Objective To observe the macular morphological changes of choroidal melanoma with coherence tomography (OCT) after plaque radiotherapy (PRT). Methods A total of 48 patients (48 eyes) with choroidal melanoma who underwent125I PRT were enrolled in this study. All the patients were examined documenting OCT to get the image of macula. The macula of all the patients was not involved. The median visual acuity was 0.4plusmn;0.2, which ranged from 0.02 to 1.0. There were 18 eyes (37.5%) with retinal detachment, 12 eyes (25.0%) with retinal pigment epithelium (RPE) changes, seven eyes (14.6%) with macular edema, epimacular membrane, detachment combined with edema, exudation and RPE changes, 11 eyes (22.9%) with normal macular structure. The median follow-up time was (10.4plusmn;5.9) months, which ranged from one to 24 months. The tumor control situation and visual acuity were observed in follow-up period. The same equipment and methods of OCT were used to return visit in follow-up period. The macular morphological changes at the final visit and its relationship with PRT and visual acuity were contrastively analyzed. Results All the patients had good control of tumor. The vision acuity improved in two eyes (4.2%), unchanged in 10 eyes (20.8%), and decreased in 36 eyes (75.0%). The differences of the visual acuity was statistically significant between before and after treatment (Z=-3.778,P＜0.05). There were 13 eyes (27.1%) with retinal detachment; nine eyes (18.8%) with RPE changes; 17 eyes (35.4%) with macular edema, detachment combined with edema, exudation and RPE changes; six eyes (12.5%) with proliferation, atrophy, detachment combined with edema, exudation and epimacular membrane;three eyes (6.3%) with normal macular structure. There were 15 patients (31.3%) with two or more abnormal macular morphology after PRT. Conclusions Retinal detachment, RPE changes, macular edema and exudation are common abnormal macular morphology after PRT. The incidence rate of abnormal macular morphology is increased. There are 31.3% patients with two or more abnormal macular morphology.
Objective To evaluate the value of AccuMap multifocal visual evoked potential (mfVEP) objective perimetry in measuring visual function of macular diseases. Methods Forty-six eyes (37 patients) with macular diseases were studied. The mean mfVEP amplitudes of central visual field within radius 2.0deg;, 5.5deg;, 10.0deg;, 15.5deg; and 24.0deg;were measured by AccuMap mfVEP objective perimetry. Automatically calculated AccuMap severity index （ASI） represented the visual field defects. Meanwhile, the mean sensitivity (MS) of central visual field within radius 2.0deg;, 4.0deg;, 6.0deg;, 8.0deg; and 10.0deg; and mean defect (MD) of central visual field within radius 10.0deg; were assessed by MP-1 microperimeter. The correlations among those parameters including logMAR visual acuity, mean mfVEP amplitudes, MS, ASI and MD were analyzed. Results Among 46 affected eyes, AccuMap mfVEP objective perimetry showed abnormal ASI with visual field defects in 43 eyes (93.45%), normal ASI without visual field defects in three eyes (6.55%). The mean mfVEP amplitudes value of the central visual field within radius of 2.0deg;, 5.5deg;, 10.0deg;, 15.5deg; and 24.0deg; were (120.78plusmn;52.91), (134.31plusmn;54.67), (149.99plusmn;52.42), (156.69plusmn;48.30), (157.54plusmn;45.07) nV respectively. The mean ASI value was 74.26plusmn;52.43. MP1 showed that the MS values of central visual field within radius 2.0deg;, 4.0deg;, 6.0deg;, 8.0deg; and 10.0deg; were (10.97plusmn;5.91), (12.71plusmn;5.13), (13.71plusmn;4.53), (14.23plusmn;4.18), (14.48plusmn;3.86) dB respectively. The MD value of central visual field within radius 10deg; was 4.49plusmn;3.07. There was a significant correlation among ASI, the mean mfVEP amplitudes of central visual field with every radius and logMAR best corrected visual acuity （P＜0.05). The mean mfVEP amplitudes of central visual field within radius 2.0deg;, 5.5deg;, 10.0deg; were positively correlated with the MS of central visual field within radius 2.0deg;, 6.0deg;, 10.0deg; (r=0.477, 0.432, 0.433;P=0.001, 0.003, 0.003). Furthermore, ASI was also correlated with MD of central visual field within radius 10.0deg;(r=0.729, P=0.000). Conclusions AccuMap mfVEP objective perimetry can reflect the changes of macular function objectively and can be used to assess the visual function of macular diseases.
Objective To investigate the clinical features, etiological classification and staging of epiretinal macular membrane(MEM)． Methods Clinical materials of 194 cases of MEM diagnosed by fundus fluorescein angiography in outpatient department of eye clinic in this hospital from 1983 to 2000 were retrospectively analyzed． Results There were typical clinical symptoms and signs of MEM in all of this 222 eyes of 194 patients． Etiological classification revealed that 4 cases were congenital(2．12%), 22 cases were secondary(11．34%), and 168 cases were idio pathic(86．60%)． Staging of course of disease indicated that 119 eyes were in early stage(53．60%), 72 eyes were in middle stage(32．43%), and 31 eyes were in late stage(13．96%)． Conclusion MEM may be classified as congenital, secondary and idiopathic type according to its pathogenesis , as early, middle and late stage according to the clinical course of disease．This can be helpful in treating the disease． (Chin J Ocul Fundus Dis, 2001,17:210-213)
ObjectiveTo observe the characteristics of macular optical coherence tomography (OCT) changes before and after silicone oil removal in patients who had undergone pars plana vitrectomy with silicone oil tamponade for macula-off rhegmatogenous retinal detachment (RRD). MethodsThirty-nine eyes that underwent silicone oil removal were enrolled in this retrospective study. The patients included 24 males and 15 females, with an average age of (53.05±4.03) years, the duration of silicone oil tamponade ranged from 3 to 7 months. Best-corrected visual acuity, intraocular pressure, slit lamp microscope and pre-lens, indirect ophthalmoscopy and fourier domain OCT were measured for all patients before and at months 1, 3 and 6 after silicone oil removal. The macular microstructure were observed before and after silicone oil removal. ResultsSubmacular fluid was detected in 6 eyes (15.38%), at the last time of follow-up, submacular fluid resolved completely in 2 eyes with disrupted ellipsoid zone, and resolved partly in 2 eyes. Disrupted ellipsoid zone were observed before silicone oil removal in 16 eyes (41.02%), 6 eyes showed simultaneous disrupted ellipsoid zone and disrupted external limiting membrane, and there were 2 eyes that external limiting membrane was not identified, at the last time of follow-up, disrupted ellipsoid zone restored in 2 eyes and the extent of disrupted ellipsoid zone became reduced in 4 eyes. Cystoids macular edema were found in 2 eyes (5.12%), it resolved completely in 1 eye and resolved partly in 1 eye at the last time of follow-up. Macular epiretinal membrane was detected in 10 eyes (25.64%), and macular epiretinal membrane was found before silicone oil removal in 5 eyes, at the last time of follow-up, the membrane became thickened in 2 eye; 5 eyes developed macular epiretinal membrane after silicone oil removal, at the last time of follow-up, the membrane became thickened in 1 eye. Secondary macular hole were noted in 2 eyes. Microcystic macular changes were observed in 9 eyes (23.07%), it was observed in 7 eyes before silicone oil removal, and was observed in 2 eyes after silicone oil removal, at the last time of follow-up, the cysts reduced in 1 eye. ConclusionSubmacular fluid, disrupted ellipsoid zone and microcystic macular are the main macular ultrastructural changes that developed in patients with RRD before and after silicone oil removal.
Objective To observe the macular morphology and circumpapillary retinal nerve fiber layer thickness (RNFL) in Parkinson's disease (PD) evaluated by spectral-domain optical coherence tomography (SD-OCT). Methods A total of 37 patients (74 eyes) with PD were in the PD group, 32 age- and sex-matched healthy subjects (64 eyes) in the control group. All subjects underwent SD-OCT examination with 5 line scanning, macular cube 512×128 scanning and optic disc volume 200×200 scanning. The retinal thickness, central foveal thickness (CFT), macular volume and thickness of circumpapillary, superior, inferior, nasal, and temporal of RNFL between two groups were comparatively analyzed. The relationship between SD-OCT parameters and age, disease duration, scores of Hoehn-Yahr and unified PD rating scale (UPDRS) Ⅲ in PD patients was analyzed by Pearson correlation analysis. Results Both of the retinal thickness and macular volume in PD group were significantly reduced than those in control group (t= −2.546, −3.410;P=0.012, 0.001). There was no difference of CFT (t= −0.463,P=0.644) and the thickness of circumpapillary (t= −1.645,P=0.102), superior (t= −0.775,P=0.439), inferior (t=−1.844,P=0.067), nasal (t= −0.344,P=0.732) and temporal (t= −0.541,P=0.590) of RNFL between two groups. The retinal thickness, macular volume, CFT and the thickness of circumpapillary, superior, inferior, nasal, temporal of RNFL had no relationship with age, disease duration and scores of Hoehn-Yahr and UPDRS Ⅲ in PD patients (P＞0.05). Conclusions In PD patients, the retinal thickness and macular volume are decreased, however, the circumpapillary RNFL have no obvious alterations.