Hydroxychloroquine retinopathy is an ocular lesions that develops following long-term or excessive use of hydroxychloroquine. The early clinical presentation of this lesion is nonspecific and is often detected when severe central vision impairment occurs in late stage. It currently mainly includes hydroxychloroquine binding to melanin, inducing degeneration of the retinal pigment epithelium, increasing the pH of lysosomes in the retinal pigment epithelium and interfering with the visual cycle. In recent years, with the development of retinal imaging technology and the in-depth study of hydroxychloroquine retinopathy, characteristic fundus structural changes such as retinal and choroidal thickness and blood vessels may occur in the early stage. This not only provides an important basis for the early diagnosis of hydroxychloroquine retinopathy, but also provides important clues for investigating its pathogenesis. Clinicians' proficiency in relevant fundus changes and pathogenesis will facilitate early diagnosis and treatment, while also minimizing irreversible central vision impairment in patients.
ObjectiveTo observe and analyze the changes of macular choroidal thickness in children with occult high myopia and its influencing factors.MethodsA prospective, non-randomized, contemporaneous controlled trial. From September 2019 to October 2020, 56 children (110 eyes) who first visited the ophthalmic clinic of the Affiliated Hospital of Chengde Medical College without any myopia correction training were enrolled in this study. There were 33 males (64 eyes) and 23 females (46 eyes), with the average age of 8.62±1.87 years old; the age ranged from 6 to 12 years old. According to the clinical manifestations of myopia in children, they were divided into occult high myopia group (27 cases, 52 eyes) and control group (29 cases, 58 eyes). In the 52 eyes of the occult high myopia group, the spherical equivalent refraction (SER) of －0.00 to －1.00 D, ＞－1.00 to －2.00 D, ＞－2.00 to －3.00 D were 15, 16 and 21 eyes. Among 58 eyes in the control group, the SER of －0.00 to －1.00 D, ＞－1.00 to －2.00 D, ＞－2.00 to －3.00 D were 21, 18 and 19 eyes, respectively. The macular fovea within 6 mm was divided into three concentric circles centered on the macular fovea, which included the central area with a diameter of 1 mm, the inner ring area with a diameter of 1-3 mm, and the outer ring area with a diameter of 3-6 mm, totally 9 areas. The inner ring and outer ring were divided into upper, lower, nasal and temporal areas. The changes of choroidal thickness in each macular area of children in occult high myopia group and control group were observed. The choroidal thickness in each macular area was compared between the two groups using independent sample t-test. Pearson correlation analysis was used to analyze the correlation between mean foveal choroidal thickness and gender, age, intraocular pressure, ocular axis, diopter and corneal curvature in occult high myopia group.ResultsChoroidal thickness in macular area of children in occult high myopia group was thinnest in nasal side and thickest in temporal side. Compared with the control group, the mean choroidal thickness in the 9 macular zones of children in the occult high myopia group was significantly thinner than that in the control group, and the difference was statistically significant (P＜0.05). The mean choroidal thickness in each macular region decreased with the increase of diopter in children with occult high myopia. Compared with the control group with the same spherical equivalent, there was no significant difference in the area above the inner ring and the outer ring of the macular fovea in the occult high myopia group of －0.00 to －1.00 D and the temporal side of the inner ring and the outer ring of the macular fovea in the occult high myopia group of ＞－2.00 to －3.00 D (P＞0.05), but there were significant differences among the other regions (P＜0.05). Pearson correlation analysis results showed that the average choroidal thickness of the fovea in children with occult high myopia was negatively correlated with age (r=－3.410, R2=11.630, P=0.010), eye axis (r=1.420, R2=2.016, P=0.030) and diopter (r=－2.680, R2=7.182, P=0.040), but not significantly correlated with gender (r=0.166, R2=0.028, P=0.240), intraocular pressure (r=0.330, R2=0.109, P=0.800) and corneal curvature (r=－0.260, R2=0.068, P=0.850).ConclusionsThe thickness of macular choroidal in children with occult high myopia is the thinnest on the nasal side of the macular fovea and the thickest on the temporal side of the macular fovea. The mean choroidal thickness in each region of the macular is thinner than that in the common myopia children with the same diopter. The mean choroidal thickness of fovea is negatively correlated with age, ocular axis and diopter.
ObjectiveTo observe the characteristics of choroidal thickness in patients with macular edema secondary to superior temporal branch retinal vein occlusion (BRVO-ME). MethodsA retrospective control study. From November 2020 to September 2021, 30 patients (30 eyes) with BRVO-ME (BRVO-ME group) were diagnosed by ophthalmology examination in Department of Ophthalmology, The Affiliated Hospital of Chengde Medical College and 14 healthy volunteers (28 eyes) were enrolled in the study. The choroidal thickness of macular area was measured by enhanced deep imaging technique of frequency domain optical coherence tomography. According to the subdivision of the diabetic retinopathy treatment group, the choroid within the 6 mm of the macular fovea was divided into three concentric circles with the macular fovea as the center, namely, the central area with the diameter of 1 mm, the inner ring of 1-3 mm and the outer ring of 3-6 mm. The inner ring area and the outer ring area are divided into upper, lower, nasal and temporal sides, respectively, which are denoted as S3, I3, N3, T3 and S6, I6, N6, T6, totaling 9 areas. To observe the distribution characteristics of choroidal thickness in different regions of two groups of eyes. The choroidal thickness of different macular regions was compared by independent sample t-test. ResultsThe choroidal thicknesses in the central area, S3, T3, I3, N3, S6, T6, I6, and N6 of the eyes in the control group and BRVO-ME group were 214.11±56.04, 207.89±57.92, 214.07±54.82, 207.14±61.54, 180.18±53.53, 204.25±59.60, 193.93±51.50, 190.54±51.21, 139.82±39.84 μm and 258.00±71.14, 256.43±68.70, 252.07±72.97, 244.37±68.49, 243.10±70.93, 247.20±68.36, 221.00±61.28, 223.77±58.64, 183.20±60.15 μm. In both groups, the choroidal thickness was the thickest in the central area, gradually thinning to the nasal side and temporal side, and the nasal choroidal thickness was thinner than other regions, and N6 area was the thinnest. Compared with the control group, the choroidal thickness of central area, S3, T3, I3, N3, S6, I6 and N6 in BRVO-ME group were significantly thicker (t=－2.899, －2.229, －2.172,－3.250, －2.543, －2.292, －3.214; P＜0.05), there was no significant difference in T6 area (t=－1.814, P=0.075). ConclusionThe choroidal thickness of macular area in patients with BRVO-ME is thicker than that in normal subjects.