Objective To evaluate the clinical application value of ocular fundus photochromy and optical coherence tomography (OCT) in epimacular membrane of traumatic eyes following vitreorential surgery. Methods Ocular fundus photochromy and OCT were used to observe the morphological changes of macula in 139 consecutive patients with unilateral ocular trauma after vitreoretinal surgery between July 2003 and September 2004. Results At the 1st, 2nd, 3rd, 6th, and 12th month postoperatively, epimacular membranes were found in 5, 8, 17, 19, 20 patients, respectively by using photochromy; and in 7, 10, 20, 26, 27 patients, respectively by using OCT. There was no significant difference in epimacular membrane between photochromy and OCT(chi;2＝0.173，Pgt;0.05). The results of OCT showed that epimacular membranes completely adhered to the macular region in 8 patients（29.63%）, and retinal neurosensory layer swelled in 12 patients（44.44%）with the fovea thickness of (290.18plusmn;288.05) mu;m. Conclusion Ocular fundus photochromy and OCT are helpful in observing and discovering the epimacular membrane after virtreoretinal surgery of the patients with traumatic retinal detachment during the early and long-term follow-up period; and OCT can provide important information of the structue and position of these epimacular membranes hence to conduct to appropriate treatment. (Chin J Ocul Fundus Dis, 2006, 22: 236-238)
ObjectiveTo observe the clinical effect of radial optic neurotomy (RON) for central retinal vein occlusion (CRVO).MethodsThe clinical data of 5 patients with CRVO who had undergone RON after a standard three-port vitrectomy were analyzed retrospectively. In the 5 patents, CRVO was diagnosed in 2 before the surgery, and the examination of visual acuity, fundus photography, fundus fluorescein angiography (FFA), color doppler imaging (CDI), and examination of perimeter and optic coherence tomography (OCT) were performed on them before and after the operations, respectively. Three patients underwent the operation because of the vitreous hemorrhage and CRVO was diagnosed during the surgery. All of the 5 patients suffered from severe macular edema. The results of post-operative visual acuities, fundus examination, fundus photography and OCT were compared with those of the pre-operative ones. The follow-up after the surgery was 12 months. ResultsThe visual acuities improved in 4 patients and decreased in 1. The results of fundus photography and (or) FFA, and OCT revealed that the macular edema was evidently alleviated 1 month after the surgery and the retinal hemorrhage was absorbed ultimately 2 months after the surgery. The result of examination of perimeter performed on 1 case showed the improvement of visual field. In addition, vitreous hemorrhage occurred in 1 patient postoperatively and hemorrhage occurred in 2 in the operation puncturing the optic disk.ConclusionsRON is helpful to ameliorate the macular edema, reduce the retinal hemorrhages, prevent the neovascularization and enhance the visual acuity to some extent, which maybe clinically feasible and valuable in treating CRVO，but more prospective, randomized, and multi-center researches are still needed to verify the efficacy.(Chin J Ocul Fundus Dis, 2005,21:6-9)
Objective To evaluate the correlation between retinal thickness (RT) at the macular area and the axial length (AL) in myopia. Mehtods Optical coherence tomography (OCT) was used to detect the RT at the macular fovea, and at the superior, nasal, inferior, and temporal side of the fovea and parafovea area. The AL of the examined eye was measured by IOL master measuring machine, and the correlation between RT at the macular area and the Al was evaluated. Results The minimum RT in the macular area in the eyes with myopia was (150.90plusmn;22.10)mu;m.The retina at the temporal side of parafovea was the thinnest. The average RT in the areas around the fovea was negatively correlated with the AL, and there was no correlation among the minimum RT, the mean RT at the fovea, and the AL of eye. Conclusions As the AL of eye increases, the RT at the parafovea decreases, while the minimum and the average RT at the fovea remain unchanged. (Chin J Ocul Fundus Dis, 2006, 22: 397-399)
Objective To evaluate the causes of the metamorphopsia in patients with reattached retina after scleral buckling surgery. Methods Amsler grid test, ophthalmoscopic examination, fundus fluores cein angiography (FFA) and optical coherence tomography (OCT) were performed on 79 patients (79 eyes) with reattached retina at the 2nd week, 2nd, 6th month and 1st year after scleral buckling operation. Results Two weeks after the operation, 51 patients (51 eyes, 64.56%) complained of metamorphopsia,and 44 patients (44 eyes, including 35 with and 9 without metamorphopsia) were examined by OCT and FFA. In patients with metamorphopsia, the results of OCT in 31 (88.57%) revealed abnormal macula with seven kinds consisting mostly of stratum neuroepithelium detachment (74.29%), while of FFA in 6 patients showed abnormal macular (17.14%) including 4 with neuroepithelium detachment (66.67%). In patients without metamorphopsia, abnormal macula could be found in 2 by OCT while nothing special was seen in FFA. Most abnormal macula in patients followed-up 2 months, 6 months and 1 year postoperatively meliorated as time went by, with alleviative or disappeared metamorphopsia; while the patients with persistently existing macular membrane had aggravating metamorphopsia. Conclusions Abnormal macula is the main reason for metamorphopsia after scleral buckling surgery. Neuroepithelium detachment and macular membrane are the main causes of metamorphopsia at the early and terminal stage after operation.(Chin J Ocul Fundus Dis，2004，20：94-97)
Objective To investigate the characteristics of optical coherence to mography (OCT) in eyes with repaired idiopathic macular hole (IMH) after operation and the relation with recovery of visual acuity. Methods The characteristics of OCT images of 24 patients (25 eyes) with repaired IMH after vitrectomy,internal limiting membrane（ILM）peeling and auto-serum healing were analyzed retrospectively. In the patients with IMH, the macular hole was found in 9 eyes at st age II, 13 eyes at stage III, and 3 eyes at stage IV. Examinations of best-corrected visual acuity, slit-lamp biomicroscopy with fundus contact lens, fundus photography, fundus fluorescein angiography(FFA) and OCT were performed on the patients 3 to 24 months after surgery. Results OCT images of the repaired IMH were categorized into 3 patterns: U-type (5 eyes ) with relative normal foveal contour; V-type (7 eyes) with steep foveal contour;W-type (13 eyes) with foveal defect of neurosensory retina, but without warped hem of retinal hole or cystic formation. Postoperative visual acuities were improved in all of the patients and the best ones were in group U-type. Conclusion Characteristics of OCT images of repaired IMH may be related to the postoperative visual acuity. (Chin J Ocul Fundus Dis，2004，20：90-93)
Objective To verify the significance of the morphological changes of the macula and its relationship to visual function by using optical coherence tomography (OCT) after scleral buckling procdure. Methods The macula of retinae of 68 patients (70 eyes) with reattached retinae after scleral buckling operation for retinal detachment were examined by OCT to scan the macula through fovea vertically and horizontally. Results Among the 70 eyes, 22 eyes revealed normal macula with thickness of neurosensory retina meant (146.47±20.59)μm. In the other 48 eyes (68.60%) with abnormal macula, 19 eyes showed extensive subretinal interspace, 9 eyes showed local subretinal interspace, 8 eyes showed macula edema, 4 eyes showed thin macula, 4 eyes showed subretinal proliferation and 4 eye showed epiretinal membrane over macula. In the normal macular structure group under the OCT, the visual acuity (VA) of the operated eyes was more than 0.3 in 6 eyes 2 weeks after operation and in 14 eyes 3 mons after operation. In the macula edema group, the VA was more than 0.3 in 1 eye 2 weeks after opoeration and 2 eyes 3 mons after operation. In the subretinal interspace group, the VA was more than 0.3 in 5 eyes 2 weeks after operation and in 23 eyes 3 mons after operation. The proportions of the numbers of operated eyes with the VA more than 0.3 after 3 mons of the operation in macular normal group subretinal interspace group and other macular disease group were significantly different (χ2=18.91, P＜0.01). Conclusion OCT can precisely detect the structural changes of macula after retinal reattachment and assess visual function after surgery of retinal detachment. (Chin J Ocul Fundus Dis, 2002, 18: 266-268)
Objective To compare the consistency and difference of optical coherence tomography angiography (OCTA) and traditional multimodal fundus imaging in the diagnosis and activity evaluation of choroidal neovascularization (CNV) in exudative age-related macular degeneration (AMD). Methods A total of 112 exudative AMD patients (130 eyes) were included in this retrospective study, 62 were men (71 eyes) and 50 were women (59 eyes). The mean age was (68.250±9.789) years (range 50 – 91 years). All patients were underwent traditional multimodal fundus imaging including fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and spectral domain optical coherence tomography (OCT); OCTA was performed at the same time. The CNV type was divided into active and non-active according to the results of traditional multimodal fundus imaging. The vascular pattern was divided into active and non-active according to the results of OCTA. Using traditional multimodal fundus imaging as the standard, the sensitivity and specialty of OCTA was evaluated. Results In 130 eyes, CNV was visualized on traditional multimodal fundus imaging in 109 eyes (83.8%); CNV was visualized on OCTA in 103 eyes (79.2%), which including 7 eyes of false negative and 1 eye of false positive. The sensitivity of OCTA for CNV diagnosis was 93.6%, with specificity of 95.2%. The CNV detection rate between two methods had no significant difference (Youden index=0.89,Kappa value=0.796,P=0.07). In 109 eyes diagnosed with CNV by traditional multimodal fundus imaging, 73 eyes (67.0%) were active CNV and 36 eyes (33.0%) were non-active CNV; the vascular pattern was active in 60 eyes (55.0%) and non-active in 49 eyes (45.0%). The sensitivity of OCTA for the detection of active CNV was 82.2%, with specificity of 100.0%. The active CNV detection rate between two methods had no significant difference (Youden index=0.82,Kappa value=0.753,P=0.00). Conclusion In the diagnosis and activity evaluation of CNV in exudative AMD, there is remarkable consistency between OCTA and traditional multimodal fundus imaging.
Objective To analyze the characteristics of myopic choroidal neovascularization (mCNV) and the outcome of intravitreal anti-vascular endothelial growth factor (VEGF) treatment by using optical coherence tomography angiography (OCTA). Methods A prospective study was carried out, which included 34 eyes of 31 patients with mCNV in West China Hospital of Sichuan University between May and December 2017. OCTA scans were conducted to all patients before treatment, 1 day, 1 week, 1 month and 3–6 months after treatment. The analysis was performed to evaluate the morphological characteristics, lesion area, parafoveal superficial vessel density and perfusion area of choroidal neovascularization before and after treatment. Results Among mCNV patients, small round crumby lesions, small branches, and capillaries responded well to anti-VEGF treatment. Compared with the mean lesion area in mCNV patients before treatment [(0.082±0.013) mm2], there was instant reduction 1 day after treatment [(0.064±0.013) mm2] and obviously decreased after 1 week [(0.046±0.011) mm2]. The parafoveal superficial vessel density and perfusion area before treatment were (15.2±0.5)% and (32.6±1.5)%, respectively, and obvious decrease was observed both in parafoveal superficial vessel density [(12.1±0.9)%] and perfusion area [(27.4±2.0)%] 1 day after treatment in mCNV patients, which began to recover 1 month after treatment. Conclusions OCTA is a non-invasive diagnostic examination, which can clearly identify tiny structures of mCNV, quantify the lesion area and display specific vasculature in mCNV patients. Furthermore, retinal microcirculation can be detected by using OCTA, which provides an effective approach of monitoring the progression and treatment effect of mCNV.
Optical coherence tomography (OCT) is a non-invasive, rapid optical medical imaging modality and has become a hot topic in biomedical research. In recent years, several functional OCTs have emerged, including Doppler OCT, polarization-sensitive OCT, spectroscopic OCT, and optical coherence tomographic elastography, etc. These newer advances in functional OCT broaden the potential clinical application of OCT by providing novel ways to observe and understand tissue activity that cannot be accomplished by other current imaging methodologies.