Objective To investigate the histological changes of the internal limiting membrane (ILM) in pathological myopic eyes, and the relationships between those changes and the formation of macular hole.Methods The clinical data of 34 patients （34 eyes）with pathological myopia and macular hole, who had undergone vitrectomy were retrospectively analyzed. All the patients had a diopter over -6.00 D, their ocular axial length ranged from 26.00 to 33.12 mm with an average of 27.74 mm. There were 5 eyes without retinal detachment （macular hole group）while the other 29 eyes all had posterior retinal detachment（RD group）. A standard threeport pars plana vitrectomy was performed in all eyes. The existence of Weiss ring was considered as the sign of posterior vitreous detachment. The epiretinal membranes from 34 eyes and ILM specimens from 19 eyes were stained by hematoxylineosin (HE) and acetate uranyl acetatelead citrate, and then investigated under optical microscope and transmission electron microscope. Results The Weiss ring was observed in 5 eyes during the surgery, multilayer of vitreous tissue resides on the retinal surface in 24 eyes. The results of optical microscope showed that the epiretinal membranes were composed of vitreous collagen, astrocytes and extracellular matrixes. The results from transmission electron microscope showed a sandwich structure (ILMvitreous collagencells) in 5 eyes, and ILM damage, surface traction and astrocytes migration in 1 eye. Conclusions Splitting of posterior surface of vitreous and surface structure change of ILM are the major mechanisms for the formation and progression of macular holes, and even retinal detachment in high myopic eyes.
Objective To evaluate the prognosis of retinopathy of prematurity (ROP) following the screening and treatment guidelines of the Chinese Ministry of Public Health. Methods From December 2003 to December 2010, 1379 premature infants diagnosed with ROP were followed by binocular indirect ophthalmoscopy or fundus photography using RetcamⅡ digital camera. For the stage 1 ROP, eyes were followed every 2 weeks until the ROP regressed. For the stage 2 ROP or pre-threshold disease, eyes were followed weekly. If the ROP decreased, eyes were followed every two weeks until the ROP regressed completely. For the stage 3 ROP or acute progressive ROP (AP-ROP), eyes were followed 2-3 times weekly. If the ROP progressed to threshold or type 1 pre-threshold disease, laser therapy was performed within 72 hours. After laser treatment, eyes were followed every 1 -2 weeks. Laser or cryotherapy was conducted when the ROP progressed after first treatment. Scleral buckle and vitrectomy with closed triple incisions was conducted when the ROP progressed to stage 4 and stage 5. The period the infants were followed ranged from 6 months to 2 years (average 152.3 days). ResultsA total of 2758 eyes of 1379 infants were diagnosed with ROP. The gestational age range was 26 . 35 weeks (average 30.6 weeks) and the birth weight of 800-2200 grams (average 1424.6 grams). Four hundred eyes (14.5%) of 206 infants with threshold or type 1 pre-threshold disease were given laser treatment. Three hundred and forty-five eyes (86.2%) completely regressed, and 55 eyes (13.8%) progressed to unfavorable structural outcomes. All 2358 eyes that did not reach threshold or type 1 prethreshold disease regressed completely. The total regression rate of our study was 980%. The incidence of unfavorable structural outcomes was 2.0% including stage 4 in 32 eyes (1.2%) and stage 5 in 13 eyes (0.5%). The retina reattatched in all 6 eyes treated with scleral buckle but macular traction remained at the optic disc. In the 39 eyes treated using vitrectomy with or without lensectomy, the retina reattached completely in 17 eyes at stage 4a. In 15 eyes at stage 4b, the retina reattached completely in 10 and remained detached in 5 eyes. In the 13 eyes at stage 5, the retina reattached completely in 4, and reattached mostly in 1 eye. Conclusion The incidence of severe ROP leading to unfavorable structural outcomes can be effectively reduced by screening and timely treatment.
Objective To observe the Fourierdomain optical coherence tomography（FD-OCT）characteristic of idiopathic epiretinal membrane (ERM) and its correlation with the patients visual acuity. Methods The 116 eyes (112 patients) with idiopathic epiretinal membrane were included in this study. All the patients had undergone examination of visual acuity (LogMAR chart), ocular fundus (direct ophthalmoscope and fundus pre-set lens), and FD-OCT (Zeiss HD-OCT) with the speed of 27 000 A scan/s,area of 6.0 mmtimes;6.0 mm, and mode of 512times;128. The central fovea thickness (CFT), volume (V), average thickness (AT) were collected from the OCT readings, and the fovea thickness (FT) was measured manually. Data were analyzed using SPSS 16.0. Results The traction on retina caused by ERM can be divided into 3 types according to the OCT findings: no traction (9.48%), tangential traction (84.48%) and tangential traction with anteriorposterior traction (6.04%). A total of 97 eyes (83.62%) had retinal edema (diffuse or cystoid) and the edema located at the outer nuclear layer(ONL), outer plexiform layer(OPL)and inner nuclear layer (INL) . A total of 14 eyes (12.07%) had retinal nerve fiber layer (RNFL) schisis and 27 eyes (23.28%) had inner segment/outer segment junction (IS/OS) impairment. Statistic analysis revealed that BCVA was not related to the age, gender, types of traction, presence of IS/OS damage or RNFL schisis (Pgt;0.05), but was related with CFT(Plt;0.05). Conclusions Idiopathic ERM can exert different types of traction on the macular, and cause different types of retinal lesions. OCT is a useful tool to measure these lesions. CFT reading is closely related to patients' visual acuity.