Adaptive optics (AO) is a technique to improve the performance of optical systems by reducing the influence of optical aberrations. Combined with scanning laser ophthalmoscope (AOSLO), the aberration of human refractive system can be corrected. Thus, the resolution and quality of imaging can be greatly improved to the cellular level in vivo retina (such as photoreceptor, nerve fibers, vascular parietal cell), therefore the earlier changes of the diseases can be detected. At the same time, microstructure changes of retinal can also be observed during the follow-up of the disease. Due to inherent technical defects of AOSLO, its wide application in clinical practice is limited. With the continuous progress of AO technology and the further improvement of related software functions, the function of the system will become more stronger and will play a more and more important role in scientific research and clinic.
Purpose To explore the role of scanning laser tomography in the assessment of macular hole surgery. Methods Fifteen eyes of 14 patients with macular holes underwent scanning of their affected macular area using the Heidelberg retina tomograph (HRT). The significance of topographic changes postoperatively were determined in eleven eyes which received vitrectomy surgery. The scan field was set at 15°of the retina and the depth was set to 1.5 mm or 2.0 mm. All the measurements were taken for 3 times and the average value of the 3 measurements was used. Results The average hole area was (0.499±0.34) mm 2 and the maximal depth of the hole was (0.284±0.11) mm. Topographic difference analysis of the eleven eyes showed a significant reduction in the height of the retina after vitrectomy. The maximal depth of the hole was (0.063±0.04) mm postoperatively. Conclusion Scanning laser tomography provides an objective evaluation of the anatomic outcome of the macular hole surgery. (Chin J Ocul Fundus Dis, 2002, 18: 125-127)
Objective To verify the applicable significance of confocal scanning laser retinal tomography in agerelated macular degeneration (AMD). Methods Heidelberg confocal scanning laser tomography was used to measure 75 eyes of 59 patients with AMD, including 25 eyes of 20 patients with exudative AMD, 25 eyes of 16 patients with atrophic AMD, and 25 eyes of 23 patients with macular drusen. The differences of the width, volume and maximum height of Z profile signal of macula were analyzed. Results Z profile signal width in macular tomography of exudative AMD was wider than that of macular drusen; maximum height and volume in macular tomography of exudative AMD were larger than that of macular drusen (P＜0.01); Z profile signal width, maximum height，and volume in macular tomography of atrophic AMD were wider and larger than that of macular drusen (P＜0.05). Macular volume of exudative AMD was obviously larger than that of atrophic AMD (P＜0.01). Conclusion Confocal scanning laser tomography may be one of the useful methods for objective evaluation of morphologic change for the development of AMD. (Chin J Ocul Fundus Dis, 2002, 18: 262-265)
Objective To observe the expression of Nogo66 receptor （NgR）in ratsprime; retina during the postnatal development． Methods The expression of NgR in 48 rats were observed by immunofluorescence histochemistry and laserconfocal microscopy 0, 3, 7, 14, 21, 35, 49, 63 days after birth, with 6 rats in each group, respectively． Results The expression of NgR is positive in the retina in the whole duration of growth, and the fluorescence pigmentation was located around the ganglion cell nuclaear. Conclusion The positive expression of NgR suggests that the interaction of NgR and CNS myelin inhibitors not only inhibit neuronal plasticity but also promote it, which could regulate neuronal plasticity.
Diabetic retinopathy (DR) is one of the most common causes of visual impairment and blindness in diabetic patients. It is particularly important to set up simpler, safer, non-invasive and highly effective methods for diagnosis as well as monitoring DR. A variety of new fundus imaging techniques show great advantages in early diagnosis, treatment and monitoring of DR in recent years. The main characteristics of wide-field scanning laser imaging system is achieving a large range of retinal image in a single photograph and without mydriasis. It provides several options for color images, FFA and FAF, which satisfy to detect the retina, choroid and vascular structure. Multi spectral fundus imaging system is suitable for DR screening, because it is able to recognize the typical characteristics of DR, such as microaneurysms, hemorrhage and exudation, and is non-invasive and convenient. OCT angiography is a quantitative examination that provides foveal avascular zone area, macular blood flow density, which provides strong evidence for DR diagnosis. The improvement of these new techniques will help us to build up a personalized evaluation system of DR.
Objective To observe the effect of scanning laser ophthalmoscope (SLO) measuring macular light sensibility on evaluating the visual function in idiopathic epiretinal membrane (IERM), and analyze the relationship among the macular light sensibility, central visual acuity, and the thickness of fovea. Methods Procedure of microperimetry of SLO was performed on 44 patients (55 eyes) with IERM diagnosed by indirect and direct ophthalmoscope and optical coherence tomography (OCT). The light sensibility at 10deg;macular central area was measured. The results were compared with 31 healthy control eyes which underwent the same examinations simutaneously. The correlation among the macular light sensibility, the thickness of fovea measured by OCT, and the results of logarithm visual acuity was anaylzed. Results Compared with the control eyes, macular light sensibility decreased in IERM eyes significantly (F=47.265, Plt;0.01), which had the positive correlation with the decrease of visual acuity (r=0.687, P=0.000) and negative correlation with the retinal thickness of macular fovea (r=-0.532,P=0.003). The mean macular light sensitivity in patients with metamorphopsia decreased obviously compared with which in patients without (t=7.039, P=0.000). The mean macular light sensitivity in patients with prolifertive IERM decreased compared with which in patients with dropsical IERM without statistical difference (t=-1.706, P=0.094). Conclusion Microperimetry of SLO may sensitively reflect the macular visual function of eyes with IERM and quantificationally evaluate the changes of macular light sensibility. The changes of macular light sensitivity correlates with the central visual acuity and retinal thickness of macular fovea. (Chin J Ocul Fundus Dis, 2006, 22: 100-102)
Objective To observe the dimensions of the capillary blood vessel arch in central fovea of macula and the foveal avascular area (FAZ), and their relationships with age.Methods Retina in macula of 32 cadavers eyes were isolated . Retinal vessels were immunostained by collagen type IV and examined by confocal laser scanning microscopy. The area and diameter of the FAZ were measured, and the relationship between FAZ and age was analysed. Results The parafoveolar capillary network was observed clearly by confocal laser scanning microscopy. The average area of the FAZ was (0.24±0.13) mm2, and the average diameter was (0.54±0.15) mm. The area and diameter of the FAZ did not show any correlation with age.Conclusions The parafoveolar capillary network could be observed by confocal laser scanning microscopy. The size of the FAZ does not change with age. The dimensions of the parafoveolar capillary network may not be influenced by age. (Chin J Ocul Fundus Dis，2003，19：73-75)
ObjectivesTo evaluate the reproducibility of Heidelberg retina tomograph (HRT) macular edema module(MEM) measuring the macular retinal thickness.MethodsSixty-two healthy volunteers (9-68 years old) were examined by HRT-II procedure. The retinal signal width (SW) at macula and fovea and macular edema index (E) were recorded for t-test, Pearson linear-correlation analysis. Intra-subject variation repeatedly measured was analyzed with coefficient of variation, 95% tolerance limits of change (TC), and intraclass coefficient of correlation (ICC). ResultsIn healthy individuals, retinal SW was (0.734±0.236) mm at macula，and (0.781±0.243) mm at fovea; macular E was (1.169±0.619). The coefficient of variation repeatedly measured: retinal SW was (8.7±68)%，retinal SW at the fovea was (8.5±6.7)%, and the average was (15.6±13.9)%; 95%TC of intra-subject sequential repeated measurement was 0.131 (8.9%) of retinal SW, 0.137 (10.5%)of fovea SW，and 0.198 (7.4%) of average E. ICC of one individual repeatedly measured by one operator was 0.950 of macular SW, 0.949 of fovea SW, and 0.898 of average edema index.ConclusionsHRT-II MEM is noninvasive, fast and highly reproducible, which provides a new technique to monitor the objective quantification of macular diseases related to retinal thickness. ( Chin J Ocul Fundus Dis, 2005,21:103-105)
Objective To explore the positive rate of scanning laser ophthalmoscope in the retromode (RM-SLO) in different types of diabetic macular edema (DME), and to analyze its correlation with foveal thickness (CMT) and macular volume. MethodsFrom March to May 2021, 40 patients (65 eyes) were diagnosed as DME by fundus examination combined with optical coherence tomography (OCT) in Affiliated Eye Hospital of Wenzhou Medical University at Hangzhou were included in the study. All eyes underwent best corrected visual acuity (BCVA), OCT and RM-SLO fundus imaging examinations, 47 eyes underwent fluorescein fundus angiography (FFA) examination. RM-SLO fundus imaging examinations were performed with Mirante SLO, including retro mode illumination deviated right (RMDR) and retro mode illumination deviated left (RMDL). If one or more of the RMDR and RMDL of the examined patient can identify macular edema, RM-SLO was considered to be able to identify macular edema. The macular volume at CMT and 6 mm from the fovea was measured by OCT software. DME were divided into 3 types based on OCT images: diffuse retinal thinkening (DRT) type; cystoid macular edema(CME) type; serous retinal detachment (SRD) type, focal leakage type, diffuse leakage type and diffuse cystic leakage type. The consistency of RMDR and RMDL in the diagnosis of DME in RM-SLO fundus imaging was evaluated, as well as their positive rate in different classifications of DME. The correlation between the detection of macular edema by RM-SLO and the DME type, CMT and foveal volume, and the correlation between BCVA and edema type, CMT and macular volume were analyzed. ResultsAmong 65 eyes, the positive rates of RMDR and RMDL fundus imaging to detect DME were 46 (70.77%, 46/65) and 48 (73.85%, 48/65), respectively. There was good consistency in identifying DME (Kappa value=0.770; P＜0.001). The positive rates of RMDR and RMDL fundus imaging DRT, CME and SRD type of DME were 42.11% (8/19), 57.89% (11/19), 77.78% (28/36), 77.78% (28/36), 100.00% (10/10), 90.00% (9/10), respectively. In the FFA classification of them, the positive rates of focal leakage, diffuse leakage and diffuse cystic leakage were 68.75% (11/16), 62.50% (10/16), 68.00% (17/25), 76.00% (19/25), 100.00% (6/6), 100.00% (6/6), respectively. The results of Spearman correlation analysis showed that whether RM-SLO could identify DME was associated with CMT and OCT classification (r=0.310, 0.365; P=0.120, 0.003); there was no correlation between FFA classification and macular volume (r=0.113, 0.117; P=0.449, 0.352). BCVA was correlated with CMT and macular volume (r=0.307, 0.269; P=0.013, 0.030), however, there was no significant correlation with OCT type, angiographic type (r=0.051, 0.175; P=0.684, 0.240). ConclusionThe diagnostic agreement of DME are good between RMDR, RMDL of RM-SLO image. DME of DRT type and patients with smaller CMT in OCT are difficult to identified by RM-SLO fundus imaging.