Objective To observe the subfoveal choroidal thickness (SFCT) in eyes of patients with diabetic macular edema (DME). Methods Twenty patients (32 eyes) with DME were enrolled in this crosssectional observational study. The patients included 12 males and eight females, with a mean age of (47.3plusmn;10.2) years. All the patients were examined documenting best corrected visual acuity (BCVA), spectraldomain optical coherence tomography (OCT) and ophthalmological examination. According to OCT DME morphology, samples are divided into diffuse macular edema, cystoid macular edema, serous retinal detachment and hard exudate groups. The SFCT was measured by a Cirrus HD-OCT with enhanced depth imaging (EDI) and was compared with the average SFCT (286.84plusmn;28.80) mu;m of same age group. Correlation between SFCT and age, diopter, diabetic duration, fasting blood glucose, BCVA and central retinal thickness were analyzed by Pearson Analysis. SFCT of different DME types were analyzed by ANOVA Analysis. Results The mean SFCT of 32 eyes was (223.81plusmn;43.74) mu;m (ranging from 120.50 to 361.50 mu;m), which was lower by 63.03 mu;m (95% confidence interval, -78.80 to -47.26 mu;m, P＜0.01) from normal SFCT. SFCT was independent of age (r=0.124), diopter (r=0.277), diabetic duration (r=0.286), fasting blood glucose (r=0.408), BCVA (r=0.087), and central retinal thickness (r=0.036). There was no significant difference of SFCT between different DME types (F=0.042，P＞0.05). Conclusion SFCT is thinner in eyes with DME as compared to normal eyes of the same age.
Objective To investigate the relationship of macular microstructure and visual prognosis of micro-invasive vitrectomy for diabetic vitreous hemorrhage. Methods Fifty-three patients (53 eyes) with diabetic vitreous hemorrhage who underwent microinvasive vitrectomy were enrolled in this retrospective study. The preoperative and postoperative best-corrected visual acuities (BCVA) were recorded. The central foveal thicknesses (CFT) were measured after surgery by spectral domainoptical coherence tomography (SD-OCT). The median follow-up time was (12.81plusmn;8.22) months, ranging from six to 36 months. According to the results of SD-OCT at last follow-up time, macular edema (ME), epiretinal membrane (ERM), interrupted inside and outside section (IS/OS) and interrupted external limiting membrane (ELM) were macular abnormalities were observed. The preoperative and postoperative BCVA of different macular abnormalities were comparatively analyzed. The correlation between BCVA and macular microstructure were analyzed. Results The CFT was ranged from 103.00 mu;m to 498.00 mu;m,with the mean of（251.12plusmn;90.23） mu;m. Macular abnormalities were observed in 37 eyes (69.8%), and normal macula in 16 eyes (30.2%). Among 37 eyes with macular abnormalities, there were 20 eyes (37.7%) with ME, 12 eyes (22.6%) with ERM, 33 eyes (62.3%) with interrupted IS/OS, and 20 eyes (37.7%) with interrupted ELM. The BCVA of ME eyes decreased significantly than that in nonME eyes （t=-2.09，P＜0.05). The difference of BCVA in ERM and nonERM eyes was not statistically significant (t=-1.10,P＞0.05). The BCVA of interrupted IS/OS eyes decreased significantly more than that in continuous IS/OS eyes （t=-4.33,P＜0.05). The BCVA of interrupted ELM eyes decreased significantly more than that in continuous ELM eyes (t=-2.58, P＜0.05). The postoperative BCVA correlated positively with integrity of the IS/OS junction, CFT, and whether ME or not (r=7.65, 8.21, 4.99; P＜0.05), but insignificantly associated with integrity of the ELM and whether ERM or not (r=0.01, 0.82; P＞0.05). Conclusion The final visual acuity of patients with diabetic vitreous hemorrhage after micro-invasive vitrectomy is related to the CFT，the status of IS/OS junction, whether ME or not, but not related to integrity of the ELM or whether ERM or not.
Objective To observe the image characteristics of eyes with choroidal osteoma using enhanced spectral domain optical Cirrus coherence tomography （SD-OCT）, and to explore their relationship with visual acuity. Methods The records and SD-OCT images of 14 patients（18 eyes） diagnosed with choroidal osteoma at this hospital were reviewed retrospectively. All patients received examinations of best corrected visual acuity (BCVA), direct or indirect ophthalmoscope, slit lamp ophthalmoscope, fundus fluorescein angiography, B scan and/or computerized tomography. Subtle structure changes of the retina and choroidal osteoma were observed by four lines of the horizontal, the vertical scanning lines through the foveal and the tumor basal diameter under the model of five Line Raster．The correlation between the retinal and choroidal morphology and visual acuity was evaluated. Results The choroidal features of SD-OCT image of choroidal osteoma can be categorized into hyper-reflective in six eyes (33.3%), isoreflective in five eyes (27.8%), hypo-reflective in three eyes (16.7%) and mixing-reflective in four eyes (22.2%). The foveal thickness ranged from 50.2 to 245.1μm, and the average foveal thickness was (130.2±58.3) μm. The horizontal and vertical diameters of choroidal osteoma ranged from 5.6 to 15.8 mm and 4.6 to 12.8 mm respectively. The average horizontal and vertical diameters of choroidal osteoma were (7.8±2.9) mm and (6.5±2.5) mm respectively. The statistical analysis revealed that BCVA was not related to the horizontal, vertical diameters of choroidal osteoma or the foveal thickness （r=0.262, 0.229, 0.137; P=0.284, 0.294, 0.362）. BCVA was related to the involvement of fovea and the integrity of photoreceptor inner/outer segment junction (IS/OS) （r=-3.838,-4.559; P=0.0015, 0.0003），but not related to macular choroidal neovascularization (CNV) or serous retinal detachment （r=-0.144, 0.411; P=0.684, 0.687）. Conclusions The main SD-OCT image characteristics of eyes with choroidal osteoma was hyper-reflective and isoreflective. BCVA was not related to the horizontal, the vertical diameters of choroidal osteoma, the foveal thickness, macular CNV or serous retinal detachment. It was related to the involvement of fovea and the integrity of IS/OS.
Objective To investigate the clinical manifestations and spectral-domain optical coherence tomography (SD-OCT) imaging features of acute zonal occult outer retinopahy (AZOOR) and to explore the role of SD-OCT in the diagnosis and follow-up of AZOOR. Methods Retrospective analysis of clinical data of 52 cases (66 eyes) who were diagnosed through comprehensive eye examinations including best corrected visual acuity, fundus exam, OCT, electroretinogram (ERG), fluorescein angiography (FFA) and indocyanine green angiography (ICGA). Results A total of 52 cases of AZOOR (66 eyes) were collected. The majority of patients complained of blurred vision, photopsia and acute onset of a scotoma. In this group, 24 cases (28 eyes) with normal fundus were defined as AZOOR typeⅠ, while the other 28 cases (38 eyes) with fundus changes were AZOOR type Ⅱ, including 9 eyes of multiple evanescent white dot syndrome (MEWDS), 25 eyes of punctate inner choroidopathy (PIC),4 eyes of multifocal choroiditis (MC). All typeⅠcases went through visual field, ERG and OCT tests. The most common visual field defect was central and paracentral scotoma, which was seen in 15 eyes (53.6%). Nine eyes (32.1%) presented with blind spot enlargement or even associated with other visual field defects. Four eyes (14.3%) showed scattered scotoma. In the series of 24 typeⅠcases （28 eyes）, 12 eyes (42.9%) demonstrated depressed scotopic and photopic amplitudes, and nine eyes only yielded reduced scotopic amplitudes, while seven eyes showed normal. All OCT showed an absence of both the inner and outer segment (IS/OS) line, and (or) the cone outer segment tip (COST) line between the IS/OS line and RPE. Many grey-white or yellowish white punctuate lesion of different sizes were found in posterior pole of the fundus in all of type Ⅱ AZOOR which were more obvious in FFA. The manifestations of OCT showed IS/OS irregularity or absence in the area corresponding to the lesions. At final follow up from 15 days to two years, the IS/OS line became discernible in 13 of 24 typeⅠcases got discernible IS/OS line, while it was still absent in the other 11 case. During one to two month follow up period, nine eyes of MEWDS and four eyes of MC showed the presence of the a continuous IS/OS line in their OCT images after treatment, but there is no significant change for 25 eyes of PIC. ConclusionsOCT showed abnormalities in the microstructures of the outer retina, e.g., IS/OS line. The high resolution of OCT images has allowed better evaluations of the intraretinal IS/OS line in AZOOR, which presented a significant correlation with different stage in the course of AZOOR. In conclusions, OCT plays an important role in the diagnosis and follow up in AZOOR.
Objective To compare the findings of posterior vitreous detachment (PVD) with B-mode ultrasonography and spectral-domain optical coherence tomography (SD-OCT), and to find the best way for clinical diagnosis of PVD. Methods This is a prospective case series study based at our hospital between May and September 2012. Patients aged 50 years or older with no obvious ocular pathology, no history of intraocular operation and refractive power within ±3 Diopter were recruited and examined with B-mode ultrasonography and SD-OCT. Posterior hyaloid status were assessed by two experienced technicians respectively. Patients with idiopathic macular pucker and macular hole indicated for vitrectomy were also included, and preoperative findings of posterior vitreous cortex status were compared with intraoperative findings. SPSS software was used for statistical analyses. Results Two hundreds and four eyes of 102 patients met the criteria were examined, in which 10 eyes of 10 patients received 23G vitrectomy. There were 31 males and 71 females. Mean age was (63.2±7.2) years old (ranged from 50 to 80 years old). Status of posterior vitreous cortex were measured by SD-OCT in 70 eyes (34.3%), 56 eyes (27.5%) of which manifested different stages of PVD and 14 eyes (6.8%) with attached posterior vitreous cortex (N-PVD). The other 134 eyes (65.7%) had no findings of posterior vitreous cortex with SD-OCT. B-mode ultrasonography showed 98 eyes (48.0%) with C-PVD. Combining the results detected by both ultrasound and SD-OCT, altogether 145 eyes (71.1%) were found with different stages of PVD. Comparison of B-mode ultrasonography and SD-OCT to intraoperative findings in 10 operated eyes showed that: seven eyes with no findings in SD-OCT actually had C-PVD; three eyes with PVD in SD-OCT were proved having PVD during operation; five eyes manifested N-PVD in B-mode ultrasonography, only one of which was proved having N-PVD; five eyes with C-PVD in B-scan were observed having C-PVD. Only one eye had a matched result of C-PVD with three detecting ways. Conclusions B-mode ultrasonography provides a significant higher detection rate of PVD than SD-OCT; SD-OCT has more advantages than ultrasound in detecting the earlier stage of PVD. Combining Bmode ultrasonography and SD-OCT can significantly improve the PVD detection rate and provide considerably more information of PVD.
Objective To observe the characteristics of optical coherence tomography (OCT) of the macular in uveitis patients. Methods A total of 51 cases (78 eyes) of uveitis admitted to affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine from May 2011 to May 2012 were reviewed retrospectively. All patients were underwent OCT examination and classified according to characteristics of OCT. Results The characteristics of OCT in uveitis were classified into six groups. Macular edema including cystoid macular edema and diffuse edema was detected in 48 eyes (61.5%). Macular epiretinal membrane was found in 22 eyes (28.2%). Choroidal neovascularization and macular hole was found in 4 eyes (5.1%), respectively. Ten eyes (12.8%) showed macular atrophy and 22 eyes (28.2%) showed serous neuroepithelium detachment. Conclusions Macular OCT in uveitis patients displayed different morphological characteristics.
Objective To observe the characteristics of fundus autofluorescence (AF) in short wavelength AF (SW-AF) and Near Infrared AF (NIR-AF), and their relationship with visual fields. Methods Twelve patients (24 eyes) with primary RP were enrolled in this study. The patients included nine males (18 eyes) and three females (six eyes). The patients aged from 15 to 69 years, with a mean age of (35.33plusmn;15.03) years. All the patients were examined for color photography, SW-AF, NIR-AF, visual fields and optical coherence tomography examination. Results There were hyper-AF ring of varying sizes in posterior pole by SW-AF and NIR-AF examinations. The area of hypo-AF which located in SW-AF hyper-AF ring had a positive correlation with the area of hyper-AF in the NIR-AF (r=0.662，P＜0.05). OCT showed that outside the hyper-AF ring, there were disconnected inner segment/outer segment (IS/OS) junction and external limiting membrane, and thinned outer nuclear layer and retinal pigment epithelium. Peripheral retinal osteocytes-like pigmentation showed non fluorescence in SW-AF and NIR-AF. The plaque-like area showed mottled and low fluorescence examined by SW-AF. SW-AF hyper-AF ring had a positive correlation with visual fields (r=0.492，P＜0.05). Conclusions The area of hypo-AF inside of the SW-AF hyper-AF ring is related to visual fields in RP patients. The retinal structures in the hypo-AF area inside of the SW-AF hyper-AF ring, and in the NIR-AF hyper-AF region are normal.