Optical coherence tomography (OCT) can depict mild papilledema and slight changes in the internal segment and external segment; measure thickness of the retinal nerve fiber layer, retinal thickness and macular volume; detect missing axons and damage to the macular ganglion cell complex. Thus, OCT has important application values and widespread prospects in diagnosis and differential diagnosis of glaucoma and nonglaucoma optic neuropathy, optic nerve diseases and macular diseases, outer and inner retinopathy as well as evaluation of curative effects, followup observation, prognosis and mechanisms in neuroophthalmological diseases. Neuro-ophthalmologists should pay more attention to the exploration and application of OCT in the field of neuro-ophthalmology.
Functional imaging is a newly arisen interdisciplinary subject compared with the routine radiology displaying anatomy and morphology of lesions.It can exhibit the functionchanged information, such as blood flow and metabolism of organs and tissues as visual images or data to provide organizational functions and metabolic information, which makes early diagnosis, more accurate orientation, qualitative definition,and also the prognosis judgment.The ophthalmologists should pay more attention to the functional imaging applications in the field of neuro-ophthalmology.
Objective To study prospectively the morphological relations among hemorrhage of optic disc, defect of retinal nerve fiber layer, and peripapillary atrophy in normal-tension glaucoma (NTG). Methods Qualitative and quantitative methods were applied to evaluate the relations among hemorrhage of optic disc, defect of retinal nerve fiber layer, and peripapillary atrophy by using stereo ocular fundus photography and computer analyzer systems. Results In 37 patients (42 eyes) in NTG hemorrhage group, 50 hemorrhagic spots at optic disc was found, including coloboma of retinal nerve fiber layer in 35 eyes (83.3%)(35/42). In 35 patients (40 eyes) in non-hemorrahge group, partial coloboma of retinal nerve fiber layer was found in 21 eyes (52.5%)(21/40). The difference of incidence of coloboma of retinal nerve fiber layer between the two groups was not significant (chi;2=1.403, P=0.236). The incidence of atrophic arc in hemorrhage group differed much from which in non-hemorrhage group (chi;2=7.008, P=0.008). The area of atrophic arc at beta;section in hemorrhage group ［(2.05plusmn;0.88)mm2］ was significantly different from which in non-hemorrhage group［(1.42plusmn;0.53)mm2］(t=-2.618, P=0.012). In the follow-up period, the difference of incidence of disc-rim loss between hemorrhage and non-hemorrhage group was significant, (chi;2=5.802, P=0.016); while the difference of the incidence of visual field defect between the two groups was not. Conclusion In eyes with NTG, hemorrhage of optic disc, coloboma of retinal nerve fiber layer and atrophic arc are closely related. More disc-rim loss and changes of atrophic-arc area in hemorrhage group in the follow-up period suggests that hemorrhage of optic disc is the risk factor of development of NTG. (Chin J Ocul Fundus Dis, 2006, 22: 232-235)
Objective To observe the characteristics of pupillary light reflex in the patients with retrobulbar neuritis, and to evaluate the effects of pupi llary light reflex on the diagnosis and treatment of retrobulbar neuritis. Methods Thirtyfive patients (thirtyfive eyes with the retrobulbar neuritis and thirtyfive fellow eyes) aged from 10 to 58 years and 50 healthy individuals (100 eyes) who didnlsquo;t differ from the patients in age and sex were examined by a automatic pupillometer. The pupillary area and response amplitude, latency and speed of papillary reflex were recorded. Results The latency of the pupillary light reflex delayed and the maximum amplitude decreased in patients with retrobulbar neuritis during the diseas eperiod, and the differences were highly significant compaired with the control group. After the treatment, as the symptoms were alleviated and the visual acuity improved, the latency of the pupillary light reflex and the maximum amplitude recovered. The statistic differences were both found between the results after treatment and those at the onset stage, and the results after treatment and those in the control group.Before the onset of the disease of the involued eyes and after the treatment, the papill ary light reflex and the maxium amplitude decreased, but didnamp;#146;t differe much from which in the control group. Conclusions The latency of the pupillary light reflex delayes and the maximum amplitude decreases in patients with retrobulbar neuritis. The examination of pupillary light reflex is helpful to diagnose retrobulbar neuritis early and inspect the condition of the disease. (Chin J Ocul Fundus Dis,2006,22:370-372)
Objective To observe the characteristics of changes of 24hour ambulatory blood pressure and heart rate of 50 patients with anterior ischemic optic neuropathy (AION). Methods Fifty patients with AION and the persons without in the control group, which had the same number, gender and age as the patients with AION, underwent 24-hour ambulatory blood pressure and heart rate measurement. Results Both groups had no difference in mean blood pressure and heart rate during the daytime (t=1.25,0.93; P＞0.05), higher than those in the nighttime (t=3.63,3.16; P＜0.05). Mean blood pressure and heart rate of AION group at night were lower than those of the control group (t=3.82,1.77; P＜0.01,0.05), especially diastolic pressure of AION group was lower than that of the control group from 2 am to 7 am (P＜0.01), as well as the heart rate from 2 am to 5 am (P＜0.05 or P＜0.01). The curves of blood pressure of AION group showed more gradual and fluctuant rising, while those of the control group showed sharper and less fluctuant rising. Conclusion According to the curves of blood pressure rising, the patients with AION may have some defects in auto-regulatory mechanism of blood pressure. The low spots of blood pressure and heart rate in early morning, which might be a critical point leading to AION. (Chin J Ocul Fundus Dis, 2002, 18: 259-261)