ObjectiveTo observe the value of optical coherence tomography (OCTA) in distinguishing ischemic and non-ischemic branch retinal vein occlusion (BRVO). MethodsA prospective clinical observational study. From January 2020 to January 2021, 44 eyes of 44 patients with BRVO diagnosed in Tianjin Medical University Eye Hospital were included in the study. Among them, there were 24 eyes of 24 males and 20 eyes of 20 females. The macular edema subsided after three consecutive anti-vascular endothelial growth factor (VEGF) drug treatments. All the affected eyes underwent best corrected visual acuity (BCVA), intraocular pressure, ultra-wide-angle fluorescein fundus angiography (UWFFA), and OCTA examination. According to the results of UWFFA, the affected eyes were divided into ischemic group and non-ischemic group, with 22 eyes in 22 patients. The macular area of the affected eye with an OCTA instrument were scaned in the range of 3 mm×3 mm to measure the blood flow density (SVD, DVD), foveal blood flow density (SFVD, DFVD), parafoveal blood flow density (SPFVD, DPFVD), affected hemilateral blood flow density (SHVD, DHVD) and affected quadrant blood flow density (SQVD, DQVD) of the superficial capillary layer (SCP) and deep capillary layer (DCP) of the retina, foveal retinal thickness (CRT), fovea avascular zone (FAZ) area, perimeter of FAZ (PERIM), out-of-roundness index (AI), and blood flow density within 300 μm width of FAZ (FD-300). The two-sample independent t test was used to compare the parameters between the ischemic group and the non-ischemic group. Receiver operating characteristic (ROC) curve analysis was used to measure the area under the curve (AUC) of blood flow density to predict ischemic BRVO, determine the critical value for predicting ischemic BRVO and the corresponding sensitivity and specificity, with AUC＞0.9 as the prediction performance was good. ResultsThe differences of BCVA (t=1.544), intraocular pressure (t=－0.404), SFVD (t=0.444), DFVD (t=－0.812), CRT (t=1.082), FAZ area (t=－0.785), PERIM (t=－0.685), AI (t=1.047) of the eyes in the ischemic group and non-ischemic group were not statistically significant (P＞0.05). The differences of age (t=2.194), SVD (t=－3.796), SPFVD (t=－4.181), SHVD (t=－4.700), SQVD (t=－3.594), DVD (t=－2.324), DPFVD (t=－2.476), DHVD (t=－2.118), DQVD (t=－6.529) and FD-300 (t=－5.116) of the eyes in the ischemic group and non-ischemic group area were statistically significant (P＜0.05). ROC curve analysis results showed that DQVD predicted the AUC of ischemic BRVO the largest (0.917), the best cut-off value was 33.75%, and the sensitivity and specificity were 90.9% and 81.8%, respectively. ConclusionOCTA can quantitatively assess the microvascular structure of SCP and DCP in the macular area of BRVO eyes, and contribute to distinguish ischemic and non-ischemic BRVO.
Objective To evaluate the effects of retinal cryotherapy and intravitreal triamcinolone injection to treat Coatsprime; disease with exudative retinal detachment.Methods This was a prospective consecutive case study, and 21 patients (21 eyes) with Coatsprime; disease accompanied by exudative retinal detachment were enrolled. There were 19 males and two females patients, aged from two to 18 years. Fifteen eyes had partial retinal detachment (stage 3A) and six eyes had total retinal detachment (stage 3B). All patients underwent cryocoagulation and intravitreal triamcinolone injection. Three eyes underwent sclerotomy to drain subretinal fluid. Four eyes underwent further treatment by photocoagulation or cryotherapy for the residual abnormal blood vessels after the surgery. The follow-up ranged from three to 15 months with an average of seven months. Visual acuity, intraocular pressure, eye position and eye movements, slit lamp microscope, indirect ophthalmoscope and color fundus imaging were followed up. The last followup time was considered as the judgment time for the therapeutic effects. Results Six eyes had increased intraocular pressure after the surgery, which was controlled by local drug treatment. At the end of follow-up, 19 eyes had reattached retina, one eye had partial retinal detachment and one eye had total retinal detachment. The vision improved in three eyes,unchanged in 14 eyes, and decreased in two eyes. Other complications included strabismus (one eye) and cataract (four eyes). Conclusion The combined treatment of cryotherapy and intravitreal triamcinolone injection is an effective therapy for the Coatsprime; disease with exudative retinal detachment, as retina reattaches and visual function is saved in most patients after this treatment.
ObjectiveTo observe effect of interferon-γ in preventing intestinal adhesion following abdominal surgery in rats.MethodsA total of 60 Wistar rats were selected, which were randomly divided into a sham operation (SO) group, model group, dexamethasone (DXMS) group, and interferon-γ group, then the interferon-γ group was randomly divided into a low, medium, and high concentrations subgroups. Except for the SO group, the laparotomies with file friction caecum were performed for all the other groups to establish the intestinal adhesion model. SO group and model group were intraperitoneally injected with saline for 4 mL/kg. The 10 mg/kg dexamethasone was injected into the abdominal cavity of rats in the DXMS group. The 7.5×104, 1.5×105, and 3.0×105 U/kg interferon-γ concentrations were injected into the abdominal cavity of rats in the low, medium, and high concentrations subgroups respectively. The Nair grading of cecum adhesion degree was assessed on the 8th day after the surgery, then the histopathological change was observed by the HE staining under the microscopy and the hydroxyproline content in the cecum tissue was detected.Results① The intestinal adhesion: Compared with the SO group, the intestinal adhesions occurred in all the other groups and the degrees of intestinal adhesions evaluated by the Nair grading were more significantly serious (P<0.05), which in the DXMS group and the medium and high concentrations of interferon-γ subgroups were significantly reduced (P<0.05) as compared with the model group, which in the high concentration of interferon-γ subgroup was significantly reduced (P<0.05) as compared with the DXMS group. ② The microscopic observation of histopathological results: Compared with the DXMS group, the high concentration of interferon-γ could effectively reduce the occurrence of fibrous tissue and inflammatory cell infiltration, the intestinal wall muscular layer structure was complete, a few inflammatory cells scattered in the infiltration. ③ The hydroxyproline content: The contents of hydroxyproline in the cecum tissue of the model group, DXMS group, and interferon-γ subgroups were significantly increased (P<0.05) as compared with the SO group, which of the DXMS group and medium and high concentrations of interferon-γ subgroups were significantly decreased (P<0.05) as compared with the model group, which of the high concentration of interferon-γ subgroup was significantly decreased (P<0.05) as compared with the DXMS group.ConclusionInterferon-γ has a preventive and therapeutic effect on postoperative intestinal adhesion and cecum injuries.
The accurate position of the center of rotation (COR) is a key factor to ensure the quality of computed tomography (CT) reconstructed images. The classic cross-correlation matching algorithm can not satisfy the requirements of high-quality CT imaging when the projection angle is 0 and 180°, and thus needs to be improved and innovated. In this study, considering the symmetric characteristic of the 0° and flipped 180° projection data in sinogram, a novel COR correction algorithm based on the translation and match of the 0° and 180° projection data was proposed. The OTSU method was applied to reduce noise on the background, and the minimum offset of COR was quantified using the L1-norm, and then a precise COR was obtained for the image correction and reconstruction. The Sheep-Logan simulation model with random gradients and Gaussian noise and the real male SD rats samples which contained the heterogenous tooth image and the homogenous liver image, were adopted to verify the performance of the new algorithm and the cross-correlation matching algorithm. The results show that the proposed algorithm has better robustness and higher accuracy of the correction (when the sampled data is from 10% to 50% of the full projection data, the COR value can still be measured accurately using the proposed algorithm) with less computational burden compared with the cross-correlation matching algorithm, and it is able to significantly improve the quality of the reconstructed images.
ObjectiveTo observe the thickness distribution of retina outer nuclear layer (ONL) by directional optical coherence tomography (D-OCT), and analyze variation of ONL thickness with age, gender and anatomical location.MethodsCross sectional observational study. From August 2017 to January 2019, the patients were included who had no abnormal eyes in Beijing Tongren Hospital, and healthy volunteers were included in the study. Cirrus HD-OCT 5-line single line scanning mode was used to scan the macular area horizontally and vertically. The pupil diameter of all the tested eyes was more than 6 mm. The protocol was approved by The Medical College of Wisconsin Institutional Review Board. The detection light was incident on the temporal, nasal, upper and lower sides about 1.5 to 2.0 mm away from the pupil center to obtain an image that was oblique and clearly showed the Henle fiber layer (HFL). The upper and lower bounds of HFL and external limiting membrane (ELM) were manually labeled. The thickness of ONL and HFL+ONL were measured and recorded at 150 μm intervals on the horizontal and vertical radial lines with the fovea as the midpoint. The thickness of ONL in different anatomic location, ages and genders were compared. The influence of age and gender on ONL were analyzed by one-way ANOVA and independent sample t test respectively.Results67 eyes of 67 subjects were enrolled. Among them, the mean age of 27 males (27 eyes) and 40 females (40 eyes) was 38.48±15.33 and 40.98±17.78 years respectively without significantly statistical difference (t=－0.582, P=0.562). The total mean age was 39.97±16.98 years old. There were 11, 22, 22 and 12 patients aged less than 20, 20-39, 40-59 and over 60 years old respectively, according which they were divided into A, B, C and D groups. According to the anatomical location, the thickness of the ONL reached a maximum in the foveola, and then decreased as the eccentricity increased. Horizontally, ONL/ONL+HFL reached the minimum as 36.1% at 0.90 mm on the nasal side, while the minimum was 38.3% at 0.75 mm on the temporal side. Vertically, ONL/ONL+HFL reached the minimum as 36.2% at 0.75 mm inferiorly and 35.6% at 0.9 mm superiorly. There was no significant difference in the ONL thickness of fovea between group A, B,C and D (P＞0.05), however, a significant difference was among the four groups in the parafoveal and the perifovea (P＜0.05). The ONL thickness of the male was larger than that of the female, and the differences between them in parafoveal and perifovea showed statistically significant (P＜0.05).ConclusionsNormal people had the thickest ONL in the fovea. While the location is farther from the fovea, the ONL is thinner. The thickness of ONL in parafovea and perifovea is gradually thin with incerase of age. The thickness of ONL in the male is thicker than that in the female.
ObjectiveTo observe the inhibitory effect of lentivirus (LV)-mediated miR-191 on the proliferation and angiogenesis of human retinal vascular endothelial cells (hREC) cultured in vitro.MethodsThe hREC cell lines were cultured in vitro and divided into control group, hypoxia group, LV-empty vector (LV-vector) group, and LV-miR-191 (LV-191) group. The LV-vector group and LV-191 group were transferred to the corresponding lentiviral vector respectively. Flow cytometry was used to detect cell transfection efficiency. Cell Counting Kit-8 (CCK-8) test was used to detect cell proliferation ability. Scarification test and invasion chamber (Transwell) test were used to detect cell migration ability. Matrigel test was used to detect cell lumen formation ability. Real-time quantitative polymerase chain reaction (qPCR) was used to detect the relative expression of miR-191 and relative mRNA expression of its downstream target genes p21, vascular endothelial growth factor (VEGF), cell division protein kinase (CDK) 6, cyclin-D1 (Cyclin D1). Independent sample t test was used for pairwise comparison. ResultsThe results of flow cytometry showed that the transfection efficiency of cells in the control group and the LV-191 group were 0.615% and 99.400%, respectively. The results of CCK-8, scarification, Transwell and Matrigel test showed that, compared with the control group, the number of cell proliferation (t=6.130, 4.606), the cell mobility (t=4.910, 6.702), the number of stained cells on the microporous membrane (t=7.244, 6.724) and the lumen formation ability cells (t=8.345, 9.859) were significantly increased in the hypoxia group and the LV-vector group (P<0.01), while the LV-191 group showed completely opposite performance (t=14.710, 6.245, 5.333, 5.892; P≤0.01). The qPCR test results showed that, compared with the control group and the LV-vector group, the relative expression of miR-191 mRNA in the cells of the LV-191 group was significantly up-regulated (t=44.110, 42.680), the relative expression of Cyclin D1 mRNA (t=29.940, 14.010) and CDK6 mRNA (t=15.200, 7.645) decreased significantly, and the difference were statistically significant (P<0.01); the relative expression of p21 mRNA increased, however, the difference was not statistically significant (t=2.013, 2.755; P>0.05). There was no significant difference in the relative expression of VEGF mRNA in the 4 groups of cells (F=0.966, P>0.05). ConclusionsLV-191 can inhibit the proliferation, migration and tubing of hREC by up-regulating p21 and down-regulating CDK6 and Cyclin D1.
ObjectiveTo observe the differences of macular microvascular structure between recurrent and non-recurrent macular edema (ME) secondary to central retinal vein occlusion (CRVO) after intravitreal injection of ranibizumab (IVR), and to preliminarily analyze the correlation between recurrence and ME. MethodsA prospective clinical observational study. Forty-five patients (45 eyes) diagnosed as CRVO with ME were included in this study in Tianjin Medical University Eye Hospital from January 2020 to December 2021. There were 22 males (22 eyes) and 23 females (23 eyes). All cases were unilateral. The average age was 61.11±10.88 years old. All patients received IVR treatment once a month for 3 consecutive months. ME were regressive after the initial three treatments. The patients were divided into recurrent group (21 cases, 21 eyes) and non-recurrent group (24 cases, 24 eyes) based on ME recurrence at 6 months after ME resolution. All patients underwent best corrected visual acuity (BCVA), intraocular pressure, and optical coherence tomography angiography (OCTA). OCTA was used to scan the macula in the area of 3 mm×3 mm, and the vessel density (VD) of superficial capillary plexus (SCP), deep capillary plexus (DCP), fovea and parafovea before and after treatment was measured. Foveal retinal thickness, foveal avascular zone (FAZ) area, perimeter of FAZ (PERIM), avascular index of FAZ (AI), VD within 300 μm width of FAZ range (FD-300). Foveal VD included superficial and deep retinal VD (SFVD, DFVD); parafoveal VD included superficial and deep retinal VD (SPFVD, DPFVD). Taking the initial three treatments as the observation time point, the changes of the parameters of the two groups were compared. Comparison between the recurrent and non-recurrent group was performed by two independent sample t-tests. Receiver operating characteristic (ROC) curve analysis was used to measure the area under the curve (AUC) of VD for predicting the recurrence of ME. ResultsThere were no significant differences in age (t=1.350), IOP (t=1.929), SFVD (t=－1.716), DFVD (t=－1.143), CRT (t=－1.207) and AI (t=1.387) between the recurrent and non-recurrent group (P＞0.05). There were significant differences in times of anti-VEGF therapy (t=5.912), BCVA (t=5.003), SVD (t=－4.617), SPFVD (t=－4.110), DVD (t=－5.503), DPFVD (t=－4.772), FAZ area (t=2.172), PERIM (t=2.606) and FD-300 (t=－3.501) between the recurrent and non-recurrent group (P＜0.05). ROC curve analysis showed that the AUC of DVD in predicting the recurrence of ME was highest, with 0.921, and the threshold was 37.65%. The sensitivity and specificity were 91.7% and 85.7%, respectively. ConclusionsThe SVD, SPFVD, DVD, DPFVD and FD-300 in the recurrence group are significantly lower than those in the non-recurrence group, while the FAZ area and PERIM are significantly higher than those in the non-recurrence group. DVD≤37.65% can be used as the best threshold for predicting the recurrence of ME.
ObjectiveTo observe the diagnostic sensitivity and specificity of color Doppler flow imaging (CDFI) for persistent hyperplastic primary vitreous (PHPV). MethodsThe clinical data of 71 children (93 eyes) with congenital cataract which suspected of concurrent PHPV were retrospectively analyzed. The children included 45 males (54 eyes) and 26 females (39 eyes), aged from 1 to 24 months, with an average age of (7.6±4.3) months. All eyes were examined by CDFI, and observe whether there was a pathological strip in the vitreous, the site of the connection between the strip echo and the wall of the eye and the signal of blood flow on the strip echo. Within 1 week after a CDFI examination under general anesthesia, 64 children (79 eyes) underwent lens excision combined with vitrectomy and the other 14 eyes of 7 children underwent mydriatic fundus examination by two experienced eye specialists. Combined with clinical features of PHPV, the diagnosis and differential diagnosis were made according to the clouding of the lens, posterior capsule proliferation, vitreous proliferation and retinal detachment position which were found during operation and fundus examination. Compare and analyze the CDFI examination results and the above diagnosis results, calculate the sensitivity and specificity of CDFI for PHPV. ResultsIn surgery and mydriatic fundus examination results of 93 eyes, vitreous abnormal in 85 eyes, no significant changes were found in vitreous of the other 8 eyes. In 85 eyes of abnormal vitreous, 68 eyes were diagnosed as PHPV, 16 eyes were diagnosed as familial exudative vitreoretinopathy (FEVR), and 1 eye was diagnosed as treactional retinal detachment. In 85 eyes of abnormal vitreous which were found by surgery and fundus examination, CDFI confirmed 81 eyes and its diagnostic sensitivity was 95.3%; the other 4 eyes were not found vitreous abnormality, and the missed diagnosis rate was 4.7%. Surgery and mydriatic fundus examination found no vitreous abnormal in 8 eyes, but CDFI explored strip low echo connected with the optic disc or posterior lens capsule in vitreous. In the 68 eyes of PHPV which were diagnosed by surgery or fundus examination, 59 eyes had the same diagnosis of CDFI, the sensitivity of CDFI was 86.8%; PHPV was not diagnosed in 25 eyes by surgery or fundus examination, but only 8 eyes were also not diagnosed by CDFI, and the specificity of CDFI was 32.0%. The remaining 17 eyes were diagnosed as FEVR in 16 eyes and traction retinal detachment in 1 eye after surgery or mydriatic fundus examination, but they were all diagnosed as PHPV in CDFI. The misdiagnosis rate of CDFI was 68.0%. ConclusionFor PHPV, the diagnostic sensitivity and specificity of CDFI are 86.8% and 32.0%, respectively.
ObjectiveTo observe the application value with color Doppler flow imaging (CDFI) in the detection of macular diseases in senile cataract.MethodsA cross-sectional descriptive study. From December 1 to December 30, 2017, 720 senile cataract patients (1380 eyes) diagnosed in Beijing Tongren Eye Center were included in this study. There were 330 males (629 eyes) and 390 females (751 eyes), with the mean age of 70.35±19.05 years. There were 716 right eyes and 664 left eyes, with the visual acuity 0.05-0.8. The fundus of all the patients can be observed. All patients were examined by OCT using Cirrus HD-Model 5000 produced by German Carl Zeiss company and CDFI using MyLab90 color Doppler ultrasound system produced by ESAOTE S.P.A. Comparing the detection rate of macular lesions between the two methods by using χ2 test. Using statistical methods to evaluate diagnostic tests, a crosstabulation was made to compare the consistency of frequency-domain OCT and CDFI in the diagnosis of macular lesions. Logistic regression analysis of correlation between detection of CDFI macular lesions and central foveal thickness (CFT), average thickness (AT), with or without macular anterior membrane, retinal folds, retinal cystoid edema, hard exudation, macular hole or lamellar macular hole, superficial detachment of neuroepithelium, detachment of pigment epithelium, vitreous macular traction.ResultsTwo hundreds and thirty-nine eyes (17.3%) showed macular disease by OCT, and 161 eyes (11.7%) showed the abnormal echo in the macular region by CDFI. The detection rate of the macular disease between two methods were statistically significant (χ2=851.661, P＜0.001), however, the consistency was well (κ=0.766, P=0.000). Logistic analysis showed that the detection rate of macular lesions was related to retinal folds, cysts in retina and CFT (r=1.396, 1.041, 0.12; P＜0.01).ConclusionCDFI can effectively detect macular lesions that affect the visual prognosis of senile cataract patients.
Objective To summarize the characteristics of color doppler flow imaging (CDFI) of ocular toxocariasis (OT) in children. MethodsA retrospective clinical study. From July 2014 to June 2020, 61 OT patients with 61 eyes diagnosed through clinical and laboratory testing in the Department of Ophthalmology of Beijing Tongren Hospital of Capital Medical University were included in the study. There were 45 males with 45 eyes and 16 females with 16 eye (male: female=2.81:1). Age were (6.93±2.50) years. The right eye and left eye were 29 and 32 eyes, respectively. Both eyes of the patient underwent two-dimensional ultrasound and CDFI examination. Two dimensional ultrasound was used to estimate the axial length (AL) of the affected eyes and healthy eyes on the opposite side. Among them, 52 cases were measured for AL using optical biometry and/or A-mode ultrasound. Vitreoretinal surgery was performed within one week after ultrasound examination. Two-dimensional ultrasound was used to observe the morphology of vitreous opacity, its connection to the eyeball wall, and whether posterior vitreous detachment and retinal detachment have occurred. CDFI examination was used to observe the presence of blood flow signals on the pathological membrane. The detection rates of different forms of vitreous opacity and traction retinal detachment were calculated. The location of proliferative lesions in the eye was analyzed. Paired t-test was performed to compare the AL of the affected eye and the healthy eye on the opposite side. Perform Kappa consistency test on the location of proliferative lesions was used during CDFI examination and vitreoretinal surgery. ResultsAll affected eyes have varying degrees of vitreous opacity. Among them, 23 eyes (37.7%, 23/61) showed typical "Christmas tree" like turbidity; 27 eyes (44.3%, 27/61) had clustered and striped echoes; 9 eyes (14.8%, 9/61) had weak punctate and strip echoes. Two eyes (3.3%, 2/61) showed a large amount of dense punctate and strip-shaped echoes. There were 50 eyes (82.0%, 50/61) with traction retinal detachment, of which 46 eyes (92.0%, 46/50) had visible blood flow signals on the detached retina, and the remaining 4 eyes (8.0%, 4/50) had no blood flow signals. During CDFI and surgery, there were 5 (8.2%, 5/61) and 4 (6.6%, 4/61) eyes with visible proliferative lesions in the periphery, respectively; 18 (29.5%, 18/61) and 14 (23.0%, 14/61) eyes were distributed in the posterior pole, respectively; there were 38 (62.3%, 38/61) and 43 (70.5%, 43/61) eyes with both peripheral and posterior polar regions, respectively. The consistency between CDFI and surgery in detecting the location of proliferative lesions was good (κ=0.832, 95% confidence interval 0.691-0.973, P＜0.001). The two-dimensional ultrasound measurement results showed that the AL of the affected eye was shorter than that of the contralateral healthy eye in 46 cases (75.4%, 46/61). Among the 52 patients who underwent AL biometry, the AL of the affected eye was shorter than that of the contralateral healthy eye by (0.63±0.68) mm, and the difference was statistically significant (t=－6.738, P＜0.05). ConclusionsCDFI can clearly display various intraocular lesions (vitreous opacity and traction retinal detachment) and eyeball sizes in children with OT. Vitreous opacity is often manifested as "Christmas tree" like, clustered, strip-shaped.