Objective To investigate the relationship between morphologic macular changes and visual outcome in eyes with persistent submacular fluid (SMF) after surgery for macula-off rhegmatogenous retinal detachment (RRD) and the relevant factors of persistent submacular fluid. Methods Sixty-three consecutive patients (63 eyes) who underwent successful surgery for macula-off RRD were enrolled in this retrospective study. The patients were divided into three groups according to duration of SMF: no SMF group, short-term group (duration of SMF less than three months) and long-term group (duration of SMF more than three months). The follow-up ranged from six to 12 months. The morphologic macular changes, height of SMF and thickness of the outer nuclear layer (ONL) one month after surgery were assessed by spectral domain-optical coherence tomography (SD-OCT). The relationship between morphologic macular changes and logarithm of the minimum angle of resolution (logMAR) visual acuity and the relevant factors of persistent SMF were evaluated. Results Forty-five of 63 eyes (71.42%) presented morphologic changes after surgery. SMF was detected in 32 eyes (50.79%), which included 21 patients that had long-term course of SMF. Irregular thickness of the photoreceptor outer segments (OS) was observed in 23 eyes; disrupted inner segment/outer segment (IS/OS) junction was noted in 21 eyes, and disrupted external limiting membrane (ELM) was noted in 14 eyes. Irregular thickness of OS in long-term group was significantly higher than that in short-term group (chi;2=5.788, P=0.035). The proportion of IS/OS disruption and ELM discontinuation in long-term group was also higher than those in short-term group, but there was no statistically significant difference (chi;2=0.744, 0.375; P=0.472, 0.403). The postoperative visual acuity correlated positively with preoperative visual acuity and the time of retinal detachment (r=0.611, -0.374; P=0.007, 0.037). There was a significant difference of postoperative logMAR visual acuity (U=28.640, P=0.049) among no SMF group (0.27plusmn;0.26), short-term group (0.42plusmn;0.31) and long-term group (0.53plusmn;0.41). The postoperative visual acuity was insignificantly associated with irregular OS and IS/OS disruption (r=0.331, 0.320; P=0.073, 0.102). The irregular OS correlated positively with IS/OS disruption (r=0.388, P=0.027). The postoperative visual acuity in eyes with disrupted both IS/OS and ELM significantly decreased (U=29.920, P=0.036). The surgery manner (r=0.477, P＜0.001), time of preoperative retinal detachment (r=0.354, P=0.047) and SMF height one month after surgery (r=0.375, P=0.039) were factors influencing persistent SMF. Conclusions The incidence of postoperative photoreceptor lesion was increased with time of persistent SMF. Disruption of both IS/OS and ELM after surgery means a poorer vision outcome. Duration of preoperative macular detachment, type of surgery and SMF heights one month after surgery were important factors for persistent SMF.
Objective To observe the content of thromboxane (TXA2 ) and prostacyclin (PGI2) in optic nerves after forehead impact injury.Methods The right forehead zones of 32 rabbits were struck by biology impact machine. Tweenty-four rabbits that had afferent papillary defect after injury were chosen, and randomly divided into four groups: 1 day, 2, 4, and 7 days group. Right eyes were in the experimental group and left eyes were in the control group. Flash visual evoked potentials were examined before and after the traumatic injury. The rabbits ′eyes were removed, the optic nerves were pathologically examined, and the content of TXB2 and 6-Keto-PGF1αwhich were the products of TXA2 and PGI2 were assayed 1, 2, 4, and 7 days after traumatic injury respectively.Results Histopath ological examination revealed the findings of injuries of optic nerves of all the 24 rabbits. The latency of wave P1 was significantly delayed after traum atic injury (Plt;0.01), and amplitude of wave P1 was significantly decreased after traumatic injury (Plt;0.01). The content of TXB2 ［(172.35±26.52) pg/mg ］and 6-Keto-PGF1α［(161.78±24.83) pg/mg］were significantly higher in the injured optic nerves than in the uninjured ones 1 day after the traumatic injury (Plt;0.01). The rate of TXB2 /6-Keto-PGF1α (1.077±0.18) was significantly increased compared to the control group (Plt;0.05), and lasted to the 7th day.Conclusions The content of TXA2 and PGI2 significantly increases and the ratio of them is lopsided after forehead impact injury in rabbits. (Chin J Ocul Fundus Dis，2003，19：49-51)