Leber hereditary optic neuropathy is an optic neuropathy associated with mitochondrial DNA. The disease affects young men mainly, which is considered to be due to denaturation of the retinal nerve ganglion cell and axonal loss of optic nerve, leading to optic atrophy. Nowadays, there are some development in studying Leber hereditary optic neuropathy by optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). It is great help to know the disease, forecast the progression of disease, and take action on intervention. In addition, there is a lack of in-depth study on OCT and OCTA characteristics among different mutation sites of LHON, different genders of the same site, different families of the same site or even different branches of the same family. It is expected to be improved in the future work.
ObjectiveTo observe the optical coherence tomography angiography (OCTA) image characteristics of polypoid choroidal vascular disease (PCV) after intravitreal injection of anti-vascular endothelial growth factor drugs, and to discuss its significance in the diagnosis and follow-up of PCV.MethodsA retrospective case study. From August 2018 to January 2020, 22 eyes of 22 patients with PCV diagnosed in the ophthalmological examination of Affiliated Hospital of Weifang Medical University were included in the study. Among them, there were 10 males with 10 eyes and 12 females with 12 eyes; the average age was 67.75±9.53 years. Best corrected visual acuity (BCVA), OCTA, and indocyanine green angiography (ICGA) were performed. All the affected eyes were injected vitreously with 10 mg/ml Conbercept 0.05 ml (including Conbercept 0.5 mg) once a month for 3 consecutive months.Tthe macular area of 3 mm×3 mm and 6 mm×6 mm with an OCTA instrument was scanned, and the foveal retinal thickness (CRT) was measured, the area of abnormal branch blood vessels (BVN). pigment epithelial detachment before and 12 months after treatment (PED) height, foveal choroid thickness (SFCT) were performed. The diagnosis rate of PCV by OCTA was observed, as well as the changes of various indicators of BCVA and OCTA. Before and after treatment, BCVA and CRT were compared by paired t test; BVN area, PED height, and SFCT were compared by variance analysis. The changes in imaging characteristics of OCTA before and after treatment were analyzed.ResultsAmong the 22 eyes, 8 eyes were BVN; 5 eyes were polypoid lesions (polyps); 5 eyes were BVN combined with polyps; 3 eyes were not found with BVN and polyps; 1 eye with small vascular network structure, this eye was ICGA Appears as strong nodular fluorescence (polyps). The detection rate of PCV by OCTA was 86.36% (19/22). Twelve months after treatment, BVN was significantly reduced or disappeared in 16 eyes (72.72%, 16/22); polyps disappeared in 17 eyes (77.27%, 17/22). Compared with before treatment, 12 months after treatment, BCVA increased (t=3.071), CRT decreased (t=2.440), the difference was statistically significant (P＜0.05); the average BVN area, PED height, and SFCT decreased. The difference in average BVN area and PED height was statistically significant (F=2.805, 3.916; P＜0.05), and the difference in SFCT was not statistically significant (F=0.047, P＞0.05).ConclusionsThe detection rate of PCV by OCTA is 86.36%. After PCV anti-vascular endothelial growth factor drug treatment, BVN area decrease and polyps subside. OCTA is an effective means for PCV diagnosis and follow-up after anti-VEGF drug treatment.
Objective To observe the image characteristics of eyes with choroidal osteoma using enhanced spectral domain optical Cirrus coherence tomography （SD-OCT）, and to explore their relationship with visual acuity. Methods The records and SD-OCT images of 14 patients（18 eyes） diagnosed with choroidal osteoma at this hospital were reviewed retrospectively. All patients received examinations of best corrected visual acuity (BCVA), direct or indirect ophthalmoscope, slit lamp ophthalmoscope, fundus fluorescein angiography, B scan and/or computerized tomography. Subtle structure changes of the retina and choroidal osteoma were observed by four lines of the horizontal, the vertical scanning lines through the foveal and the tumor basal diameter under the model of five Line Raster．The correlation between the retinal and choroidal morphology and visual acuity was evaluated. Results The choroidal features of SD-OCT image of choroidal osteoma can be categorized into hyper-reflective in six eyes (33.3%), isoreflective in five eyes (27.8%), hypo-reflective in three eyes (16.7%) and mixing-reflective in four eyes (22.2%). The foveal thickness ranged from 50.2 to 245.1μm, and the average foveal thickness was (130.2±58.3) μm. The horizontal and vertical diameters of choroidal osteoma ranged from 5.6 to 15.8 mm and 4.6 to 12.8 mm respectively. The average horizontal and vertical diameters of choroidal osteoma were (7.8±2.9) mm and (6.5±2.5) mm respectively. The statistical analysis revealed that BCVA was not related to the horizontal, vertical diameters of choroidal osteoma or the foveal thickness （r=0.262, 0.229, 0.137; P=0.284, 0.294, 0.362）. BCVA was related to the involvement of fovea and the integrity of photoreceptor inner/outer segment junction (IS/OS) （r=-3.838,-4.559; P=0.0015, 0.0003），but not related to macular choroidal neovascularization (CNV) or serous retinal detachment （r=-0.144, 0.411; P=0.684, 0.687）. Conclusions The main SD-OCT image characteristics of eyes with choroidal osteoma was hyper-reflective and isoreflective. BCVA was not related to the horizontal, the vertical diameters of choroidal osteoma, the foveal thickness, macular CNV or serous retinal detachment. It was related to the involvement of fovea and the integrity of IS/OS.
Lipid globules in retina and choroid are new definitions based on pathology and high-resolution optical coherence tomography (OCT). OCT examination shows that the lipid globules are low reflective circular cavities in the choroid and retina, without strong reflective boundaries around them, followed by a characteristic superreflective tail. It occurs in healthy human eyes and in age-related macular degeneration characterized by retinal pigment epithelium (RPE) atrophy. Its characteristic superreflective tail is the key to distinguishing it from other diseases. At present, the understanding of lipid globules is still in the initial stage. Although lipid globules can be observed in healthy human eyes, a certain prevalence rate indicates that they are associated with choroidal hypoperfusion and RPE atrophy. In the future, larger randomized controlled trials and longer follow-up time are needed to explore its pathogenesis, pathological characteristics and treatment prognosis.
ObjectiveTo observe the clinical efficacy of half-dose photodynamic therapy (PDT) in the treatment of acute central serous chorioretinopathy (CSC) by enhanced deep imaging-OCT (EDI-OCT).MethodsA retrospective case study. From September 2015 to November 2018, 100 patients with acute CSC who received half-dose PDT in Hangzhou Branch of the Eye Optometry Hospital of Wenzhou Medical University were included in the study. Among 100 patients, 69 patients were males and 31 patients were females; the average age was 49.63±7.97 years; the average duration of disease was 2.19±0.71 months. All patients underwent BCVA, EDI-OCT, FFA, ICGA and other examinations. BCVA was used on the international standard visual acuity chart and converted to logMAR visual acuity records. Before treatment, the average logMAR BCVA was 0.29±0.19, the average macular foveal retinal thickness (CMT) was 370.59±134.98 μm, and the average macular subfoveal choroidal thickness (SFCT) was 366.93±86.95 μm. All patients were treated with half-dose PDT. We compared the changes of BCVA, CMT, SFCT, and subretinal fluid (SRF) of the eye before treatment and 2 weeks after treatment and 1, 3, and 6 months. Pearson correlation analysis method was used to analyze the correlation between BCVA and baseline BCVA, CMT, SFCT after 6 months of treatment.ResultsSix months after treatment, SRF was completely absorbed in 98 eyes, with an effective rate of 98.0%. Compared with before treatment, 2 weeks and 1, 3, and 6 months after treatment, the BCVA of the eye significantly increased (F=66.493, P＜0.001), and CMT and SFCT significantly decreased (F=134.625, 30.394; P＜0.001,＜0.001). The results of Pearson correlation analysis showed that BCVA was positively correlated with baseline BCVA 6 months after treatment (r=0.529, P＜0.001), and there was no significant correlation with CMT and SFCT. There were no serious complications related to treatment during the follow-up period.ConclusionsHalf-dose PDT can effectively increase BCVA in a short period of time for acute CSC. EDI-OCT can observe that CMT, SFCT and SRF absorption are significantly reduced after treatment.
ObjectiveTo observe the blood perfusion changes of peripapillary and macular vessels in patients with nonarteritic anterior ischaemic optic neuropathy (NAION).MethodsRetrospective cohort study. Thirty-six eyes (19 affected eyes and 17 fellow eyes) of 19 patients with NAION diagnosed in People’s Hospital of Wuhan University from November 2017 to January 2019 were included in this study. There were 10 males and 9 females, with the mean age of 55.05±7.11 years. Forty eyes of 20 normal subjects matched with NAION patients were included as controls. BCVA, fundus color photography, SD-OCT and OCT angiography were performed in normal controls and repeated in NAION affected eyes at 1-2 weeks, 1-2 months, 3-5 months intervals. OCT quantitative measurements: average retinal nerve fiber layer thickness (aRNFL) of the disc and its superior values (sRNFL) and the inferior values (iRNFL), average ganglion cell complex thickness (aGCC) in macular region and its superior values (sGCC) and the inferior values (iGCC). OCTA quantitative measurements: average radial peripapillary capillary density (aRPC) and its superior values (sRPC) and the inferior values (iRPC), average vascular density of superficial retina (aSVD) in macular region and its superior values (sSVD) and the inferior values (iSVD), average vascular density of deep layer retina (aDVD), areas of foveal avascular zone (FAZ). The differences of OCT and OCTA quantitative measurements between NAION eyes and the fellow eyes and normal controls were comparatively analyzed. Independent sample t test, paired sample t test or nonparametric rank sum test were performed for comparison among three groups. Pearson or Spearman correlation analysis were used to analyze the correlation between RNFL and RPC, GCC and SVD, RNFL and GCC, RPC and SVD.ResultsAt baseline, the aRNFL, aRPC and aDVD of NAION patients were significantly higher than those of normal controls. Compared with the fellow eyes, the aRNFL increased significantly and the aRPC decreased significantly in NAION affected eyes. The overall differences of aRNFL, aRPC, aGCC and aSVD at four intervals within NAION affected eyes were statistically significant (P＜0.05). The average sRNFL, sRPC, sGCC and sSVD at 1-2 months interval were significantly lower than the average iRNFL, iRPC, iGCC and iSVD (P＜0.05). Correlation analysis: at 1-2 months interval, aGCC was positively correlated with aSVD (r=0.482, P=0.037); at 3-5 months interval, aRNFL was positively correlated with aRPC (r=0.631, P=0.037).ConclusionThere is a sectorial reduction of vascular density of peripapillary RPC and macular SVD with the disease progression of NAION.
Objective
To explore the consistency and significance of optical coherence tomography (OCT) and clinical and histopathological findings in adoptively transferred uveitis in mice.
Methods
The adoptively transferred experimental autoimmune uveitis (EAU) model was established by intraperitoneal injection of antigen-specific T cells in C57BL/6 mice. Since 9 days after transferred, inflammation of eyes was observed by indirect ophthalmoscope with +90D lens and record clinical scores every 3 days. The disease was divided into 6 phases including onset phase, early phase, pre-peak phase, peak phase, resolution phase and late phase of EAU, which respectively corresponding to clinical score 0.5, 1.0, 1.5 - 2.0, 2.5 - 3.0, 1.0 - 2.0 and less than 1.0. Since 9 days after transferred, the retina and retinal thickness (RT) was measured by spectralis OCT about 1 disc from the disc edge in 10 time points including 9, 11, 16, 21, 25, 30, 35, 40, 50 and 60 days after transferred. The OCT score was recorded as from 0.0 to 4.0. After transferred 9, 21 and 60 days, the mice were killed and eye balls were examined in histology. OCT score, clinical score and histology in the mouse were compared and analyzed.
Results
The disease was divided into onset phase, early phase, pre-peak phase and peak phase of EAU, which respectively corresponding to 9, 16, 21 and 26 days after transferred. In four phases, OCT score were 0.5, 1.0, 2.0 and 4.0 respectively. After transferred 30 days, which was in resolution phase of EAU, the inflammation cells in vitreous were decreased and OCT score was 3.0. After transferred 60 days, which was in late phase of EAU, inflammation cells in vitreous were disappeared and retina was atrophic topically. The histology showed the vitreous has slight inflammation cells and retinal structure was normal at onset of EAU. The vitreous has massive inflammation cells and retina structure was disorder at pre-peak of EAU. And in resolution phase of EAU, the inflammation cells in vitreous were slightly and retina was atrophic and thinned. The data in this study demonstrated that OCT score was well correlated with clinical score in EAU (r=0.957 9, P < 0.000 1).
Conclusion
OCT and clinical and histopathological findings in adoptively transferred uveitis in mice were consistency and OCT is contribute to evaluate the disease dynamically and quantifiably.
Objective
To observe the characteristics of spectral-domain optical coherence tomography (SD-OCT) for leakage point in acute central serous chorioretinopathy (CSC).
Methods
A total of 21 acute CSC patients (21 eyes) were enrolled in this retrospective study, including 17 men (17 eyes) and 4 women (5 eyes). The mean age was (47.3±8.8) years (range 35 - 66 years). The mean duration was (1.6±0.8) months (range 0.5 - 3.0 months). All patients were underwent mydriatic fundus photography, SD-OCT examination and fluorescein fundus angiography (FFA). SD-OCT and FFA images were carefully compared to observe the SD-OCT examination characteristics of fluorescence leakage point.
Results
21/21 eyes had one fluorescein leakage point. In addition to serous retinal detachment, leakage point in the SD-OCT examination showed retinal pigment epithelium (RPE) protrusion in 10 eyes (47.6％), RPE detachment in 7 eyes (33.3％), highly re?ective areas suggesting ?brinous exudate in the subretinal space in 3 eyes (14.3％), and RPE defect in 1 eye (4.8％).
Conclusion
The SD-OCT characteristics of acute CSC include RPE protrusion, RPE detachment, highly re?ective areas suggesting ?brinous exudate in the subretinal space and RPE defect.
ObjectiveTo observe the positional relationship between the central fixation point of the retina and the fovea in normal adults.MethodsA retrospective clinical study. From August 2019 to January 2020, 100 eyes of 100 normal adults who underwent physical examination at the Fourth People's Hospital of Shenyang were included in the study. All patients underwent BCVA, diopter, microfield, OCT examination, and axial length (AL) measurement. There were 42 males and 58 females with the average age was 46.4±14.7 years. The average diopter was －1.02±1.99 D, the average AL was 23.22±0.47 mm, the average foveal avascular zone (FAZ) area was 0.38±0.13 mm2. The MP-3 microperimetry was used for central fixation examination. After the examination, high-definition fundus images were automatically taken and the central fixation point of the retina were automatically calculated by the equipment. The Nidek Overlay functional multi-mode imaging platform was used to superimpose the images containing the central fixation point of the retina and the macular fovea, the positional relationship between the two was observed, and the distance between the two was measured. Pearson correlation analysis was performed on the distance between the fixation point of the center of the retina and the center of the fovea, age, diopter, and FAZ area of the macula.ResultsThe fixation point of the retinal center of all tested eyes was within the range of the macular fovea, which did not coincide with the center of the macular fovea. Among 100 eyes, the fixation point of the center of the retina were 53, 23, 15, and 9 eyes at the nose, lower, temporal, and upper sides, respectively. The average distance between the fixation point of the center of the retina and the center of the fovea was 158.31±71.56 μm. The distance between the fixation point of the retinal center and the center of the macular fovea and age (r=0.140), diopter (r=－0.009), FAZ area ( r=0.038) were not correlated (P=0.165, 0.932, 0.707) in correlation analysis.ConclusionThe central fixation point of normal adult retina is more common on the fovea nasal side.
ObjectiveTo observe the OCT angiography (OCTA) imaging features of isolated choroidal hemangioma (CCH).MethodsA retrospective case study. From January 2017 to February 2019, 18 CCH patients (18 eyes) diagnosed in the Affiliated Eye Hospital of Nanjing Medical University were included in the study. There were 13 males (13 eyes) and 5 females (5 eyes), with the mean age of 44.5 years. All the tumors were orange-red, with clear boundaries, located at the posterior pole or around the optic disc. OCTA was used to scan the 6 mm×6 mm of macular area or in the range of 6 mm×6 mm. After automatic image processing, the system provided the blood flow map of shallow capillary plexus, deep capillary plexus, outer retina and choroidal capillary plexus, as well as the corresponding structure en-face image and B-scan image.ResultsOCTA examination found that when the stratification line was adjusted to the periphery of the choroidal capillary layer, the blood flow map showed clear boundary of the tumor, and the blood vessels on the surface of the tumor presented a network crisscross with different thickness. B-scan image showed that the whole layer of retinal choroid at the tumor presented a dome-shaped uplift, and the neurocortical layer could be accompanied by thickening, subretinal effusion, exudation and splitting. En-face image showed that the boundary of the tumor was clear, the surrounding exudation was strong reflection in spots or patches, local pigmentation showed weak reflection, and the signal reflection was uneven.ConclusionOCTA can clearly show the vascular morphology on the surface of CCH.
