ObjectiveTo observe the morphologic characteristics of drusen in atrophic age-related macular degeneration (AMD) by spectral domain optical coherence tomography (SD-OCT). MethodsFifty-four patients (84 eyes) with macular drusen and atrophic AMD, and 56 age-matched control patients (56 eyes) with cataract were included in this study. Atrophic AMD patients were divided into two groups: D1 group with drusen involving the fovea (42 eyes) and D2 group with drusen not involving the fovea (42 eyes). The SD-OCT images in macular (6 mm×6 mm scans) were acquired, and the foveal retinal thickness (FRT) was measured. The size, morphology, inner reflection, homogeneity of drusen and its relationship with surrounding tissues were analyzed. ResultsThe FRT of D1 group, D2 group and control group were (160.90±38.47), (194.21±26.11), (222.42±19.29) μm respectively. The FRT of D1 group and D2 group were thinner than that of control group (F=57.08, P=0.00). Totally 1124 drusen were found by SD-OCT images in 84 eyes, with an average of 10.84 drusen in each eye. 3.0%, 12.5% and 84.5% of all 1124 drusen were small, medium and large sized respectively. 56.6%, 14.2%, 20.4% and 8.8% of all drusen were dome, pointed, saw-toothed and basal-shaped respectively. 17.1%, 57.5% and 25.4% of all drusen had low, medium and high internal reflectivity respectively. The internal reflectivity of 65.6%, 2.8% and 31.7% of all drusen were homogeneous, nonhomogeneous with core, and nonhomogeneous without core respectively. Overlying retinal pigment epithelium (RPE) damage and photoreceptor inner segment/outer segment (IS/OS) junction damage were presented in 34.5% and 24.8% drusen respectively. The most common type of drusen was dome-shape, homogeneous, with medium internal reflectivity, and without overlying RPE or IS/OS junction damage (81.0%). ConclusionsThe FRT becomes thinner in patients with drusen. The most common drusen types are dome-shaped, homogeneous, with medium internal reflectivity, and without overlying RPE or IS/OS junction damage.
Objective To observe the optical coherence tomography (OCT) features of Best vitelliform macular dystrophy (BVMD) at different stages.Methods Twenty-eight BVMD patients (56 eyes) were enrolled in this study. All the patients were examined for visual acuity, slit-lamp microscopy, direct ophthalmoscope, fundus photography, electrooculogram, fundus fluorescein angiography (FFA) and OCT. Fifty-six eyes were classified into stage 0 (eight eyes)、Ⅰ (two eyes)、Ⅱ(10 eyes)、Ⅱa （12 eyes）、Ⅲ (six eyes) 、Ⅳa (six eyes)、Ⅳb (five eyes) and Ⅳc (seven eyes) accordingly. The OCT features of BVMD at different stages were observed.Results The OCT results showed that the macular area was normal in eyes of stage 0; disturbance of retinal pigment epithelium (RPE) and subretinal hyporeflective area were found in eyes of stage I; the location of the yellowish material between RPE and the inner segment and outer segment (IS/OS) with normal appearance in RPE and IS/OS interface were found in eyes of stage Ⅱ. In all the other progressing stages from Ⅱa、Ⅲ and Ⅳ, the vitelliform material appeared as a thicker highly reflective lesion located between the outer nuclear layer and RPE layer, usually accompanied by optical hyporeflective lesion. Images of stage Ⅳc were in similar appearance besides edema of retina. OCT images of Ⅳb stage were demonstrated atrophy of retinal layer and IS/OS loss with fibrosis. Conclusions OCT demonstrated the location of the yellowish material between RPE and IS/OS. Optical hyporeflective lesion between the outer nuclear layer and RPE layer accompanied thicker highly reflected lesion might be the characteristic image in stages II a to IV of BVMD.
Objective To evaluate different methods in determ ining the postoperative changes of anatomical structures in macular diseases． Methods Thirty-one eyes of 31 cases of macular diseases, were studied among them there were 15 eyes with idiopathic macular hole (IMH),and the others included 8 eyes with macular epiretinal membranes(ERMs), 4 eyes with age relate d macular degeneration(AMD) and 4 eyes with idiopathic submacular neovasculariza tions(SRNV)． All cases were examined with retinoscope or retinogra phy, fundus fluorescein angiography (FFA) and optical coherence tomography (OCT ) pre-and postoperatively． Results Funduscopy showed that all of the 15 IMHs were closed after operation, but OCT showed th at among them 2 affected eyes still had partial retinal detachment at the macular hole edge in one quadrant and the sensory layer in macular area became thinner in 1 affected eye． FFA revealed damage of retinal pigment epithelium (RPE) in 5 cases． As for the ERMs and SRNV, funduscopy could n ot identify wether they were completely removed or not after operation． FFA ind icated that SRNV and SRNV were completely removed and the damage of RPE．OCT discovere d that the ERMs and SRNV were completely removed and the sensory layer became th inner in 3 eyes． Conclusion The combination of funduscopy , FFA and OCT can get the whole view of macular diseases and their postopera tive anatomical evaluation． (Chin J Ocul Fundus Dis, 2001,17:33-36)