Objective To observe the imaging features of ultra-wide field short wave fundus autofluorescence (SW-FAF) in eyes with multiple evanescent white dot syndrome (MEWDS), and analysis the correspondence to conventional images. Methods It was a retrospective case series study. Thirteen patients (14 eyes) diagnosed with MEWDS were enrolled. There were 12 females and 1 male, aged from 22 to 57 years, mean age was 34.5 years. All the eyes underwent fundus color photography, optical coherence tomography (OCT) and ultra-wide field autofluorescence (FAF). Simultaneous fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed in 6 eyes. The characteristic changes of SW-FAF in studied eyes were observed and compared with the images of FFA and ICGA. All the eyes were followed up every 1 to 2 weeks, with an average of 16.7 weeks. The characteristic images of SW-FAF and corresponding OCT were studied during follow up. Results MEWDS presented with numerous multiple hyper-autofluorescent spots, sized from 50-500 μm, with a vague boundary in ultra-wide field SW-FAF. These spots located mainly at the peripapillary area and the posterior pole with a confluent pattern. The lesions extended to the mid-peripheral retina as well and became more scattered. The distribution of the hyper-autofluorescent lesions in SW-FAF corresponded roughly to that of the greyish-white spots seen in color photograph and the hyper-fluorescent spots detected by FFA. It was consistent with the distribution of hypo-fluorescent spots in late-phase ICGA as well. But the number of the spot showed in FAF is much more than that in FFA, and slightly less than that in ICGA. The OCT scans through the hyper-autofluorescent lesions in SW-FAF showed impairment of outer retina. After the recovery, the hyper-autofluorescent spots disappeared with the outer retina structure repaired completely. Conclusions MEWDS presented with numerous multiple hyper-autofluorescent spots which located mainly at the peripapillary area in ultra-wide field SW-FAF. The distribution of the hyper-autofluorescent lesions in SW-FAF corresponded roughly to color photograph, FFA and ICGA in late-phase. The OCT scans through the hyper-autofluorescent lesions in SW-FAF showed impairment of outer retina.
Retinal vein occlusion (RVO) is a vascular disease characterized by intraretinal hemorrhage, edema and hard exudation, which is caused by increased retinal vein pressure. OCT angiography (OCTA) has been widely used in the diagnosis of retinal vascular diseases including RVO by virtue of non-invasive, high resolution and stratified display of superficial, deep retinal vessels and quantification of retinal vessel density and non-perfusion area size. OCTA can provide information of retinal microvascular structure and blood perfusion under the condition of disease, it also can be used to evaluate the effect of treatment and changes of retinal circulation during the course of disease follow-up. Although OCTA cannot replace fundus angiography completely, it has brought us more information about the pathogenesis, disease progression and prognostic factors of RVO. It is believed that with the progress of technology, OCTA will bring us a new chapter in the study of retinal vascular diseases including RVO.
Macular edema is an important cause of visual impairment in many eye diseases such as diabetic retinopathy, retinal vein occlusion and uveitis. Optical coherence tomography (OCT) provides high-resolution image of retinal microstructures in a non-contact and rapid manner, which greatly improves the ability of diagnosis and follow-up to macular edema patients. OCT has been widely used in the clinical detection of patients with macular edema. No matter what the cause of macular edema is, it can be observed in OCT images that there are spot-like deposits with strong reflection signals in the retina, which are mostly distributed discretely or partially convergent, and are called hyperreflective foci. At present, the nature or source of hyperreflective foci is not clear, however, may involve the destruction of the blood retina barrier, retinal inflammatory reaction, neurocellular degeneration, and so on. These mechanisms are also the key physiological mechanisms in the development of macular edema. The clinical research on hyperreflective foci provides a new direction for understanding the pathogenesis of macular edema and predicting the prognosis of macular edema. The distribution and quantity characteristics of hyperreflective foci may be an important biological marker to predict the prognosis of macular edema.nosis of macular edema. foci provides a new direction for understanding the pathogenesis of macular edema and predicting the prognosis of macular edema. The distribution and quantity characteristics of HRF may be an important biological marker to predict the prognosis of macular edema.
ObjectiveTo observe the pathological changes of central retinal artery occlusion (CRAO) by optical coherence tomography (OCT).MethodsFifty-three eyes of 53 patients who were diagnosed as CRAO in our center between January 2001 to January 2004 underwent the examination by OCT. The intervals between the disease onset and OCT examination were less than 2 weeks. The scan modes of OCT were horizontal or vertical line scan. The locations of scanning were macular, posterior pole of retina, optical papilla and the focus of bleeding or exudation.ResultsThe OCT pathological changes of CRAO in vivo includes increase of retinal thickness and reflex of retina, width of dark layer of photoreceptor (edema), edema or cystoid edema of fovea, retinal bleeding, cotton-wool spot and papilla edema. Four patients who had ciliary retinal artery showed normal retinal structure in the supply region of ciliary retinal artery.ConclusionOCT can display the pathological changes of retinal tissues in CRAO in vivo, especially on the old patients or the patients with systemic disease who were contraindicated by FFA. The unique OCT image of pathological changes of CRAO supply the objective signs for the instant clinical diagnosis.(Chin J Ocul Fundus Dis, 2005,21:74-78)
ObjectiveTo observe the correlation between the thickness of foveal ganglion cell-inner plexiform layer (GCIPL) and visual field mean defect before and after gamma knife treatment in patients of sellar region tumors with optic chiasmal compression. MethodsThis was a prospective case series. 72 eyes of 37 consecutive patients suffering from optic chiasmal compression of sellar region tumors treated with gamma knife were enrolled in the study. According to the change of visual field before and after gamma knife treatment, the patients were divided into three groups. There were 13 eyes of 7 patients in group 1 with no vision defect pre-and post-treated, 34 eyes of 17 patients in group 2 with improvement of visual field defect after treatment, 25 eyes of 13 patients in groups 3 with no improvement or reorganization of visual field defect after treatment. Overall average thickness of GCIPL, and of the superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal retina were measured with the Cirrus high-definition spectral domain optical coherence tomography, and mean deviation (MD) with the Humphrey field analyzer before and 6 months after treatment. There was no significant difference in MD values between group 2 and 3 pre-treated (t=1.471, P=0.084). There was significant difference between all the groups in total average value of GCIPL thickness and the 6 quadrant GCIPL thickness values pre-treated (P < 0.05). Logistic regression model was applied to analysis of the correlation between GCIPL thickness and the improvement of visual field after treatment. ResultsThe MD values of the group 1, 2 and 3 were (-2.96 ±0.75), (-10.24 ±1.31), (-20.2 ±5.88) dB at 6 months after treatment. There was significant difference between group 2 and 3 of MD value after treatment (t=6.974, P=0.000). In group 1, there was no significant difference in mean GCIPL thickness and the 6 quadrant GCIPL thickness values between pre-and post-treated (t=0.882, P=0.395).The mean thickness of GCIPL, superonasal and inferonasal GCIPL was increased than pre-treated in group 2, and the difference was statistically significant (t=2.438, 4.630, 4.457; P=0.035, 0.001, 0.001). The mean thickness of GCIPL, superonasal and inferonasal GCIPL was decreased than pre-treated in group 3, and the difference was statistically significant (t=-2.387, -4.603, -4.975; P=0.041, 0.002, 0.001).Logistic regression analysis showed that the greater of the value of average GCIPL thickness of patients with visual field defect pre-treated, the higher of the proportion of patients with improvement of visual field defect post-treated. There was a significant correlation between the value of superonasal or inferonasal GCIPL and the improvement of the visual field post-treated (OR=5.374, 4.693; P=0.000, 0.000). There was no significant correlation between the value of superotemporal or upper or lower or inferotemporal GCIPL and the improvement of the visual field post-treated (OR=1.058, 1.101, 1.074, 1.056; P=0.183, 0.080, 0.162, 0.186). ConclusionsIn patients with optic chiasmal compression of sellar region tumor, the greater of the average GCIPL thickness pre-treated, the higher of the proportion of patients with improvement of visual field defect post-treated. There was a significant correlation between superonasal or inferonasal value of the GCIPL thickness and the improvement of visual field defect post-treated.
Objective To observe the distribution of macular thickness and its relationship with axial length, gender, refraction status and race in six-year-old children. Methods 1543 six-year-old children from 34 schools in Sydney were randomly selected. The thickness of center macula（CM）, inner macula（IM）and outer macula（OM）were measured by optical coherence tomography（OCT）, the differences of macular thickness between different genders and races were comparatively analyzed. The axial length and refraction status of all children were measured by IOL Master and autorefractor RK-F1 respectively. Results The CM, IM and OM thickness of all those six-year-old children were normally distributed，on average they were 193.6, 264.3 and 236.9 mu;m respectively,the differences were statistically significant（t=0.40,0.08,0.20;P＜0.05）. The CM,IM and OM average thickness was 194.2,264.9,229.0 mu;m for boys and 189.3,262.5,231.5 mu;m for girls respectively. CM and IM thickness of boys were thicker than those in girls（t=0.15,0.11;P＜0.05）. The CM,IM and OM average thickness was 196.0,265.2,237.5 mu;m for White kids,186.0,262.3,236.5 mu;m for East Asia kids and 19.4,263.7,233.8 mu;m for Central East kids respectively. The CM and IM thickness of White and Central East children were significantly thicker than East Asia children (t=0.12,0.15;Plt;0.05）. There was no difference between these three races in OM thickness（t=0.16,P=0.6）. The IM and OM were thinner with longer axial length (Plt;0.05). The CM,IM and OM thickness was thicker with higher hyperopic degrees (Plt;0.05). Conclusions Macular thickness was normally distributed in six-year-old children and was significantly affected by gender, race, axial length and refraction status.