As a neurodegenerative disease of the retina, glaucoma can cause irreversible vision loss in patients. More and more evidences indicate that systemic blood flow abnormalities, decreased optic nerve blood flow, and retinal microcirculation disorders are related to the mechanism of glaucoma ganglion injury. Optical coherence tomography (OCTA) has the advantages of non-invasive, high resolution, quick inspection, three-dimensional imaging, and quantitative blood flow perfusion. Compared with other blood flow detection methods such as color ultrasound Doppler, laser speckle blood flow imaging, etc. it has higher performance and accuracy, and is easier to be applied in clinical practice. OCTA can not only be used for the early diagnosis and follow-up of glaucoma, but has a strong correlation with retinal nerve fiber layer thickness and visual field parameters; it can also provide objective data for the follow-up of patients with advanced glaucoma to assess the progress of the disease. In the future, OCTA is expected to become a routine detection method and follow-up method for the diagnosis of glaucoma.
ObjectiveTo observe the retinal reattachment of suprachoroidal injection with sodium hyaluronate in the treatment of rhegmatogenous retinal detachment (RRD).MethodsTwelve eyes of 12 patients with RRD diagnosed by the examinations of B-mode ultrasound, binocular indirect ophthalmoscope, OCT and scanning laser ophthalmoscope in West China Hospital of Sichuan University from October 2018 to February 2019 were included in this study. There were 7 males and 5 females, aged from 15 to 66 years, with the mean age of 32.40±14.81 years. There were 4 eyes with BCVA＜0.1, 4 eyes with BCVA 0.1-0.4, 4 eyes with BCVA＞0.4. The extent of retinal detachment involves 1 to 4 quadrants. All eyes were injected with sodium hyaluronate via suprachoroidal space under non-contact wide-angle system. Surgery was performed by the same ophthalmologist with extensive surgical experience. During the operation, the retinal hole was handled with scleral freezing and laser photocoagulation. The follow-up was 2 months. The retinal reattachment was observed.ResultsOf the 12 eyes, 6 eyes (50.00%) were anatomically reattached, 4 eyes (33.33%) ere partly anatomically reattached with subretinal fluid, 2 eyes (16.67%) were not reattached. The holes in 4 eyes of partly anatomically reattached with subretinal fluid were located on the choroidal pad and the holes were closed, in addition, the subretinal fluid gradually absorbed over time. Two eyes failed in retinal reattachment received vitrectomy with silicone oil tamponade or sclera buckling surgery. No severe complications such as endophthalmitis and choroidal hemorrhage were found at follow-up visits.ConclusionSuprachoroidal injection of sodium hyaluronate is an effective and safe treatment for RRD, which can promote retinal reattachment.