Dome-shaped macula (DSM) of high myopia has been described as an inward convexity or bulge of the macular within the concavity of the posterior staphyloma in highly myopic eyes, with the bulge height over than 50 μm, which can be observed by optical coherence tomography. There are three patterns of DSM, including the typical round dome, the horizontally oriented oval-shaped dome and the vertically oriented oval-shaped dome. The pathogenesis of DSM development remains unclear, several hypotheses have been suggested, such as localized choroidal thickening in the macular area, relatively localized thickness variation of the sclera under the macula, resistance to deformation of sclera staphyloma, ocular hypotony and tangential vitreoretinal traction. Vision-threatening macular complications of DSM including serous retinal detachment, choroidal neovascularization, foveoschisis and retinal pigment epithelial atrophy. Clinically, asymptomatic patients with DSM mainly take regular follow-up observation. Appears serous retinal detachment and significant visual impairment, treatment with half-dose photodynamic therapy, supplementary of laser photocoagulation or oral spironolactone may have a beneficial effect. However, more large clinical studies are required to confirm the exact efficacy of these treatments.
Purpose To observe the features of multi-focal electroretinogram (mERG) in Stargardtprime;s disease, and evaluate the validity of mE RG on diagnosis of this disease. Methods mERG had been recorded in 7 cases (14 eyes) of Stargardtprime;s disease with VERIS 4.0，and the findings were compared with normal individuals. Results The mERG were remarkably abnormal in all cases of the disease, as the amplitudes of N1 and P1 waves were seriously decreased and the latencies were prolonged in all the 6 regions (Plt;0.01). The degrees of the amplitude changes of N1, P1 waves were not the same in those areas,and the most decreased part was in fovea. The responses of N1, P1waves from the fovea of patients were about 19 and 10 percent respectively of which in controls. As the eccentricity enlarged, these differences had a tendency of reduction. The mERG topography of this disease could be divided to two types, i.e. central decreased and diffuse decreased types. Conclusion There are remarkably abnormalities on mERG in Stargardtprime;s disease,and the most damaged location of macular function is in fovea. (Chin J Ocul Fundus Dis, 2001,17:271-273)
ObjectiveTo observe the effect of epinephrine in intraocular irrigation solution on retinal vascular caliber and macular thickness. MethodsA prospective control study. 32 eyes of 32 patients with macular hole who underwent vitrectomy were enrolled in this study. The patients including 14 males (14 eyes) and 27 females (18 eyes), with the average age of (64.0±4.5)years. Uncorrected visual acuity, corrected visual acuity, slit lamp biomicroscopy, indirect ophthalmoscopy, fundus color photography and optical coherence tomography were performed in all patients. Retinal vascular caliber located in 0.5-1.0 disc diameter from optic disk was measured from digital fundus photographs and summarized as central retinal artery (CRAE) and vein (CRVE) equivalents in all eyes at baseline and at the 1 month, 3 months follow-up visit. The macular thickness is the distance from retinal interface of inner plexiform layer to retinal pigment epithelium layer. The macula was divided into inner ring ( < 3 mm) and outer ring (3-6 mm) according to the distance from the fovea. The patients were divided into experiment group (include epinephrine in intraocular irrigation solution, 1:1000) and control group (without epinephrine in intraocular irrigation solution), 16 eyes in each group. The difference of CRAE and CRVE between two groups was not significant (P > 0.05). The difference of macular thickness between inner ring and outer ring was not significant (P > 0.05). The average follow-up was 3.5 months. CRAE, CRVE and macular thickness in inner ring and outer ring before and 1 month, 3 months after surgery were comparatively analyzed. ResultsThe differences of CRAE and CRVE before and 1, 3 months after surgery both in experiment group (tCRAE=0.322, 0.148; tCRVE=0.317, 0.005) and control group (tCRAE=0.226, 0.137; tCRVE=0.284, 0.151) were not significant (P > 0.05). The differences of CRAE (t=0.624, 0.424) and CRVE (t=0.015, 0.041) between experiment group and control group also were not significant (P > 0.05). The differences of macular thickness in inner ring and outer ring before and 1, 3 months after surgery both in experiment group (tinner=0.322, 0.148;touter=0.317, 0.005) and control group (tinner=0.226, 0.137;touter=0.284, 0.151) were not significant (P > 0.05). The differences of macular thickness in inner ring (t=1.568, 0.373) and outer ring (t=-1.697, 0.536) between experiment group and control group also were not significant (P > 0.05). ConclusionEpinephrine (1:1000) in intraocular irrigation solution has no effect on retinal vascular caliber and macular thickness in patients with macular hole.
Objective To test the hypothesis that the macular pigment may be a marker of foveal cone function and consequently the structural integrity of foveal cones.Methods Sixteen patients (32 eyes) diagnosed to have Stargardt dystrophy and three patients with full thickness macular holes by clinical criteria were studied with a scanning laser ophthalmoscopy (SLO) comparing argon laser blue and infrared images for the presence or absence of macular pigment (MP) in the fovea. An C++ computer based program was used to evaluate the density of MP. Eyes were graded into three categories: those without foveal macular pigment, those with partial pigment and those with normal amounts of macular pigment. These categories were compared with visual acuity determined by the Snellen chart. Results Thirteen eyes with a visual acuity of 20/200 or worse had no macular pigment in the fovea. Eleven eyes with visual acuity of 20/40 or better had a normal amount of macular pigment in the fovea and 1 eye had partial macular pigment. Eleven eyes with partial macular pigment had intermediary acuity value.Conclusions Foveal macular pigment is closely related to foveal cone acuity and therefore may be a marker for the presence of foveal cones. Infrared light is a sensitive indicator of early macular diseases.(Chin J Ocul Fundus Dis，2003，19：201-268)
Purpose To investigate the association between the macular volume and thickness, as assessed by optical coherence tomography (OCT), with refraction state and axial length (AL) in children. Methods A total of 100 normal children whose right eyes were randomly selected were divided into five groups due to their refraction, comprising hyperopia, emmetropia, low myopia, moderate myopia, high myopia. The AL of the eyes was measured by IOL mas ter measuring machine. Then the macular volume and thickness were measured by OCT. Results Children with high myopia have smaller macular volume and thinner parafoveal retinal thickness (especially out-ring macular). The minimum thickness and average thickness of the fovea were not significantly different among the five groups. The macular volume ,total average macular thickness and quadrant-specific macular thickness(except the nasal inner quadrants) were positively associated with refraction and negatively associated with AL, while t here were no correlation between minimum foveal thickness, the average foveal th ickness and refraction or AL. Conclusions In Chinese children, increasing axial length was associated with reduced macular volume and thickness (except the foveal region and the nasal inner quadrant). (Chin J Ocul Fundus Dis,2008,24:114-117)
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)