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.
ObjectiveTo observe the anatomical and functional changes in patients with different degrees of myopic traction maculopathy (MTM) after vitrectomy. MethodsIt was a retrospective case series study. Forty-seven consecutive patients (47 eyes) diagnosed with MTM were studied between January 2010 and May 2014. There were 38 females (38 eyes) and 9 male (9 eyes),mean age was (65.13±6.98) years, mean axial length was (29.23±1.77) mm. The eyes was divided into 3 groups according to the macular morphologies on optical coherence tomography (OCT), including macular retinoschisis only group (MRS group, 18 eyes), foveal retinal detachment group (FD group, 13 eyes) and full-thickness macular hole group (MH group, 16 eyes). All the eyes underwent minimum resolution angle in logarithmic (logMAR) best corrected visual acuity (BCVA), intraocular pressure, axial length, A or B- ultrasonography, fundus photography, OCT and microperimetry examinations. The average logMAR BCVA of 47 eyes was 1.43±0.52. The center retinal thickness (CRT) of eyes in MRS and FD group was (528.45±167.61) μm. All the patients underwent pars plana vitrectomy combined with internal limiting membrane peeling. The mean follow-up period was 23.4 months. The changes of logMAR BCVA, microperimetry and macular microstructural were observed. ResultsAt the final follow-up, the logMAR BCVA of 47 eyes was 0.86±0.42, which improved compared with the preoperative vision (t=7.36,P<0.001). The mean CRT of eyes in MRS and FD group was (250.90±91.81) μm, which improved compared with the preoperative CRT (t=8.17,P<0.001). In MRS group, the retina was attached in 18 eyes. In FD group, the retina was attached in 11 eyes, MH was observed in 2 eyes. In MH group, recurrent retinal detachment was observed in 1 eye. The differences of logMAR BCVA and retinal sensitivity among MRS, FD and MH groups were significant (χ2=6.38, 11.08; P=0.030, 0.004). ConclusionThe macular structural and visual function in MTM eyes with macular retinoschisis only after vitrectomy are better than those in MTM eyes with MH and foveal retinal detachment.
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.