Objective To observe the visual field loss after 577 nm krypton pan-retinal photocoagulation (PRP) in the treatment of diabetic retinopathy (DR). Methods A prospective clinical studies. Forty-six eyes of 26 patients with proliferative DR (PDR) and severe non-proliferative DR (NPDR) diagnosed by clinical examination from No. 306 Hospital of PLA during January 2014 and December 2015 were included in this study. Among them, 21 eyes of NPDR and 20 eyes of PDR; 13 eyes with diabetic macular edema (DME) (DME group) and 28 eyes without DME (non-DME group). All eyes underwent best corrected visual acuity (BCVA), fundus color photography, fundus fluorescein angiography (FFA) and optical coherence tomography (SD-OCT) examinations. The visual field index (VFI) and visual field mean defect (MD) values were recorded by Humphrey-7401 automatic visual field examination (center 30° visual field). The BCVA of DR eyes was 0.81±0.28; the VFI and MD values were (89.8±8.4)% and −7.5±3.85 dB, respectively. The BCVA of the eyes in the without DME group and DME group were 0.92±0.20 and 0.57±0.27, the VFI were (90.86±7.86)% and (87.46±9.41)%, the MD values were −6.86±3.43 and 8.87±4.48 dB. PRP was performed on eyes using 577 nm krypton laser. The changes of VFI, MD and BCVA were observed at 1, 3, and 6 months after treatment. Results Compared with before treatment, the VFI of DR eyes decreased by 12.0%, 12.3% and 14.8% (t=7.423, 4.549, 4.79; P＜0.001); the MD values were increased by −4.55, −4.75, 6.07 dB (t=−8.221, −5.313, −5.383; P＜0.001) at 1, 3 and 6 months after treatment, the differences were statistically significant. There was no difference on VFI (t=1.090, −0.486; P＞0.05) and MD value (t=−0.560, −0.337; P＞0.05) at different time points after treatment. Compared with before treatment, the BCVA was significantly decreased in DR eyes at 1 month after treatment, the difference was statistically significant (t=2.871, P＜0.05). Before and after treatment, the BCVA of the DME group was lower than that of the non-DME group, the difference were statistically significant (t=4.560, 2.848, 3.608, 5.694; P＜0.001); but there was no differences on the VFI (t=1.209, 0.449, 0.922, 0.271; P＞0.05) and MD values (t=1.582, 0.776, 0.927, 1.098; P＞0.05) between the two groups. Conclusion The range of 30° visual field loss is about 12%-14.8% after 577 nm krypton laser PRP for DR. VFI and MD can quantitatively analyze the and extent of visual field loss after PRP treatment.
ObjectiveTo evaluate the macular visual function of patients with myopic choroidal neovascularization (MCNV) before and after intravitreal injection of conbercept.MethodsA prospective, uncontrolled and non-randomized study. From April 2017 to April 2018, 21 eyes of 21 patients diagnosed as MCNV in Shanxi Eye Hospital and treated with intravitreal injection of conbercept were included in this study. There were 9 males (9 eyes, 42.86%) and 12 females (12 eyes, 57.14%), with the mean age of 35.1±13.2 years. The mean diopter was −11.30±2.35 D and the mean axial length was 28.93±5.68 mm. All patients were treated with intravitreal injection of conbercept 0.05 ml (1+PRN). Regular follow-up was performed before and after treatment, and BCVA and MAIA micro-field examination were performed at each follow-up. BCVA, macular integrity index (MI), mean sensitivity (MS) and fixation status changes before and after treatment were comparatively analyzed. The fixation status was divided into three types: stable fixation, relatively unstable fixation, and unstable fixation. The paired-sample t-test was used to compare BCVA, MI and MS before and after treatment. The x2 test was used to compare the fixation status before and after treatment.ResultsDuring the observation period, the average number of injections was 3.5. The logMAR BCVA of the eyes before treatment and at 1, 3, and 6 months after treatment were 0.87±0.32, 0.68±0.23, 0.52±0.17, and 0.61±0.57, respectively; MI were 89.38±21.34, 88.87±17.91, 70.59±30.02, and 86.76±15.09, respectively; MS were 15.32±7.19, 21.35±8.89, 23.98±11.12, 22.32±9.04 dB, respectively. Compared with before treatment, BCVA (t=15.32, 18.65, 17.38; P＜0.01) and MS (t=4.08, 3.50, 4.26; P＜0.01) were significantly increased in the eyes 1, 3, and 6 months after treatment. There was no significant difference in the MI of the eyes before treatment and at 1, 3, and 6 months after treatment (t=0.60, 2.42, 2.58; P＞0.05). Before treatment and at 1, 3, and 6 months after treatment, the proportion of stable fixation were 28.57%, 38.10%, 38.10%, 33.33%;the proportion of relatively unstable fixation were 47.62%, 47.62%, 52.38%, 57.14% and the proportion of unstable fixation were 23.81%, 14.28%, 9.52%, 9.52%, respectively. The proportion of stable fixation and relatively unstable fixation at 1, 3 and 6 months after treatment were higher than that before treatment, but the difference was not statistically significant (x2=1.82, 1.24, 1.69; P＞0.05).ConclusionBCVA and MS are significantly increased in patients with MCNV after intravitreal injection of conbercept.
Objective To investigate the distribution properties of multifocal pattern visual evoked potential across visual field. Methods Multifocal pattern visual evoked potentials(VEP) of 14 normals were measured with VERIS ScienceTM4.0The visual stimuli were dart board 60 with patterns which consisted of 60 patches arranged in dart board configuration spanning a 26deg; vis ual field. The temporal modulation of each patch was controlled by a special type of pseudorandom sequence called binary m-sequence. The electrodes were placed at equal distances 2 cm inferior to and 2 cm superior to and straddling the inion. The first slice of the second order kernel for each stimulus patch was analysed. The 60 patches were grouped into several sectors. The summed responses of these sectors were analysed and compared. Results Compared with that of the lower hemifield , the polarity of the multifocal VEP of the upper hemifield was reverse, and the latency delayed, the response density decreased. With the eccentricity increased, the response density of the multifocal VEP decreased. The properties of the multifocal VEP of the horizontal sectors were different from that of the vertical sectors. Conclusion VEP of many locations within visual field could be recorded simultaneously in a short time with the method of mutifocal VEP. The multifocal VEP showed different properties in different sectors within visual field. (Chin J Ocul Fundus Dis, 2001,17:280-283)
ObjectiveTo observe the clinical efficacy of oral glucocorticoids in the treatment of acute non-arteritic anterior ischemic optic neuropathy (NAION).MethodsA prospective clinical study. From December 2017 to June 2020, 40 eyes of 40 patients with acute NAION who were diagnosed in Department of Ophthalmology of Tengzhou Central People's Hospital were included in the study. All the affected eyes underwent best corrected visual acuity (BCVA) and optical coherence tomography (OCT) examination of optic disc; 35 eyes (BCVA≥0.1) underwent visual field examination at the same time. The BCVA examination was carried out using the international standard decimal visual acuity chart, which was converted into the logarithm of the minimum angle of resolution (logMAR) visual acuity during statistics. The static visual field inspection was performed with Humphrey automatic perimeter to obtain the average mean deviation (MD) value. The thickness of peripapillary retinal nerve fire layer (pRNFL) around the optic disc of the affected eye was measured with an OCT instrument. According to the wishes of patients, they were divided into hormone treatment group and control group. All were given vitamin B1 and methylcobalamin orally; the hormone treatment group was given oral prednisone acetate treatment, 60 mg/d (regardless of body weight); after 2 weeks, the dose was reduced by 5 mg every 5 days, and the dose was reduced to 40 mg and maintained until optic disc edema subsides; thereafter, the dose was quickly reduced until the drug was stopped. Three and 6 months after treatment, the same equipment and methods were used for related examinations before treatment to observe the thickness changes of BCVA, MD, and pRNFL. The thickness of BCVA, MD, and pRNFL between the two groups was compared by Mann-Whitney U test. The thickness of BCVA, MD, and pRNFL before and after treatment within the group was compared by rank analysis of variance. ResultsAmong 40 eyes of 40 cases, 21 eyes were in the hormone treatment group, and 19 eyes were in the control group. There were differences in age, sex composition, course of disease, associated systemic risk factors, BCVA, MD, and pRNFL thickness between the two groups. There was no statistical significance (P＞0.05). At 3 and 6 months after treatment, the average logMAR BCVA of the eyes of the hormone treatment group and the control group were 0.26±0.32, 0.26±0.34, 0.28±0.30, 0.25±0.32, respectively. The visual field MD were －15.52±6.87, －15.55±6.04 dB and －14.82±7.48, －15.18±6.40 dB; pRNFL thickness was 70.38±10.22, 73.79±11.82 μm and 65.67±10.07, 69.26±10.85 μm. LogMAR BCVA (Z=－0.014, －0.315; P=1.000, 0.768), visual field MD (Z=－0.041, －0.068; P=0.979, 0.957), pRNFL thickness (Z= －0.965, －1.112; P=0.347, 0.270), the difference was not statistically significant. ConclusionCompared with the control group, oral glucocorticoid treatment of acute NAION fail to improve the visual function and morphological prognosis during the 6-month follow-up period.
Objective To investigate the characteristic of the multifocal visual evoked potentials(MVEP)and the visual function across the visual field in anisometropic amblyopes and isometropic amblyopes. Methods MVEP from 32 anisometropic amblyopic eyes and 31 control eyes were tested. Results In anisometropic amblyopic eyes,the latencies of MVEP were significantly prolonged．The amplitudes of MVEP were significantly attenuated in the central region of the visual field,and these phenomena gradually reduced with the increase of the eccentricity． Conclusion The visual function of anisometropic amblyopic eyes is reduced more significantly in the central region than in the peripheral region of the visual field. (Chin J Ocul Fundus Dis,20000,16:27-29)
ObjectiveTo investigate the difference in microperimetry between acute and chronic central serous chorioretinopathy (CSC). MethodsCross-sectional cases study. A consecutive series of 208 patients (221 eyes) with CSC diagnosed by fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) were enrolled in the study. The patients were divided into acute group (136 patients, 143 eyes) and chronic group (72 patients, 78 eyes) according to the duration and FFA. There were no statistical difference in sex (χ2=0.012, P=0.912) and mean age (t=-1.492, P=0.137) between two groups. All eyes received the examination of microperimetry and minimum resolution angle in logarithmic (logMAR) best corrected visual acuity (BCVA). The mean retinal sensitivities (MS) and fixation rate in the central 2°(P1) and 4° (P2) were determined. ResultsThe mean value of logMAR BCVA in acute group and chronic group were 0.32±0.23 and 0.48±0.33, there was significant difference (Z=-3.353, P=0.001). In acute group and chronic group, the MS were (21.25±5.06) and (15.82±7.23) dB, P1 were (76.36±25.78)% and (55.01±32.34)%, P2 were (92.21±13.06)% and (79.83±23.11)%. There were statistical differences in MS (Z=-5.456, P < 0.001), P1 (Z=-4.629, P < 0.001) and P2 (Z=-4.265, P < 0.001) between two groups. In acute group, fixation was stable in 98 eyes (68.5%), relative unstable in 30 eyes (21.0%), unstable in 15 eyes (10.5%). In chronic group, fixation was stable in 30 eyes (38.5%), relative unstable in 22 eyes (28.2%), unstable in 26 eyes (33.3%). The difference of fixation between two groups was statistically significant (χ2=23.196, P < 0.001). ConclusionMS, fixation rate and fixation stability in chronic CSC eyes were all decreased compared with acute CSC eyes.
Objective To observe visual field outcome and refractive status of patients with retinopathy of prematurity (ROP) treated by laser photocoagulation. Method The data of 39 ROP patients (73 eyes) who received laser photocoagulation were retrospectively analyzed and compared with 13 normal control subjects (25 eyes) whose age and sex were matched with ROP group. There were 24 males (45 eyes) and 15 females (28 eyes) in ROP group, with an average age of (7.0±1.28) years. The first laser treatment was carried out at postnatal age (PA) of (38.74±3.82) weeks, the birth weight (BW) of (1402.33±369.61) g and the number of laser burns was (517.86±277.40). The control group included 7 females (13 eyes) and 6 males (12 eyes), with an average age of (7.17±0.96) years. The age (t=0.691) and gender (χ2=1.425) were comparable between the two groups (P=0.491, 0.233). The data of patients and controls were retrospectively analyzed including best corrected visual acuity, refractive examination, automated perimetry test. The differences of the mean deviation (MD) of visual field and the spherical equivalent (SE) between these two groups were comparatively observed. ROP patients were divided into no VF loss group (MD≤2 dB) and VF loss group (MD＞2 dB), mild VF loss group (MD≤6 dB) and moderate VF loss group (MD＞6 dB) according to the results of automated perimetry test, the differences of gestational age (GA), PA, BW, number of laser burns and SE between these groups were comparatively observed. Results The MD in ROP group and control group were 4.87±5.12 dB and 1.27±3.34 dB, respectively; the difference between the two groups was statistically significant (t=–4.01,P＜0.001). The subgroup analysis showed that BW, number of laser burns, and SE were significantly different between no VF loss group and VF loss group (t=2.074, –1.996, –2.162;P=0.042, 0.026, 0.034); while the GA was not significantly different between these two groups (t=1.973,P=0.052). The difference of PA was not statistical significant different between mild VF loss group and moderate VF loss group (t=2.03,P=0.051) and SE was significantly different between the above two groups (t=3.283,P=0.002). For refractive outcomes, the BW and ROP stage correlated with SE significantly (r=–0.304, –0.387;P=0.015, 0.002). The mean BCVA in ROP group was 0.84±0.23, and 59 eyes (91.2%) with BCVA better than 0.5. Conclusion Laser treatment for ROP tends to have less effect on long term refractive status and VF loss, with good visual outcome.
Objective To observe the microperimetry performance of macular function in pathologic myopia patients. Methods The clinical data of 90 patients (142 eyes) with pathologic myopia were retrospectively analyzed. All patients were asked in details about history, and take examinations of best corrected visual acuity (BCVA), refractive dioptre, eye axis, fluorescent fundus angiography (FFA), indirect ophthalmoscopy and optical coherence tomography (OCT). According to the test results, patients were divided into non-pathological macular group (20 patients, 24 eyes) and pathological macular group (70 patients, 118 eyes). Retinal imaging and macular microperimetry were measure by MP-1 Microperimeter.The mean retinal sensitivities (MS) and fixation stability in the central 10deg;, fixation rate and fixation position in the central 2deg; and 4deg;were determined.Results The MS of pathological and non-pathological macular group were(16.39plusmn;2.12), (10.80plusmn;4.53) dB respectively, the difference was statistically significant(F=15.044,t=-9.314;P=0.000). Among 24 eyes of non-pathological macular group, fixation was stable in 19 eyes (79.17%), relative unstable in five eyes (20.83%); among 118 eyes of pathological macular group, fixation was stable in 45 eyes (38.14%), relative unstable in 52 eyes (44.07%), unstable in 21 eyes (17.79%), the difference was statistically significant(chi;2=13.56, P=0.000). The differences of 2 deg;and 4 deg;fixation rate between those two groups are statistically significant (F=5.773, 13.230; t=-4.110,-5.465;P=0.000) . Among 24 eyes of non-pathological macular group, center fixation occurred in 23 eyes (95.83%), weak center fixation occurred in one eye (4.17%); among 118 eyes of pathological macular group, fixation center occurred in 81 eyes (68.64%), weak center fixation occurred in 16 eyes (13.56%)，eccentric fixation occurred in 21 eyes (17.80%), the difference was statistically significant (F=9.618,t=-5.773；P=0.000).Conclusion Pathological myopia patients with pathological macular changes have decreased retinal sensitivity, decreased fixation stability and eccentric fixation points.
ObjectiveTo observe the full-field ERG (ff-ERG) characteristics of patients with acute regional occult outer retinopathy (AZOOR).MethodsA retrospective observational study. From June 2017 to June 2019, 62 eyes of 42 patients (AZOOR group) who were diagnosed with AZOOR in the Department of Ophthalmology of West China Hospital of Sichuan University were included in the study. All patients had no obvious localized disease on the fundus. Among 62 eyes, BCVA of 16 eyes were＜0.1, BCVA of 27 eyes were ≤0.5, and BCVA of 19 eyes were＞0.5. From June 2018 to January 2019, 40 normal volunteers (80 eyes) who attended the outpatient clinic of West China Hospital of Sichuan University and passed detailed ophthalmological examination to exclude all eye diseases including refractive errors were selected as the normal control group. All the examined eyes were tested with ff-ERG using the German Roland visual electrophysiological inspection system. The peak times and amplitudes of the waveforms induced by each response of dark adaptation 0.01 ERG, dark adaptation 3.0 ERG, dark adaptation 3.0 ERG, light adaptation 3.0 ERG, and light adaptation 30 Hz flicker ERG were recorded, respectively. The peak time and amplitude of each ff-ERG response between the two groups were compared by independent sample t test. The peak time and amplitude of each ff-ERG response between different BCVA eyes in the AZOOR group were compared by variance test.ResultsCompared with the normal control group, 0.01 ERG b wave of the dark adaptation of AZOOR group (t=3.601, －6.120), 3.0 ERG a wave and b wave of dark adaptation (t=2.627, －4.263, 3.719, －5.866), 3.0 Oscillation potential P2 wave of dark adaptation (t=－6.625), 3.0 ERG a wave and b wave of bright adaptation (t=3.762, －3.612, 3.648, －3.739) and 30 Hz flicker ERG P wave of bright adaptation (t=－3.832), all peak time of those were significantly delayed, the amplitude decreased, and the difference was statistically significant (P＜0.05). Comparison of different BCVA eyes in the AZOOR group showed that 0.01 ERG b wave amplitude of dark adaptation (F=3.950), 3.0 ERG a peak and b wave amplitude of dark adaptation (F=4.408, 4.876), oscillation potential P2 wave amplitude of dark adaptation (F=4.295), 3.0 ERG b wave amplitude of bright adaptation (F=4.344) and 30 Hz flicker ERG P wave amplitude of bright adaptation (F=4.483) of differences were statistically significant (P＜0.05). There was no statistically significant difference in waveform peak time and amplitude of the other reactions (P＞0.05). Pairwise comparison results showed that, compared with those with 0.1≤BCVA≤0.5 and BCVA＞0.5, those with BCVA＜0.1 dark adaptation to 0.01 ERG b wave, dark adaptation 3.0 ERG b wave, dark adaptation oscillation potential P2 wave, and light adaptation 3.0 ERG b wave and light adaptation 30 Hz scintillation ERG P wave amplitude were significantly reduced, and dark adaptation to 3.0 ERG a peak was significantly delayed, the difference was statistically significant (P＜0.05).ConclusionsThe ff-ERG of patients with AZOOR show delayed peak time and decreased amplitude of each response. The worse BCVA are accompanied by the more obvious decrease of each response amplitude of ff-ERG.
ObjectiveTo evaluate visual field changes in early mild Parkinson's disease. Methods A total of 66 eyes of 33 cases with early mild Parkinson's disease and 72 eyes of 36 age-matched normal individuals were enrolled into the study. Humphrey Field Analyzer II was applied for central visual field test. The visual field indices of mean deviation (MD) and pattern standard deviation (PSD) were analyzed to evaluate the location and the characteristics of visual field defect in this study. ResultsVisual field indices MD (-3.4±2.5) dB was significantly changed in patients with PD when compared to the controls (-0.6±1.7) dB. PSD (4.3±2.6) was significantly higher in patients with PD than that in the control group (2.1±1.8) dB. Glaucoma hemifield test (GHT) assessment was within normal limits in the controls. Of the 33 patients (66 eyes) in PD, GHT showed outside normal limits in 31 eyes, borderline in 8 eyes, and within normal limits in 27 eyes. 31 eyes outside normal limits appeared glaucomatous visual field defects, in which 16 with nasal step and 5 with arcuate defect. ConclusionsVisual field indices including MD and PSD in early mild patients with PD were significantly worse than that in the controls group. GHT abnormalities could be found in early mild PD patients with visual field defects, including pericentral scotoma and nasal step, which mimicked glaucomatous changes.