Optic disc drusen (ODD) is an acellular deposit located in front of the cribriform of the optic disc. ODD has been much underdiagnosed due to few obvious clinical symptoms. These clinical symptoms are easily confused with optic disc edema caused by systemic high-risk diseases. The current mainstream view is that optic nerve fiber axon metabolism is disordered, leading to intracellular mitochondrial calcification. After axon chronic disintegration, calcified mitochondria continuously release outside the cell, resulting in a much higher concentration of extracellular calcium than inside the cell. The continuous deposit and accumulation of extracellular calcification fuse to small calcified corpuscles, which lead to ODD formation. OCT enhanced deep imaging can detect ODD sensitively, and its image feature is a weak reflection core completely or partially surrounded by a strong reflection edge. ODD is one of the common causes for optic disc crowding. During adolescence, the accumulating calcified bodies buried in the deep optic disc gradually extrude and migrate to the superficial optic disc, which turn into superficial ODD. As a consequence, part of these ODD patients rapidly progress during adolescence and generally become stable in adulthood with anterior ischemic optic neuropathy, or other vascular complications.
Objective To evaluate the changes of optic nerve head (ONH) and the thickness of peripapillary retinal nerve fiber layer (RNFL) in patients with non-arteritic anterior ischemic optic neuropathy (NAION) using optical coherence tomography (OCT). Methods Circular and cross-sectional OCT scans of an area with a diameter of 3.38 mm surrounding the optic disc were performed for 108 eyes (96 cases) with NAION, including 96 eyes (96 cases) in acute edema phase and 41 eyes (37 cases) in resolving phase. Follow-up period was 2 weeks to 24 months, with an average of 6 months. Results The RNFL was thickener with shallow cup or small cups in the acute edema phase. Comparing with the RNFL in the ischemic sector, the thickness of peripapillary RNFL in the nonischemic sector was greater in 59 eyes (59 cases, 61%), lesser in 26 eyes (26 cases, 27%) and no difference in 11 eyes (11 cases, 12%). During the treatment NAION eyes were dynamically observed by OCT. While ischemic edema of the optic disc resolved in about two weeks, non-ischemic edema subsided in 3-6 weeks. After 1 month in the resolving phase, the thickness of peripapillary RNFL in the ischemic sector of 35 cases (95%) was thinner than the thickness of non-ischemic sector and fellow normal controls. After 3 month in the resolving phase, 26 cases (70%) showed thinner RNFL of whole optic disc. Conclusion The thickness of RNFL in NAION patients in acute edema phase is thicker than that in the fellow normal eyes, and is also thicker in ischemic sector than that in non-ischemic sector. In resolving phase, the thickness of RNFL is thinner in NAION eyes than that in the fellow normal eyes.
ObjectiveTo evaluate the effect of form deprivation myopia on optic nerve head and retinal morphology in guinea pigs using optical coherence tomography (OCT). MethodsTwenty guinea pigs aged from 4 to 5 weeks were chosen and randomly divided into the experimental group and control group, with 10 guinea pigs in each group. Form deprivation myopia was established for the right eyes of guinea pigs in experimental group for 4 weeks. The guinea pigs of control group were not intervened. Before and 4 weeks after form deprivation, refraction was measured by retinoscopy after cycloplegia; the axial length was measured by A-scan ultrasound; retinal nerve fiber layer (RNFL) thickness, optic nerve head and retinal morphology of guinea pigs were analyzed using OCT. ResultsBefore form deprivation, there were no statistically significant differences in spherical equivalent, axial length, RNFL thickness, disc edge area, optic disc area, average cup disc ratio, vertical cup disc ratio, cup volume, retinal thickness, or retinal volume between the experimental group and control group of guinea pig (P > 0.05). After 4 weeks of form deprivation, RNFL thickness of (64.9±17.7) μm in guinea pigs in experimental group was thinner compared to (97.9±25.1) μm in control group (t=-2.845, P=0.015). Retinal thickness of (142.7±3.4) μm in guinea pigs in experimental group was thicker compared to (138.4±3.5) μm in control group (t=2.338, P=0.038). There were no significant differences in disc edge area, optic disc area, average cup disc ratio, vertical cup disc ratio, cup volume or retinal volume between groups (P > 0.05). There were statistically significant differences in spherical equivalent, axial length, RNFL thickness, vertical cup to disc ratio cup volume, and retinal thickness between after and before form deprivation in the right eye of guinea pigs in the experimental groups (t=46.001, -50.119, 5.385, 3.447, -2.814, -8.911; P < 0.05), while there were no statistically significant differences in disc edge area, optic disc area, average cup disc ratio, or retinal volume (P > 0.05). ConclusionForm deprivation myopia has an effect on RNFL and retinal thickness.
Objective To observe the characteristics of morphosis parameter of the optic disc of physiologic large cup. Methods 100 eyes with physiologic large cup and 74 eyes with normal cup were examined by Heidelberg Retina Tomograph (HRT ). The differences of morphosis parameters between two groups were analyzed comparatively on disc area (DA), cup volume (CV), cup/disc area ratio (C/DR), rim area (RA), cup volume (CV), rim volume (RV), mean cup depth (MeCD), maximum cup depth (MxCD), cup shape measure (CSM), height variation contour (HVC), mean retinal nerve fiber layer thickness (mRNFLt), and retinal nerve fiber layer cross-section area (RNFLcsa). The characteristics of the inferior, superior, nasal, and temporal quadrants of the physiologic large cups were analyzed. Results DA, CA, C/DR, CV, MeCD, CSM （P=0.00, respectively）and MxCD （P=0.04）were significantly larger in eyes with physiologic large cup than in eyes with normal cup. RA, RV, HVC, mRNFLt, RNFLcsa （P=0.00, respectively) were significantly smaller in eyes with physiologic large cup than in eyes with normal cup. The temporal quadrant of RV of the physiologic large cup is the narrowest. RNFLcsa decreased as the fol lowing order: superior, inferior, nasal, and temporal（P＜0.05）. Conclusions Mo rphosis parameter of the optic discs of physiologic large cup has its own repres entation on characteristics. Compared to normal cups, physiologic large cups had larger discs but smaller mRNFLt. The nasal quadrant of DA was larger than the i nferior quadrant. （Chin J Ocul Fundus Dis，2008，24：213-216）
ObjectiveTo observe and analyze the structural characteristics of the optic discs in high myopia (HM) combined with primary open-angle glaucoma (POAG) and the optic disc parameters with diagnostic efficacy. MethodsA cross-sectional study. From August 2020 to March 2021, a total of 114 eyes of 68 patients with POAG, HM and healthy volunteers who were diagnosed by Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University were included in the study. Among them, 21 POAG patients (39 eyes) were divided into H+P group (9 patients, 18 eyes) and non-H+P group (12 patients, 21 eyes) according to whether or not HM was combined; 26 HM patients (37 eyes) were selected as HM group; 21 healthy volunteers (38 eyes) were selected as normal control group. The subjects included 31 males (51 eyes) and 37 females (63 eyes), whose average age was 36.93±12.60 years old. Diopter, central corneal thickness (CCT) and axial length (AL) were measured. There was no significant difference in age (F=8.333), sex composition ratio (χ2=0.863), and CCT (F=1.425) among the four groups (P＞0.05); while, there were significant differences in AL (F=69.956), diopter (F=37.711), visual field index (VFI) (F=43.254) and mean defect (MD) (F=49.793) among the four groups (P＜0.01). Enhanced depth imaging using optical coherence tomography was used to obtain the tilt parameters, the disc rim parameters, the lamina cribrosa parameters and the retinal nerve fiber layer (RNFL) thickness. The tilt parameters included optic disc horizontal diameter, optic disc vertical diameter, optic disc ellipse index (horizontal diameter/vertical diameter); the disc rim parameters included Bruch’s membrane opening-minimal rim width (BMO), optic cup area, optic disc area, disc rim area, cup-disc area ratio; the lamina cribrosa parameters included anterior laminar insertion depth (ALID), prelaminar neural tissue (PLNT), and lamina cribrosa thickness. The pairwise comparison between groups were performed by ANOVA test. Pearson correlation analysis was used to analyze the correlation between disc tilt parameters, disc rim parameters, lamina cribrosa parameters and visual field parameters, as well as between disc rim parameters and RNFL thickness. According to receiver operating characteristic (ROC) curve and area under the curve (AUC), the predictive value of those above related factors for HM combined with POAG was evaluated. ResultsTilt parameters: compared with the optic disc horizontal diameter of non-H+P group, those of normal control group, HM group and H+P group were significantly decreased (P＜0.05), the ellipse indices of HM group and H+P group were significantly lower than those of normal control group and non-H+P group (P＜0.05). The results of correlation analysis showed that the optic disc horizontal and vertical diameters were negatively correlated with MD (r=－0.302, －0.235; P=0.002, 0.017), and negatively correlated with VFI (r=－0.291, －0.246; P=0.003, 0.013). Disc rim parameters: the disc cup area and cup-disc area ratio of non-H+P group and H+P group were significantly larger than those of normal control group and HM group (P＜0.05). The disc rim area and the average BMO of HM group, non-H+P group and H+P group were significantly smaller than those of normal control group (P＜0.05). The results of correlation analysis showed that the cup-disc area ratio (r=－0.584), the average BMO (r=0.650) had the highest correlation with the average RNFL thickness (P＜0.001). The superior, inferior, nasal and temporal BMO were all positively correlated with the corresponding quadrant RNFL thicknesses (r=0.431, 0.656, 0.362, 0.375; P＜0.05); the optic disc rim area, the average BMO were positively correlated with MD (r=0.449, 0.618) and VFI (r=0.449, 0.605) (P＜0.05), among which the correlation of the average BMO was the highest; the optic cup area and cup-disc area ratio were negatively correlated with MD (r=－0.346,－0.559) and VFI (r=－0.312,－0.548) (P＜0.001), among which the correlation of the cup-disc area ratio was the highest. Lamina cribrosa parameters: ALID of non-H+P group and H+P group were significantly deeper than those of normal control group and HM group (P＜0.05). LC of non-H+P group and H+P group were significantly thinner than those of normal control group and HM group (P＜0.05). The results of correlation analysis showed that ALID was negatively correlated with MD and VFI (r=－0.402, P＜0.001), VFI (r=－0.405, P=0.001); LC was positively correlated with MD and VFI (r=0.403, P＜0.001), VFI (r=－0.401, P=0.015). Comparison of diagnostic efficiency between various optic disc parameters: the results of ROC analysis showed that the cup-disc area ratio had the highest diagnostic performance (AUC=0.847, P=0.007), the maximum Youden index was 0.563, the sensitivity and specificity were 0.833 and 0.730, respectively, and the best critical value was 0.340. ConclusionsOptic disc tilt is more pronounced in HM combined with POAG; BMO in each quadrant could objectively reflect the disc rim defect of HM combined with POAG; the thinning and the backward shift of the lamina cribrosa were consistent with the aggravation of the visual field defect. Among them, the cup-disc area ratio had better diagnostic performance．
Objective To determine the long-term changes in optic disc parameter and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) and macular retina after acute primary angle closure. Methods Prospective clinical case-control study. A total of 26 patients (30 eyes) with acute primary angle-closure glaucoma (APACG) were in the APACG group, whose intraocular pressure were control after a single episode acute primary angle closure; 30 age-and sex-matched healthy subjects (30 eyes) in the control group. All subjects underwent three dimensional optical coherence tomography (3D-OCT) examination with 3D optic disk scanning or circle optic disk scanning and 6 mm×6 mm macular scanning. The parameters included average thickness of entire CP-RNFL, thickness of nasal, superior, temporal and inferior quadrant of CP-RNFL, disc area, disc cup area, rim area, cup/disc (C/D) area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio. The foveal retinal thickness, center retinal thickness (≤1 mm from the fovea), 4 quadrants of macular inner-ring ( > 1 mm but≤3 mm from the fovea) retinal thickness, 4 quadrants of macular outer-ring ( > 3 mm but≤6 mm from the fovea) retinal thickness, average thickness of macular retinal thickness and macular volume were measured and analyzed. Results The disc area, disc cup area, C/D area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio in APACG group were significantly bigger than the control group (t=3.22, 4.12, 3.90, 3.00, 3.23; P < 0.05), rim area was smaller than the control group (t=-2.63, P < 0.05). The average thickness (t=-6.68) and the thickness of superior (t=-5.90), temporal (t=-11.64) and inferior (t=-5.06) quadrants of CP-RNFL, center retinal thickness (t=-2.50), 4 quadrants of macular inner-ring retinal thickness (t=-4.91, -4.88, -2.83, -3.59), nasal (t=-2.13) and superior (t=-2.49) quadrants of macular outer-ring retinal thickness as well as average thickness of macular retinal thickness (t=-2.65) were significantly thinner than the control group (P < 0.05), and the macular volume (t=-2.69) was significantly smaller than the control group (P < 0.05). There was no statistically difference at nasal CP-RNFL (t=-0.11), foveal retinal thickness (t=-0.59), temporal (t=-0.67) and inferior (t=-1.02) quadrants of macular outer-ring retinal thickness between two groups (P > 0.05). Conclusions In comparison with the healthy subjects, the disc area, disc cup area, C/D area ratio, C/D horizontal diameter ratio, C/D vertical diameter ratio in APACG eyes were bigger, while rim area was smaller; the CP-RNFL and macular retinal thickness were thinner except nasal CP-RNFL, fovea, temporal and inferior quadrants of macular outer-ring retinal.
ObjectiveTo observe the differences of horizontal optic disc diameter and cup/disc (C/D) ratio in eyes with different kinds of retinal vein occlusion (RVO). MethodsA total of 392 eyes from 385 RVO patients diagnosed by fundus fluorescein angiography (FFA) were included in this study. The patients included 192 males and 193 females. The average age was (58.30±11.51) years. The disease duration was from 7 days to 1 month. The eyes were divided into RVO group (356 eyes), RVO combining diabetes mellitus (DM) group (20 eyes) and RVO combining high blood pressure (HP) group (16 eyes). One hundred normal eyes examined by FFA in the same testing period were selected as the control group. Among the 356 eyes in the RVO group, there were 201 eyes with branch RVO (BRVO), 100 eyes with central RVO (CRVO), 17 eyes with hemi CRVO (H-CRVO), and 38 eyes with macular BRVO (M-BRVO). Among the 101 non-ischemic RVO eyes, there were 17 eyes with BRVO, 53 eyes with CRVO, 6 eyes with H-CRVO, and 25 eyes with M-BRVO. Among the 255 ischemic RVO eyes, there were 184 eyes with BRVO, 47 eyes with CRVO, 11 eyes with H-CRVO and 13 eyes with M-BRVO. The diameter of optic cup and disk, and the C/D ratio was measured on fundus infrared radiation (IR) IR30°image by Heidelberg confocal laser fundus imaging system. ResultsThere was no significant difference of horizontal optic disc diameter among 4 groups (F=1.17, P>0.05). The difference of C/D ratio was significant among 4 groups (F=82.24, P<0.05). The differences of horizontal optic disc diameter and C/D ratio in different kinds of RVO in normal group and RVO group were significant (F=4.49, 61.396; P<0.05). The horizontal optic disc diameter of eyes with CRVO was a little smaller than normal eyes (P<0.05). There was no difference of horizontal optic disc diameter between the eyes with BRVO, M-BRVO, H-CRVO and normal eyes (P>0.05). The difference of C/D ratio was significant between the eyes with BRVO, CRVO, M-BRVO, H-CRVO and normal eyes (P<0.05). The differences of horizontal optic disc diameter and C/D ratio were significant between RVO group (in different kinds of RVO eyes) and control group (F=3.94, 33.16; P<0.05). Compared the horizontal optic disc diameters of RVO eyes with the same subtype, the difference was significant between non-ischemic H-CRVO and ischemic H-CRVO (P<0.05), while the differences were not significant between other non-ischemic RVO and ischemic CRVO (BRVO:P=0.35,CRVO:P=0.86,M-BRVO:P=0.22). The difference of C/D ratio between non-ischemic RVO and ischemic CRVO was not significant (BRVO:P=0.35,CRVO:P=0.48,H-CRVO:P=1.00,M-BRVO:P=1.00). ConclusionsThe C/D ratio increased with varying degrees in RVO eyes. There is no obvious change in horizontal optic disc diameters except for CRVO eyes.
PURPOSE:To discuss the clinical characteristics and differential diagnosis of peripapillary subretinal hemorrhage(PPSRH). METHOD:Retrospective analysis of the clinical documents including mainly the ocular manifestations and the findings of fundus fluorescein angiography(FFA)of 37 patients (38 eyes)with PPSRH. RESULTS:In all of these 37 patients,36 were myopes, 31 were young persons ,the average age was 21 years old,and 36 were affected unilaterally. The subretinal hemorrhage revealed itself in 4 types :PPSRH (5 eyes),PPSRH with disc iaemorrhage (21 eyes),PPSRH with vitreous hemorrhage (2 eyes), and PPSRH with disc hemorrhage and vitreous hemorrhage (10 eyes). In the FFA, the hemorrhages showed blocked fluorescence and the optic discs showed irregular hyperfluorescence at the late phase. All of the hemorrhages were absorbed within 3 weeks to 3 months without any treatment. CONCLUSIONS:According to the manifestation of the optic discs in FFA PPSRH might be complicatton of the buried optic disc drusen. （Chin J Ocul Fundus Dis,1997,13: 143-145 ）
ObjectiveTo compare the choroidal thickness (CT) of macular and peripapillary area among malignant glaucoma(MG), chronic primary angle-closure glaucoma (CPACG) and normal control eyes. And to investigate the correlation between CT and MG. Methods Sixteen subjects (32 eyes) with MG, 31 (31 eyes) with CPACG and 32 (32 eyes) normal controls were collected. MG eyes and the fellow non-MG eyes were included in the MG group. CT of all subjects was measured in the fovea, 1mm and 3mm to the fovea and peripapillary area using enhanced-depth imaging technique of optical coherence tomography (OCT-EDI). The average of CT in fovea by horizontal and vertical macular scan was defined as the average CT in fovea. The average of temporal, superior, nasal and inferior CT in 1 mm and 3 mm to the fovea were measured respectively. The average of temporal, superior, nasal and inferior CT was defined as the average CT in peripapillary area. The differences of CT among MG, CPACG and normal controls were compared. And the differences of CT between MG eyes and the fellow non-MG eyes were compared. ResultsAfter eliminating the influence of age, the average CT of MG in the fovea, 1mm and 3mm to the fovea was significantly thicker than that of CPACG and normal controls (P < 0.05). And the average CT of CPACG in the fovea, 1mm and 3mm to the fovea was significantly thicker than that of normal controls (P < 0.05). In peripapillary area, the temporal, superior and inferior CT of MG was significantly thicker than that of CPACG and normal controls (P < 0.05). There was no significant difference of CT in peripapillary area between CPACG and normal controls (P > 0.05). In the fovea, 1mm and 3mm to the fovea and peripapillary area, there was no significant difference of CT between MG eye and the fellow non-MG eye in MG group (t=－1.029~－0.130, P > 0.05). ConclusionsThe choroid thickness of macular and peripapillary area in MG eyes is thicker than that of CPACG and the normal controls. An increased CT of macular and peripapillary area may be one of the risk factors for MG.
Objective:To observe the changes of the thickness of reti nal nerve fiber layer (RNFL) of optic disc in rats with chronic glaucoma continuously dete cted by optic coherence tomography (OCT). Methods:A total of 48 Wist ar rats (24 males and 24 females) were randomly divided into 3 groups with 16 ra ts (32 eyes) in each group. The right eyes were the photocoagulation eyes and the left ones were as the control. Laser photocoagulation with the wavelength of 532 nm was perfo rmed on the trabecular network of the right eyes to induce the chronic middlelevel oc u lar hypertension. The changes of the intraocular pressure (IOP) were observed. O pticdisc linear scanning of OCT was performed 3, 6, and 9 weeks after IOP incr e ased, and the thickness of RNFL of optic disc was detected by the computer. Eight rats in each group were killed and retinal histology slic es were used to detect the thickness of RNFL. The flatmount s of retina from the right eyes of the other 8 rats in each group were stai ned by 1% toluidine blue. The density of retinal ganglion cells (RGC) was calcul ated and the results were compared and analyzed. Results:IOP o f the rats increas ed chronically and moderately after photocoagulation. IOP of the experimental ey e 3,6, and 9 weeks after photocoagulation was obviously higher than which of the control eyes, respectively （P＜0.001）. The results of OCT showed that the thickness of the RNFL of the experimental eyes was (67.39plusmn;5.91) mu;m, (53.4 2plusmn;5.64) mu;m，and (44.35plusmn;5.76) mu;m 3, 6, and 9 weeks after photocoagulation, and the corresponding thickness in the control eyes was（80.32plusmn;5.87）, （79.69plusmn;5.69）, and （80.78plusmn;5.84）mu;m, respectively. The thickness of the retinal fiber layer detecte d by histological method was （64.38plusmn;6.54）, （51.47plusmn;6.4）, and （42.10 plusmn;6.10）mu;m in the experimental eyes 3, 6, and 9 weeks after photocoagulation, and (76.23plusmn;6.78), (78.64plusmn;6.15), and (77.64plusmn;6.63) mu;m in the control eyes. Regression analysis of the thickness detected by the two methods was made, and the regression coefficients was 0.932（P＜0.001）.The differ ence of the ave rage density of RGC between the two groups was significant (P＜0.05）. Conclusi on:Glaucoma model in Wistar rats may successfully set up b y photocoagulating the trabecular meshwork. The thickness of retinal nerve fiber layer of the optic disc in rats with chronic glaucoma detected by OCT and obser ved by the light m icroscope is accordant. The changes of the thickness of RNFL in rats with chroni c glaucoma could be continuously detected by OCT to investigate the progress of the glaucomatic retinopathy in rat model.