Objective lt;brgt;To evaluated the effect of transpupillary thermotherapy (TTT) on age-related macular degeneration (AMD). lt;brgt; lt;brgt;Methods lt;brgt;Sixty-two cases (62 eyes) of exudative AMD were managed with TTT. Before treatment, 58 cases underwent fundus fluorescein angiography(FFA),42 cases underwent simultaneous indocyanine green angiography (ICGA), and 56 cases underwent optic coherence tomography (OCT).TTT was delivered using a 810 nm diode laser with variable spot sizes 0.5-3.0 mm and power range 60-40 mW,60 seconds duration. Sixty-two cases were followed up for 1-10 months with 4.8 months average. lt;brgt; lt;brgt;Results lt;brgt;The visual acuities of last visit were compared with those before the treatment. The visual acuity was unchanged in 43 cases (69.3%), improved in 15 cases (24.2%), and declined in 4 cases (6.5%). OCT was re-done in 51 cases and compared with OCT images before TTT treatment. The height of macular edema was unchanged in 29 cases (56.9%), decreased in 18 cases (35.3%), and increased in 4 cases (7.8%). The amelioration of visual acuity was compatible with that of macular configuration in the majority of cases (74.5%). Only in 13 cases (25.5%) the amelioration of visual acuity lagged behind that of macular configuration. The re-treatment was performed in 18 cases (29.1%), probably due to insufficiency of laser power. No side-effect was found. lt;brgt; lt;brgt;Conclusion lt;brgt;TTT makes most of the cases of exudative AMD retaining or improving their visual acuity. The employment is secured. Further exploration is needed in order to obtain the parameters of the laser treatment. (Chin J Ocul Fundus Dis, 2002, 18: 180-183)
Objective To observe and estimate the image characters of indocyanine green angiography (ICGA) and fundus fluorescein angiography (FFA) in atrophic age-related macular degeneration(AMD) and macular drusen. Methods FFA, ICGA and fundus photography were performed on 95 eyes of 73 atrophic AMD patients, in cluding 19 patients (26 eyes) with depigmentation and atrophy of retinal pigment epithelium (RPE), 15 (30 eyes) with macular drusen, and 39 (39 fellow eye) with unilateral exudative AMD.Results In 26 eyes with depigmentation and atrophy of RPE, the result of FFA of 24 eyes with depigmentaion showed patch hyperfluore scence, and of ICGA showed patch hyperfluorescence and hypofluorescence on the late photographs; in 2 eyes with maplike atrophy of RPE, the result of FFA showed patch hyperfluorescence, and of ICGA showed choriocapillaris defect with sharply demarcated boundaries and hypofluorescence of large choroidal vessels. In 30 eyes with macular drusen, the result of FFA of 8 eyes with hard drusen showed hyperfluorescence, and of ICGA showed patch and spot hyperfluorescence; the result of FFA of 16 eyes with soft drusen showed hyperfluorescence, and of ICGA showed persistent patch hypofluorescence intermixed with cluster hyperfluorescence; and the result of FFA of 6 eyes with both soft and hard drusen showed hyperfluorescence, and of ICGA showed patch hyperfluorescence intermixed with hypofluorescence. When it was hypofluorescence in ICGA in patients with macular drusen, larger quantity and range of fluorescence were found in FFA than in ICGA; when it was hyperfl uorescence in ICGA, smaller quantity and range of fluorescence were found in FFA than in ICGA. In 39 fellow eyes of unilateral exudative AMD, 32 or 31 eyes, examined by ICGA or FFA, had abnormal fluorescence of drusen and depigmentation and atrophy of RPE damage.Conclusions Simultaneous examination of IC GA and FFA can be useful for accurate evaluation of fundus image characters of types of angiography in atrophic AMD.(Chin J Ocul Fundus Dis，2003，19：79-82)
ObjectiveTo summarize the clinical results and safety of photodynamic therapy (PDT) through 4 years after single and multi-treatments of patients with subfoveal choroidal neovascularization (CNV) caused by age-related macular degeneration(AMD). MethodsClinical data of 73 AMD cases (95 eyes) diagnosed through fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optic coherence tomography (OCT), treated with PDT were reviewed and analyzed in this hospital from June 2000 to June 2004. The changes of best corrected visual acuity (BCVA), fundus pictures, FFA, ICGA and OCT were compared before and after PDT. Follow-up time varied from 3 months to 4 years (mean, 2 years). ResultsThe mean age of 73 patients was 67.8 years old. The BCVA was from CF/10 cm to 1.0. At the final follow up, the BCVA was improved (increase≥2 lines) in 39 eyes (41.1%), stabilized (±1 line) in 51 eyes (53.7 %) and decreased 2 lines in 5 eyes (5.3%). Fundus hemorrhage and exudation reduced after PDT. FFA and ICGA showed CNV complete closure in 58 eyes (61.05%), partial closure in 6 eyes (6.32%), CNV incomplete closure in 22 eyes (23.16% ) and recurrence in 9 eyes (9.47%). After once PDT of 12 eyes with early-stage AMD, the BCVA improved (from 0.6 to 1.5), CNV completely closed, and the OCT showed disappearance of macular edema and neursensory retinal deta chment. No CN V recurred in our four years follow-up observation and the BCVA of the patients remained stable. The mean number of PDT treatment was 1.8 per eye in 95 cases. No serious local or systemic complications were encountered. ConclusionsSingle or multiple sessions of PDT can acheive long-term safety and efficacy. For early-stage AMD patients with minimally classic CNV, PDT can completely make CNV closed and reduce the risk of visual loss.(Chin J Ocul Fundus Dis，2004，20：275-279)
Intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs is the main treatment for diabetic macular edema (DME), however, 30% of patients still respond poorly to its treatment. At present, imaging markers that can indicate the prognosis of anti-VEGF drug treatment include ischemic index, deep retinal capillary plexus foveal avascular zone area, number of microaneurysms, blood flow density, disorder of the inner retinal layer, outer membrane and/or the degree of damage to the ellipsoid zone, strong reflex foci, intraretinal cysts, subretinal fluid. Biomarkers include high-sensitivity C-reactive protein, neutrophil to lymphocyte ratio, anti-fumarase antibody, intraocular aqueous humor cell adhesion molecule-1, interleukin (IL)-6, IL-8, etc. Understanding these clinical markers that may predict and evaluate the prognosis of anti-VEGF drug therapy can be beneficial to adjust the treatment plan, and more effectively monitor, treat, and manage DME patients.
PURPOSE:Understanding the characteristics of color vision defects in patients with maculopathy. METHODS:Applying Panel D-15 test and FM 100-hue test to evaluate the color vision of 78 patients (122 eyes) with maculopathy and analyzing the types of color vision defects and the relationship between the color discrimination and the visual acuity. RESULTS:All eyes of the wetform AMT(14 eyes),Stargardt's disease(10 eyes),macular hole (6 eyes)and central exudative retinochoroidopathy(3 eyes)showed color vision defects and high average roots of total error scores of FM 1000-hue test.The abnormal rates of color vision and the average roots of tota error scores in patients with epiretinal membrane (18 eyes)and dry-form AMD(71 eyes)were low.The roots of total error scores in FM 100-hue test was negatively relative with the visual acuity（r-0.8944）. CNCLUSION:The types and severities of color vision defects vary in different maculopathy.The color discrimination was negatively relative with the visual acuity. （Chin J Ocul Fundus Dis,1996,12: 80-82）
PURPOSE:To search for the occult choroidal neovascularization(CNV)of age-related macular degeneration (AMD)with macular hemorrhage using indocyanine green angiography(ICGA). METHODS:FFA and ICGA were performed in a series of 22 cases(24 eyes)of AMD with macular hemorrhage,and the findings of both angiograms were compared each other. RESULTS :ICGA was found to be superior than FFA in evaluating the occult CNV of AMD with hemorrhage owing to the following outstanding findings in this series,i.e,in judging the presence,position,number and range of the occult CNV. CONCLUSION:ICGA is an important technique in diagnosing the subretinal occult CNV in AMD with macular hemorrhage,and useful in selecting therapeutic measures including photocoagulation and surgical treatment. （Chin J Ocul Fundus Dis,1997,13: 146-149）
Age-related macular degeneration (AMD) is a multifactorial disease affected by environmental factors and genetic variation, which is a major cause of irreversible vision loss in the elderly. miRNA is a kind of endogenous non-coding RNA, which plays an important role in the pathogenesis of AMD, such as oxidative stress, pathological neovascularization and inflammation, by inhibiting or silencing the expression of transcription genes. miRNA has unique advantages in terms of ease synthesis, targeting and additive effect, a large number of experiments have proved the therapeutic potential of miRNA in AMD, which is expected to become a new method for the treatment of AMD in the future. Since the pathogenesis of AMD has not been fully elucidated, it is still necessary to continue to study the pathogenesis of AMD, the biological effects and mechanisms of various miRNA in the occurrence and development of AMD, and observe its therapeutic effects in AMD, so as to provide more effective options for the precise prevention and treatment of AMD.
Purpose To explore the role of scanning laser tomography in the assessment of macular hole surgery. Methods Fifteen eyes of 14 patients with macular holes underwent scanning of their affected macular area using the Heidelberg retina tomograph (HRT). The significance of topographic changes postoperatively were determined in eleven eyes which received vitrectomy surgery. The scan field was set at 15°of the retina and the depth was set to 1.5 mm or 2.0 mm. All the measurements were taken for 3 times and the average value of the 3 measurements was used. Results The average hole area was (0.499±0.34) mm 2 and the maximal depth of the hole was (0.284±0.11) mm. Topographic difference analysis of the eleven eyes showed a significant reduction in the height of the retina after vitrectomy. The maximal depth of the hole was (0.063±0.04) mm postoperatively. Conclusion Scanning laser tomography provides an objective evaluation of the anatomic outcome of the macular hole surgery. (Chin J Ocul Fundus Dis, 2002, 18: 125-127)
ObjectiveTo observe the changes of macular structure and microvessels in eyes with diabetes macular ischemia (DMI). MethodsA retrospective case study. From January 2023 to July 2023, 23 patients of 31 eyes diagnosed with DMI at Tangshan Ophthalmological Hospital were included in this study. Among them, there were 14 males with 23 eyes; Female cases with 8 eyes. Age were (59.5±4.6) years old. According to the DMI grading standard formulated by the research group for early treatment of diabetes retinopathy, the patients were divided into mild DMI group, moderate DMI group, and severe DMI group, with 8, 12, and 11 eyes respectively. The blood flow density (VD), perfusion area (FA), small vessel VD (SVD), inner retinal capillary plexus VD, FA, and outer retinal, choroidal, and ganglion cell complex (GCC) thickness within 1 mm of the macular fovea in retinal superficial vascular plexus (SVP)were measured using a scanning frequency light source optical coherence tomography instrument. The changes in macular structure and microvasculature in the affected eyes of different degrees of DMI groups were compared and observed. Inter group comparisons were conducted using one-way ANOVA or Kruskal Wallis H-test. Spearman correlation analysis was used to analyze the correlation between DMI severity and GCC, outer retina, choroid thickness, VD, FA and SVP VD, SVD and FA in inner retina. ResultsThe GCC (F=70.670), outer retinal thickness (H=12.393), VD (F=105.506), SVD (H=25.300), FA (F=107.655), and VD (H=24.098) and FA (H=25.300) of the retinal SVP in the mild, moderate, and severe DMI groups were compared, and the differences were statistically significant (P＜0.05). There was no statistically significant difference in choroidal thickness (H=2.441, P＞0.05). Pairwise comparison between groups: VD, SVD, FA of GCC thickness and SVP, and VD of inner retina were statistically significant between severe DMI group and moderate DMI group, and between moderate DMI group and mild DMI group (P＜0.05). The thickness of outer retina was statistically significant between severe DMI group and moderate DMI group (P＜0.05). Inner retinal FA: there were statistically significant differences between severe DMI group, moderate DMI group and mild DMI group (P＜0.05). The correlation analysis results showed that GCC (rs=－0.918), outer retinal thickness (rs=－0.448), and inner retinal VD (rs=－0.894) and FA (rs=－0.918), as well as VD (rs=－0.919), SVD (rs=－0.924), and FA (rs=－0.939) of retinal SVP, were all negatively correlated with the degree of DMI (P＜0.05). There was no correlation between choroidal thickness and degree of DMI (rs=－0.081, P＞0.05). ConclusionThe thickness of GCC, outer retina and choroid, the VD, SVD, and FA of the retinal SVP, the VD and FA of inner retina are all reduced in eyes with different degrees of DMI, while all of them are negatively correlated with the degree of DMI, except for choroid thickness.
ObjectiveTo investigate the course of the idiopathic macular hole (IMH) clinically diagnosed as at stage Ⅰ-Ⅳ by optical coherence tomography (OCT), and analyze the relationship between the posterior vitreous detachment (PVD) and the course of IMH. MethodsHadn′t undergone any operation, periodical OCT were performed on 72 eyes of 58 patients with IMH at stage Ⅰ-Ⅳ confirmed by Gass standard and the features of OCT images.ResultsThe longest follow-up period was 43 months (average 13.4 months), and the examine times of OCT on each eye were between twice to 10 times (average 4.7 times). During the followup period, 23 eyes were in stage I in which 9 (39.1%) developed to stage II and 2 had recovered normal curve of fovea after PVD; 19 were in stage II in which 13 (68.4%) developed to Ⅲ-Ⅳ and 1 had closed hole after PVD; 11 were in stage III in which 5 (45.5%) developed to stage IV and 1 had partly closed hole 12 months later. The images of OCT showed that the process of macular hole was consistent with the course that vitreous depart from retina from the circumference of fovea till entire posterior detachment.Fifteen affected eyes in this series of patients had undcrygong surgical treatment due to serious progression of IMH in follow-up period. ConclusionsThere is a close relationship between the formation and development of macular hole and the occurrence of PVD. OCT can show the progress of the macular hole directly and offer an important technique in diagnosis, classification and surgical treatment of IMH. (Chin J Ocul Fundus Dis, 2005,21:79-82)