ObjectiveTo invesitigate the relationship between the macular histomorphological changes and the prognosis of the visual acuity (VA) in eyes with rhegmatogenous retinal detachment (RRD).MethodsOptical coherence tomography (OCT) was performed on 39 patients (39 eyes) with rhegmatogenous retinal detachment. According to the macular neurepithelial configuration displayed by OCT, the patients were divided into 3 groups: neurepithelial edema group, neurepithelial detachment group, and neurepithelial cystoid degeneration group. The time of retinal detachment, pre- and post-operative VA, and macular neurepithelial thickness OCT images were observed and analyzed statistically.ResultsThere was no difference of pre-operative VA among the three groups (P＞0.05). Significant differences of post-operative VA, time of retinal detachment, and neurepithelial thickness were found (P＜0.05). The differences of time of retinal detachment and neurepithelial thickness between neurepithelial degeneration group and cystoid degeneration group were significant (P＜0.05) except the postoperative VA (P＞0.05).ConclusionsThe time of retinal detachment and post-operative VA in patients with retinal detachment relate to the neurepithelial thickness detected by OCT. When the duration of retinal detachment becomes longer, the macular neurepithelium becomes thicker, the histomorphological changes increase, and the post-operative VA decreases. (Chin J Ocul Fundus Dis, 2005,21:83-85)
ObjectiveTo observe the correlation between the changes of area foveal avascular zone (FAZ), central foveal thickness (CFT), the thickness of the macular ganglion cell-inner plexiform layer (GCIPL) and the BCVA in type 2 diabetic mellitus patients with different fundus lesions.MethodsA prospective clinical study. Eighty-three eyes of 51 patients with type 2 diabetic mellitus were collected in Shengjing Hospital of China Medical University from January 2018 to January 2019, including 31 males and 20 females. The average age was 53.4±7.8 years. According to the diabetic retinopathy international clinical staging criteria, the patients were divided into the non-diabetic retinopathy (NDR) group with 17 patients (31 eyes), and the non-proliferative diabetic retinopathy (NPDR) group with 34 patients (52 eyes). And 13 control eyes of 8 age- and sex-matched healthy physical examination subjects (control group) were selected in this study. The BCVA examination was performed using the international standard visual acuity chart, which was converted into IogMAR visual acuity. OCT was used to measure the CFT, the mean and the minimum thickness of GCIPL. OCT angiography (OCTA) examination was applied to obtain blood flow density scan images in macular area of 3 mm × 3 mm size. The superficial FAZ area was measured by Photoshop software. The differences of the superficial FAZ area, BCVA, CFT, the mean and the minimum thickness of GCIPL in each group were statistically analyzed, and to explore the correlation between the parameters. Analysis of variance was used to compare measurement data among three groups, and chi-square test was used for the comparison of counting data among three groups. The statistical correlation was evaluated using Pearson’s correlation coefficient.ResultsThe average area of superficial FAZ area in the control group, NDR group and NPDR group were 0.314±0.103, 0.349±0.102, 0.416±0.148 mm2; the mean logMAR BCVA were 0.015±0.038, 0.029±0.059, 0.129±0.133; the mean CFT were 247.46±13.35, 244.13±25.09, 263.12±24.96 μm; the mean GCIPL thickness were 89.00±4.98, 86.06±4.43, 82.61±14.32 μm; the mean minimum GCIPL thickness were 84.85±3.18, 80.68±5.39, 71.19±19.94 μm, respectively. The superficial FAZ area, logMAR BCVA, CFT and the minimum thickness of GCIPL showed significant differences (F=4.660, 11.708, 6.891, 6.333; P=0.012, 0.000, 0.002, 0.003) among these three groups. Correlation analysis showed that the logMAR BCVA was positively correlated with the superficial FAZ area (r=0.335, P=0.001), negatively correlated with the mean GCIPL thickness (r=－0.348, P=0.001) and the minimum GCIPL thickness (r=－0.416, P=0.000), no significant correlated with the CFT (r=0.171, P=0.095). The superficial FAZ area was negatively correlated with the CFT (r=－0.262, P=0.010) and the minimum GCIPL thickness (r=－0.213, P=0.037), no significant correlated with the mean GCIPL thickness (r=－0.179, P=0.081).ConclusionsWith the aggravation of fundus lesions in patients with type 2 diabetic mellitus, the superficial FAZ area gradually expands, the minimum GCIPL thickness gradually becomes thinner and the BCVA gradually decreases. Both the superficial FAZ area and the GCIPL thickness are correlated with BCVA. The superficial FAZ area is correlated with CFT and the minimum GCIPL thickness.
ObjectiveTo observe the changes of choroid, macular microcirculation and retinal light sensitivity (MS) in people with different degrees of myopia and emmetropia, and to analyze the relationship between them and the axial length (AL).MethodsA cross-sectional observational study. From May 2019 to November 2020, 142 people (142 eyes) of different degrees of myopia and volunteers from Nanchang Aier Eye Hospital were included in the study. All subjects underwent comprehensive optometry, OCT angiography (OCTA), micro-perimetry examination, and axial length (AL) measurement. A frequency domain OCTA instrument was used to measure the blood flow density of the superficial retinal capillary plexus (SVD), the blood flow density of the deep capillary plexus (DVD), the area of the foveal avascular zone (FAZ) and the choroidal capillaries in the 6 mm×6 mm area of the macula, and percentage of vascular blood flow blank area (FD). The macular integrity assessment instrument was used to measure macular 10° retinal MS and macular fovea 2°, 4° fixation rate (P1, P2), 63% and 95% hyperbolic ellipse area (BCEA). Pairwise comparisons between groups were tested by the least significant difference method.ResultsAmong 142 eyes, 68 eyes were in male, 74 eyes were in female. According to different equivalent spherical powers (SER), subjects were divided into emmetropia group, low myopia group, moderate myopia group, and high myopia group, with 31 eyes, 36 eyes, 44 eyes, and 31 eyes, respectively. Compared with SER (H=132.776) and AL (F=61.118) of the tested eyes in the 4 groups, the difference was statistically significant. The SVD (P=0.003, 0.002, 0.003) and DVD (P＜0.001,＜0.001, P=0.001) of the emmetropia group, low myopia group, and moderate myopia group were higher than those of the high myopia group, and the difference was statistically significant. The FAZ area of the emmetropia group was higher than that of the moderate myopia group, the difference was statistically significant (P=0.013). The FD percentage of choroidal capillaries in the moderate myopia group and the high myopia group was higher than that of the emmetropia group, the difference was statistically significant (P=0.011, 0.030). MS in the high myopia group was significantly lower than that in the emmetropia group, low myopia group, and moderate myopia group, the difference was statistically significant (P＜0.001,＜0.001, P=0.035). Compared with 63% BCEA, 95% BCEA, P1 and P2 among subjects in the emmetropia group, low myopia group, moderate myopia group, and high myopia group, the difference was not statistically significant (H=6.936, 7.041, 5.450, 4.239; P>0.05). The results of correlation analysis showed that the macular area SVD (r=－0.256, P=0.002), DVD (r=－0.465, P＜0.001), FAZ area (r=－0.308, P＜0.001) were negatively correlated with AL. The percentage of FD of choroidal capillaries was positively correlated with AL (r=0.170, P=0.043). Retinal MS was positively correlated with SVD (r=0.252, P=0.003), DVD (r=0.298, P＜0.001), FAZ area (r=0.334, P＜0.001), it was negatively correlated with AL (r=－0.439, P＜0.001), it was not related to the percentage of FD of choroidal capillaries (r=－0.061, P=0.473).ConclusionsWith the increase of myopic refractive power and AL, the macular area SVD, DVD, and retinal MS all show a downward trend. The decline of retinal MS is related to the decrease of SVD and DVD.
ObjectiveTo observe the safety and efficacy of Keluoxin capsules in the treatment of moderate to severe non-proliferative diabetic retinopathy (NPDR). MethodsAn open-label, multi-center, single-arm, phase Ⅱa clinical trial. From May 2014 to December 2016, the patients diagnosed with moderate to severe NPDR who received Keroxin treatment in General Hospital of Central Theater Command, Affiliated Eye Hospital to Nanchang University, Xiyuan Hospital of China Academy of Chinese Medical Sciences, and Eye Hospital China Academy of Chinese Medical Sciences were divided into moderate NPDR group and severe NPDR group. The baseline data of the patients were obtained, best-corrected visual acuity (BCVA), optical coherence tomography, fundus fluorescein angiography and fundus photography were performed. On the basis of maintaining the original diabetes treatment, all patients took Keluoxin capsules orally for 24 weeks; 24 weeks after treatment was used as the time point for evaluating the efficacy. BCVA letters, central macular thickness (CMT) and 6 mm diameter total macular volume (TMV), retinal vascular leakage area, and retinal non-perfusion (RNP) area within an average diameter of 6 mm were compared between the two groups at baseline and 24 weeks after treatment. Independent sample Mann-Whitney U test was used to compare continuous variables between groups. Categorical data were compared by χ2 test. ResultsA total of 60 NPDR patients and 60 eyes were included, 9 cases were lost to follow-up, and 51 cases and 51 eyes were finally included, including 37 eyes in the moderate NPDR group and 14 eyes in the severe NPDR group, respectively. At baseline, BCVA in moderate NPDR group and severe NPDR group were (80.1±6.8), (81.4±6.3) letters, respectively. CMT were (249.5±32.1), (258.9±22.2) μm, respectively. TMV were (8.79±1.09), (8.95±1.31) mm3, respectively. Retinal vascular leakage areas were (7.69±10.63), (10.45±7.65) mm2, respectively. RNP area were (2.48±5.74), (10.63±20.06) mm2, respectively. There were 11 (29.7%, 11/37) and 4 (28.6%, 4/14) eyes with diabetic macular edema (DME), respectively; 24 weeks after treatment, BCVA in moderate NPDR group and severe NPDR group increased by (1.3±5.2), (3.2±3.0) letters, respectively. Compared with baseline, there was a statistically significant difference in the severe NPDR group (t=－3.986, P=0.033). CMT were (252.1±45.6), (269.8±57.2) μm, respectively. There were no significant differences compared with baseline (t=－0.567, －0.925; P＞0.05). TMV were (9.96±1.16), (10.09±1.32) mm3, respectively. There were no significant differences compared with baseline (t=－0.996, －1.304; P＞0.05). Retinal vascular leakage area decreased (0.19±6.90), (1.98±7.52) mm2, respectively. There were no significant differences compared with baseline (t=0.168, 0.983; P＞0.05). RNP area were (3.01±6.47), (10.36±19.57) mm2, respectively. Compared with baseline, the differences were statistically significant (t=－1.267, 0.553; P＞0.05). There were 8 (21.6%, 8/37) and 3 (21.4%, 3/14) eyes with DME, respectively. Compared with baseline, the difference was statistically significant (χ2=11.919, 4.571; P=0.001, 0.033). ConclusionKeluoxin capsules can stabilize or improve BCVA, CMT, TMV and RNP area in patients with moderate and severe NPDR, and reduce the area of retinal vascular leakage.
ObjectiveTo observe and analyze the rate of visual acuity progression and binocular symmetry in patients with choroideremia (CHM). MethodsA single-center retrospective longitudinal cohort study. From April 2009 to August 2022, 38 eyes of 19 patients diagnosed with CHM through clinical and genetic testing at the Department of Ophthalmology, Peking Union Medical College Hospital, were included in this study. All patients underwent at least 2 follow-up visits with a minimum interval of 1 year between visits, and binocular best-corrected visual acuity (BCVA) results were recorded at each follow-up visit. Decimal visual acuity was converted into logarithm of the minimum angle of resolution (logMAR) for analysis. The patient group consisted of 19 males from 16 unrelated families. The age at initial visit was (39.52±13.24) years, with a (2.63±1.61) follow-up visits over a duration of (4.95±2.68) years. A total of 50 binocular BCVA data were included. Annual progression rate of visual acuity was calculated based on longitudinal and cross-sectional data. Spearman correlation coefficient and Bland-Altman method were used to evaluate the binocular symmetry. ResultsThe rate of visual acuity progression was (0.095±0.148) logMAR units/year based on longitudinal data and (0.018±0.009) logMAR units/year based on cross-sectional data. The binocular symmetry for BCVA of the baseline values was strong; however, the binocular symmetry of progression rates for BCVA was moderate. Spearman correlation analysis showed that binocular symmetry in baseline BCVA was high (r=0.881, P＜0.001). The symmetry of binocular vision progression rates based on longitudinal data was moderately symmetric (r=0.528, P=0.020). Bland-Altman analysis showed that 94.7% of binocular baseline BCVA differences were within 95% confidence interval (CI) of 95% limit difference (LOA), indicating good symmetry of binocular baseline BCVA. The number of binocular BCVA progression rate differences within 95%CI of 95%LOA was 89.5%, suggesting moderate symmetry in binocular BCVA progression rate. The results of Spearman correlation coefficient and Bland-Altman analysis of binocular symmetry were basically consistent. ConclusionsThe rate of visual acuity progression of patients with CHM based on longitudinal and cross-sectional data is (0.095±0.148) and (0.018±0.009) logMAR units/year, respectively. Cross-sectional data from patients of different ages should not be used to infer the progression rate of the natural history. Binocular eyes with highly symmetrical baseline visual acuity may differ in the rate of visual acuity progression.