ObjectiveTo observe and analyze the changes and correlation of macular mean sensitivity (MS) and the thickness of ganglionic plexiform layer (GCIPL) in patients with non-arteriotic anterior ischemic optic neuropathy (NAION). MethodsA cross-sectional clinical study. From March to August 2023, 37 patients with 38 eyes of NAION (NAION group) diagnosed by ophthalmic examination in the First Affiliated Hospital of Zhengzhou University were included in the study. In the NAION group, 29 patients with contralateral healthy eyes were selected as the contralateral healthy eye group. A total of 31 eyes of 16 healthy subjects matching gender and age were selected as the normal control group. NAION group was divided into acute stage group (disease course ≤3 weeks), subacute stage group (disease course 4-12 weeks) and chronic stage group (disease course＞12 weeks), with 16, 10 and 12 eyes, respectively. Best corrected visual acuity (BCVA), optical coherence tomography (OCT), perimetry, and microperimetry were performed. BCVA statistics are converted to logarithm of the minimum angle of resolution (logMAR). The macular region was scanned by Cirrus HD-OCT macular volume 512×128 scanning program. The mean (GCIPLav), minimum (GCIPLmin), and the GCIPL thickness at supranasal, superior, subnasal, supratemporal, inferior, and inferotemporal quadrants were detected. The Humphrey 24-2 automated visual field test was utilized to measure the mean defect (MD) of the visual field. MP-3 microperimetry was used to measure MS (total MS) in the 10° macular region and MS in the supranasal, superior, subnasal, supratemporal, inferior, and inferotemporal quadrants. MS＞21 dB was defined as normal. One-way analysis of variance was used to compare among groups. t test was used to compare GCIPL thickness between MS≤21 dB and＞21 dB regions. Spearman correlation analysis was used to analyze the correlation between GCIPL thickness and MS in corresponding areas. ResultsThere were statistically significant differences in logMAR BCVA and MS in the NAION group, contralateral healthy eye group, and normal control group (F=13.595, 83.741; P＜0.05). GCIPL thickness in the MS≤21 dB region was significantly lower than that in the＞21 dB region in the NAION group (t=2.634, P=0.009). The thickness of GCIPL in the inferotemporal quadrant decreased in the NAION group compared with the contralateral healthy eye group and normal control group, but the difference was not statistically significant (P=0.092, 0.192). The thickness differences of GCIPLav and GCIPLmin and GCIPL in other quadrants were statistically significant (P＜0.05). Compared with the contralateral healthy eye group and normal control group, the thickness of GCIPLmin, superior and supratemporal of GCIPL in the acute stage group were significantly decreased (P＜0.05). The thickness of GCIPLav, GCIPLmin, GCIPL in upranasal, superior and supratemporal quadrants were significantly decreased in the subacute stage group (P＜0.05). The thickness of GCIPLav, GCIPLmin and GCIPL in all quadrants were significantly decreased in the chronic stage group (P＜0.05). Correlation analysis showed that total MS were significantly correlated with logMAR BCVA (r=0.779, －0.596, P＜0.001) in NAION group. The inferior GCIPL thickness was significantly correlated with MS in the corresponding region (r=0.410, P=0.046), while no correlation was found in the other quadrants (r=0.220, 0.148, －0.131, 0.296, 0.321; P＞0.05) in NAION group. GCIPL thickness in acute and subacute groups was significantly correlated with MS (r=0.329, 0.400; P=0.007, 0.028). There was no correlation in the chronic phase group (r=0.238, P=0.103). ConclusionsGCIPL atrophy and thinning and MS decrease in the macular area of NAION. The thickness of GCIPL in the MS decreasing region is significantly lower than that in the MS normal region. GCIPL atrophy and thinning in acute and subacute stages are correlated with MS.
ObjectiveTo observe and analyze the effect of peripore cavity size on visual function of macular area before and after surgery for idiopathic macular hole (IMH). MethodsA retrospective clinical study. From July 2020 to February 2021, a total of 25 patients with 25 eyes with monocular IMH (operation group) diagnosed by ophthalmology examination in Department of ophthalmology, Fourth Hospital of Hebei Medical University were included in the study. The control group was contralateral healthy eyes. All subjects were examined by best corrected visual acuity (BCVA), microfield of vision, frequency domain optical coherence tomography (SD-OCT), and OCT angiography (OCTA). The diameter of macular hole was measured by SD-OCT. The cystic morphology of deep capillary plexus (DCP) was detected by en face OCT, and the cystic area was measured by Image J software. MP-3 microperimeter was used to measure central macular retinal light sensitivity (MS) and mean macular retinal light sensitivity (MMS). Central macular retinal light sensitivity (CMS), MMS and cystic cavity MS were measured in the operation group. MMS was measured in the control group. The microperimetry images were superimposed on the DCP layer of OCTA to identify and calculate the average MS within the lumen and compare it with the control group. Standard three incisions were performed in all affected eyes by vitrectomy of the flat part of the ciliary body + stripping of the inner boundary membrane + intraocular sterile air filling. Three months after the operation, the same equipment and methods were used to perform relevant examinations. Paired sample t test was used to compare MS between operation group and control group. Pearson correlation analysis was used to analyze the correlation between capsular area, macular hole diameter before and after operation and MS before and after operation. The correlation between BCVA and capsular area before and after surgery was analyzed by Spearman correlation analysis. ResultsIn the surgical group, the retinal MS was (4.24±3.07) dB. The MMS of control group was (19.08±6.11) dB. The MS in the surgical group was significantly lower than that in the control group, and the difference was statistically significant (t=10.832, P＜0.01). Before operation, the area of cyst was (1.04±0.55) mm2, and the diameter of macular hole was (564.80±166.59) μm. CMS and MMS were (2.27±2.29) dB and (9.08±3.65) dB, respectively. The diameter of macular hole (r=0.50, P=0.010) and BCVA before operation (r=0.57, P＜0.001) were positively correlated with peripore cavity area. Before operation, CMS and MMS were negatively correlated with peripore cavity area (r=－0.53, －0.47; P=0.010, 0.020). At 3 months after surgery, the capsular area was negatively correlated with CMS and MMS (r=－0.65,－0.76; P=0.020, 0.030). There was no correlation with BCVA (r=0.23, P=0.470). ConclusionsRetinal MS is decreased in the peri-capsular area of IMH pore. There is a positive correlation between capsule area, BCVA and macular hole diameter before operation. The capsular area is negatively correlated with CMS and MMS before operation.
ObjectiveTo observe Leber's hereditary optic neuropathy (LHON) microperimetry features, discuss its significance in diagnosis and treatment of LHON assessment. MethodsA retrospective clinical study. A total of 13 LHON patients (25 eyes) diagnosed in Department of Ophthalmology of the First Affiliated Hospital of Army Medical University from May 2015 to May 2020 (disease group) were included in the study, including 9 males (18 eyes) and 4 females (7 eyes), and beginning with the age of 15.0 (10.0, 57.0). Ten healthy volunteers (19 eyes) were selected as the normal group, including 7 males (13 eyes) and 3 females (6 eyes), aged 22.0 (6.0, 46.0) years at the first diagnosis. According to the course is divided into: asymptomatic group (carriers), subacute (＜6 months), the dynamic group (6-12 months), chronic group (＞12 months). There were 7, 6, 5 and 7 eyes, respectively. All eyes underwent best corrected visual acuity (BCVA) and microperimetry. BCVA test was performed using the international standard visual acuity chart, which was statistically converted to the logarithm of the minimum Angle of resolution (logMAR) visual acuity. MP-3 microperimetry was used to perform microperimetry, and the mean sensitivity (MS) values of five regions were recorded: center, superior, temporal, inferior, and nasal. Mann-Whitney U test was used for comparison between two groups, and Kruskal-Wallis H test was used for comparison between multiple groups. ResultsCompared with the normal group, MS in the center, superior, temporal, inferior and nasal of the diseased group decreased, and the differences were statistically significant (Z=－5.629, －4.906, －5.630, －5.631, －5.227; P＜0.05). There were significant differences in different regions of MS between different course groups (H=12.296, 11.583, 10.110, 12.994, 8.663; P＜0.05). There were significant differences in logMAR BCVA and central MS between asymptomatic group and subacute group (P=0.040, 0.007). There were significant differences in temporal, inferior and superior MS between subacute group and dynamic group (P=0.026, 0.017, 0.018). Dynamic and chronic group, MS above the difference was statistically significant (P=0.031). Idebenone treatment significantly improved visual field defects in 4 of 23 eyes. ConclusionsIn the early stage of LHON, the central visual field defect gradually progresses to the temporal, inferior and superior areas, and the temporal and inferior areas are more severe. Visual field defects reached a stable level at 6-12 months. MP-3 can assist in early diagnosis of LHON, and provide reliable basis for efficacy evaluation.