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 the changes of glaucoma optic nerve head (ONH) parameters and macular ganglion cell complex (GCC) structure in preperimetric glaucoma (PPG) patients. Methods Eighteen PPG patients (18 eyes, PPG group), 22 primary open-angle glaucoma (POAG) patients (22 eyes, POAG group), and 20 patients (20 eyes) with physiologic large optic cup (physiological big optic cup group) were included in this study. Seventeen healthy volunteers (17 eyes) were the normal control. The optic nerve head and macular was scanned by fourier-domain optic coherence tomography (FD-OCT) for all subjects. The following 15 parameters, including nerve fiber layer thickness (RNFL), the optic disk rim volume (RV), optic nerve head volume (NHV), optic disc area (ODA), rim area (RA), cup volume (CV), cup/disc area ratio (CDAR), vertical cup/disc ratio (VCDR), horizontal cup/disc ratio (HCDR) and optic cup area (CA), macular GCC, superior GCC, inferior GCC thickness, focal loss of volume (FLV) and global loss of volume (GLV), were measured at 10 different quadrants. The relationship between macular GCC thickness or optic disc RNFL thickness and RA was analyzed by simple linear regression analysis. ResultsThe RNFL thickness of PPG patients was (99.29±19.93) μm (superior quadrant), (97.29±22.86) μm (inferior), (114.61±15.64) μm (superior temporal, ST), (119.22±26.19) μm (inferior temporal, IT), (116.11±39.32) μm (superior nasal, SN), (111.33±37.65) μm (inferior nasal, IN), (77.56±17.22) μm (temporal upper, TU), (76.78±10.34) μm (temporal lower, TL), (88.94± 42.54) μm (nasal upper, NU), and (82.33±43.83) μm (nasal lower, NL) respectively, which was thinner than normal control group and physiologic large cup group, but thicker than POAG patients. Compared to normal controls and physiologic large cup patients, PPG patients also had 4 parameters reduced (RV, NHV, ODA and RA), and 5 parameters increased (CV, CDAR, VCDR, HCDR and CA), the differences are statistically significant (P < 0.05). However, these parameters were similar to POAG patients (P > 0.05). For macular GCC parameters, PPG patients also had 3 parameters reduced (average GCC, superior and inferior GCC thickness), and 2 parameters increased (GLV and FLV) compared to normal control group and physiologic large cup patients (P < 0.05). However, these parameters were similar to POAG patients (P > 0.05).Simple linear regression analysis showed that, with the GCC macular thinning, reducing the number of ganglion cells reduced, optic disc RNFL thickness became thinner (regression coefficient=1.25, P=0.00) and RV reduced (regression coefficient=0.037, P=0.00). ConclusionsPPG patients and normal control had a similar distribution of optic disc RNFL. Five parameters (RV, NHV, ODA, RA, macular GCC thickness) were less than normal control and physiological big optic cup group, but had no significant differences compared with POAG group.
ObjectiveTo observe and analyze the accuracy of the optic disc positioning and segmentation method of fundus images based on deep learning.MethodsThe model training strategies were training and evaluating deep learning-based optic disc positioning and segmentation methods on the ORIGA dataset. A deep convolutional neural network (CNN) was built on the Caffe framework of deep learning. A sliding window was used to cut the original image of the ORIGA data set into many small pieces of pictures, and the deep CNN was used to determine whether each small piece of picture contained the complete disc structure, so as to find the area of the disc. In order to avoid the influence of blood vessels on the segmentation of the optic disc, the blood vessels in the optic disc area were removed before segmentation of the optic disc boundary. A deep network of optic disc segmentation based on image pixel classification was used to realize the segmentation of the optic disc of fundus images. The accuracy of the optic disc positioning and segmentation method was calculated based on deep learning of fundus images. Positioning accuracy=T/N, T represented the number of fundus images with correct optic disc positioning, and N represented the total number of fundus images used for positioning. The overlap error was used to compare the difference between the segmentation result of the optic disc and the actual boundary of the optic disc.ResultsOn the dataset from ORIGA, the accuracy of the optic disc localization can reach 99.6%, the average overlap error of optic disc segmentation was 7.1%. The calculation errors of the average cup-to-disk ratio for glaucoma images and normal images were 0.066 and 0.049, respectively. Disc segmentation of each image took an average of 10 ms.ConclusionThe algorithm can locate the disc area quickly and accurately, and can also segment the disc boundary more accurately.
ObjectiveTo compare the differences of optic nerve head (ONH) parameters and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) between acute Vogt-Koyanagi-Harada syndrome (VKH) and acute central serous chorioretinopathy (CSC) patients.MethodsRetrospective clinical case control analysis. This study included 38 eyes of 20 acute VKH patients (VKH group) and 37 eyes of 37 acute CSC patients (CSC group). Seventy five eyes of 57 normal healthy subjects, matching patients with age and gender, were collected as control group. The disc RPE angle, the thickness of average CP-RNFL, the nasal, superior, temporal and inferior quadrant CP-RNFL thickness, and ONH parameters including optic disc area, cup area, rim area, C/D area ratio, linear CD ratio (CDR), vertical CDR were measured by 3D-OCT. Analysis of variance was performed for comparison among three groups. Minimum significant difference t test was performed for comparison between two groups.ResultsThe differences of ONH parameters between VKH group and CSC group: 29 eyes of VKH group appeared retinal detachment next to disc, only 12 eyes appeared in CSC group. Twenty one eyes of VKH group appeared optic disc hyperemia while none in CSC group. The three groups’ disc RPE angles were (138.62±11.96)°, (154.09±5.85)° and (153.41±5.77)°. VKH group were significantly smaller than CSC group (t=－2.05, P=0.00) and control group (t=－1.68, P=0.00), while there was no significant difference between CSC group and control group (t=－1.88, P=0.72). The optic cup area and rim area were significantly bigger in VKH group than in CSC group (t=4.61, 2.71; P=0.00, 0.01), and the thickness of mean CP-RNFL, all quadrants of CP-RNFL were significantly thicker in VKH group than in CSC group (t=6.25, 4.40, 3.53, 5.48, 2.69; P=0.00, 0.00, 0.00, 0.00, 0.01).ConclusionCompared with the acute CSC, VKH patients are likely to appear retinal detachment next to disc, their disc RPE angles are smaller, their optic cup area and rim area are bigger, and their CP-RNFL thickness are thicker.
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.
ObjectiveTo observe the changes of optic disc structure and retinal nerve fiber layer thickness (RNFL) in patients with different degrees of Parkinson's disease (PD).MethodsThirty eyes of 30 patients with primary PD and 20 eyes of 20 healthy subjects (control group) in Xuanwu Hospital of Capital Medical University from October 2016 to October 2017 were enrolled in this study. The patients were divided into mild to moderate PD group (15 eyes of 15 patients) and severe PD group (15 eyes of 15 patients). All the patients underwent OCT examination. The optic disc area, cup area, C/D area ratio, rim volume, disc volume, cup volume, rim area, C/D area, linear C/D, vertical C/D, the thickness of average RNFL, superior, inferior, temporal upper (TU), superior temporal (ST), superior nasal (SN), nasal upper (NU), nasal lower (NL), inferior nasal (IN), inferior temporal (IT), temporal lower (TL) quadrant RNFL thickness. Analysis of variance was performed for comparison among three groups. Minimum significant difference t test was performed for comparison between two groups.ResultsOptic disc structure parameters: there was no significant difference in the area of optic disc between the three groups (F=1.226, P＞0.05). The other optic disc parameters were significantly different in the three groups (F=5.221, 5.586, 6.302, 5.926, 5.319, 5.404, 5.861, 6.603; P＜0.05). The cup area, cup volume, C/D area, linear C/D, vertical C/D of the mild to moderate PD group and severe PD group were higher than that of the control group (P＜0.05). The cup area, cup volume, C/D area, linear C/D, vertical C/D of the severe PD group were higher than those of mild to moderate PD group (P＜0.05), the rim area, rim volume and disc volume of the severe PD group were smaller than that of mild to moderate PD group (P＜0.05). The thickness of RNFL: there was no significant difference between the three groups of ST, SN, NU and NL (F=3.586, 2.852, 2.961, 2.404; P＞0.05). The average thickness of RNFL, TU, IN, IT and TL in patients of the mild to moderate PD group and severe PD group were less than that in the control group (P＜0.05). The thickness of the average RNFL, TU, IN, IT and TL in patients of the severe PD group were less than that in the mild to moderate PD group (P＜0.05). With the increase of PD severity, the RNFL of TL and TU thinned most significantly.ConclusionsWith the increase of the severity of PD, the optic disc structure and RNFL thickness changes obviously, showing reduced optic disc area and volume, enlarged cup area and volume significantly enlarged C/D ratio. The average RNFL thickness of PD patients is significantly thinner than that of the controls, and it is the most obvious in the TU and TL quadrant.
Non-arteritic ischemic optic neuropathy (NAION) is a neurological disease due to poor perfusion in optic disk. It causes severe visual function impairment, characterized by loss of vision and visual field defect. Optical coherence tomography (OCT) is vital for detecting anterior laminar depth, peripapillary nerve fiber layer thickness, ganglion cell complex thickness and peripapillary choroid thickness change in eyes with NAION at different course of the disease. In addition, OCT features are in accordance with visual function impairment. OCT angiography (OCTA) reveals retinal and choroidal vasculature networks in optic and macular area. OCTA revealed vasculature perfusion decline in eyes with NAION, even if their visual sensitivity and visual evoked potential were normal. Studying OCT and OCTA features is vital for exploring the pathogenesis and prognosis of NAION.
ObjectiveTo evaluate the clinical features of 18 cases of juxtapapillary capillary hemangioma.MethodsIn 18 cases of 18 cases of juxtapapillary capillary hemangioma,the clinical datd of 19 eyes,the results of funds fluorescein angiography(FFA) of 16 eyes ,and the follow-up observation of 7eyes were retrospectively analyzed.ResultsIn 18 cases,the sex retio of male and female is 1:2 with the average age of 28.9 years.Peripheral retinal angioma was found in 3 cases(4eyes). In19 eyes,thr center of hemangioma was located beyond the rim of optic,most of which was in inferotemporal quadrant of the optic (7/19) with the size of 1-2.5 disc diameter (DD).Most of the tumors were red in colour (12/19).In the result of FFA of 16 eyes ,wash-out at the late phase was found in 13 eyes.decreased acuity was found in all 7 cases that were followed up more than 12 months (including 5 cases treated by laser photocoagulation).retinal detachment did't occur in 6 cases without exudative retinal detachment after being follow-up for 54.5 months of the average term.ConclusionMost of the juxtapiallary capillary hemangioma are orange or red oval tumors.The center of hemangioma are located beyond the rim of the optic.The patients often complain gradually decreased visual acuity when they are in prime of their life with exudation and edema in different degree around the tumor,FFA is helpful for the diagnosis and differential diagnosis of this disease.(Chin J Ocul Fundus Dis，2004，20：1-4)
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.
ObjectiveTo observe the macular choroidal and retinal pigment epithelium (RPE) thickness in tilted disc syndrome (TDS). MethodsThis is a descriptive study. Thirty eyes of 22 TDS patients (TDS group) and 30 eyes of 15 normal subjects (control group) were analyzed. Among TDS group, there were 8 males (11 eyes) and 14 females (19 eyes), the average age was (9.00±2.78) years old. The best corrected visual acuity (BCVA) was 0.3-1.0, and the average spherical equivalent degree was (-3.44±2.22) DS. Among the control group, there were 8 males (16 eyes) and 7 females (14 eyes), the average age was (9.33±1.11) years old. The best corrected visual acuity (BCVA)≥1.0, and the average spherical equivalent degree was (-3.18±1.13)DS. The difference of the spherical equivalent degree between two groups was not statistically significant (t=-1.648, P=0.110). Enhanced depth imaging techniques of frequency-domain optical coherence tomography was used to measure the thickness of choroid and RPE at totally 17 sites. There sites included subfoveal, 4 sites each (500, 1000, 1500 and 2000 μm from the fovea) at the horizontal (nasal/temple) and vertical (superior/inferior) directions. ResultsThe subfoveal choroidal thickness was (235.53±51.77) μm and (273.45±60.3) μm in TDS patients and control respectively, the difference was significant(t=-2.612,P=0.011). The difference of the choroidal thickness of the other 8 horizontal sites (F=24.180) and 8 vertical sites (F=23.390) in TDS group was statistically significant (P=0.000). The TDS choroidal thickness of all horizontal sites except nasal 1000 μm site was thinner than corresponding sites of the control group (P<0.05). The TDS choroidal thickness of the subfoveal site and 4 inferior vertical sites was thinner than corresponding sites of the control group (P<0.05). The subfoveal RPE thickness was (32.56±5.00) μm and (36.58±3.60) μm in TDS patients and control respectively, the difference was significant(t=-3.567,P=0.001). The subfoveal RPE thickness was the thickest among other 16 sites in both groups, and the TDS RPE thickness of all sites was thinner than control group, the difference was statistically significant (P<0.05). ConclusionThe choroidal and RPE thickness of TDS patient was thinner than normal subjects.