Objective To observe the the clinical characteristics of images of optic coherence tomography (OCT) in highly myopic eyes with retinoschisis. Methods The clincial data of 158 patients (158 eyes) with high myopia diagnosed by examinations of best corrected visual acuity and refraction, indirect stereoscopic ophthalmoloscopy, A/Bscan ultrasonography, and OCT, were retrospectively analyzed. The patients were divided into retinoschisis group and nonretinoschisis group according to the results of OCT (whether the patients had macular reinoschisis at the posterior pole). There were 53 patients (55 eyes, 34.8%) in the former group, and 101 patients (103 eyes, 65.2%) in the latter group. The age, sex, diopter, visual acuity, ocular axial length, and incidence of posterior scleral staphyloma, vitreous traction, and retinal detachment of the two groups were compared. Results B-scan ultrasonography showed posterior scleral staphloma in all of the 158 eyes. OCT indicated that in the 55 eyes in the retinnoschisis group, 15 （27.3%） had inner, 53 （96.4%）had outer, and 7 （12.7%）had middle retinoschisis. The inner and outer one could exist independently or in the same eye, while the middle one was always accompanied by the outer retinoschisis. Two or more types of schisis coexisted in 13 eyes （23.6%）, single outer retinoschisis was found in 40 eyes （72.7%）, and single inner retinoschisis was found in 2 eyes （3.6%）. There were 26 eyes（47.3%）were accompanied with retinal detachment, 13 eyes（23.6%） with macular hole, and 12 eyes （21.8%）with vitreous traction. In the 103 eyes in the nonretinoschisis group， 23 eyes （22.3%）had vitreous traction, 19 eyes （18.4%） had macular hole, and 21 eyes （20.4%）had retinal detachment. The differences of age, diopter and ocular axial length, sex, incidence of macular hole and vitreous traction between the two groups were not statistically significant (Pgt;005）. The visual acuity in retinoschisis group was much lower than that in the nonretinoschisis group （Plt;005）, and the difference of incidence of the retinal detachment between the two groups was significant (Plt;001). 〖WTHZ〗Conclusion 〖WTBZ〗Macular retinoschisis in eyes with high myopia can exist in inner or middle retina, but most of them locate at outer retina.The patients always have poor visual acuity and are often accompanied by other macular lesions such as retinal detachment.
Objective To observe the spectral domain optical coherence tomography (SD-OCT) features of acute Vogt-Koyanagi-Harada (VKH) eyes before and after treatment.Methods Twenty-eight patients (56 eyes) with acute VKH diagnosed by slitlamp microscopy, B mode ultrasound and fundus fluorescein angiography (FFA) were enrolled in this study. All the patients were treated with steroid after diagnosis. SD-OCT was performed in all the patients before and after treatment. The follow-up was ranged from 12 to 32 weeks with a mean of (21.30plusmn;8.53) weeks. The foveal retinal detachment height, inner and outer segments (IS/OS) of photoreceptors, and the changes in retinal structure within the vascular arcades before and after treatment were comparatively analyzed. Results OCT examination results showed that before treatment, all eyes had retinal neural epithelial detachment. The average neural epithelial detachment height in the fovea was (635.44plusmn;340.04) mu;m. Forty-three eyes (76.8%) had different types of subretinal exudates; 41 eyes (73.2%) had b granular reflection in the subretinal space. Twenty-two eyes (39.3%) had paraforveal outer nuclear layer (ONL) thickening with finger-like protrusions attached with membrane-like structure. Thirty-three eyes (58.9%) had wavy lines of the retinal pigment epithelium (RPE). After the treatment, these exudates dissolved within one week and RPE line became straight. The retina reattached after (2.33plusmn;0.82) weeks. In most patients external limiting membrane and IS/OS became intact after (5.01plusmn;6.71) weeks and (11.40plusmn;7.89) weeks respectively. However, at the end of follow-up, 46 eyes (82.1%) still had focal areas of IS/OS defect and 11 eyes (19.6%) had focal ONL thinning. Conclusions Before the treatment, the OCT features of acute VKH are serous retinal detachment at fovea, different types of subretinal exudates and wavy RPE. After the treatment, the OCT features of acute VKH are exudates dissolving, straight RPE line and early recovery of external limiting membrane.
Objective To observe the images characteristics of optic coherence tomography (OCT) on macular edema in retinal vein occlusion （RVO）, and to explore the application value of Fourier-domain (FD) OCT in RVO macular edema.Methods The clinical data of 91 RVO patients (92 eyes) were retrospectively analyzed. All patients received examinations of best corrected visual acuity （BCVA）, direct or indirect ophthalmoscope, slit lamp ophthalmoscope, and 60 patients （60 eyes）also underwent fundus fluorescein angiography. There were 35 patients （35 eyes）with central retinal vein occlusion （CRVO） and 56 patients（57 eyes）with branch retinal vein occlusion (BRVO). The type and involved layer of macular edema, and subtle structure changes of the outer retina were observed through the horizontal and vertical scanning lines through the foveal under the model of 5 Line Raster. The foveal thickness (FT), height of serous retinal detachment, width and height of foveal cystoid spaces and thickness of foveal photoreceptor layer were measure manually. The central fovea thickness (CFT), volume (V) and average thickness (AT) were collected from the OCT readings. Further analysis was focused on different type of the edema,characteristics of OCT images and the relationship between the different type of the edema and vision.Results The manifestation of macular edema was variable by OCT scanning, and can be categorized into diffuse edema (spongelike thickening of the retina with reduced reflectivity) 12 patients （12 eyes, 13.0%), cystoid edema (multicystlike space in the neuroretina separated by tissue column) 21 patients （21 eyes, 22.8%) and serous retinal detachment (separation of neuroretina and retinal pigment epithelium by space with low reflectivity) 37 patients （37 eyes, 40.2%) and mixed edema（mix of the above several edema form）58 patients （59 eyes, 64.1%）. The edema can happen at different layers of the neuroretina, including outer nuclear layer/outer plexiform layer (ONL/OPL) in 92 patients （92 eyes, 100.0%), inner nuclear layer (INL) in 68 patients （68 eyes, 74.2%）and ganglion cell layer (GCL) in 23 patients （23 eyes, 25.0%）.Statistic analysis revealed that BCVA was related to the integrity of IS/OS （r=3.778 6, P=0.000）, ELM （r=4.462 2,P=0.000）and FT (r=-0.4513, P=0.000 ), but not related to CFT （r=0.269 7, P=0.121）, V（r=0.0528, P=0.054）and AT (r=0.060 8,P=0.075). Conclusion he manifestation of macular edema associated with RVO is variable. FD-OCT can demonstrate its fine details, and some changes are related to visual acuity. Therefore, the value of quantitative analysis in these patients needs further confirmation.
Objective To observe the relationship between retinal microglial activations and ganglion cell (RGC) damages in early-stage diabetic rats. Methods A total of 20 SpragueDawley（SD）rats were randomly divided into 4 groups (each with 5 rats): 1 month control group, 1 month diabetes group, 3 month control group, 3 month diabetes group. Diabetes was induced by intraperitoneal injection of streptozotocin (STZ). The RGCs of all rats were retrograde labeled by carbocyanine dye DiI injected at the superior colliculi.Microglial cells and RGCs in retinal flat-mounts and sections were stained immunohistochemically and recorded under confocal microscope.Results The diabetic microglial cells were amoeboid and ovoid with fewer processes on retinal flat mounts. The density of microglial cells which phagocytosed DiI particles in the RGC layer significantly increased in the 3month diabetes group（P＜0.01）. The density of microglial cells in the RGC layer significantly increased in the 1- and 3- month diabetes group（P＜0.05）. However there were more microglial cells in the RGC layer in the 3- month diabetes group than the 1-month diabetes group（P＜0.0001）. Significant correlation was found between the amount of microglial cells and that of RGCs in the early-stage of diabetes. Conclusions Microglial cell activation has close relationship with the RGC damages in early-stage diabetic rats.
Objective To observe the emulsification of silicone oil in eyes with rhegmatogenous retinal detachment (RRD) after silicone oil filling surgery, and to preliminarily analyze the possible clinical factors related to it. MethodsA cross-sectional clinical study. From January 2019 to April 2022, 50 eyes of 50 patients with RRD who underwent pans plana vitrectomy (PPV) combined with silicone oil filling surgery in Eye and ENT Hospital of Fudan University were included in the study. Among them, there were 25 males with 25 eyes and 25 females with 25 eyes; the age was 54.86±11.79 years old. The retina was in place 3 months after surgery. Before silicone oil removal surgery, intraocular pressure ＞21 mm Hg (1 mm Hg=0.133 kPa) or treated with≥1 anti-glaucoma drug (high intraocular pressure) in 20 eyes; intraocular pressure ≤21 mm Hg and no anti-glaucoma drug treatment in 30 eyes (normal intraocular pressure). During follow-up after surgery, silicone oil emulsification was found and those who met the indications for silicone oil removal were subjected to silicone oil removal surgery. The first 2 ml of lavage fluid was collected immediately after removal of the silicone oil, and the particle diameter and number of emulsified silicone oil were measured using a Multisizer® 3 particle/cell counter and particle size analyzer. The measuring range was 0.4-12.0 μm, and the diameter is accordingly divided into 0.4-＜1.0, 1.0-＜3.0, 3.0-＜5.0, 5.0-＜7.0, 7.0-12.0 μm. Each sample was measured 3 times and the average value was taken. Spearman correlation analysis and multiple linear regression analysis were used to analyze the correlation between the number of emulsified silicone oil particles and clinical factors. ResultsThe number of emulsified silicone oil particles was (1.74±2.94)×107/ml (0.96×107-14.11×107/ml), of which the diameter of 0.4-＜1.0 μm emulsified silicone oil particle was (1.25±2.41)×107/ml, accounted for (64.26±12.70)% [(1.25±2.41)×107/(1.74±2.94)×107]. The results of correlation analysis showed that there was no correlation between the total particle number of emulsified silicone oil and various clinical factors (P＞0.05). The number of emulsified silicone oil particles with a diameter of 7.0-12.0 μm was negatively correlated with age (r=－0.298, P=0.036), and positively correlated with axial length (r=0.325, P=0.021). There was no correlation between the previous ocular trauma, choroidal detachment and different lens states and the number of emulsified silicone oil particles (P＞0.05). Multiple linear regression analysis showed that eye axis (β=1 570.868, P=0.023) and age (β=－316.128, P=0.039) were the risk predictors of silicone oil emulsification into large diameter particles (7-＜12 μm). The number of emulsified silicone oil particles with a diameter of 7-12 μmin the patients with high intraocular pressure was significantly higher than that in the patients with normal intraocular pressure, and the difference was statistically significant (U=195.00, P=0.037). ConclusionsMost of the emulsified silicone oil particles in the eyes of RRD patients after silicone oil filling surgery are small-diameter particles; the silicone oil emulsification is more serious in young patients and patients with long ocular axis, and young patients are more prone to high intraocular pressure.
Objective To observe the optical coherence tomography (OCT) features of Best vitelliform macular dystrophy (BVMD) at different stages.Methods Twenty-eight BVMD patients (56 eyes) were enrolled in this study. All the patients were examined for visual acuity, slit-lamp microscopy, direct ophthalmoscope, fundus photography, electrooculogram, fundus fluorescein angiography (FFA) and OCT. Fifty-six eyes were classified into stage 0 (eight eyes)、Ⅰ (two eyes)、Ⅱ(10 eyes)、Ⅱa （12 eyes）、Ⅲ (six eyes) 、Ⅳa (six eyes)、Ⅳb (five eyes) and Ⅳc (seven eyes) accordingly. The OCT features of BVMD at different stages were observed.Results The OCT results showed that the macular area was normal in eyes of stage 0; disturbance of retinal pigment epithelium (RPE) and subretinal hyporeflective area were found in eyes of stage I; the location of the yellowish material between RPE and the inner segment and outer segment (IS/OS) with normal appearance in RPE and IS/OS interface were found in eyes of stage Ⅱ. In all the other progressing stages from Ⅱa、Ⅲ and Ⅳ, the vitelliform material appeared as a thicker highly reflective lesion located between the outer nuclear layer and RPE layer, usually accompanied by optical hyporeflective lesion. Images of stage Ⅳc were in similar appearance besides edema of retina. OCT images of Ⅳb stage were demonstrated atrophy of retinal layer and IS/OS loss with fibrosis. Conclusions OCT demonstrated the location of the yellowish material between RPE and IS/OS. Optical hyporeflective lesion between the outer nuclear layer and RPE layer accompanied thicker highly reflected lesion might be the characteristic image in stages II a to IV of BVMD.