Long-Term Changes of Macular Thickness after Pars Plana Vitrectomy in Optic Disc Pit Maculopathy: A Spectral-Domain Optical Coherence Tomography Study

Purpose: To evaluate macular thickness (MT) changes, using spectral domain optical coherence tomography (SD-OCT) in patients with optic disc pit (ODP) maculopathy after pars plana vitrectomy (PPV) with or without internal limiting membrane (ILM) peeling. Procedures: Our retrospective study included nine patients with ODP maculopathy, treated with either PPV (n?=?5) or PPV with ILM peeling (n?=?4). All participants, who had a mean long-term follow-up of 33.4?±?7.0 months, underwent a complete ophthalmological examination and SD-OCT. Due to the preoperative macular elevation, the postoperative MT in the operated patients was compared with that of fellow eyes and with normative data. Results: A significant reduction in MT was noticed in all macular sectors of the operated cases at the last examination. The reduction was more evident in the group of PPV with ILM peeling. At the last examination of the follow-up, there was a statistically significant improvement regarding BCVA in both groups in comparison with baseline, while the two groups did not differ significantly in between (p?=?0.245). Conclusions: In the long-term follow-up period, our study demonstrated a significant reduction in MT in patients with ODP maculopathy treated with PPV, which was more profound in those cases where PPV included ILM peeling.     

Swept-Source OCT Angiographic Characteristics of Treatment-Naïve Nonexudative Macular Neovascularization in AMD Prior to Exudation

PurposeTo investigate the characteristics of treatment-naïve nonexudative macular neovascularization (MNV) in age-related macular degeneration before the onset of exudation using swept-source optical coherence tomography angiography.MethodsMNV area, choriocapillaris (CC) flow deficits (FDs), vessel area density (VAD), vessel skeleton density (VSD), retinal pigment epithelial detachment (PED) volume, mean choroidal thickness (MCT), and choroid vascularity index (CVI) measurements were assessed at two visits prior to exudation. We compared measurements made at the second visit and the rate of change between visits in eyes with and without exudation. The differences in these parameters between eyes with and without subsequent exudation were summarized with 95% confidence intervals (CIs).ResultsTwenty-one eyes with nonexudative MNV were identified and followed. Nine eyes developed exudation, and 12 eyes did not develop exudation. Differences between these groups of eyes for all parameters tended to be small, and the 95% CIs largely ruled out any substantial differences. Overall, eyes with exudation had 24% smaller VAD, 20% smaller VSD, and 33% smaller PED volume measurements. No noteworthy differences were observed for MNV area, CC FDs, MCT, or CVI measurements.ConclusionsThe onset of exudation was correlated with lesions having less vascularity and smaller PED volume measurements, but measurements of MNV area, CC FDs, MCT, and CVI were not correlated with near-term exudation. Investigations are ongoing to further explore these and other anatomic changes as harbingers of near-term exudation.     

Intravitreal Combination of Triamcinolone Acetonide and Bevacizumab (Kenacort-Avastin) in Diffuse Diabetic Macular Edema

Purpose: To evaluate the effect of intravitreal injection of the combination of Triamcinolone Acetonide and Bevacizumab in patients with diabetic macular edema.

Materials and Methods: Twenty seven eyes of 17 patients with diabetic macular edema were treated with an intravitreal injection of triamcinolone acetonide (2?mg) combined with bevacizumab (1.25?mg).

Results: During the 6 months follow-up period 24 eyes (89%) had to repeat the treatment according to the monthly follow-up examination.The mean visual acuity and the central macular thickness improved significantly (P<0.05) throughout the follow-up period.

Conclusion: Intravitreal combination of Triamcinolone Acetonide and Bevacizumab seems to be effective in improving visual acuity and macular edema in patients with diabetic maculopathy.     

Role of OCT Angiography in the Detection of Retinal Vascular and Macular Abnormalities in Subjects with Asteroid Hyalosis

Purpose: To study the role of Optical coherence tomography (OCT) Angiography (OCTA) in detecting retinal vascular and macular abnormalities as compared to Fundus Fluorescein Angiography (FFA) in subjects with Asteroid hyalosis (AH).

Methods: In a prospective study, patients with AH underwent OCTA and FFA. AH graded as Grade 1 in 8 (optic disc, second order vessels visible), Grade 2 in 4 (optic disc, first-order vessels visible), Grade 3 in 11 (hazy view of optic disc) and Grade 4 (no view of fundus) in 2 eyes.

Results: A total of 20 patients (25 eyes) with AH were included. In comparison to FFA, OCTA was able to similarly detect Diabetic Retinopathy changes such as Neovascularization, microaneurysms, capillary dropout, and foveal avascular zone extent in vascular occlusion in all grades of AH.

Conclusion: OCTA, a noninvasive imaging tool, could detect various retinal vascular and macular abnormalities in patients with all grades of AH in comparison to FFA.     

有晶状体眼虹膜固定型人工晶状体植入术后房角宽度的改变

目的 使用光学相干断层扫描(optical coherence tomography,OCT)评估有晶状体眼虹膜固定型人工晶状体(intraocular lens,IOL)近视患者植入术后患者房角宽度的变化.方法 28眼(14例)近视患者植入虹膜固定型IOL矫正高度近视.观察术前、术后患者的等效球镜、角膜内皮细胞计数、眼压以及2点、3点、4点、8点、9点、10点钟位的房角宽度.结果 术前、术后等效球镜分别为(-12.95±0.77)D、(-0.35±0.08)D,差异有显著统计学意义(P＜O.001).术前、术后角膜内皮细胞计数分别为(2859.38±62.27) mm-2、(2783.92±62.67) mm-2,差异有统计学意义(P =0.012).术前、术后眼压分别为(11.87±0.40)mmHg(1 kPa=7.5 mmHg)、(11.80±0.40) mmHg,差异无统计学意义(P=0.800).术后3个月,3点、9点钟位房角较术前变窄,差异均有统计学意义(均为P＜0.05),其他方位房角宽度术前、术后差异均无统计学意义(均为P＞0.05).结论 植入虹膜固定型IOL后高度近视患者部分房角变窄,术后应对患者前房变化情况进行随访观察.     

ICL植入术后黄斑区节细胞-内丛状层及视网膜厚度的变化

目的：应用OCT观察ICL植入术后黄斑区节细胞-内丛状层及中央区视网膜厚度的改变,明确ICL植入术对于眼后节的影响。

方法：前瞻性研究。最终纳入行ICL植入术患者26例41眼,平均年龄28.19±6.48岁。所有受试者均行眼轴长度(AL)、裸眼视力(UCVA)、综合验光、最佳矫正视力(BCVA)、眼压(IOP)及OCT检查。观察术前及术后的中央区视网膜厚度(CRT)和节细胞-内丛状层厚度(GCT),以及UCVA、BCVA和IOP的变化。

结果： ICL植入术后UCVA和BCVA较术前均有提高(P<0.05),而眼压无变化。术前,术后1wk,1、3mo CRT分别为273.20±25.48、274.07±27.64、277.85±25.49、275.99±24.68μm,而GCT分别为85.31±5.19、88.95±6.87、87.73±4.23、87.45±4.59μm(均P<0.05),其中CRT在术后1mo较术前有增加(P<0.01),GCT在术后1wk,1、3mo均比术前有增加(P<0.05)。GCT在术后1wk的变化与AL呈正相关(r_s=0.529, P=0.001)。

结论：ICL植入术具有良好的有效性及一定的安全性,但术后也会发生一定的黄斑区改变,需给予一定的重视。     

Longitudinal Changes in Retinal Nerve Fibre Layer Thickness after an Isolated Unilateral Retrobulbar Optic Neuritis: 1-Year Results

The objective of this study was to investigate the longitudinal changes in retinal nerve fibre layer (RNFL) thickness 1 year after an episode of unilateral acute optic neuritis. This prospective cohort study recruited consecutive patients with a first episode of isolated, unilateral acute optic neuritis from October 2010 to June 2013. RNFL thickness of the attack and normal fellow eyes was measured by optical coherence tomography on presentation and 3, 6, and 12 months post attack in both the treatment and non-treatment groups. The treatment group consisted of subjects that opted for systemic steroids to hasten recovery time. In 20 subjects, 11 received systemic steroids and 9 were treated conservatively. The baseline RNFL thickness was similar in the attack and fellow eyes (p ≥ 0.4). Progressive RNFL thinning was seen in the attack eye over the 12-month period, with significant differences for baseline versus 3 months; baseline versus 12 months; and 3 versus 12 months (all p < 0.0001). At 12 months, the attack eye had a thinner average RNFL than the fellow eye (100.9 ± 6.1 versus 107.3 ± 5.5 µm; p = 0.002). The 12-month RNFL was similar between the treatment and non-treatment groups (p ≥ 0.6). A single episode of optic neuritis triggered an accelerated, progressive RNFL thinning up to 6 months post attack. Initial treatment with systemic steroids did not seem to alter the degree of RNFL loss at 12 months.     

OCT and Visual Field Changes as Useful Markers for Follow-up of Axonal Loss in Multiple Sclerosis in Egyptian Patients

Purpose: The aim of this work was to correlate optical coherence tomography (OCT) parameters, retinal sensitivity (perimetry) and best-corrected visual acuity (BCVA) with disease duration and neurologic functional disability in Egyptian patients with multiple sclerosis (MS).

Methods: This is a cross-sectional observational cohort study in which 68 MS patients and 23 healthy controls had full neurologic examination, including expanded disability status scale (EDSS) and full ophthalmologic examination, including functional and structural assessments of the optic nerve through BCVA, visual field examination (SITA), and OCT (Optovue).

Results: Retinal nerve fiber layer (RNFL) thickness was significantly decreased in MS eyes. MS eyes had significantly decreased GCC. RNFL thickness was significantly negatively correlated to EDSS and disease duration. GCC was significantly negatively correlated to disease duration. BCVA and retinal sensitivity (MD) were significantly correlated to the MS duration.

Conclusions: OCT is a promising tool to detect subclinical changes in RNFL and GCC in Egyptian patients with MS.     

Dynamics of Retinal Function after Multiple Photodynamic Therapies in Age-Related Macular Degeneration: A Report of Cases

Purpose: To monitor retinal function after multiple laser treatments by photodynamic therapy (PDT) with the multifocal electroretinogram (mfERG) in age-related macular degeneration (AMD). Methods: Five eyes of five subjects with AMD were investigated before the first and 1 month after each of three PDT treatments. Function was assessed using the cone- and rod-mediated mfERG, high-contrast distance visual acuity, central visual fields and contrast sensitivity. For each subject the local first-order mfERG results before treatment were used as a template and fitted against the local post-treatment results (Matlab, Mathworks). Results: We found transient reduction of the cone- and rod-mediated amplitudes between the first and second treatments but stable or improved mfERG function in four of five eyes for the cone-mediated mfERG and in all eyes for the rod-mediated mfERG after three treatments. Visual acuities and contrast sensitivities remained stable between treatments in four and two eyes respectively, whereas visual fields showed substantially higher mean defects in two subjects after all treatments. Conclusion: As found in previous studies of the cone-mediated mfERG after one PDT treatment, objective function was stabilized after multiple treatments in this case report. Similarly, although poor at baseline, rod-mediated function was not further compromised. Transiently reduced amplitudes after 1 month possibly reflected choroidal hypoperfusion. A larger sample size is needed to confirm if additional evaluation using electrophysiological criteria might be helpful in re-treatment decisions during PDT. This study was presented in part at the 2004 Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO) Fort Lauderdale, Florida.The authors have no propriety interest.     

Macular abnormalities in patients with retinitis pigmentosa: prevalence on OCT examination and outcomes of vitreoretinal surgery

Purpose: To determine the prevalence of macular abnormalities detected by optical coherence tomography (OCT) in patients with retinitis pigmentosa (RP), and to report the results of pars plana vitrectomy (PPV) in five patients with RP. Methods: OCT images of the macula of 622 eyes of 323 patients with RP were evaluated. All patients had a complete clinical examination, and PPV was performed on two RP patients with a macular hole (MH), two patients with vitreomacular traction (VMT) syndrome, and one patient with cystoid macular oedema (CME). Results: A macular lesion was detected by OCT in 46 eyes (7.4%) of 37 patients (11.5%). CME was detected in 34 eyes (5.5%) of 26 patients, an epiretinal membrane in four eyes of four patients, VMT in five eyes of four patients, and full‐thickness MH in three eyes of three patients. PPV was performed on five of these eyes. The MH was closed with vision improvement after a single surgery in one eye, and was closed after repeated PPVs with a decrease of vision in another eye. In both patients with VMT, the visual acuity decreased after the surgery. The macular morphology and visual acuity did not improve postoperatively on the one patient with CME who underwent PPV. Conclusion: When OCT is used, macular abnormalities are present in 7.4% of patients with RP, which is lower than the prevalence reported earlier. Although vitrectomy can improve the macular morphology in some patients with RP, improvement of visual function may be limited most likely because of the long‐standing retinal dysfunction.     

正常眼压性青光眼患者白内障术后房角参数的变化

目的利用眼前节光学相干断层扫描(optical coherence tomography,OCT)观察正常眼压性青光眼(normal tension glaucoma,NTG)患者白内障手术后前房角形态和眼压的变化。方法共有106例患者纳入本研究,其中单纯年龄相关性白内障患者67例67眼为对照组、NTG合并白内障患者43例43眼为观察组。2组患者均行白内障超声乳化吸出联合人工晶状体植入术治疗。在术前和术后1个月、6个月测量眼压、前节OCT检查房角,自动计算四个象限(颞侧、鼻侧、上方和下方)的中央前房深度(anterior chamber depth,ACD)、前房宽度(anterior chamber width,ACW)、房角开放距离(angle open distance,AOD)、小梁虹膜空间面积(trabecular iris area,TISA)、房角隐窝面积(angle recess area,ARA)。比较手术前后两组患者眼压、房角参数的变化。结果观察组术前眼压为(13.2±2.9)mmHg(1 kPa=7.5 mmHg),术后1个月、6个月眼压分别为(10.5±3.0)...     

Early OCT changes of neuroretinal foveal thickness after first versus repeated PDT in AMD

Purpose To compare early optical coherence tomography (OCT) changes in neuroretinal foveal thickness (NFT) after first versus repeated photodynamic treatment (PDT) in eyes with choroidal neovascularization (CNV) due to age-related macular degeneration (AMD). Methods This is a prospective comparative case series study. Consecutive AMD patients, treated with PDT due to subfoveal CNV, were enrolled. The eyes were divided into two groups: group A included eyes that had received the first initial treatment, and group B included eyes that had received repeated treatment. All eyes underwent serial examinations with OCT: prior to PDT, 1 h, and 3 months after the PDT. The primary outcome measure was early OCT change in NFT after PDT. Results Thirty-three eyes of 33 patients were included in this study; 16 in group A and 17 in group B. Optical coherence tomography showed a significant increase in NFT 1 h after PDT, as compared to pre-treatment status, in group A eyes (P = 0.008) but not in group B eyes (P = 0.731). Subretinal fluid was increased in both groups (93.8% and 88.2%, respectively), whereas intraretinal fluid was remarkably more increased in group A eyes (88%) than in group B eyes (59%). Conclusion Early change in NFT, demonstrated on OCT, indicates that PDT causes different retinal response in primary versus repeated treatment of PDT for CNV due to AMD.     

频域OCT观察两种类型视网膜脱离术后黄斑中心凹结构变化

目的　利用频域光学相干断层扫描（ｏｐｔｉｃａｌｃｏｈｅｒｅｎｃｅｔｏｍｏｇｒａｐｈｙ,ＯＣＴ）观察单纯视网膜脱离（ｒｈｅｇｍａｔｏｇｅｎｏｕｓｒｅｔｉｎａｌｄｅｔａｃｈｍｅｎｔ,ＲＲＤ）和视网膜脱离合并脉络膜脱离（ｒｈｅｇｍａｔｏｇｅｎｏｕｓｒｅｔｉｎａｌｄｅｔａｃｈｍｅｎｔａｓｓｏｃｉａｔｅｄｗｉｔｈｃｈｏｒｏｉｄａｌｄｅｔａｃｈｍｅｎｔ,ＲＲＤＣＤ）术后黄斑中心凹结构的变化,并分析中心凹结构与术后最佳矫正视力的相关性。方法　７７例（７７眼）视网膜脱离患者纳入研究,其中ＲＲＤ组４４例（４４眼）,ＲＲＤＣＤ组３３例（３３眼）,所有患者均接受玻璃体切割联合硅油填充复位视网膜,利用频域ＯＣＴ观察术后黄斑区光感受器内／外节（ｐｈｏｔｏｒｅｃｅｐｔｏｒｉｎｎｅｒａｎｄｏｕｔｅｒｓｅｇｍｅｎｔ,ＩＳ／ＯＳ）连接带及外界膜（ｅｘｔｅｒｎａｌｌｉｍｉｔｉｎｇｍｅｍｂｒａｎｅ,ＥＬＭ）的形态、视网膜中心凹厚度,分析两组间中心凹形态变化差异,并分析ＩＳ／ＯＳ连接带与ＥＬＭ形态以及视网膜中心凹厚度与术后最佳矫正视力的相关性。结果　两组间的ＩＳ／ＯＳ连接带形态差异有统计学意义（χ２＝６．８８８,Ｐ＝０．０３２）,ＲＲＤＣＤ组ＩＳ／ＯＳ连接带的形态消失率明显高于ＲＲＤ组;两组间ＥＬＭ形态差异无统计学意义（χ２＝３．５９７,Ｐ＝０．１６６）,两组的ＩＳ／ＯＳ连接带及ＥＬＭ形态的完整性均与术后最佳矫正视力有相关性（ＲＲＤ组:ｒ＝０．６４９、Ｐ＜０．０５,ｒ＝０．４６６、Ｐ＜０．０５;ＲＲＤＣＤ组ｒ＝０．４８０、Ｐ＜０．０５,ｒ＝０．４４２、Ｐ＝０．０１０）。结论　频域ＯＣＴ是一种评价视网膜脱离复位术后黄斑微结构改变的有效手段。ＲＲＤＣＤ的ＩＳ／ＯＳ连接带消失率明显高于ＲＲＤ,这也是提示术后视力较差的原因之一,ＩＳ／ＯＳ连接带及ＥＬＭ形态的完整性可能是预测视网膜脱离复位术后视力恢复的重要因素。     

眼前节光学断层成像量化观察超声乳化术后前房深度及屈光度变化

目的：分析超声乳化人工晶状体植入后随时间推移,在眼内的前后位移度及其和屈光度变化的关系。方法：选择行白内障超声乳化联合单焦点一体式折叠人工晶状体植入术患者102例102眼,检测和分析术后人工晶状体在眼前节光学断层成像（ OCT ）图像中的位移表现,于术后1、3、6mo,2a分别记录前房深度变化值,远近视力及屈光度,并进行相关性分析。平均随访24±3．8 mo。结果：所选102眼术后1、3、6mo,2a远视力平均分别为0．78±0．13、0．75±0．14、0．72±0．12、0．72±0．10,近视力平均分别为0．38±0．12、0．41±0．13、0．46±0．12、0．47±0．10,患者术眼术后平均前房深度分别为3．75±0．16、3．69±0．13、3．61±0．12、3．62±0．11mm,患者术后屈光度分别为－0．47±0．26、－0．65±0．28、－0．93±0．24、－0．95±0．20 D。眼前节OCT图像显示白内障术后人工晶状体随时间推移向前移位,术后1、3、6 mo组间各数值两两比较均差异明显（P＜0．05）,术后6mo和术后2a比较无明显差异。结论：白内障术后人工晶状体随时间推移向前移动,出现“视近漂移”,远视力降低,近视力增加,术后6 mo基本达稳定状态。