Optical coherence tomography (OCT) can depict mild papilledema and slight changes in the internal segment and external segment; measure thickness of the retinal nerve fiber layer, retinal thickness and macular volume; detect missing axons and damage to the macular ganglion cell complex. Thus, OCT has important application values and widespread prospects in diagnosis and differential diagnosis of glaucoma and nonglaucoma optic neuropathy, optic nerve diseases and macular diseases, outer and inner retinopathy as well as evaluation of curative effects, followup observation, prognosis and mechanisms in neuroophthalmological diseases. Neuro-ophthalmologists should pay more attention to the exploration and application of OCT in the field of neuro-ophthalmology.
Objective To study prospectively the morphological relations among hemorrhage of optic disc, defect of retinal nerve fiber layer, and peripapillary atrophy in normal-tension glaucoma (NTG). Methods Qualitative and quantitative methods were applied to evaluate the relations among hemorrhage of optic disc, defect of retinal nerve fiber layer, and peripapillary atrophy by using stereo ocular fundus photography and computer analyzer systems. Results In 37 patients (42 eyes) in NTG hemorrhage group, 50 hemorrhagic spots at optic disc was found, including coloboma of retinal nerve fiber layer in 35 eyes (83.3%)(35/42). In 35 patients (40 eyes) in non-hemorrahge group, partial coloboma of retinal nerve fiber layer was found in 21 eyes (52.5%)(21/40). The difference of incidence of coloboma of retinal nerve fiber layer between the two groups was not significant (chi;2=1.403, P=0.236). The incidence of atrophic arc in hemorrhage group differed much from which in non-hemorrhage group (chi;2=7.008, P=0.008). The area of atrophic arc at beta;section in hemorrhage group ［(2.05plusmn;0.88)mm2］ was significantly different from which in non-hemorrhage group［(1.42plusmn;0.53)mm2］(t=-2.618, P=0.012). In the follow-up period, the difference of incidence of disc-rim loss between hemorrhage and non-hemorrhage group was significant, (chi;2=5.802, P=0.016); while the difference of the incidence of visual field defect between the two groups was not. Conclusion In eyes with NTG, hemorrhage of optic disc, coloboma of retinal nerve fiber layer and atrophic arc are closely related. More disc-rim loss and changes of atrophic-arc area in hemorrhage group in the follow-up period suggests that hemorrhage of optic disc is the risk factor of development of NTG. (Chin J Ocul Fundus Dis, 2006, 22: 232-235)
Objective To observe the characteristics of changes of 24hour ambulatory blood pressure and heart rate of 50 patients with anterior ischemic optic neuropathy (AION). Methods Fifty patients with AION and the persons without in the control group, which had the same number, gender and age as the patients with AION, underwent 24-hour ambulatory blood pressure and heart rate measurement. Results Both groups had no difference in mean blood pressure and heart rate during the daytime (t=1.25,0.93; P＞0.05), higher than those in the nighttime (t=3.63,3.16; P＜0.05). Mean blood pressure and heart rate of AION group at night were lower than those of the control group (t=3.82,1.77; P＜0.01,0.05), especially diastolic pressure of AION group was lower than that of the control group from 2 am to 7 am (P＜0.01), as well as the heart rate from 2 am to 5 am (P＜0.05 or P＜0.01). The curves of blood pressure of AION group showed more gradual and fluctuant rising, while those of the control group showed sharper and less fluctuant rising. Conclusion According to the curves of blood pressure rising, the patients with AION may have some defects in auto-regulatory mechanism of blood pressure. The low spots of blood pressure and heart rate in early morning, which might be a critical point leading to AION. (Chin J Ocul Fundus Dis, 2002, 18: 259-261)
ObjectiveTo observe the fundus fluorescein angiography (FFA) manifestations of pediatric morning glory syndrome (MGS) patients. MethodsFourteen eyes diagnosed as MGS of 14 patients were studied. Among the 14 cases, there were 7 male and 7 female patients. At the time of FFA, the mean age of the patients was (38.75±33.91) months old, ranging from 5.5 to 128.0 months. Among the 14 eyes, four (28.57%) were associated with persistent hyperplastic primary vitreous; four (28.57%) were associated with retinal detachment with no retinal breaks, and one (7.14%) was associated with peripapillary subretinal exudation. All patients underwent peripapillary laser photocoagulation under general anesthesia first and then FFA with the third generation of wide-angle digital retinal imaging system. The arm-retinal circulation time (A-RCT), numbers of blood vessels on the edges of optic disc of the MGS eyes and the contralateral healthy eyes, retinal vascular morphology, the peripheral avascular area, neovascularization, retinal detachment and other abnormalities were documented. The horizontal and vertical diameters of the optic disc of the affected eyes and the contralateral healthy eyes were measured. To compare the A-RCT, 16 children with normal FFA were selected as control group. ResultsThe diameters of the vertical and horizontal axis of the affected eyes were as (2.56±0.58) and (2.73±0.60) times of the contralateral healthy eyes respectively. The average A-RCT of the affected eyes and eyes of the control group were (13.25±4.10) and (9.34±2.20) s respectively. The affected eyes had significantly prolonged A-RCT. At early stage, the optic disc and peripapillary areas showed hypo-fluorescence, while the irregular retinochoroidal atrophy area outside of the optic disk manifested as hyper-fluorescence ring. At late stage, optic disc showed hyper-fluorescence. Numbers of blood vessels on the edge of the optic disc of the affected eyes and contralateral healthy eyes were 30.27±4.86 and 15.83±1.95 respectively, the affected eyes had much more vessels than the contralateral healthy eyes. All affected eyes had peripheral retinal non-perfusion areas. ConclusionFFA examination showed prolonged A-RCT and peripheral retinal non-perfusion areas in the affected MGS eyes.