Objective To observe the features of the images of optical coherence tomograpy (OCT) in patients with traumatic macular hole (TMH), and detect the clinical significance of OCT. Methods Consecutive 74 patients (74 eyes) diagnosed with TMH by examinations of visual acuity, slit lamp, and direct or indirect ophthalmoscopy underwent optical coherence tomography (OCT). The analysis software of OCT was used to make the quantitative measurements of TMH. And the TMH were classified according to the morphological characteristics of the images of OCT. 50deg;color fundus photography was performed on the patients after OCT. The relationship of TMH with the average visual acuity, disease duration, average neuroepithelial thickness on the margin of hole, and the base diameter and the apex diameter of macular hole were retrospectively analyzed. Results The characterisctics of the images of 74 cases (74 eyes) of TMH were classified into 5 types: macular holes with symmetric edema of the neurosensory retina at the margin in 27 eyes (36.5%), macular holes with asymmetric edema of the neurosensory retina at the margin in 12 eyes (16.2%), macular hole with full-thickness defect of neurosensory retina without edema or detachment at the margin in 14 eyes (18.9%), macular hole with localized detachment of the neurosensory retina at the margin without edema in 17 eyes (23.0%), and macular hole with thinning neurosensory retina in 4 eyes ( 5.4%). There was no significant difference of visual acuity among different types of TMH (F=1.574, P=0.191). The visual acuity was positively related with the marginal retinal thickness (r=0.342, P=0.003), but not related to age, diameter of macular hole or the disease duration (r value was from －0.022 to －0.134，P value was from 0.863 to 0.261）. The disease duration of Type IV TMH was shorter than that of other TMH types. In the patients with the disease duration over 90 days, Type I TMH was predominant. The average retinal thicknesses at the margin of the hole showed significant differences among different TMH types (F=13.921, P=0.000). Conclusions TMH could be divided into 5 types according to the characteristics of images of OCT; the clinical characteristics of different types of TMH varies.
ObjectiveTo observe the pathological changes of central retinal artery occlusion (CRAO) by optical coherence tomography (OCT).MethodsFifty-three eyes of 53 patients who were diagnosed as CRAO in our center between January 2001 to January 2004 underwent the examination by OCT. The intervals between the disease onset and OCT examination were less than 2 weeks. The scan modes of OCT were horizontal or vertical line scan. The locations of scanning were macular, posterior pole of retina, optical papilla and the focus of bleeding or exudation.ResultsThe OCT pathological changes of CRAO in vivo includes increase of retinal thickness and reflex of retina, width of dark layer of photoreceptor (edema), edema or cystoid edema of fovea, retinal bleeding, cotton-wool spot and papilla edema. Four patients who had ciliary retinal artery showed normal retinal structure in the supply region of ciliary retinal artery.ConclusionOCT can display the pathological changes of retinal tissues in CRAO in vivo, especially on the old patients or the patients with systemic disease who were contraindicated by FFA. The unique OCT image of pathological changes of CRAO supply the objective signs for the instant clinical diagnosis.(Chin J Ocul Fundus Dis, 2005,21:74-78)
Objective To investigate the characteristics and analyze the differences of choroidal neovascularization (CNV) image between exudative age-related macular degeneration (AMD) and central exudative chorioretinopathy (CEC) using optical coherence tomography (OCT). Methods Twenty-three eyes of 22 patients with exudative AMD and 20 eyes of 19 patients with CEC, which were diagnosed as CNV using fundus fluorescein angiograph (FFA) or indocyanine green angiograph ( ICGA), were examined by OCT.The size of CNV and the thickness of retinal neurosen sory layer in foveola were measured by OCT software. Results On OCT image, CNV had three main types of morphological features including simple CNV, CNV with serous retinal neurosensory layer detachment and CNV with choroidoretinal exudation. Exudative AMD mainly showed CNV with choroidoretinal exudation (56.52%) and CEC showed simple CNV (90.0%). The thickness of retinal neurosensory layer in foveola of patients with exudative AMD was thicker than that of patients with CEC and the size of CNV of patients with exudative AMD was larger than that of patients with CEC. Negative correlation was found between retinal neurosensory layer thickness in foveola and vision in both groups (gamma;=-0.521, P=0.001). Conclusions There were certain discrepancy in morphology and area in volved of CNV between exudative AMD and CEC on OCT images. (Chin J Ocul Fundus Dis, 2001,17:299-302)