ObjectiveTo observe the morphological characteristics of retinal vessels in patients with ischemic stroke, and to preliminary analyze the correlation between retinal vascular morphological parameters and ischemic stroke. MethodsA retrospective study. From May 2015 to May 2017, 73 patients with ischemic stroke (ischemic stroke group) confirmed by examination at the Beijing Friendship Hospital, Capital Medical University were included in this study. In addition, 146 patients were included in the control group. A total of 146 patients with acute stroke who were excluded by head CT and/or magnetic resonance imaging were selected as the control group. Fundus images of patients were collected by nonmydriatic fundus camera. Retinal vascular parameters were measured by artificial intelligence fundus image analysis system, included retinal artery and vein caliber as well as vascular curvature, branching angle, fractal dimension, and density. The morphological characteristics of retinal vessels were compared between the control and ischemic stroke groups, and correlation between the retinal vascular parameters and ischemic stroke was analyzed using binary logistic regression. ResultsCompared with the control group, the ischemic stroke group had thinner retinal artery caliber, smaller retinal vascular fractal dimension, and lower retinal vascular density; moreover, these differences were statistically significant (t=3.232, 3.502, 3.280; P＜0.05). Vascular fractal dimension [odds ratio (OR)=0.291, 95% confidence interval (CI) 0.160-0.528] and retinal artery caliber (OR=0.924, 95%CI 0.870-0.981) were strongly correlated with ischemic stroke (P＜0.01). ConclusionCompared with the control group, the retinal artery caliber, fractal dimension and retinal vascular density in ischemic stroke group are smaller; decreased retinal artery caliber and fractal dimension are correlated with ischemic stroke.
ObjectiveTo explore the distribution of choroidal thickness and its influence factors in university students.MethodsA cross-sectional study. A total of 896 eyes of 896 college students were included in the study. Among them, there were 350 males (350 eyes) and 546 females (546 eyes). All the eyes were right eyes. The average age was 19.18 ± 1.36 years old. According to the spherical equivalent refraction (SER), the eyes were divided into non-myopia group, low myopia group, moderate myopia group and high myopia group, which were 59, 251, 356 and 230 eyes, respectively. The subfoveal ChT (SFCT) was measured using a swept-frequency source optical coherence tomography scanner. According to the ETDRS, the choroid within 6 mm of the fovea was divided into three concentric circles centered on the fovea of the macula, which were the central area with a diameter of 1 mm, the inner ring area of 1-3 mm and the outer ring area of 3-6 mm. The outer ring area of 3-6 mm has a total of 9 zones. The inner ring and outer ring 4 regions were superior, inferior, nasal and temporal, respectively. The distribution characteristics of ChT in different regions, genders and diopter groups were observed. Bivariate correlation analysis were used to analyze the correlation of ChT and SER, axial length (AL).ResultsThe average SFCT of 896 eyes was 221.28±67.35 μm. The mean SFCT of males and females were 227.20±69.38 and 217.50±65.80 μm, respectively. The difference of SFCT between different genders was statistically significant (t=2.075, P=0.038). Compared with the central region ChT, there was no significant difference in ChT between the outer ring and the outer region (t=0.086, P=0.932). The difference of ChT in other regions was statistically significant (t=-21.973, -5.818, 36.328, -3.065, -18.017, -10.595, 57.007; P＜0.001, ＜0.001, ＜0.001, ＜0.002, ＜0.001, ＜0.001, ＜0.001). In the horizontal direction, ChT gradually thickens from nasal to temporal (F=2 251.558, P＜0.001); in the vertical direction, ChT gradually decreases from superior to the central, but have a little increased from central to inner inferior, then decreased to outer inferior again (F=45.425, P＜0.05). Correlation analysis showed that SFCT was negatively correlated with AL (r=0.478, P＜0.01) and a negative correlation with axial length (r=−0.395, P＜0.01), and positively correlated with SER (r=0.478, P＜0.01). SFCT decreased by 12.29 μm for every in myopic refractive error of 1 D, or by 20.14 μm for every increase in AL of 1 mm.ConclusionsChT is changed by different location. The horizontal direction is gradually thickened from nasal to temporal. The vertical direction is thicker than the center. The inferior inner ring area is thicker than the outer ring area. Gender, SER and AL are the influencing factors of SFCT.
Objective To observe the changes of optic disc structure in patients with high myopia and the correlation with the morphological markers of the fundus. MethodsA retrospective study. From July 2018 to January 2020, 90 patients (155 eyes) diagnosed as high myopia in Department of Ophthalmology of Beijing Friendship Hospital affiliated to Capital Medical University were included in the study. Among them, there were 31 males (52 eyes) and 59 females (103 eyes), with age of 57.1±14.2 years old and axial length (AL) of 28.5±2.6 mm. According to the classification of myopic macular degeneration, patients were divided into 4 groups based on forms and degree of lesions, including non-pathological myopia group, mild traction lesions group, severe traction lesions group and neovascular lesions group, 35, 58, 41, 21 eyes, respectively. The digitized fundus photographs and an Image J system were used to measure the horizontal, vertical, maximal, and minimal diameter of the optic disc, the horizontal and vertical diameter of the parapapillary δ zone and γ zone, ovality index, distance between the most superior point of the temporal superior arterial arcade and most inferior point of the temporal inferior arterial arcade (VDA), angle between the temporal arterial arcade and optic disc (angle kappa), distance between the optic disc center and the fovea (DFD), angle between the horizontal disc axis and the disc–fovea line (DFA). The correlation between the diameter of the optic disc and other parameters was analyzed. Univariate and multivariate analysis were used to compare differences between groups. ResultsThe horizontal diameter of the optic disc was positively correlated with the horizontal diameter of the δ zone (r=0.300, P＜0.001), Kappa angle (r=0.260, P=0.003), and elliptic index (r=0.650, P＜0.001); it was negatively correlated with DFD (r=－0.190, P=0.030). Optic disc vertical diameter and optic disc horizontal diameter (r=0.280), δ-zone horizontal diameter (r=0.330) and vertical diameter (r=0.460), γ-zone horizontal diameter (r=0.430) and vertical diameter (r=0.390), DFD (r=0.390) was positively correlated (P<0.001); it was negatively correlated with DFA (r=－0.210, P=0.001) and Kappa angle (r=－0.210, P=0.004). Compared with the non-pathological myopia group, there were statistically significant differences in the horizontal and vertical diameters of the optic disc in the severe traction disease group (P＜0.05). Among them, the horizontal diameter difference did not depend on the eye axis and age difference; the vertical diameter difference was caused by the eye axis difference. Compared with the non-pathological myopia group, the difference in the horizontal diameter of the optic disc in the neovascular disease group was statistically significant (P＜0.05), and did not depend on the difference in the axis and age; the difference in the vertical diameter of the optic disc was not statistically significant (P＞0.05). ConclusionThe morphology of optic disc was related to several fundus morphological markers, which was differentiated according to the age, AL and the degree of disease in patients with high myopia.
Objective To observe the choroidal blood flow and morphological changes in patients with severe stenosis of internal carotid artery stenosis (ICAS). Methods A retrospective case-control study. Forty-six patients (46 eyes) with ICAS were enrolled in this study. There was severe stenosis in one side (the eyes in this side were set as case group) and mild or no stenosis in other side (the eyes in this side were set as control group). Color doppler ultrasound (CDI) was used to observe the changes of hemodynamic parameters of the ophthalmic artery (OA) and posterior ciliary artery (PCA), the main parameters of ultrasound Doppler imaging are peak systolic velocity (PSV), end diastolic velocity (EDV), resistance indices (RI) and the calculation of the pulsation indices (PI) through the use of a formula. Enhanced binarization of deep imaging coherence tomography (EDI-OCT) was used to measure the subfoveal choroidal thickness (SFCT). The total subfoveal choroidal area (TCA), luminal (LA), stromal (SA) and choroidal vascularity index (CVI) were obtained by modified image binarization technique. Results In the case group, the PSV in the OA and PCA was significantly lower than that of the control group (t=−2.200, −2.612; P=0.030, 0.011). There were no significant differences in EDV, RI, PI of OA (t=0.337, −1.810, −1.848; P=0.737, 0.074, 0.068) and PCA (t=−1.160, 1.400, 0.815; P=0.249, 0.165, 0.417). The SFCT (t=−3.711, P＜0.001), TCA (t=−2.736, P=0.007), LA (t=−3.188, P=0.002) and CVI (t=−2.096, P=0.039) of the case group was significantly lower than that of the control group. There were no significant differences in SA (t=−1.262, P=0.210) and LA/SA (t=−1.696, P=0.093). Conclusion In severe stenosis ICAS eyes, the PSV in the PCA and SFCT, TCA, LA, CVI are decreased.