Objective To observe the features of frequency domain optical coherence tomography (FD-OCT) in acute central serous chorioretinopathy (CSC). Methods The data of FD-OCT and fundus fluorescein angiography (FFA) of 31 patients with unilateral acute CSC were retrospectively analyzed. The FD-OCT of retinal pigment epithelial (RPE) layer at leakage points, retinal detachment area and RPE layer in the fellow eyes was documented. Results Thirty-four leakage points were detected in 31 eyes on FFA. At the sites of fluorescein leakage, FD-OCT showed that serous pigment epithelial detachment (PED) in 18 leakage points (52.9%) and 17 eyes (54.8%), a small RPE protrusion in 8 leakage points (23.5%) and 8 eyes (25.8%), RPE irregularity in 6 leakage points (17.6%) and 4 eyes (12.9%) and no detectable RPE abnormality in 2 leakage points (5.9%) and 2 eyes (6.5%). An RPE defect at the edge of or within the PED was found in 7 leakage points (20.6%) and 7 eyes (22.6%). Serous retinal detachment and interruption or complete disappearance of the hyperreflective inner/outer segment junction (IS/OS) were detected in all diseased eyes. Uneven thickness of the outer segments (OS) was found in 24 eyes (77.4%), 14 of which had sagging sign. Flaking of the OS was found in 10 eyes (32.3%), multiple hyperreflective dots on the posterior surface of the detached neurosensory retina and on the surface of the RPE were found in 8 eyes (25.8%). Among 31 fellow eyes, FD-OCT also showed RPE abnormalities in 11 eyes (35.5%), in which PED, RPE protrusion and RPE irregularity were detected in 2 (6.5%), 1 (3.2%) and 8 eyes (25.8%), respectively. Conclusions In acute CSC the FD-OCT images at leakage points of are featured by PED, RPE protrusion, RPE irregularity and no detectable RPE abnormality; in retinal detachment area FD-OCT are featured by serous retinal detachment, interruption or disappearance of IS/OS, uneven thickness of OS, flaking of OS and hyper-reflective dots on the posterior surface of the detached neurosensory retina and on the surface of the RPE.
Objective To observe the retinal manifestations and classification of mitochondrial encephalomyopathy，and explore the relationship between retinopathy and systemic manifestations.Method The clinical data of 88 inpatients with mitochondrial encephalomyopathy were retrospectively analyzed，in whom 12 patients（24 eyes）with retinal manifestations who diagnosed by ophthalmology consultation and complete medical records were collected. There were nine males and three females aged from 14 to 33 years with the mean age of（20.1±7.0）years. The disease duration ranged from 2.5 to 20 years，with the mean of（9.5±6.8）years. All the patients had the eye symptoms of the different degree，such as limbs weakness，hearing decline and central nervous system symptoms. Ophthalmologic examination including best corrected visual acuity，slit lampa microscope，indirect ophthalmoscopy，noncontact Tonometer，ptosis，ocular movement，pupillary reflex and color fundus photography. Among the patients，three，one，two and five patients had undergone fundus fluorescein angiography（FFA），optical coherence tomography（OCT），lectroretinogram（ERG）and visual field examination respectively. Diabetic retinopathy were divided into “salt and pepper”， retinitis pigmentosa（RP），retinal pigment epithelium（RPE），choroidal capillary atrophy and simplex optic atrophy according to the inspection results.Results All the patients′ both eyes were involved，the disease degree of bilateral eyes was accordant. The ptosis and（or）eye movement limitation were found in nine patients（75.0%），and decreased visual acuity was in six patients（50.0%）.“Salt and pepper” was found in six patients（12 eyes），presenting retinal granular pigmentation and depigmentation；the visual acuity was 0.4-1.2；no central nervous system symptoms were found in patients，such as hearing decline，twitch，ataxia and hypophrenia. RP was found in one patient（two eyes），presenting retinal cells sample pigmentation，retinal vessel shrink，optic atrophy；the vision were light perception in both eyes；hypophrenia，hearing decline，bilateral lower limbs pain and onset twitch were also found in them. RPE and choroidal capillary atrophy were found in three patients（six eyes），the choroidal great vessels and flake pigment accumulation surrounding the retina were observed；the visual acuity was hand movement0.7；limbs weakness was found in two patients；hearing decline was found in three patients；barylalia and hypophrenia were found in two patients；somnolence was found in one patient. Simplex optic atrophy was found in two patients（four eyes）；the vision was 0.1-0.7；central nervous system symptoms were found in patients，such as limbs weakness，twitch，hypophrenia and headache.Conclusion Retinopathy types is concerned with visual prognosis and central nervous system symptoms.