ObjectiveTo observe the characteristics of blue light(BLAF) versus near infrared wavelength (IRAF) fundus autofluorescence in central serous chorioretinopathy (CSC) patients. MethodsSeventy-seven eyes of 81 patients diagnosed with CSC were enrolled in this study. According to the duration of disease, patients were divided into acute CSC group and chronic or recurrent CSC group. All patients were examined with fundus fluorescein angiography, including BLAF and IRAF. There were forty-six patients (47 eyes) with acute, thirty-one patients (34 eyes) with chronic or recurrent CSC. The characteristics of BLAF and IRAF in CSC were compared. ResultsIn acute CSC, there were nineteen eyes (40.4%) showed scattered hyper-fluorescence corresponding to the leaking points, eleven eyes (23.4%) showed mottled hypo-fluorescence in BLAF; while 17 eyes (36.2%) showed normal change corresponding to the leaking points. There were 35 eyes can be observed serous retinal detachments in the BLAF images, 21 eyes (60.0%) showed hypo-fluorescence and 14 eyes (40.0%) showed hyper-fluorescence. In the IRAF images, 25 eyes (53.2%) showed mottled fluorescence corresponding to the leaking points, 11 eyes (23.4%) presented with scattered hyper-fluorescent spots and normal fluorescence. The serous retinal detachments of 26 eyes exhibited hypo-fluorescence in the IRAF images. In chronic or recurrent CSC, 19 eyes (55.9%) showed scattered hyper-fluorescence corresponding to the leakage points; followed by no abnormal change in 10 eyes, accounting for 29.4%; few showed mottled hypo-fluorescence (5 eyes 14.7%). There were 35 eyes (41.2%) can be observed serous retinal detachments in the BLAF images. IRAF mainly displayed mottled hypo-fluorescence (22 eyes, 64.7%), ten eyes (29.4%) presented with scattered hyper-fluorescence and 2 eyes (5.8%) presented without abnormal change. The serous retinal detachments of 3 eyes (8.8%) exhibited hypo-fluorescence in the IRAF images. ConclusionsFor acute CSC, a variety of fluorescence were showed in BLAF images and the proportion of the various fluorescences was similar; hypo-fluorescence was showed in the IRAF images. For chronic CSC, hyper-fluorescence was showed in BLAF while hypo-fluorescence in the IRAF images.
Objective To observe the optic disc perfusion in anterior ischemic optic neuropathy (AION) patients. Methods Forty eyes of 40 AION patients and 30 eyes of 30 normal subjects were included. The stage of the diseases was defined based on the course of the disease, including acute stage (less than 3 weeks) and recovery stage (more than 3 months). Optic disc blood flow area, outer vascular density and blood flow index were measured by optical coherence tomography angiography in all the subjects. Optic disc perfusion was observed in acute and recovery stage of disease. Results The optic disc blood flow area, outer vascular density and blood flow index were decreased of AION eyes in acute stage compared with the normal subjects, the difference was statistically significant (P < 0.05); while the optic disc blood flow area, outer vascular density and blood flow index of AION eyes in the recovery stage showed no significant difference compared with normal subjects (P > 0.05). ConclusionDisc perfusion is reduced in AION at the acute stage, but recovered at the recovery stage.
Idiopathic parafoveal telangiectasis (IPT) is a retinal vascular disease which is characterized by foveal and parafoveal telangiectasia. The main clinical manifestations are retinal telangiectasis, reduced retinal transparency, retinal venular dilatation, yellow exudation, retinal pigment epithelial lesions, retinal hemorrhage, macular atrophy, macular hole or lamellar hole, subretinal neovascularization and retinal detachment. According to the clinical characteristics and features of fluorescein angiography, IPT can be divided into 3 types and 6 subtypes. Laser photocoagulation, photodynamic therapy, and intravitreal injection of glucocorticoid or anti-vascular endothelial growth factor drugs, can reduce the macular edema and neovascularization. However, due to the unclear etiology of IPT, the existing treatment measures are not specific for its etiology. We need to work hard to understand further the clinical features and pathogenesis of IPT and search the targeted treatments based on its pathogenesis mechanism.
ObjectiveTo analyze the protein expression changes in the retina of non-arteritic anterior ischemic optic neuropathy (NAION) in rats.MethodsThe rat NAION (rNAION) model was established by Rose Bengal and laser. Twenty Sprague-Dawley rats were randomly divided into 4 groups, the normal control group, the laser control group, the RB injection control group, and the rNAION model group, with 5 rats in each group. The right eye was used as the experimental eye. The retina was dissected at the third day after modeling. Enzyme digestion method was used for sample preparation and data collection was performed in a non-dependent collection mode. The data were quantitatively analyzed by SWATH quantitative mass spectrometry, searching for differential proteins and performing function and pathway analysis.ResultsCompared with the other three control groups, a total of 184 differential proteins were detected in the rNAION group (expression fold greater than 1.5 times and P＜0.05), including 99 up-regulated proteins and 85 down-regulated proteins. The expressions of glial fibrillary acidic protein, guanine nucleotide binding protein 4, laminin 1, 14-3-3γ protein YWHAG were increased. Whereas the expressions of Leucine-rich glioma-inactivated protein 1, secretory carrier-associated membrane protein 5, and Clathrin coat assembly protein AP180 were decreased. The differential proteins are mainly involved in biological processes such as nerve growth, energy metabolism, vesicle-mediated transport, the regulation of synaptic plasticity, apoptosis and inflammation. Pathway enrichment analysis showed that PI3K-Akt signaling pathway and complement and thrombin reaction pathway was related to the disease.ConclusionThe protein expressions of energy metabolism, nerve growth, synaptic vesicle transport and PI3K-Akt signaling pathway can regulate the neuronal regeneration and apoptosis in NAION.
ObjectiveTo investigate the prevalence and risk factors of tessellation fundus (TF) among Tianjin Medical University students with different refractive statuses. MethodsA cross-sectional study. From September to December 2019, 346 students from Tianjin Medical University were randomly selected and underwent slit-lamp examination, non-cycloplegic auto-refraction, subjective refraction, best-corrected visual acuity, ocular biometric measurement, and non-dilation fundus photography. The differences in the prevalence of TF in basic characteristics and ocular biometric parameters were compared. Based on the equivalent spherical (SE), refractive status was divided into the non-myopia group (SE＞－0.50 D) and the myopia group (SE≤－0.50 D). The myopia group was further divided into mild myopia group (－3.00 D＜SE≤－0.50 D), moderate myopia group (－6.00 D＜SE≤－3.00 D), and high myopia group (SE≤－6.00 D). According to the axis length (AL), the subjects were divided into AL＜24 mm group, 24-26 mm group, and ＞26 mm group. The logistic regression was used to analyze the risk factors affecting TF. Trend tests were performed for each risk factor and TF. ResultsOf the 346 subjects, 324 (93.6%, 324/346) were myopia, of whom 73 (21.1%, 73/346), 167 (48.3%, 167/346), and 84 (24.3%, 84/346) were mild myopia, moderate myopia, and high myopia, respectively; 22 (6.4%, 22/346) were non-myopia. There were 294 (85.0%, 294/346) students with TF in the macula, including 9 (40.91%, 9/22), 58 (79.45%, 58/73), 145 (86.83%, 145/167), and 82 (97.62%, 82/84) in non-myopia, low myopia, moderate myopia, and high myopia group, respectively; 52 (15.0%, 52/346) students were without TF in the macula. There were statistically significant gender differences (χ2=4.47), SE (t=6.29), AL (t=－8.29), anterior chamber depth (Z=－2.62), lens thickness (Z=－2.23), and average corneal radius (Z=－3.58) between students with and without TF in the macula (P＜0.05). Spherical equivalent and axial length were independent risk factors for TF and its severity (P≤0.001). With an increasing degree of myopia, and increasing axial length, the risk of TF increased (P for trend＜0.001). ConclusionsThe prevalence of TF is 85.0% among Tianjin Medical University students. TF is detected in the fundus of no myopia, mild myopia, moderate myopia and high myopia. The degree of myopia is higher, the AL is longer, the possibility of TF is higher.
ObjectiveTo compare the consistency and difference of nonmydriatic ultrawide field retinal imaging system versus nonmydriatic 2-field 45°digital fundus photography system in a large-scale diabetic retinopathy (DR) screening. MethodsA total of 733 with type 2 diabetic patients (1466 eyes) underwent nonmydriatic ultrawide field retinal imaging and nonmydriatic 2-field 45°digital fundus photography examination. Two independent readers graded images respectively to determine the stage of DR. A third masked retinal specialist adjudicated discrepancies. Using nonmydriatic 2-field 45°digital fundus photography examination as the standard, the consistency of nonmydriatic ultrawide field retinal imaging was evaluated. The statistic index included sensitivity, specificity, Youden index and Kappa value. The difference of two methods was analyzed by comparative t-test. ResultsBased on nonmydriatic ultrawide field retinal imaging, the results were as follows: non DR (NDR) in 1062 eyes (74.1%), DR in 340 eyes (23.7%), ungradable in 32 eyes (2.2%). Among 340 DR eyes, there were mild nonproliferative DR (NPDR) in 48 eyes, moderate NPDR in 216 eyes, severe NPDR in 57 eyes, proliferative DR (PDR) in 19 eyes. Based on nonmydriatic 2-field 45°digital fundus photography, the results were as follows: NDR in 1080 eyes (75.3%), DR in 270 eyes (18.8%), ungradable in 84 eyes (5.6%). Among 270 DR eyes, there were NPDR in 36 eyes, moderate NPDR in 175 eyes, severe NPDR in 53 eyes, PDR in 6 eyes. Compared with nonmydriatic 2-field 45°digital fundus photography for screening DR, the sensitivity was 98.0%, the specificity was 95.0%, and the kappa value was 0.87. For screening severe NPDR and PDR, the sensitivity was 100.0%, the specificity was 99.0%, and the kappa value was 0.94. The DR detection rate and the ratio of the picture can't interpretation between two methods both had significant difference (P=0.00). ConclusionsIn rapid large-scale DR screening, there is high consistency between nonmydriatic ultrawide field retinal imaging versus nonmydriatic 2-field 45°digital fundus photography. Nonmydriatic ultrawide field retinal imaging is proved to be more adaptive, and more comprehensive and precise.
Objective To observe the difference of macular microvascular features in superficial and deep vascular plexi in patients with branch retinal vein occlusion (BRVO). Methods A total of 63 BRVO patients (63 eyes) were enrolled in this study. There were 28 males (28 eyes) and 35 females (35 eyes). The patients aged from 39 to 74 years, with the mean age of (59.76±8.48) years. All eyes were evaluated by optical coherence tomography angiography (OCTA). The macular angiography scan protocol covered a 3 mm×3 mm area. The focus of angiography analysis included superficial vascular plexus and deep vascular plexus. The following vascular morphological parameters were assessed in these two plexi: foveal avascular zone (FAZ) enlargement, capillary non-perfusion (CNP) occurrence, microvascular abnormalities (MA) appearance, and vascular congestion (VC) signs. The FAZ area was measured by the built-in software. The macular microvascular morphology changes in superficial and deep vascular plexi were compared through McNemar test. Results The superficial and deep plexi showed FAZ enlargement in 43 eyes (68.3%) and 50 eyes (79.4%), CNP in 51 eyes (81%) and 50 eyes (79.4%), MA in 62 eyes (98.4%) and 62 eyes (98.4%), VC in 23 eyes (36.5%) and 52 eyes (82.5%), respectively. FAZ area was (0.55±0.37) mm2. There was no difference in CNP (P=1.000) and MA (P=1.000) between superficial and deep plexi. But, there was difference in FAZ enlargement (P=0.039) and VC signs (P＜0.001) between superficial and deep plexi. Conclusion Deep vascular plexus showed more FAZ enlargement and VC sign than superficial plexus in BRVO patients.
Objective To observe the effect of different macular edema on the area of foveal avascular zone (FAZ) and its correlation in eyes with branch retinal vein occlusion (BRVO). Methods A total of 72 patients (75 eyes) diagnosed with BRVO were included in the study. There were 40 patients males (42 eyes) and 32 females (33 eyes), with the mean age of (56.00±9.96) years. All the eyes were examined by BCVA, intraocular pressure, slit lamp microscope combined with preset lens, fundus color photography and optical coherence tomography angiography (OCTA). BRVO patients were divided into two groups according to the degree of macular edema: group M300 that was CRT ≥300 μm (38 patients, 39 eyes) and group L300 that was CRT＜300 μm (34 patients, 36 eyes). The macular angiography scan protocol covered a 3 mm×3 mm area. The parameters of macular were measured by the built-in measurement software of the system: (1) area of FAZ, perimeter of FAZ (PERIM), avascular index of FAZ (AI), vascular density within a width of 300 μm around the FAZ region (FD-300); (2) central retinal thickness (CRT); (3) vascular density (VD): the superficial central fovea vascular density (SFVD), the deep central fovea vascular density (DFVD), the superficial hemi-macular vascular density (SHVD), the deep hemi-macular vascular density (DHVD). Spearman test was used to test the correlation between FAZ area and other parameters in each group. Results The FAZ area in group M300 and L300 were 0.388±0.166 mm2 and 0.596±0.512 mm2, respectively. The results of Spearman test showed that the FAZ area of group M300 was positively correlated with PERIM and AI (r=0.932, 0.591; P=0.000, 0.000), negatively correlated with SFVD, DFVD and SHVD (r=−0.490, −0.429, −0.339; P=0.002, 0.006, 0.035). But there was no significant negative correlation between FAZ area and FD-300, CRT, DHVD in group M300 (r=−0.129, −0.053, −0.400; P=0.435, 0.749, 0.395). The FAZ area in group L300 was positively correlated with PERIM and AI (r=0.887, 0.633; P=0.000, 0.000), negatively correlated with SFVD, DFVD, SHVD and DHVD (r=−0.413, −0.643, −0.630, −0.370, −0.411; P=0.012, 0.000, 0.000, 0.026, 0.013). But there was no significant positive correlation between FAZ area and FD-300 in group L300 (r=0.093, P=0.590). Conclusion FAZ area varies with the degree of macular edema. The degree of macular edema is higher, the FAZ area is smaller. FAZ area is positively correlated with PERIM and AI significantly, and negatively correlated with SFVD, DFVD and SHVD.
ObjectiveTo observe the relationship between the response to anti-vascular endothelial growth factor (VEGF) drug treatment and single nucleotide polymorphism (SNP) genotype in patients with wet age-related macular degeneration (wAMD). MethodsA retrospective clinical study. From August 2019 to September 2020, 103 eyes of 103 wAMD patients diagnosed in Tianjin Medical University Eye Hospital were included in the study. Among them, there were 59 males (57.28%, 59/103) and 44 females (42.72%, 44/103); the average age was 68.74±7.74 years. The standard logarithmic visual acuity chart was used to detect the Best Corrected Visual Acuity of the affected eye and converted to the logarithmic minimum angle of resolution (logMAR) visual acuity during statistics. Optical coherence tomography was used to detect the central retinal thickness (CRT) of the affected eye. At the same time, the patient's high-density lipoprotein cholesterol (HDL-C) was tested. All eyes were treated with intravitreal injection of anti-VEGF drugs once a month for 3 months. Before the initial treatment, peripheral venous blood from the patient were collected. Interleukin-8 (IL-8), complement C3 gene (C3), complement factor H (CFH), liver lipase (LIPC), cholesterol ester transfer protein (CETP), ATP binding cassette subfamily a member 1 (ABCA1), lipoprotein lipase (LPL), fatty acid desaturation gene cluster (FADS1) SNP. According to gene frequency, genotypes are divided into wild type and mutant type were detected. Qualitative data such as the frequency difference of the genotype distribution in the clinical phenotype and the Hardy-Weinberg equilibrium of the genotype distribution were compared with the Chi-square test or Fisher's exact test. ResultsThere were fewer CRT responders in IL-8 rs4073 mutant (TA+AA) patients than wild-type (TT) [odds ratio (OR)=0.310, 95% confidence interval (CI) 0.106-0.910, P＜0.05). Among them, after the drug stratification test, the proportion of patients with IL-8 rs4073 locus TT genotype in the conbercept treatment group was less CRT non-responders (OR=0.179, 95% CI=0.034-0.960, P=0.033). Patients with LIPC rs2043085 mutant (CT+TT) with BCVA increased ≥0.2 logMAR are more likely than wild-type (CC) (OR=3.031, 95% CI 1.036-8.867, P＜0.05); HDL-C level was significantly lower Compared with wild type (CC), the difference was statistically significant (t=2.448, P=0.016). There was no significant difference in logMAR BCVA and CRT between IL-8 rs4073, LIPC rs2043085 mutant and wild-type patients before treatment (IL-8 rs4073: Z=－0.198, －1.651; P=0.843, 0.099; LIPC rs2043085: Z=－0.532, －0.152; P=0.595, 0.879). C3 rs 225066, CFH rs800292, CETP rs708272, ABCA1 rs1883025, FADS1 rs174547, LPL rs12678919 have no correlation with anti-VEGF drug treatment response. Conclusions Patients with wAMD are treated with anti-VEGF drugs. Those with IL-8 rs4073 locus A genotype may be less responsive to CRT. LIPC rs2043085 locus T genotypes may be relatively more responsive to BCVA.