Objective To observe the morphologic alterations of retina pigment epithelial around fluorescein leakage site using spectral-domain optical coherence tomography (SD-OCT) in acute central serous chorioretinopathy (CSC) before and after laser coagulation. Methods Twenty-four eyes of 24 consecutive patients with unilateral acute CSC who underwent laser photocoagulation (wave length: 561 nm, energy: 80-100 mW, spot diamteter: 100 μm, exposure time: 0.1 s) were enrolled in this retrospective study. The patients included 22 males and 2 females, with an average age of (39.2±7.2) years and an average duration of (1.1±0.6) months. The fluorescein leakage outside the foveal avascular zone and serous retinal detachment were found in all the eyes by fluorescein fundus angiography (FFA) and SD-OCT. Twenty-six leakage sites were observed in 24 eyes on FFA. There were 5 smoky leakage points (19.2%), 21 inky leakage points (80.8%). The retinal pigment epithelial (RPE) layer at leakage points were scanned by SD-OCT before and at 2 weeks, 2 months after treatment. SD-OCT showed that the RPE abnormalities were detected at all of the fluorescein leakage points, including serous pigment epithelial detachment (PED) in 16 leakage points (64.5%), protruding RPE in 5 leakage points (19.5%), and irregular RPE in 5 leakage points (19.2%). The morphologic alterations of RPE around fluorescein leakage point before and after laser coagulation were observed. Results At 2 weeks after laser photocoagulation, PED existed in 7 leakage points (26.9%), protruding RPE in 3 leakage points (11.5%), and irregular RPE in 16 leakage points (61.5%). At 2 months after laser photocoagulation, protruding RPE existed in 3 leakage points (11.5%), and irregular RPE in 5 leakage points (19.2%), including RPE defect in 2 leakage points. And there were undetectable RPE abnormalities in other 16 leakage points (61.5%). Conclusions In acute CSC, SD-OCT shows that morphologic features of the RPE layer are changed, including PED, protruding RPE, irregular RPE around the leakage point. After laser photocoagulation the abnormalities of RPE can also be altered from PED to irregular RPE, and RPE defect is observed in restricted regions.
Objective To explore the feasibility and safety of extracorporeal membrane oxygenation (ECMO) to support the airway reconstruction for the patients with airway obstruction or stenosis who cannot be ventilated routinely. Methods There were 3 patients received trachea reconstruction procedures assisted by ECMO. Among the patients, 2 cases with tracheal neoplasms underwent fibrobrochoscopy treatments, another one with endotracheal stenosis and fistula received tracheoplasty and semi-tracheostomy. Results ECMO can provide enough oxygenation for the patients with airway obstruction or stenosis and more time for advanced therapies. All three patients recovered after interventional surgeries, in whom one case died due to multiple organ failure caused by esophageal carcinoma metastasis after 3 months, and the others survived with dyspnea classification of 2-3 grade. Conclusion ECMO can be a safe and effective approch for the patients who cannot be ventilated conventionally in airway reconstruction.
Objective To observe the macular morphology and circumpapillary retinal nerve fiber layer thickness (RNFL) in Parkinson's disease (PD) evaluated by spectral-domain optical coherence tomography (SD-OCT). Methods A total of 37 patients (74 eyes) with PD were in the PD group, 32 age- and sex-matched healthy subjects (64 eyes) in the control group. All subjects underwent SD-OCT examination with 5 line scanning, macular cube 512×128 scanning and optic disc volume 200×200 scanning. The retinal thickness, central foveal thickness (CFT), macular volume and thickness of circumpapillary, superior, inferior, nasal, and temporal of RNFL between two groups were comparatively analyzed. The relationship between SD-OCT parameters and age, disease duration, scores of Hoehn-Yahr and unified PD rating scale (UPDRS) Ⅲ in PD patients was analyzed by Pearson correlation analysis. Results Both of the retinal thickness and macular volume in PD group were significantly reduced than those in control group (t= −2.546, −3.410;P=0.012, 0.001). There was no difference of CFT (t= −0.463,P=0.644) and the thickness of circumpapillary (t= −1.645,P=0.102), superior (t= −0.775,P=0.439), inferior (t=−1.844,P=0.067), nasal (t= −0.344,P=0.732) and temporal (t= −0.541,P=0.590) of RNFL between two groups. The retinal thickness, macular volume, CFT and the thickness of circumpapillary, superior, inferior, nasal, temporal of RNFL had no relationship with age, disease duration and scores of Hoehn-Yahr and UPDRS Ⅲ in PD patients (P＞0.05). Conclusions In PD patients, the retinal thickness and macular volume are decreased, however, the circumpapillary RNFL have no obvious alterations.