PURPOSE:To examine the role of apoptosis in photoreceptor cells degeneration process in Pathologic myopia. METHODS: Nine human eyes with pathologic myopia were studied by histopathologic and TDT-mediated biotin-dUTP nick-end labelling (TUNEL) techniques. RESULT:The characteristic DNA fragmentation of apoptosis was observed in scattered photoreceptor cells in 4 of 9 eyes. CONCLUSION:The results suggested that apoptosis is one of the pathways of photoreceptor cells death in retinal degeneration of pathologic myopia. （Chin J Ocul Fundus Dis,1996,12: 144-146 ）
Objective To investigate the features of optic disc formation and retinal nerve fiber layer(RNFL) changes in primary open-angle glaucoma with myopia (M-POAG). Methods On 63 eyes of 38 patients with M-POAG were imaged of the fundus,and were evaluated with the microcomputer image analyser,and were compared with the simple POAG (S-POAG) eyes. Results Variant features of the optic disc and RNFL atrophy were found in this M-POAG eyes.The shapes of the optic disc were revealed to be vertically or horizontally oval,obliquely inserted and irregular,the color of the most of optic disc was pallor.The pattern of glaucomatous cupping was saucer-like (28.6%),vertical (25.4%),oblique (23.8%),pot-like (9.5%),and focally or concentrically cupped.The quotient of the neuroretinal rim area and horizontal C/D ratio were significantly lower than those in S-POAG eyes (Plt;0.05,Plt;0.001).The focal point of the optic disc excavtions tended to be inferior.Most of the incidence in the focal atrophy of RNFL was located inferiorly,and the diffuse atrophy of RNFL was correlated positively with middle or late high-myopia POAG eyes (P＜0.005). Conclusion The variant features of the optic discs,glaucomatous cupping and RNFL atrophy formation in M-POAG eyes found in this series might be helpful in clinical diagnosis. (Chin J Ocul Fundus Dis,2000,16:81-84)
ObjectiveTo evaluate the macular visual function of patients with myopic choroidal neovascularization (MCNV) before and after intravitreal injection of conbercept.MethodsA prospective, uncontrolled and non-randomized study. From April 2017 to April 2018, 21 eyes of 21 patients diagnosed as MCNV in Shanxi Eye Hospital and treated with intravitreal injection of conbercept were included in this study. There were 9 males (9 eyes, 42.86%) and 12 females (12 eyes, 57.14%), with the mean age of 35.1±13.2 years. The mean diopter was ?11.30±2.35 D and the mean axial length was 28.93±5.68 mm. All patients were treated with intravitreal injection of conbercept 0.05 ml (1+PRN). Regular follow-up was performed before and after treatment, and BCVA and MAIA micro-field examination were performed at each follow-up. BCVA, macular integrity index (MI), mean sensitivity (MS) and fixation status changes before and after treatment were comparatively analyzed. The fixation status was divided into three types: stable fixation, relatively unstable fixation, and unstable fixation. The paired-sample t-test was used to compare BCVA, MI and MS before and after treatment. The x2 test was used to compare the fixation status before and after treatment.ResultsDuring the observation period, the average number of injections was 3.5. The logMAR BCVA of the eyes before treatment and at 1, 3, and 6 months after treatment were 0.87±0.32, 0.68±0.23, 0.52±0.17, and 0.61±0.57, respectively; MI were 89.38±21.34, 88.87±17.91, 70.59±30.02, and 86.76±15.09, respectively; MS were 15.32±7.19, 21.35±8.89, 23.98±11.12, 22.32±9.04 dB, respectively. Compared with before treatment, BCVA (t=15.32, 18.65, 17.38; P＜0.01) and MS (t=4.08, 3.50, 4.26; P＜0.01) were significantly increased in the eyes 1, 3, and 6 months after treatment. There was no significant difference in the MI of the eyes before treatment and at 1, 3, and 6 months after treatment (t=0.60, 2.42, 2.58; P＞0.05). Before treatment and at 1, 3, and 6 months after treatment, the proportion of stable fixation were 28.57%, 38.10%, 38.10%, 33.33%;the proportion of relatively unstable fixation were 47.62%, 47.62%, 52.38%, 57.14% and the proportion of unstable fixation were 23.81%, 14.28%, 9.52%, 9.52%, respectively. The proportion of stable fixation and relatively unstable fixation at 1, 3 and 6 months after treatment were higher than that before treatment, but the difference was not statistically significant (x2=1.82, 1.24, 1.69; P＞0.05).ConclusionBCVA and MS are significantly increased in patients with MCNV after intravitreal injection of conbercept.
Objective To investigate the iconographic characteristics and clinical significances of synchronic examination of indocyanine green angiography (ICGA) and fundus fluorescein angiography (FFA) for high myopia.Methods Thirty patients (57 eyes) with high myopia（gt;-6.00D）, selected randomly and consecutively, were examined by ICGA and FFA synchronically.Results The result of early phase of FFA showed hypofluorescence of the background in 25 eyes，while of late phase showed subretinal neovascularization (SRNV) in 10 eyes and streak formation in 40 eyes. The result of ICGA showed choroidal retrobulbar arteries in 8 eyes, hypofluorescence of the background in 35 eyes, SRNV in 8 eyes, and streak formation in 52 eyes.Conclusion The iconographic characteristics of ICGA and FFA of high myopia include hypofluorescence of the background, SRNV and streak formation. ICGA can givemore exact information on the lesions of choroid in high myopia. The synchronic examination of ICGA and FFA may act as a guide to the therapy for high myopia.(Chin J Ocul Fundus Dis，2003，19：87-89)
ObjectiveTo evaluate the effect of form deprivation myopia on optic nerve head and retinal morphology in guinea pigs using optical coherence tomography (OCT). MethodsTwenty guinea pigs aged from 4 to 5 weeks were chosen and randomly divided into the experimental group and control group, with 10 guinea pigs in each group. Form deprivation myopia was established for the right eyes of guinea pigs in experimental group for 4 weeks. The guinea pigs of control group were not intervened. Before and 4 weeks after form deprivation, refraction was measured by retinoscopy after cycloplegia; the axial length was measured by A-scan ultrasound; retinal nerve fiber layer (RNFL) thickness, optic nerve head and retinal morphology of guinea pigs were analyzed using OCT. ResultsBefore form deprivation, there were no statistically significant differences in spherical equivalent, axial length, RNFL thickness, disc edge area, optic disc area, average cup disc ratio, vertical cup disc ratio, cup volume, retinal thickness, or retinal volume between the experimental group and control group of guinea pig (P > 0.05). After 4 weeks of form deprivation, RNFL thickness of (64.9±17.7) μm in guinea pigs in experimental group was thinner compared to (97.9±25.1) μm in control group (t=-2.845, P=0.015). Retinal thickness of (142.7±3.4) μm in guinea pigs in experimental group was thicker compared to (138.4±3.5) μm in control group (t=2.338, P=0.038). There were no significant differences in disc edge area, optic disc area, average cup disc ratio, vertical cup disc ratio, cup volume or retinal volume between groups (P > 0.05). There were statistically significant differences in spherical equivalent, axial length, RNFL thickness, vertical cup to disc ratio cup volume, and retinal thickness between after and before form deprivation in the right eye of guinea pigs in the experimental groups (t=46.001, -50.119, 5.385, 3.447, -2.814, -8.911; P < 0.05), while there were no statistically significant differences in disc edge area, optic disc area, average cup disc ratio, or retinal volume (P > 0.05). ConclusionForm deprivation myopia has an effect on RNFL and retinal thickness.
Peripapillary intrachoroidal cavitation (PICC) is a common pathological change observed in high myopia. The exact pathogenesis of PICC is still unclear. Expansion and mechanical stretching of the peripapillary sclera, breakage and defect in the retina near the border of the myopic conus and communication between intrachoroidal cavity and the vitreous space may be important segments during the development of PICC. Color fundus photography shows a localized and well-circumscribed peripapillary lesion with yellow-orange colour, often accompanied by fundus changes, such as myopic conus excavation, optic disc tilting and inferotemporal retinal vein bending at the transition from the PICC to the myopic conus. However, the PICC lesion is not easy to be recognized in the fundus photography. Fluorescein angiography shows early hypofluorescence and later progressively staining in the lesion. Indocyanine green angiography shows hypofluorescence throughout the examination. Optical coherence tomography (OCT) is vital in diagnosing PICC. Hyporeflective cavities inside the choroid, sometimes communicating with the vitreous chamber, can be observed in OCT images. OCT angiography indicates lower vessel density or even absence of choriocapillary network inside or around PICC lesions.
ObjectiveTo investigate the effects of form deprivation on the morphology of different types of RGC in mice.MethodsSixty B6.Cg-Tg (Thy1-YFP) HJrs/J transgenic mice were randomly assigned to form-deprived group (n=28) and control group (n=32). The right eyes of mice in the form-deprived group were covered by an occluder for 2 weeks as experimental eyes. The right eyes of mice in the control group were taken as control eyes. Before and 2 weeks after form deprivation, the refraction and ocular biometrics were measured; RGC were stained with Bra3a antibody and counted; the morphology of RGC was reconstructed with Neuroexplore software after immunohistochemical staining. The data was compared among experimental eyes, fellow eyes and control eyes by one-way analysis of variance.ResultsTwo weeks after form deprivation, the axial myopia was observed in the experimental eyes (refraction: F=15.009, P＜0.001; vitreous chamber depth: F=3.360, P=0047; ocluar axial length: F=5.011, P=0013). The number of RGC in central retina of the experimental eyes was decreased compared with the fellow eyes and the control eyes (F=4.769, P=0.035). The reconstructed RGC were classified into 4 types according to their dendritic morphology. Form deprivation affected all 4 types of RGC but in a different way. Among them, 3 types of RGC were likely contribute to form vision perception. Form deprivation increased the dendrite branches in these types of ganglion cells. However, form deprivation decreasd dendrite segment numbers in both eyes and the intersection and length insholl analyse type 4 ganglion cells which were morphologically identified as ipRGC.ConclusionForm deprivation distinguishingly affects the morphology of different types of RGC, indicating that form vision and non-form vision play different role in myopia development.
OBJECTIVE:The study was undertaken to evaluate the clinical effects of an improved posterior seleral reinforcement procedure for retinal detachment(RD)with macular hole in high myopic patients. METHODS:Twenty high myopic eyes with RD and macular hole were treated in our hospital from March 1993 to November 1995 with posterior scleral reinforcement surgery and were retrospectiv- ely analysed. RESULTS:The average length of ocular axis was 28.22 mm on admission and 26.87 mm on discharge in 14 comparable eyes. The retinas were reattached in 17 eyes with corrected vision of 0. 02~0.2. The surgery was failed in 3 eyes and the PVR got worse. CONCLUSION :The improved pro- cedure can efficiently treat high myopic patients with RD and macular hole without severe PVR,and might be better for preserving the survival central vision than choroiretinal adhesive methods. （Chin J Ocul Fundus Dis,1996,12: 214-216）
Dome-shaped macula (DSM) of high myopia has been described as an inward convexity or bulge of the macular within the concavity of the posterior staphyloma in highly myopic eyes, with the bulge height over than 50 μm, which can be observed by optical coherence tomography. There are three patterns of DSM, including the typical round dome, the horizontally oriented oval-shaped dome and the vertically oriented oval-shaped dome. The pathogenesis of DSM development remains unclear, several hypotheses have been suggested, such as localized choroidal thickening in the macular area, relatively localized thickness variation of the sclera under the macula, resistance to deformation of sclera staphyloma, ocular hypotony and tangential vitreoretinal traction. Vision-threatening macular complications of DSM including serous retinal detachment, choroidal neovascularization, foveoschisis and retinal pigment epithelial atrophy. Clinically, asymptomatic patients with DSM mainly take regular follow-up observation. Appears serous retinal detachment and significant visual impairment, treatment with half-dose photodynamic therapy, supplementary of laser photocoagulation or oral spironolactone may have a beneficial effect. However, more large clinical studies are required to confirm the exact efficacy of these treatments.
High myopia is frequently associated with retinal degenerative changes (such as myopic foveoschisis, macular hole and its related retinal detachment, and choroidal neovascularization) which are the major causes of visual loss in high myopic eyes. Optical coherence tomography may help us to understand the macular lesions in high myopia. Peeling of internal limiting membrane and removal of posterior vitreous cortex at an appropriate time, are believed to facilitate restoring the retinal flexibility and resolution of myopic foveoschisis, and promote the macular hole closure and retinal reattachment. Antiangiogenesis treatment combined with photodynamic therapy and (or) corticosteroid therapy are the future options to treat myopic choroidal neovascularization. Correctly understanding and mastering the methods and timing of diagnosis and treatment of high myopiarelated macular degeneration, and taking targeted interventions to enable patients to be rational and effective treated, are the keys to further reduce the damage of visual function in patients with high myopia.