Objective To compare the macular imaging and measurements of patients with idiopathic epiretinal membranes (ERM) by stratus optical coherence tomography (OCT) and two different types of spectral-domain OCT. Methods Forty-six consecutive patients (46 eyes) diagnosed as idiopathic ERM in the period of August 2008 to October 2008 were enrolled in this study. The patients included 11 males and 35 females, with a mean age of (61.04plusmn;10.13) years. Twenty-one age- and sex- matched normal subjects (21 eyes) were enrolled in this study as control group. All the subjects underwent stratus OCT, cirrus OCT and 3D OCT-1000 examinations. The macular area was divided into three concentric circles which including central region with 1 mm diameter, inner area with ＞1 mm but le;3 mm diameter, and outer ring area with ＞3 mm but le;6 mm diameter. The inner area and outer ring area were divided into superior, nasal, inferior and temporal quadrants by two radioactive rays. The characteristics of OCT images and the quantitative measurements were compared among these three machines. The macular thickness of ERM group and control group was also compared. And the correlation of visual acuity and the macular thickness in idiopathic ERM patients was evaluated. Results The increased macular retinal thickness, disorder structure of inner retina, uneven surface and proliferative inner and outer plexiform layer were observed in ERM group by stratus and spectral-domain OCT. But the minor pathological changes on inner retina structure and internal surface proliferation could be observed more clearly by spectral-domain OCT than those by stratus OCT.The macular thicknesses of all the subjects measured by Cirrus OCT and 3D OCT-1000 were thicker than those measured by Stratus OCT (t=7.445-11.253,P=0.000). The correlations of measurements between three OCTs were good (r＞0.9). The flatted or disappeared fovea of ERM patient group was observed by all three OCTs. The macular thicknesses on different subfields of patients in ERM group were thicker than those in control group, especially in the 1-3 mm inner ring (t=2.477-10.139,P＜0.05). Moderate negative correlations were shown on the macular thickness and visual acuity in ERM group (r=-0.216-0.517). Conclusions Spectral domain OCT yields better visualization of the intraretinal layers than time domain OCT. The images in spectral domain OCT are more clear and fine compared to stratus OCT. Stratus OCT correlates with spectral domain OCT, but they are different, and cannot be replaced by each other.
ObjectiveTo observe the characteristics of optical coherence tomography (OCT) angiography (OCTA) in retinal vein occlusion (RVO). MethodsProspective and observational study. Clinical examination of 81 consecutive patients (86 eyes) diagnosed with RVO were included in the study, in which the branch retinal vein occlusion in 47 eyes, central retinal vein occlusion in 39 eyes. Forty-five patients were male and 36 patients were female. Aged from 28 to 76 years old, the mean age was (55.36±10.01) years old. Comprehensive optical and imaging examination were performed, including fundus photography, fundus fluorescein angiography (FFA), spectral domain OCT, en face OCT and OCTA. The retinal blood flow imaging scan mode and the optic disc blood flow imaging scan mode were performed, the scanning region in the macular area were 3 mm×3 mm, 6 mm×6 mm, 8 mm×8 mm respectively, around the optic disc were 3 mm×3 mm and 4.5 mm×4.5 mm. Each region scans 2 times. The characteristics of foveal avascular zone change, macular edema, non-perfusion and optical disc edema in OCTA and their corresponding FFA and en face OCT were observed. ResultsBy OCTA, 67 eyes (77.9%) for foveal avascular zone change, 23 eyes (26.7%) for macular edema, 40 eyes (46.5%) for non-perfusion, and 33 eyes (38.4%) for optical disc edema can be detected. The foveal avascular zone change can be indentified as the tranformation, destruction and even vanish of the arch in superfacial layer of retinal macular area, acompanied with the dilatation and thickening of capillary vessels, the occlusion and expanding of capillary vessels arounded the foveal avascular zone in the deep layer of macular area. Those performances were more clear than FFA. The main expression of macular edema was low signal and was not as clear as en face OCT. The tortuosity and expansion of retinal vessels, density decreasing and even occlusion or abnormal traffic branch of capillary vessels can be observed in non-perfusion. These observations were similar to FFA. However, pieces of highly signal identical with non-perfusion area can be detected in chroid capillary. The representation of optical disc edema was the brush-like expanding of capillary vessels aroud optical disc. ConclusionsOCTA can help for observing the abnormal changing of capillary vessels in foveal avascular zone and macular edema, non-perfusion and optical disc edema. Foveal avascular zone change showed occlusion and expanding of capillary vessels around the foveal avascular zone in the deep layer of macular area. Macular edema showed the weak signal. Non-perfusion showed tortuosity and expansion of retinal vessels, density decreasing and even occlusion or abnormal traffic branch of capillary vessels. Optical disc edema showed brush-like expanding of capillary vessels around optical disc.
ObjectiveTo observe the imaging features of branching vascular network (BVN) in polypoidal choroidal vasculopathy (PCV). MethodsEighty PCV patients (90 eyes) were enrolled in this study. The patients included 58 males and 22 females. The age was ranged from 49 to 85 years, with a mean age of 61.4 years. All the patients were examined for fundus photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT). The fibrovascular retinal pigment epithelium detachment (PED) was defined as a well-demarcated subretinal heterogeneous plaque with increasing fluorescence on FFA. The late lichenoid hyperfluorescent plaque was defined as a well-demarcated lichenoid hyperfluorescent plaque on late phase ICGA. The double-layer sign on OCT was defined as a wide range of shallow PED from Bruch membrane. ResultsBVN were found on early ICGA in 76 eyes among the 90 eyes (84.4%). Among these 76 eyes, 18 eyes (23.7%) demonstrated the subretinal reddish-orange branches corresponding to BVN. Fifty-six eyes (73.7%) demonstrated all or part of the BVN on early FFA. Three eyes (3.9%) demonstrated branching transmitted fluorescence corresponding to BVN throughout the FFA. Seventy-three eyes (96.1%) were manifested by occult choroidal vascularization on FFA, and 21 eyes (27.6%) of them were fibrovascular PED. Among the 76 eyes with BVN, all BVN appeared earlier than polypoidal lesions on ICGA. Polypoidal lesions located on the terminal of BVN in 62 eyes (81.6%). Sixty-nine eyes (90.8%) on ICGA demonstrated the late lichenoid hyperfluorescent plaque, whose area was equal to or greater than the area of BVN shown on early ICGA. Seventy-two eyes (94.7%) had the double-layer sign. Among these 72 eyes, 15 eyes (20.8%) had lumen-like structure within the double-layer sign. Sixty-five eyes (90.3%) had punctate and linear hyper-reflectance within the double-layer sign. Two eyes (2.8%) demonstrated a hyporeflective short segment and a gap of Bruch membrane on OCT corresponding to the origin of the BVN. Sixty-three eyes (87.5%) had an area of double-layer sign that matched the area of late lichenoid hyperfluorescent plaque on ICGA. ConclusionsBVN in PCV can be noted as reddish-orange branches on fundus examination. Most of the BVN are shown as early branching transmitted fluorescence but collectively an occult choroidal vascularization on FFA, as lichenoid hyperfluorescent plaque on late ICGA, and as double-layer sign on OCT whose area matches late lichenoid hyperfluorescent plaque.
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.
Idiopathic macular hole (IMH) refers to full thickness defects of retina in macular area with no clear reasons. The management of IMH includes vitrectomy combined with internal limiting membrane (ILM) peeling and pharmacological vitreolysis. But ILM peeling may damage the inner retina; novel techniques, such as inverted ILM flap technique and foveola non-peeling ILM surgery, autologous ILM transplantation had made the method of ILM peeling more diversified with less damage. Pharmacological vitreolysis targeting fibronectin and laminin is considered to work in a two-step mechanism, involving both vitreoretinal separation and vitreous liquefaction. Furthermore, IMH judgment and prognosis indicators like ellipsoid zone, macular hole index, hole formation factor, diameter hole index and tractional hole index based on spectral domain optical coherence tomography enriched the assessment of macular hole diameter, depth and shape. How to make full use of new interventions to reduce the incidence of macular hole and obtain a better visual acuity with closed holes is an important direction for future research.
Objective To observe the changes of retinal nerve fiber layer (RNFL) thickness and its correlation with visual field mean defects（MD）in Parkinsonprime;s disease (PD).Methods Fifteen eyes of 15 PD patients in early stage and 18 eyes of 18 normal controls undertook RNFL examination by Stratus OCT3. Circular scans (diameter is 3.46 mm) were taken around the optic nerve head including eight quadrants (superior, inferior, temporal, nasal, temporalsuperior, temporalinferior, nasalsuperior and nasalinferior). The RNFL thickness in different quadrants in the two groups was analyzed. The visual field of PD patients was measured by central 302 program of Humphery750 visual field analyzer, and the MD was recorded. The correlation between RNFL thickness and MD was analyzed by linear correlation and regression analysis.Results RNFL thicknesses of superior, inferior, temporal, nasal, temporalsuperior, temporalinferior, nasalsuperior, nasalinferior and average RNFL thickness in the control group were (132.7plusmn;17.4), (141.5plusmn;15.3) ,（83.2plusmn;17.5）, (83.7plusmn;22.3) ,（120.8plusmn;21.2）, (117.9plusmn;24.5) ,（109.6plusmn;20.6）,（110.2plusmn;27.7）, and（109.9plusmn;8.5）mu;m respectively, while in the PD group they were (128.1plusmn;25.3) , (128.6plusmn;13.2) , (68.7plusmn;13.5) , (76.5plusmn;17.8) ,（102.6plusmn;23.7）, (103.3plusmn;14.1) ,（101.2plusmn;20.9）,（96.6plusmn;15.0）,（102.3plusmn;11.9） mu;m. Compared with each other, the differences of RNFL thickness of inferior, temporal, temporalsuperior, temporalinferior and average RNFL thickness were statistically significant（t=2.595，2.700，2.330，2.153，2.131；P=0.014，0.011，0.026，0.040，0.041）. There was a close negative relationship between average RNFL thickness and MD in PD patients (r=-0.933，P＜0.0001). Conclusions RNFL thickness was significantly thinner in PD patients than that in the normal controls. There was a negative relationship between RNFL thickness and MD in PD patients.
Objective To observe the types and features of Bruchprime;s membrane (BM) in the choriocapillarioBruchprime;s membraneretinal pigment epithelium complex (CBRP-C) in central serous chorioretinopathy (CSC) by optical coherence tomography (OCT). Methods This is a retrospective case control study. Sixty eyes of 60 patients (43 males, 17 females) with CSC who underwent laser photocoagulation (51 eyes) or half-dose verteporfin photodynamic therapy (9 eyes) were enrolled. The macular area of all the patients was scanned by SpectralisOCT before and after the treatment, BM was observed as the core indicators of CBRP-C. According to the reflection band,BM was classified into distinguishable BM and indistinguishable BM. The distinguishable BM was classified into phenotype BM (with a subRPE fluid cavity) and cryptotype BM (without a sub-RPE fluid cavity). The types and features of BM in CBRPC of CSC patients before and after the treatment were comparatively analyzed. Results Before the treatment, distinguishable BM were observed in all patients, including 59 eyes (98.3％) with phenotype BM and 1 eye (1.7％) with cryptotype BM. At 1 month after laser photocoagulation, there were, 1/51 eye (2.0%) with indistinguishable BM, and 50/51 eyes (98.0%) with distinguishable BM, including 34 eyes (68.0%) with phenotype BM and 16 eyes (32.0%) with cryptotype BM. At 1 month after half-dose PDT, there were 1/9 eye (11.1%) with indistinguishable BM and 8/9 eyes (88.9%) with distinguishable BM, including 1 eye (12.5%) with phenotype BM and 7 eyes (87.5%) with cryptotype BM. Conclusion The phenotype BM exists in CSC patients before and after the treatment, but it has been improved after treatment.