ± 4.4 years and the average BCVA was 0.79 ± 0.17, the K-W grades were 0. There was no significant difference (P=0.265, 1.000, 0.563) between the two groups in age (t=1.739), sex ratio (χ2=0.036) or BCVA (t=0.585). All subjects were examined by BCVA, fundus photography and OCTA. OCTA scanned the macular area in the range of 3 mm × 3 mm. The software automatically divided the image into two concentric circles with the macular fovea as the center, which are the inner ring with a diameter of 1 mm (foveal area) and the outer ring with a diameter of 1-3 mm. The blood flow density of the whole, temporal, upper, nasal and lower capillary layers within 3 mm of the macular area, and foveal avascular zone (FAZ) area, central foveal retinal thickness (CFT) were measured.ResultsSignificant differences were observed in the vascular densities of total, temporal, nasal and inferior area of maculas (t=2.188, 2.472, 5.105, 2.734; P=0.037, 0.020, 0.000, 0.010) between the two groups, while no significant differences were evidenced in foveal vascular densities and superior vascular densities (t=0.575, 0.140; P=0.570, 0.889). There was no significant difference in FAZ area or CFT between the two groups (t=0.367, 0.753; P=0.714, 0.457). Macular arches were intact in all hypertension patients.ConclusionsThe vascular densities of total, temporal, nasal and inferior area of maculas in the hypertension patients without HRP decreased. The area of FAZ did not expand, and the structures of macular arch ring were normal.
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.
ObjectiveTo evaluate the changes of metamorphopsia in patients with rhegmatogenous retinal detachment (RRD) who underwent primary vitrectomy and to analyze the correlation between macular microstructure changes and metamorphopsia.MethodsIt was a retrospective clinical study. From January 2017 to January 2019, 57 patients (57 eyes) with RRD were examined and diagnosed in the Department of Ophthalmology of Baoding First Central Hospital were enrolled in this study. All patients underwent 23G PPV. All patients had retinal anatomical reduction after the first PPV. The best corrected visual acuity (BCVA), intraocular pressure, slit-lamp microscope, indirect ophthalmoscope, changes of metamorphopsia, and optical coherence tomography (OCT) were examined before PPV and 1, 6, 12 months after the operation. The BCVA examination was performed using the international standard visual acuity chart, which was converted into a logarithm of the minimum angle of resolution (logMAR) BCVA for the record. The macular fovea retinal thickness (CRT) was measured by Carl Zeiss Cirrus HD-OCT5000 instrument from Carl Zeiss Company, Germany, and the microstructural changes in the macular area were recorded, including the presence of the anterior macular membrane (ERM), cystic macular edema (CME), subretinal fluid (SRF), and the integrity of the ellipsoid zone (EZ) and outer membrane (ELM). The value of metamorphopsia (M value) was measured by the M-Chart table. The changes of BCVA, M value, and the microstructure of the macular area before and after operation were analyzed. The correlation between BCVA and M value was analyzed by Pearson correlation. Spearman correlation analysis was used to analyze the correlation between the changes of macular microstructure and BCVA and M values.ResultsThe mean logMAR BCVA before the operation was 1.15±0.43. At 1, 6, and 12 months after the operation, the mean logMAR BCVA was 0.62±0.17, 0.39±0.18, and 0.34±0.13, respectively. The visual acuity improved significantly after operation compared with before operation, and the difference was statistically significant (F=119.731, P=0.000). The mean CRT before the operation was 476.0±104.1 μm. At 1, 6, and 12 months after the operation, the average CRT were 299.8±29.9, 272.2±17.8, and 261.0±19.3 μm, respectively. The average CRT after the operation was significantly lower than those before the operation (F=185.518, P=0.000). At 1, 6, and 12 months after the operation, the mean M values were 0.62±0.54, 0.43±0.41, and 0.32±0.36, respectively; the difference was statistically significant (F=6.568, P=0.020). After the operation, 48 eyes (84.2%, 48/57) had microstructural abnormalities in the macular area, including EZ and ELM integrity disruption, SRF, CME, and ERM. Correlation analysis showed that M value was significantly positively correlated with BCVA, CRT, and SRF height before operation (r/rs=0.672, 0.385, 0.932; P＜0.05). There was no correlation between M value and BCVA (r/rs=0.503), EZ and ELM integrity (r/rs=0.497, 0.472), SRF (r/rs=0.416), CME (r/rs=0.821) and ERM (r/rs=0.632) after operation (P＞0.05).ConclusionsThe BCVA is significantly increased and the metamorphopsia is improved after anatomically successful RRD surgery. Postoperative M value is highly correlated with preoperative BCVA, CRT, and SRF.
ObjectivesTo evaluate the reproducibility of Heidelberg retina tomograph (HRT) macular edema module(MEM) measuring the macular retinal thickness.MethodsSixty-two healthy volunteers (9-68 years old) were examined by HRT-II procedure. The retinal signal width (SW) at macula and fovea and macular edema index (E) were recorded for t-test, Pearson linear-correlation analysis. Intra-subject variation repeatedly measured was analyzed with coefficient of variation, 95% tolerance limits of change (TC), and intraclass coefficient of correlation (ICC). ResultsIn healthy individuals, retinal SW was (0.734±0.236) mm at macula，and (0.781±0.243) mm at fovea; macular E was (1.169±0.619). The coefficient of variation repeatedly measured: retinal SW was (8.7±68)%，retinal SW at the fovea was (8.5±6.7)%, and the average was (15.6±13.9)%; 95%TC of intra-subject sequential repeated measurement was 0.131 (8.9%) of retinal SW, 0.137 (10.5%)of fovea SW，and 0.198 (7.4%) of average E. ICC of one individual repeatedly measured by one operator was 0.950 of macular SW, 0.949 of fovea SW, and 0.898 of average edema index.ConclusionsHRT-II MEM is noninvasive, fast and highly reproducible, which provides a new technique to monitor the objective quantification of macular diseases related to retinal thickness. ( Chin J Ocul Fundus Dis, 2005,21:103-105)
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.
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 macular retinal thickness and volume in patients with different degrees of Parkinson's disease (PD).MethodsThirty eyes of 30 patients with primary PD and 20 eyes of 20 healthy subjects (control group) in Xuanwu Hospital of Capital Medical University from October 2016 to October 2017 were enrolled in this study. There were 17 males and 13 females, with the mean age of 63.2±6.4 years and disease course of 3.9±2.4 years. The patients were divided into mild to moderate PD group (15 eyes of 15 patients) and severe PD group (15 eyes of 15 patients). The macular area was automatically divided into 3 concentric circles by software, which were foveal area with a diameter of 1 mm (inner ring), middle ring of 1 to 3 mm, and outer ring of 3 to 6 mm. The middle and outer ring were divided into 4 quadrants by 2 radiations, respectively. The changes of retinal thickness and macular volume of the macular center and its surrounding quadrants were analyzed. SPSS 16.0 software was used for statistical analysis. One-way ANOVA were used to analyze all data.ResultsCompared with the control group, the retinal thickness and volume in macular center and each quadrant of the mild to moderate PD group and severe PD group were reduced. Compared with the mild to moderate PD group, the retinal thickness and volume in macular center and each quadrant of the severe PD group were reduced. The differences of retinal thickness and macular volume among 3 groups were significant (F=5.794, 5.221, 5.586, 5.302, 5.926, 5.319, 5.404, 5.261, 5.603; P=0.001, 0.007, 0.003, 0.005, 0.000, 0.004, 0.004, 0.006, 0.002). In inner ring of the mild to moderate PD group and the severe PD group, the retinal thickness and macular volume in the upper and the nasal were the largest, the inferior was followed, and the temporal was the smallest. In outer ring of the mild to moderate PD group and the severe PD group, the retinal thickness and macular volume in the nasal was the largest, the upper was the second, the temporal and the inferior were the smallest.ConclusionsThe retinal thickness and volume of the macular central fovea and its surrounding areas in PD patients are significantly thinner than that in the healthy subjects. And with the increase of the severity of PD, the macular structure changes obviously, showing macular center and its surrounding macular degeneration thin, macular volume reduced.