Objective To evaluate the value of AccuMap multifocal visual evoked potential (mfVEP) objective perimetry in measuring visual function of macular diseases. Methods Forty-six eyes (37 patients) with macular diseases were studied. The mean mfVEP amplitudes of central visual field within radius 2.0deg;, 5.5deg;, 10.0deg;, 15.5deg; and 24.0deg;were measured by AccuMap mfVEP objective perimetry. Automatically calculated AccuMap severity index （ASI） represented the visual field defects. Meanwhile, the mean sensitivity (MS) of central visual field within radius 2.0deg;, 4.0deg;, 6.0deg;, 8.0deg; and 10.0deg; and mean defect (MD) of central visual field within radius 10.0deg; were assessed by MP-1 microperimeter. The correlations among those parameters including logMAR visual acuity, mean mfVEP amplitudes, MS, ASI and MD were analyzed. Results Among 46 affected eyes, AccuMap mfVEP objective perimetry showed abnormal ASI with visual field defects in 43 eyes (93.45%), normal ASI without visual field defects in three eyes (6.55%). The mean mfVEP amplitudes value of the central visual field within radius of 2.0deg;, 5.5deg;, 10.0deg;, 15.5deg; and 24.0deg; were (120.78plusmn;52.91), (134.31plusmn;54.67), (149.99plusmn;52.42), (156.69plusmn;48.30), (157.54plusmn;45.07) nV respectively. The mean ASI value was 74.26plusmn;52.43. MP1 showed that the MS values of central visual field within radius 2.0deg;, 4.0deg;, 6.0deg;, 8.0deg; and 10.0deg; were (10.97plusmn;5.91), (12.71plusmn;5.13), (13.71plusmn;4.53), (14.23plusmn;4.18), (14.48plusmn;3.86) dB respectively. The MD value of central visual field within radius 10deg; was 4.49plusmn;3.07. There was a significant correlation among ASI, the mean mfVEP amplitudes of central visual field with every radius and logMAR best corrected visual acuity （P＜0.05). The mean mfVEP amplitudes of central visual field within radius 2.0deg;, 5.5deg;, 10.0deg; were positively correlated with the MS of central visual field within radius 2.0deg;, 6.0deg;, 10.0deg; (r=0.477, 0.432, 0.433;P=0.001, 0.003, 0.003). Furthermore, ASI was also correlated with MD of central visual field within radius 10.0deg;(r=0.729, P=0.000). Conclusions AccuMap mfVEP objective perimetry can reflect the changes of macular function objectively and can be used to assess the visual function of macular diseases.
To investigate the characteristics of fundus autofluorescence (AF) in the leakage site of central serous chorioretinopathy (CSC). Methods Sixty-seven CSC patients (67 eyes) underwent fundus fluorescein angiography (FFA) examination with a confocal scanning angiography (HRA2). Autofluorescence was elicited by the wavelength of 488 nm. The patterns of autofluorescence corresponding to the leakage site on FFA were observed. All the enrolled patients were grouped by age (agele;45 in 47 eyes and age ＞45 in 20 eyes) and courses (acute CSC in 25 eyes and chronic or recurrent CSC in 42 eyes), the patterns of autofluorescence were analyzed respectively. Results There are 4 patterns of AF in the leakage site on FFA of CSC patients: no AF changes, punctuate hypo-AF, expanded hypo-AF or speckled AF, hyper-AF. The percentages of those patterns in all 67 eyes are 52.2%, 23.9%, 14.9% and 9.0% respectively. The percentages of those patterns in the group of age le;45 (n=47) are 55.3%, 23.4%, 14.9% and 6.3% respectively. The percentages of those patterns in the group of age ＞45 (n=20) are 45.0%, 25.0%, 15.0% and 15.0% respectively. The percentages of those patterns in acute CSC (n=20) are 80.0%, 16.0%, 4.0% and 0% respectively. The percentages of those patterns in chronic or recurrent CSC (n=42) are 35.7%, 28.6%, 21.4% and 14.3% respectively. Conclusion There are different patterns of fundus autofluorescence in different age and courses of CSC patients.
Objective To observe the of macular serous neuroepithelial detachment and the necessary auxiliary examination methods for the diagnosis.Methods The clinical data of 46 patients (49 eyes) aged above 45 years with macular serous neuroepithelial detachment who have been diagnosed by binocular indirect ophthalmoscope and optical coherence tomography (OCT) were retrospectively analyzed. All the patients had undergone fundus fluorescein angiography (FFA) and indocyanine angiography (ICGA), and the diagnosis was established based on the results of FFA, ICGA and OCT. Results In these 46 patients (49 eyes), central serous chorioretinopathy (CSC) was found in 31 (34 eyes, 69.4%), agerelated macular degeneration (AMD) was found in 12 (12 eyes, 24.5%), and polypoidal choroidal vasculopathy (PCV) was found in 3 (3 eyes, 6.9%). In the 34 eyes with CSC, 12 eyes (35.3%) had typical CSC and 22 eyes (64.7%) had chronic CSC. If the 12 eyes with AMD, 9 eyes (75%) had occult CNV, 2 eyes (16.7%) had minimally classic CNV, and 1 eye had classic CNV. Conclusions The causes of serous macular neuroepithelial detachment in patients aged above 45 years are complex; ICGA may help to establish the definitive diagnosis of chronic CSC, occult CNV,and PCV should be considered.
ObjectiveTo study the relationship between macular pigment optical density (MPOD) and serum concentration of lutein and zeaxanthin in an adult population. MethodsTwenty patients with mild cataract and 39 healthy subjects were enrolled in this study, including 15 males and 44 females. The average age was 43.75 years. Fifty-three subjects were non-smokers and 6 male subjects were smokers. Two subjects preferred meat diet, 22 preferred meat-less diet, and 35 have balanced diet. MPOD was measured using heterochromatic flicker photometry at 0.25, 0.5, 1.0 and 1.75 degrees, and serum concentration of lutein and zeaxanthin was measured using high-performance liquid chromatography. The relationship between MPOD and serum concentration of lutein and zeaxanthin was analyzed. The differences of serum lutein and zeaxanthin between different gender, smokers and non-smokers and subjects with different dietary pattern were also analyzed. ResultsMPOD at 0.25, 0.5, 1.0 and 1.75 degrees were 0.59, 0.48, 0.34 and 0.18, and the average concentration of lutein and zeaxanthin were (0.45±0.16) μmol/L and (0.11±0.04) μmol/L respectively. Serum concentration of lutein and zeaxanthin in males were slightly higher than that in females, but it was not statistically significant (t=1.13, 0.86; P=0.27, 0.40). The differences of serum lutien and zeaxanthin between smokers and non-smokers (t=-0.15, -0.11; P=0.87, 0.91), among subjects of 3 dietary patterns groups were not statistically significant (Flutein=3.87, 4.05, 0.18; P=0.83, 0.81, 0.99. Fzeaxanthin＝0.99, 1.51, 0.52; P＝0.85, 0.68, 0.72). There was no correlation between MPOD and serum concentration of lutein (r=-0.06,-0.02,-0.07,0.03;P>0.05)and zeaxanthin(r=0.02,0.12,0.09,0.11;P>0.05). ConclusionMPOD was not statistically significantly correlated with serum concentration of lutein and zeaxanthin in the studied population.
Objective To observe the efficacy of intravitreal injection of ranibizumab (Lucentis) and combination treatments of photodynamic therapy (PDT) and intravitreal injection of ranibizumab for exudative age-related macular degeneration (eAMD). Methods Thirty eyes from 30 patients with eAMD were enrolled in this study. Fifteen eyes were treated with intravitreal injection of ranibizumab (ranibizumab group), while 15 eyes were treated with combination treatments of PDT and intravitreal injection of ranibizumab (combination group). The follow-up ranged from 6 to 17 months with a mean of 12.5 months. The patients in ranibizumab group received intravitreal injection of ranibizumab (0.5 mg) once a month for 12 consecutive months. Follow-up visits were performed monthly after the first injection. The patients in the combination group received intravitreal injection of ranibizumab (0.5 mg) within 24 hours after PDT. Then the same dose of intravitreal injection was given the 2nd and 3rd months. They were examined on follow-up visits monthly after the 3rd injection. Injections were repeated if necessary during followup period. The mean number of repetitive intravitreal injections of ranibizumab was (3.7plusmn;1.0) times/eye. Changes in best corrected visual acuity (BCVA), results of optic coherence tomography (OCT), fundus fluorescein angiography (FFA) and MP-1, injection times and complications were observed. Results The 1st, 3rd, 6th and 12th month after treatment, the average improvement value in mean light sensitivity (MS) were 1.9, 3.8, 5.0 and 5.5 dB in ranibizumab group; 2.0, 4.2, 3.7 and 4.8 dB in combination group respectively. The difference between two groups was not statistically significant (P＞0.05). The differences of improvement in BCVA and OCT between two groups also were not statistically significant (P＞0.05). The MS has positive relationship with BCVA (r=0.660,P＜0.05). No complications such as endophthalmitis, retinal pigment epithelial tear or vitreous hemorrhage were observed during the follow-up period. Conclusions Both intravitreal injection of ranibizumab and combination treatments of PDT and intravitreal injection of ranibizumab are effective for eAMD. Combination of PDT and ranibizumab therapy decreases the frequency of retreatment.