Objective To evaluate the changes of optic nerve head (ONH) and the thickness of peripapillary retinal nerve fiber layer (RNFL) in patients with non-arteritic anterior ischemic optic neuropathy (NAION) using optical coherence tomography (OCT). Methods Circular and cross-sectional OCT scans of an area with a diameter of 3.38 mm surrounding the optic disc were performed for 108 eyes (96 cases) with NAION, including 96 eyes (96 cases) in acute edema phase and 41 eyes (37 cases) in resolving phase. Follow-up period was 2 weeks to 24 months, with an average of 6 months. Results The RNFL was thickener with shallow cup or small cups in the acute edema phase. Comparing with the RNFL in the ischemic sector, the thickness of peripapillary RNFL in the nonischemic sector was greater in 59 eyes (59 cases, 61%), lesser in 26 eyes (26 cases, 27%) and no difference in 11 eyes (11 cases, 12%). During the treatment NAION eyes were dynamically observed by OCT. While ischemic edema of the optic disc resolved in about two weeks, non-ischemic edema subsided in 3-6 weeks. After 1 month in the resolving phase, the thickness of peripapillary RNFL in the ischemic sector of 35 cases (95%) was thinner than the thickness of non-ischemic sector and fellow normal controls. After 3 month in the resolving phase, 26 cases (70%) showed thinner RNFL of whole optic disc. Conclusion The thickness of RNFL in NAION patients in acute edema phase is thicker than that in the fellow normal eyes, and is also thicker in ischemic sector than that in non-ischemic sector. In resolving phase, the thickness of RNFL is thinner in NAION eyes than that in the fellow normal eyes.
Objective To observe the characteristics of morphosis parameter of the optic disc of physiologic large cup. Methods 100 eyes with physiologic large cup and 74 eyes with normal cup were examined by Heidelberg Retina Tomograph (HRT ). The differences of morphosis parameters between two groups were analyzed comparatively on disc area (DA), cup volume (CV), cup/disc area ratio (C/DR), rim area (RA), cup volume (CV), rim volume (RV), mean cup depth (MeCD), maximum cup depth (MxCD), cup shape measure (CSM), height variation contour (HVC), mean retinal nerve fiber layer thickness (mRNFLt), and retinal nerve fiber layer cross-section area (RNFLcsa). The characteristics of the inferior, superior, nasal, and temporal quadrants of the physiologic large cups were analyzed. Results DA, CA, C/DR, CV, MeCD, CSM （P=0.00, respectively）and MxCD （P=0.04）were significantly larger in eyes with physiologic large cup than in eyes with normal cup. RA, RV, HVC, mRNFLt, RNFLcsa （P=0.00, respectively) were significantly smaller in eyes with physiologic large cup than in eyes with normal cup. The temporal quadrant of RV of the physiologic large cup is the narrowest. RNFLcsa decreased as the fol lowing order: superior, inferior, nasal, and temporal（P＜0.05）. Conclusions Mo rphosis parameter of the optic discs of physiologic large cup has its own repres entation on characteristics. Compared to normal cups, physiologic large cups had larger discs but smaller mRNFLt. The nasal quadrant of DA was larger than the i nferior quadrant. （Chin J Ocul Fundus Dis，2008，24：213-216）
Objective:To observe the changes of the thickness of reti nal nerve fiber layer (RNFL) of optic disc in rats with chronic glaucoma continuously dete cted by optic coherence tomography (OCT). Methods:A total of 48 Wist ar rats (24 males and 24 females) were randomly divided into 3 groups with 16 ra ts (32 eyes) in each group. The right eyes were the photocoagulation eyes and the left ones were as the control. Laser photocoagulation with the wavelength of 532 nm was perfo rmed on the trabecular network of the right eyes to induce the chronic middlelevel oc u lar hypertension. The changes of the intraocular pressure (IOP) were observed. O pticdisc linear scanning of OCT was performed 3, 6, and 9 weeks after IOP incr e ased, and the thickness of RNFL of optic disc was detected by the computer. Eight rats in each group were killed and retinal histology slic es were used to detect the thickness of RNFL. The flatmount s of retina from the right eyes of the other 8 rats in each group were stai ned by 1% toluidine blue. The density of retinal ganglion cells (RGC) was calcul ated and the results were compared and analyzed. Results:IOP o f the rats increas ed chronically and moderately after photocoagulation. IOP of the experimental ey e 3,6, and 9 weeks after photocoagulation was obviously higher than which of the control eyes, respectively （P＜0.001）. The results of OCT showed that the thickness of the RNFL of the experimental eyes was (67.39plusmn;5.91) mu;m, (53.4 2plusmn;5.64) mu;m，and (44.35plusmn;5.76) mu;m 3, 6, and 9 weeks after photocoagulation, and the corresponding thickness in the control eyes was（80.32plusmn;5.87）, （79.69plusmn;5.69）, and （80.78plusmn;5.84）mu;m, respectively. The thickness of the retinal fiber layer detecte d by histological method was （64.38plusmn;6.54）, （51.47plusmn;6.4）, and （42.10 plusmn;6.10）mu;m in the experimental eyes 3, 6, and 9 weeks after photocoagulation, and (76.23plusmn;6.78), (78.64plusmn;6.15), and (77.64plusmn;6.63) mu;m in the control eyes. Regression analysis of the thickness detected by the two methods was made, and the regression coefficients was 0.932（P＜0.001）.The differ ence of the ave rage density of RGC between the two groups was significant (P＜0.05）. Conclusi on:Glaucoma model in Wistar rats may successfully set up b y photocoagulating the trabecular meshwork. The thickness of retinal nerve fiber layer of the optic disc in rats with chronic glaucoma detected by OCT and obser ved by the light m icroscope is accordant. The changes of the thickness of RNFL in rats with chroni c glaucoma could be continuously detected by OCT to investigate the progress of the glaucomatic retinopathy in rat model.
ObjectiveTo evaluate the clinical features of 18 cases of juxtapapillary capillary hemangioma.MethodsIn 18 cases of 18 cases of juxtapapillary capillary hemangioma,the clinical datd of 19 eyes,the results of funds fluorescein angiography(FFA) of 16 eyes ,and the follow-up observation of 7eyes were retrospectively analyzed.ResultsIn 18 cases,the sex retio of male and female is 1:2 with the average age of 28.9 years.Peripheral retinal angioma was found in 3 cases(4eyes). In19 eyes,thr center of hemangioma was located beyond the rim of optic,most of which was in inferotemporal quadrant of the optic (7/19) with the size of 1-2.5 disc diameter (DD).Most of the tumors were red in colour (12/19).In the result of FFA of 16 eyes ,wash-out at the late phase was found in 13 eyes.decreased acuity was found in all 7 cases that were followed up more than 12 months (including 5 cases treated by laser photocoagulation).retinal detachment did't occur in 6 cases without exudative retinal detachment after being follow-up for 54.5 months of the average term.ConclusionMost of the juxtapiallary capillary hemangioma are orange or red oval tumors.The center of hemangioma are located beyond the rim of the optic.The patients often complain gradually decreased visual acuity when they are in prime of their life with exudation and edema in different degree around the tumor,FFA is helpful for the diagnosis and differential diagnosis of this disease.(Chin J Ocul Fundus Dis，2004，20：1-4)
Objective To evaluate the effects of cold provoca tion on optic dise blood flow and retinal light sensitivity of primary open-angle glaucoma (POAG) patients,and explore the relationship between the changes of optic disc blood flow and retin al light sensitivity. Methods A total 33 POAG patients (33 eyes)and 13 normal controls (13 eyes) were tested by usin g th e Heidelberg retinal flowmetry (HRF) and Topcon automatic perimeter,and the optic disc blood flow and retinal light sensitivity of POAG patients and normal cont rols were measured at normal conditions and after cold provocation. Results The mean optic disc blood flow,volume and the mean retinal light sensitivity of POAG patients decreased significantly (Plt;0.05) after cold provocation.There was a linear and significant relationsh ip between the decrease of mean optic disc blood flow and mean retinal light sen sitivity of POAG patients (r=0.615,P＜0.001). The optic disc blood flow of POAG patients with a history of migraine were more likely to r educe in response to cold provocation and reduced much more than those without such history (Plt;0.05). Conclusion Cold provocation can significantly reduce both the optic disc blood flow and retinal light sensitivity in POAG patients.A close correlation was fo und between the amount of mean optic disc blood flow decrease and the volume of mean retinal light sensitivity decline. (Chin J Ocul Fundus Dis, 2001,17:37-40)
PURPOSE:To discuss the clinical characteristics and differential diagnosis of peripapillary subretinal hemorrhage(PPSRH). METHOD:Retrospective analysis of the clinical documents including mainly the ocular manifestations and the findings of fundus fluorescein angiography(FFA)of 37 patients (38 eyes)with PPSRH. RESULTS:In all of these 37 patients,36 were myopes, 31 were young persons ,the average age was 21 years old,and 36 were affected unilaterally. The subretinal hemorrhage revealed itself in 4 types :PPSRH (5 eyes),PPSRH with disc iaemorrhage (21 eyes),PPSRH with vitreous hemorrhage (2 eyes), and PPSRH with disc hemorrhage and vitreous hemorrhage (10 eyes). In the FFA, the hemorrhages showed blocked fluorescence and the optic discs showed irregular hyperfluorescence at the late phase. All of the hemorrhages were absorbed within 3 weeks to 3 months without any treatment. CONCLUSIONS:According to the manifestation of the optic discs in FFA PPSRH might be complicatton of the buried optic disc drusen. （Chin J Ocul Fundus Dis,1997,13: 143-145 ）
ObjectiveTo observe the macular choroidal and retinal pigment epithelium (RPE) thickness in tilted disc syndrome (TDS). MethodsThis is a descriptive study. Thirty eyes of 22 TDS patients (TDS group) and 30 eyes of 15 normal subjects (control group) were analyzed. Among TDS group, there were 8 males (11 eyes) and 14 females (19 eyes), the average age was (9.00±2.78) years old. The best corrected visual acuity (BCVA) was 0.3-1.0, and the average spherical equivalent degree was (-3.44±2.22) DS. Among the control group, there were 8 males (16 eyes) and 7 females (14 eyes), the average age was (9.33±1.11) years old. The best corrected visual acuity (BCVA)≥1.0, and the average spherical equivalent degree was (-3.18±1.13)DS. The difference of the spherical equivalent degree between two groups was not statistically significant (t=-1.648, P=0.110). Enhanced depth imaging techniques of frequency-domain optical coherence tomography was used to measure the thickness of choroid and RPE at totally 17 sites. There sites included subfoveal, 4 sites each (500, 1000, 1500 and 2000 μm from the fovea) at the horizontal (nasal/temple) and vertical (superior/inferior) directions. ResultsThe subfoveal choroidal thickness was (235.53±51.77) μm and (273.45±60.3) μm in TDS patients and control respectively, the difference was significant(t=-2.612,P=0.011). The difference of the choroidal thickness of the other 8 horizontal sites (F=24.180) and 8 vertical sites (F=23.390) in TDS group was statistically significant (P=0.000). The TDS choroidal thickness of all horizontal sites except nasal 1000 μm site was thinner than corresponding sites of the control group (P<0.05). The TDS choroidal thickness of the subfoveal site and 4 inferior vertical sites was thinner than corresponding sites of the control group (P<0.05). The subfoveal RPE thickness was (32.56±5.00) μm and (36.58±3.60) μm in TDS patients and control respectively, the difference was significant(t=-3.567,P=0.001). The subfoveal RPE thickness was the thickest among other 16 sites in both groups, and the TDS RPE thickness of all sites was thinner than control group, the difference was statistically significant (P<0.05). ConclusionThe choroidal and RPE thickness of TDS patient was thinner than normal subjects.
ObjectiveTo observe the differences of horizontal optic disc diameter and cup/disc (C/D) ratio in eyes with different kinds of retinal vein occlusion (RVO). MethodsA total of 392 eyes from 385 RVO patients diagnosed by fundus fluorescein angiography (FFA) were included in this study. The patients included 192 males and 193 females. The average age was (58.30±11.51) years. The disease duration was from 7 days to 1 month. The eyes were divided into RVO group (356 eyes), RVO combining diabetes mellitus (DM) group (20 eyes) and RVO combining high blood pressure (HP) group (16 eyes). One hundred normal eyes examined by FFA in the same testing period were selected as the control group. Among the 356 eyes in the RVO group, there were 201 eyes with branch RVO (BRVO), 100 eyes with central RVO (CRVO), 17 eyes with hemi CRVO (H-CRVO), and 38 eyes with macular BRVO (M-BRVO). Among the 101 non-ischemic RVO eyes, there were 17 eyes with BRVO, 53 eyes with CRVO, 6 eyes with H-CRVO, and 25 eyes with M-BRVO. Among the 255 ischemic RVO eyes, there were 184 eyes with BRVO, 47 eyes with CRVO, 11 eyes with H-CRVO and 13 eyes with M-BRVO. The diameter of optic cup and disk, and the C/D ratio was measured on fundus infrared radiation (IR) IR30°image by Heidelberg confocal laser fundus imaging system. ResultsThere was no significant difference of horizontal optic disc diameter among 4 groups (F=1.17, P>0.05). The difference of C/D ratio was significant among 4 groups (F=82.24, P<0.05). The differences of horizontal optic disc diameter and C/D ratio in different kinds of RVO in normal group and RVO group were significant (F=4.49, 61.396; P<0.05). The horizontal optic disc diameter of eyes with CRVO was a little smaller than normal eyes (P<0.05). There was no difference of horizontal optic disc diameter between the eyes with BRVO, M-BRVO, H-CRVO and normal eyes (P>0.05). The difference of C/D ratio was significant between the eyes with BRVO, CRVO, M-BRVO, H-CRVO and normal eyes (P<0.05). The differences of horizontal optic disc diameter and C/D ratio were significant between RVO group (in different kinds of RVO eyes) and control group (F=3.94, 33.16; P<0.05). Compared the horizontal optic disc diameters of RVO eyes with the same subtype, the difference was significant between non-ischemic H-CRVO and ischemic H-CRVO (P<0.05), while the differences were not significant between other non-ischemic RVO and ischemic CRVO (BRVO:P=0.35,CRVO:P=0.86,M-BRVO:P=0.22). The difference of C/D ratio between non-ischemic RVO and ischemic CRVO was not significant (BRVO:P=0.35,CRVO:P=0.48,H-CRVO:P=1.00,M-BRVO:P=1.00). ConclusionsThe C/D ratio increased with varying degrees in RVO eyes. There is no obvious change in horizontal optic disc diameters except for CRVO eyes.
ObjectiveTo compare the choroidal thickness (CT) of macular and peripapillary area among malignant glaucoma(MG), chronic primary angle-closure glaucoma (CPACG) and normal control eyes. And to investigate the correlation between CT and MG. Methods Sixteen subjects (32 eyes) with MG, 31 (31 eyes) with CPACG and 32 (32 eyes) normal controls were collected. MG eyes and the fellow non-MG eyes were included in the MG group. CT of all subjects was measured in the fovea, 1mm and 3mm to the fovea and peripapillary area using enhanced-depth imaging technique of optical coherence tomography (OCT-EDI). The average of CT in fovea by horizontal and vertical macular scan was defined as the average CT in fovea. The average of temporal, superior, nasal and inferior CT in 1 mm and 3 mm to the fovea were measured respectively. The average of temporal, superior, nasal and inferior CT was defined as the average CT in peripapillary area. The differences of CT among MG, CPACG and normal controls were compared. And the differences of CT between MG eyes and the fellow non-MG eyes were compared. ResultsAfter eliminating the influence of age, the average CT of MG in the fovea, 1mm and 3mm to the fovea was significantly thicker than that of CPACG and normal controls (P < 0.05). And the average CT of CPACG in the fovea, 1mm and 3mm to the fovea was significantly thicker than that of normal controls (P < 0.05). In peripapillary area, the temporal, superior and inferior CT of MG was significantly thicker than that of CPACG and normal controls (P < 0.05). There was no significant difference of CT in peripapillary area between CPACG and normal controls (P > 0.05). In the fovea, 1mm and 3mm to the fovea and peripapillary area, there was no significant difference of CT between MG eye and the fellow non-MG eye in MG group (t=－1.029~－0.130, P > 0.05). ConclusionsThe choroid thickness of macular and peripapillary area in MG eyes is thicker than that of CPACG and the normal controls. An increased CT of macular and peripapillary area may be one of the risk factors for MG.
ObjectiveTo observe the changes of glaucoma optic nerve head (ONH) parameters and macular ganglion cell complex (GCC) structure in preperimetric glaucoma (PPG) patients. Methods Eighteen PPG patients (18 eyes, PPG group), 22 primary open-angle glaucoma (POAG) patients (22 eyes, POAG group), and 20 patients (20 eyes) with physiologic large optic cup (physiological big optic cup group) were included in this study. Seventeen healthy volunteers (17 eyes) were the normal control. The optic nerve head and macular was scanned by fourier-domain optic coherence tomography (FD-OCT) for all subjects. The following 15 parameters, including nerve fiber layer thickness (RNFL), the optic disk rim volume (RV), optic nerve head volume (NHV), optic disc area (ODA), rim area (RA), cup volume (CV), cup/disc area ratio (CDAR), vertical cup/disc ratio (VCDR), horizontal cup/disc ratio (HCDR) and optic cup area (CA), macular GCC, superior GCC, inferior GCC thickness, focal loss of volume (FLV) and global loss of volume (GLV), were measured at 10 different quadrants. The relationship between macular GCC thickness or optic disc RNFL thickness and RA was analyzed by simple linear regression analysis. ResultsThe RNFL thickness of PPG patients was (99.29±19.93) μm (superior quadrant), (97.29±22.86) μm (inferior), (114.61±15.64) μm (superior temporal, ST), (119.22±26.19) μm (inferior temporal, IT), (116.11±39.32) μm (superior nasal, SN), (111.33±37.65) μm (inferior nasal, IN), (77.56±17.22) μm (temporal upper, TU), (76.78±10.34) μm (temporal lower, TL), (88.94± 42.54) μm (nasal upper, NU), and (82.33±43.83) μm (nasal lower, NL) respectively, which was thinner than normal control group and physiologic large cup group, but thicker than POAG patients. Compared to normal controls and physiologic large cup patients, PPG patients also had 4 parameters reduced (RV, NHV, ODA and RA), and 5 parameters increased (CV, CDAR, VCDR, HCDR and CA), the differences are statistically significant (P < 0.05). However, these parameters were similar to POAG patients (P > 0.05). For macular GCC parameters, PPG patients also had 3 parameters reduced (average GCC, superior and inferior GCC thickness), and 2 parameters increased (GLV and FLV) compared to normal control group and physiologic large cup patients (P < 0.05). However, these parameters were similar to POAG patients (P > 0.05).Simple linear regression analysis showed that, with the GCC macular thinning, reducing the number of ganglion cells reduced, optic disc RNFL thickness became thinner (regression coefficient=1.25, P=0.00) and RV reduced (regression coefficient=0.037, P=0.00). ConclusionsPPG patients and normal control had a similar distribution of optic disc RNFL. Five parameters (RV, NHV, ODA, RA, macular GCC thickness) were less than normal control and physiological big optic cup group, but had no significant differences compared with POAG group.