Objective To observe the imaging features of ultra-wide field short wave fundus autofluorescence (SW-FAF) in eyes with multiple evanescent white dot syndrome (MEWDS), and analysis the correspondence to conventional images. Methods It was a retrospective case series study. Thirteen patients (14 eyes) diagnosed with MEWDS were enrolled. There were 12 females and 1 male, aged from 22 to 57 years, mean age was 34.5 years. All the eyes underwent fundus color photography, optical coherence tomography (OCT) and ultra-wide field autofluorescence (FAF). Simultaneous fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed in 6 eyes. The characteristic changes of SW-FAF in studied eyes were observed and compared with the images of FFA and ICGA. All the eyes were followed up every 1 to 2 weeks, with an average of 16.7 weeks. The characteristic images of SW-FAF and corresponding OCT were studied during follow up. Results MEWDS presented with numerous multiple hyper-autofluorescent spots, sized from 50-500 μm, with a vague boundary in ultra-wide field SW-FAF. These spots located mainly at the peripapillary area and the posterior pole with a confluent pattern. The lesions extended to the mid-peripheral retina as well and became more scattered. The distribution of the hyper-autofluorescent lesions in SW-FAF corresponded roughly to that of the greyish-white spots seen in color photograph and the hyper-fluorescent spots detected by FFA. It was consistent with the distribution of hypo-fluorescent spots in late-phase ICGA as well. But the number of the spot showed in FAF is much more than that in FFA, and slightly less than that in ICGA. The OCT scans through the hyper-autofluorescent lesions in SW-FAF showed impairment of outer retina. After the recovery, the hyper-autofluorescent spots disappeared with the outer retina structure repaired completely. Conclusions MEWDS presented with numerous multiple hyper-autofluorescent spots which located mainly at the peripapillary area in ultra-wide field SW-FAF. The distribution of the hyper-autofluorescent lesions in SW-FAF corresponded roughly to color photograph, FFA and ICGA in late-phase. The OCT scans through the hyper-autofluorescent lesions in SW-FAF showed impairment of outer retina.
Retinal vein occlusion (RVO) is a vascular disease characterized by intraretinal hemorrhage, edema and hard exudation, which is caused by increased retinal vein pressure. OCT angiography (OCTA) has been widely used in the diagnosis of retinal vascular diseases including RVO by virtue of non-invasive, high resolution and stratified display of superficial, deep retinal vessels and quantification of retinal vessel density and non-perfusion area size. OCTA can provide information of retinal microvascular structure and blood perfusion under the condition of disease, it also can be used to evaluate the effect of treatment and changes of retinal circulation during the course of disease follow-up. Although OCTA cannot replace fundus angiography completely, it has brought us more information about the pathogenesis, disease progression and prognostic factors of RVO. It is believed that with the progress of technology, OCTA will bring us a new chapter in the study of retinal vascular diseases including RVO.
ObjectiveTo observe the pathological changes of central retinal artery occlusion (CRAO) by optical coherence tomography (OCT).MethodsFifty-three eyes of 53 patients who were diagnosed as CRAO in our center between January 2001 to January 2004 underwent the examination by OCT. The intervals between the disease onset and OCT examination were less than 2 weeks. The scan modes of OCT were horizontal or vertical line scan. The locations of scanning were macular, posterior pole of retina, optical papilla and the focus of bleeding or exudation.ResultsThe OCT pathological changes of CRAO in vivo includes increase of retinal thickness and reflex of retina, width of dark layer of photoreceptor (edema), edema or cystoid edema of fovea, retinal bleeding, cotton-wool spot and papilla edema. Four patients who had ciliary retinal artery showed normal retinal structure in the supply region of ciliary retinal artery.ConclusionOCT can display the pathological changes of retinal tissues in CRAO in vivo, especially on the old patients or the patients with systemic disease who were contraindicated by FFA. The unique OCT image of pathological changes of CRAO supply the objective signs for the instant clinical diagnosis.(Chin J Ocul Fundus Dis, 2005,21:74-78)
ObjectiveTo evaluate the changes in subfoveal choroidal thickness (SFCT) in amblyopic eyes.MethodsA evidence-based medicine study. Chinese and English as search terms for amblyopia and choroid was used to search literature in Wanfang, CNKI, and PubMed of National Library of Medicine. Incomplete or irrelevant literature and review literature were excluded. The literature was meta-analyzed using STATA 15.0. The weighted mean difference (WMD) and 95% confidence interval (CI) were selected as the estimated value of effect size, and subgroup analysis and sensitivity analysis were used to detect the source of heterogeneity.ResultsAccording to the search strategy, 75 articles were initially retrieved, and 15 articles were finally included for meta-analysis. A total of 650 patients with amblyopia, aged 3 to 65 years old, were included. The enhanced depth imaging technology of spectral domain optical coherence tomography was used to measure SFCT. The results of meta analysis showed that SFCT of amblyopic eyes was more effective than the contralateral eye (WMD=18.89 μm, 95% CI 14.81-22.98 μm, P＜0.001) and normal eyes were thicken (WMD=39.49 μm, 95% CI 33.88-45.09 μm, P＜0.001). There was no statistically significant difference in SFCT between anisometropic and strabismic amblyopia eyes (WMD=－5.03 μm, 95% CI －19.50-9.44 μm, P=0.495).ConclusionsThe SFCT of amblyopic eyes in amblyopic patients is thicker than that of the contralateral eye and normal eyes. There is no difference in SFCT between anisometropia and strabismus amblyopia.
Although attention plays an important role in cognitive and perception, there is no simple way to measure one's attention abilities. We identified that the strength of brain functional network in sustained attention task can be used as the physiological indicator to predict behavioral performance. Behavioral and electroencephalogram (EEG) data from 14 subjects during three force control tasks were collected in this paper. The reciprocal of the product of force tolerance and variance were used to calculate the score of behavioral performance. EEG data were used to construct brain network connectivity by wavelet coherence method and then correlation analysis between each edge in connectivity matrices and behavioral score was performed. The linear regression model combined those with significantly correlated network connections into physiological indicator to predict participant's performance on three force control tasks, all of which had correlation coefficients greater than 0.7. These results indicate that brain functional network strength can provide a widely applicable biomarker for sustained attention tasks.
Objective To observe the image features of high myopia with retinoschisis by spectraldomain optical coherence tomography (SD-OCT). Methods The clinical data of eight patients (eight eyes) of high myopia with retinoschisis were retrospective analyzed. All patients were diagnosed by SD-OCT (Topcon 3D-OCT 1000), had no macular holes and underwent vitrectomy including internal limiting membrane (ILM) peeling and gas tamponade. All patients also underwent visual acuity, refraction, premirror fundus examination and A/B mode ultrasound examination. Visual acuity and SD-OCT were followed up at one, three and six months after surgery. Before surgery, premirror fundus examination revealed shallow foveal detachment in 3/8 eyes, posterior scleral staphyloma in 7/8 eyes. SD-OCT showed concave arc stripes in 7/8 eyes, and outer retinoschisis in 8/8 eyes, middle or inner retinoschisis in 5/8 eyes and foveal detachment in 5/8 eyes. Results Six months after surgery, posterior retinoschisis disappeared in six eyes, foveal detachment still presented in one eye and parafoveal hole occurred in one eye. The corrected visual acuity improved from the 0.15 to 0.8 in one eye which had a restored continuous inner segment/outer segmen (IS/OS) line by SD-OCT. The corrected visual acuity improved from 0.01 to 0.1 in one eye, from 0.05 to 0.15 in one eye, not changed in five eyes. There was no continuous IS/OS line in those patients by SD-OCT. Conclusions SD-OCT shows a variety of morphological features of myopic retinoschisis which could be cured anatomically and functionally by vitrectomy combined ILM peeling. The continuity of IS/OS layer from SD-OCT could help to interpret the vision recovery after the operation.
Retinal vein occlusion (RVO) is one of the most common retinal vascular diseases causing blindness, macular edema (ME) is often secondary to it, which causes serious visual impairment to patients. Imaging biomarkers in the changes of retina and choroid of ME secondary to RVO (RVO-ME) have important clinical value in the evaluation of condition, curative effect and visual acuity prediction of patients with RVO-ME. Among them, the disorganization of the retinal inner layers, the integrity of external limiting membrane and ellipsoid zone, and the change of central macular thickness are reliable indexes to evaluate the prognosis of visual acuity; hyperreflective foci, subretinal fluid and intraretinal fluid can be used as important parameters to reflect the level of inflammation; prominent middle limiting membrane and paracentral acute middle maculopathy are the objective basis for judging the degree of retinal ischemia; the changes of choroidal vascular index and choroidal thickness also have potential advantages in evaluating the progress of the disease. Accurately grasp the characteristics of biological markers of RVO-ME related optical coherence tomography is conducive to its reasonable and accurate use in the clinical diagnosis and treatment of RVO-ME, and helpful to further explore the pathogenesis of the disease.
Objective To observe the retinal and choroidal changes in morphology and thickness after photodynamic therapy(PDT) for idiopathic choroidal neovascularization(ICNV). Methods Sixteen eyes of 16 patients with ICNV were treated with verteporfin PDT. 16 eyes of 16 agematched normal subjects were observed for the purpose of comparison. The best corrected visual acuity(BCVA) was checked before and 1, 3 and 6 months after PDT treatment. Enhanced depth imaging optical coherence tomography (EDI-OCT) technique was used to measure central retinal thickness (CRT) and central choroidal thickness(CCT). The correlations between BCVA and CRT, CCT were analyzed by Pearson statistical anallyses. Results BCVA was improved at 1, 3 and 6 months after PDT, and the difference had statistical significance compared with that before treatment (F=3.08,P=0.030). There was edema in the retina at 1 month after PDT. CNV in 13 eyes became fibrotic at 3 months after PDT, and all became fibrotic at 6 months after PDT. The reflex of choroid correspond to CNV was weak at 1, 3 and 6 months after PDT. CRT decreased at 1, 3 and 6 months after PDT (F=8.946,P=0.000). The difference was statistically significant between the CRT of control group and that 1 months after PDT (P=0.001), but there was no statistically significant difference between the CRT of control group and that 3 and 6 months after PDT（P=0.128, 0.083）. The CCT group had no statistically significant difference before and 1, 3 and 6 months after PDT (F=1.674, P=0.170). The CCT group also had no statistically significant differences between the control group and 1, 3 and 6 months after PDT (P=0.186, 0.551, 0.98). The BCVA was inversely correlated with CRT and CCT, and the correlation had no statistical significance (r=－0.051,－0.164;P=0.739,0.283). Conclusions PDT may improve BCVA in ICNV. Retinal edema resolves, CRT decreases, but CCT had almost no changes after PDT.
ObjectiveTo investigate the correlation of visual sensitivity, best corrected visual acuity (BCVA) and central retinal thickness (CRT) in diabetic macular edema (DME).MethodsA retrospectives study. Forty-five eyes of 30 patients in DME were included. There were 20 eyes of 16 males, 25 eyes of 14 females, with an average age of 54.49±7.45 years. All the patients had type 2 diabetes; the average duration of diabetes was over 10 years. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logarithmic logarithm (logMAR) visual acuity. The following parameters provided by the MAIA microperimetric device were evaluated, including average threshold (AT), macular integrity index (MI), fixation indexes (P1 and P2), bivariate contour ellipse area (BCEA) for 63% and 95% of points, and horizontal and vertical axes of the ellipse of fixation (H63, H95, V63, V95). The CRT was measured and the integrity of the ellipsoidal band was observed by optical coherence tomography (OCT). The integrity of the ellipsoid band was divided into continuous smooth (group A): fully visible; part of the light band was interrupted (B group): not completely visible; missing light band (C group): completely invisible. Pearson correlation analysis was used to analyze the correlation between the factors; non-parametric tests were used to compare the logMAR BCVA, AT, and CRT between the different ellipsoid zone integrity groups; multiple linear regression analysis was used to analyze factors related to AT.ResultsPearson correlation analysis showed that the logMAR BCVA was positively correlated with MI (r=0.303, P=0.04) and CRT (r=0.342, P=0.02), negatively correlated with AT (r=−0.59, P=0.00) and P1 (r=−0.38, P=0.01). There was negative correlation between AT and MI (r=−0.55, P=0.00). The result of multivariate linear regression analysis showed that the logMAR BCVA is inversely correlated with AT (t=−3.53, P=0.001). Group A, B and C were 23, 17 and 5 eyes in the 45 eyes, respectively. There were significant differences in logMAR BCVA, AT, and CRT between the three groups of eyes (P=0.045, 0.049, 0.018).ConclusionsIn DME patients, the logMAR BCVA was positively correlated with CRT, negatively correlated with AT and P1. The logMAR BCVA is inversely correlated with AT. Microperimetry combined with OCT and visual acuity can be used to assess the visual function of patients with DME.
Peripapillary intrachoroidal cavitation (PICC) is a common pathological change observed in high myopia. The exact pathogenesis of PICC is still unclear. Expansion and mechanical stretching of the peripapillary sclera, breakage and defect in the retina near the border of the myopic conus and communication between intrachoroidal cavity and the vitreous space may be important segments during the development of PICC. Color fundus photography shows a localized and well-circumscribed peripapillary lesion with yellow-orange colour, often accompanied by fundus changes, such as myopic conus excavation, optic disc tilting and inferotemporal retinal vein bending at the transition from the PICC to the myopic conus. However, the PICC lesion is not easy to be recognized in the fundus photography. Fluorescein angiography shows early hypofluorescence and later progressively staining in the lesion. Indocyanine green angiography shows hypofluorescence throughout the examination. Optical coherence tomography (OCT) is vital in diagnosing PICC. Hyporeflective cavities inside the choroid, sometimes communicating with the vitreous chamber, can be observed in OCT images. OCT angiography indicates lower vessel density or even absence of choriocapillary network inside or around PICC lesions.