非动脉炎性前部缺血性视神经病变患者急性期视盘周围脉络膜血流信号分析

目的　利用光学相干断层扫描血管成像（OCTA）观察非动脉炎性前部缺血性视神经病变（NAION）患者急性期的视盘周围脉络膜血流信号特征。方法　对2017年1月至2019年9月首次确诊为NAION且接受OCTA检查的13例（13眼）患者进行回顾性横断面研究。由两位医师分别定性分析OCTA中脉络膜毛细血管层的血流信号中的低信号区,并分区。将分区的结果与en face OCT、视野检查结果进行对比。患者均至少随访1个月。结果　急性期NAION患眼的视盘OCTA在脉络膜毛细血管层水平的低信号区可分为视盘本身部位、视盘水肿部位和沿神经纤维方向延伸部位3个区域。13眼中,10眼首次就诊时出现3个低信号区,2眼在第2次就诊时出现3个低信号区,1眼仅出现视盘本身部位和视盘水肿部位的低信号区。其中,沿神经纤维方向延伸部位的低信号区与视野缺损关系密切,对应比例达91.6%,该低信号区平均出现时间为发病后19.9 d。随访期内,9眼沿神经纤维方向延伸部位的低信号区出现神经纤维层萎缩。结论　NAION患者急性期的视盘周围脉络膜层面的血流信号可以通过OCTA提示神经纤维层水肿、消退以及萎缩的变化过程。     

甲状腺相关视神经病变的研究进展

甲状腺相关视神经病变是甲状腺相关眼病的继发性病变，临床表现包括视力下降、色觉受损、相对性传入性瞳孔障碍、视盘水肿或萎缩等。眼科辅助检查表现为视野异常和视觉诱发电位异常等，影像学检查显示眶尖拥挤可辅助诊断。目前此病的发病机制未明，既往研究提出其与视神经压迫、牵拉和缺血有关。治疗方法包括大剂量糖皮质激素静脉冲击治疗、眼眶减压手术、眼眶放射治疗和生物制剂等。本文主要回顾流行病学特征、发病机制及临床诊治等方面的进展，以期为临床实践和研究提供参考。     

Measuring contrast sensitivity in patients with Graves' ophthalmopathy complicated by ocular hypertension and suspect glaucoma or dysthyroid optic neuropathy

The present study compares contrast sensitivity functions of patients with uncomplicated Graves' ophthalmopathy, patients with ophthalmopathy and elevated intraocular pressure or suspect glaucoma, and patients with dysthyroid optic neuropathy (DON). Aim of the study was to investigate the clinical potential for the contrast sensitivity functions (CSF) in distinguish between the groups. Contrast sensitivity measurements were obtained from twenty-seven subjects with endocrine ophthalmopathy. Group I included patients with uncomplicated ophthalmopathy (n=20 eyes); group II included patients with ophthalmopathy, intraocular pressure 24 mmHg with and without early visual field defects, and no evidence of apical crowding on coronal computed tomography scan (n=14 eyes); group III included patients with DON (n=12 eyes). Contrast thresholds were determined for stationary and 6.87 Hz phase-alternating gratings at eight spatial frequencies from 0.18 to 15.7 c/deg. Data from each group was compared with data from age-matched normal subjects. Observers with uncomplicated ophthalmopathy had normal CSFs. Eyes affected with DON showed contrast sensitivity disruption at overall intermediate-high spatial frequencies. Eyes with elevated intraocular pressure or suspect glaucoma had pronounced sensitivity loss in the low frequency range (0.18-0.70 c/deg) as compared to eyes with DON. This study shows that CSF detects visual function abnormalities noninvasively in patients with complicated Graves' ophthalmopathy. Results also indicate that the clinical potential for CSF in distinguish between patients suffering from ophthalmopathy complicated by ocular hypertension or suspect glaucoma and patients with DON improves when a temporal modulation of 6.87 Hz and gratings of low spatial frequency (< 1 c/deg) are used.     

Visual evoked potentials in patients with Graves' ophthalmopathy complicated by ocular hypertension and suspect glaucoma or dysthyroid optic neuropathy

The study compared visual evoked potentials of patients with uncomplicated Graves' ophthalmopathy, patients with ophthalmopathy and elevated intraocular pressure or suspect glaucoma, and patients with dysthyroid optic neuropathy (DON). The aim of the study was to investigate the clinical potential for the visual evoked potentials (VEP) in the differential diagnosis among the groups. The VEPs were obtained from 43 subjects with endocrine ophthalmopathy. Group I included patients with uncomplicated ophthalmopathy (30 eyes); group II included patients with ophthalmopathy, intraocular pressure 23 mmHg with and without early visual field defects, and no evidence of apical crowding on coronal computed tomography scan (28 eyes); group III included patients with DON (28 eyes). Amplitude and latency of major component of pattern VEP were obtained at three visual angles (60', 30', 15'). Data from each group was compared with data from age-matched normal subjects. Disturbances of VEP were found mainly in patients of Group II and Group III. Control Group had normal VEP. About the differential diagnosis between Group II and Group III the most important parameter was the N75-P100 amplitude for 15' of pattern stimulation. Only for this visual angle, Group II and Group III had not overlapped N75-P100 amplitude. This study shows that VEP detect visual function abnormalities noninvasively in patients with complicated Graves' ophthalmopathy. Results also indicate the clinical potential for VEP in the differential diagnosis between patients suffering from ophthalmopathy complicated by ocular hypertension or suspect glaucoma and patients with dysthyroid optic neuropathy.     

The effect of intravenous high-dose glucocorticoids and orbital decompression surgery on sight-threatening thyroid-associated ophthalmopathy

AIM: To report the effects of intravenous high-dose glucocorticoids (ivGC) and orbital decompression (OD) surgery for treatment of sight-threatening thyroid-associated ophthalmopathy (TAO). METHODS: A retrospective review of medical records from patients with sight-threatening TAO [definite or highly suspected dysthyroid optic neuropathy (DON)] treated with ivGC (60 cases) and OD (25 cases) was conducted at the Zhongshan Ophthalmic Center between January 2001 and January 2009. Patients were initially treated with ivGC (ivGC group). If no significant improvement in visual function was obtained, they then received OD surgery (OD group). The pre- versus post-treatment efficacies of either ivGC or OD in these patients were assessed using several indices, including visual acuity, intraocular pressure, ocular alignment, ocular motility, and exophthalmos. RESULTS: Nighty-one eyes had definite DON while 79 were considered to have highly suspected DON. In the ivGC group, 51 individuals (85.0%) eventually demonstrated normal vision, while 10 patients (16.7%) demonstrated a reduction in deviation (P<0.01), and 35 cases (58.3%) showed slight improvements in ocular motility (P<0.01). In OD group, visual acuity improved in 24 cases (96.0%, P<0.01) and all patients showed varying reductions of exophthalmos (mean: 4.35±1.13 mm, P<0.01). Eight cases (32.0%) experienced an 8-15 PD reduction of deviation and ocular motility improved in 12 cases (48.0%), while 3 patients (12.0%) developed new-onset strabismus with diplopia post-surgically (P<0.01). Patients were followed up at an average of 1.55±1.07y. CONCLUSION: Both ivGC and OD show good therapeutic efficacy in the treatment of sight-threatening TAO. The presence of extremely poor eyesight (≥0.5logMAR) was corrected in some patients with ivGC alone, thus sparing these patients from subsequent OD surgery. In patients who were refractory to steroids, subsequent OD surgery often provided satisfactory outcomes, however, new-onset strabismus with diplopia was observed in 12.0% of these cases.     

Contrast sensitivity and the diagnosis dysthyroid optic neuropathy

Contrast sensitivity function (CSF) was investigated in 19 patients (34 eyes) with clinical signs and symptoms of dysthyroid optic neuropathy (DON). CSF was disturbed in 33 eyes and was shown to improve after orbital decompression. These results indicate that the CSF may be a useful supplementary test of visual function in patients with DON.Abbreviations CSF contrast sensitivity function - DON dysthyroid optic neuropathy - RE right eye - LE left eye - c circles - deg degrees This study was presented at the annual meeting of the Dutch Ophthalmological Society, Dronten, 13–16 February 1990.     

甲状腺相关眼病患者97例回顾性分析

目的探讨甲状腺相关眼病(thyroid-associated ophthalmopathy,TAO)的临床特征、病情特点及影响因素,为临床早期诊断和治疗提供依据。方法对我院2007年1月至2009年12月诊治的97例(171眼)TAO患者的临床资料进行回顾性分析。结果 97例TAO患者平均发病年龄(44.6±12.8)岁,女性多见,多为双眼发病,以眼球突出为主要就诊原因。78例(144眼)患者伴有甲状腺功能异常。眼睑退缩127眼(73.2%),上睑迟落116眼(63.9%),闭合不全54眼(33.0%),眼睑肿胀76眼(42.3%),球结膜充血及水肿65眼(37.1%);眼球突出119眼(70.1%),眼球运动受限116眼(69.1%),CT测量眼外肌肥厚132眼(77.2%),下直肌受累124眼(72.5%),眼压增高34眼(27.8%),视神经病变21眼(13.4%)。结论 TAO的发病多伴甲状腺功能的异常,其临床特征有其自身的特点,早期正确的临床诊断及病情分析对疾病的治疗有重要意义。     

Automated evaluation of parapapillary choroidal microvasculature in crowded optic discs: a controlled, optical coherence tomography angiography study

AIM: To compare superficial and deep vascular properties of optic discs between crowded discs and controls using optical coherence tomography angiography (OCT-A). METHODS: Thirty patients with crowded discs, and 47 control subjects were enrolled in the study. One eye of each individual was included and OCT-A scans of optic discs were obtained in a 4.5×4.5 mm2 rectangular area. Radial peripapillary capillary (RPC) density, peripapillary retinal nerve fiber layer (pRNFL) thickness, cup volume, rim area, disc area, cup-to-disc (c/d) area ratio, and vertical c/d ratio were obtained automatically using device software. Automated parapapillary choroidal microvasculature (PPCMv) density was calculated using MATLAB software. When the vertical c/d ratio of the optic disc was absent or small cup, it was considered as a crowded disc. RESULTS: The mean signal strength index of OCT-A images was similar between the crowded discs and control eyes (P=0.740). There was no difference in pRNFL between the two groups (P=0.102). There were no differences in RPC density in whole image (P=0.826) and peripapillary region (P=0.923), but inside disc RPC density was higher in crowded optic discs (P=0.003). The PPCMv density in the inner-hemisuperior region was also lower in crowded discs (P=0.026). The pRNFL thickness was positively correlated with peripapillary RPC density (r=0.498, P<0.001). The inside disc RPC density was negatively correlated with c/d area ratio (r=-0.341, P=0.002). CONCLUSION: The higher inside disc RPC density and lower inner-hemisuperior PPCMv density are found in eyes with crowded optic discs.     

Analysis of retinal vasculature changes in indirect traumatic optic neuropathy using optic coherence tomography angiography

AIM: To assess the retinal vasculature alterations in indirect traumatic optic neuropathy (ITON) patients following craniofacial trauma by optic coherence tomography angiography (OCTA). METHODS: Patients diagnosed of monocular ITON were recruited from August 2016 to May 2020. OCTA was performed using the AngioVue OCT-A system for two cube scans centered at the optic nerve head and fovea. OCTA data included thicknesses of peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell complex (GCC), as well as proportion of capillary perfusion and data were analyzed for correlation with post-injury timepoints: within 7, 8-30, 31-90, and 91-365d. RESULTS: A total of 73 ITON patients were studied. Significant thinning of RNFL and GCC layers and attenuation of microvascular perfusion were observed in ITON eyes as compared to contralateral unaffected eyes (for most of the analyzed sectors and quadrants, P<0.05). Without respect to surgical intervention and vision recovery, the decrease in retinal layer thicknesses and microvascular perfusion was time-dependent, and most significant within three months (P<0.001). CONCLUSION: ITON presents with time-dependent thinning of retinal layers and attenuation of microvasculature, indicating possible degeneration of retinal ganglion cells due to reduced retinal blood supply.     

糖尿病性视神经病变的OCT图像特点分析

目的：回顾分析糖尿病性视神经病变( diabetic optic neuropathy, DON )的相干光断层成像( optical coherence tomography,OCT)的特点。
　　方法：回顾性系列病例研究。选择2013-12/2015-10西安交通大学医学院第二附属医院眼科门诊和内分泌科会诊期间诊断为2型糖尿病且伴有眼底病变的患者175例350眼的临床资料,记录患者的全身检查情况和疾病史,阅读所有患者的彩色眼底照相、荧光素眼底血管造影( fluorescein fundus angiography,FFA)、OCT的影像结果,并进行分析统计。
　　结果：通过FFA 检查视乳头具有异常荧光表现,确定有DON的有49例90眼,占25.7%。 OCT结果显示DON 90眼中15眼(16.7%)表现为视神经形态大致正常;20眼(22.2%)表现为视杯凹陷变小或消失,筛板前组织肿胀,同时伴有盘周神经纤维层水肿;26眼(28.9%)表现为视杯深陷,杯盘比变大;18眼(20.0%)表现为视盘内或视盘表面组织增生;11眼(12.3%)玻璃体视乳头牵拉,视盘边缘抬高。在FFA中有相同荧光表现的DON患眼,在OCT检查可表现出不同的组织形态。
　　结论：FFA从视神经的血循环状态变化定义DON,而OCT可以发现FFA所不能显示的视神经组织形态的变化,从而更清晰视神经病变的位置和原因,为治疗提供依据。OCT无创、快捷、费用低、可重复性强等优点有利于DON患者的复查及治疗效果追踪。     

Optical coherence tomography with or without enhanced depth imaging for peripapillary retinal nerve fiber layer and choroidal thickness

AIM: To assess peripapillary retinal nerve fiber layer (RNFL) and choroidal thickness obtained with enhanced depth imaging (EDI) mode compared with those obtained without EDI mode using Heidelberg Spectralis optical coherence tomography (OCT). METHODS: Fifty eyes of 25 normal healthy subjects and 32 eyes of 20 patients with different eye diseases were included in the study. All subjects underwent 3.4 mm diameter peripapillary circular OCT scan centered on the optic disc using both the conventional and the EDI OCT protocols. The visualization of RNFL and choroidoscleral junction was assessed using an ordinal scoring scale. The paired t-test, intraclass correlation coefficient (ICC), 95% limits of agreement (LoA), and Bland and Altman plots were used to test the agreement of measurements. RESULTS: The visibility score of RNFL obtained with and without EDI was of no significant difference (P=0.532), the visualization of choroidoscleral junction was better using EDI protocol than conventional protocol (P<0.001). Peripapillary RNFL thickness obtained with EDI was slightly thicker than that obtained without EDI (103.25±9.42 μm vs 101.87±8.78 μm, P=0.010). The ICC of the two protocols was excellent with the value of 0.867 to 0.924, the 95% LoA of global RNFL thickness was between -10.0 to 7.4 μm. Peripapillary choroidal thickness obtained with EDI was slightly thinner than that obtained without EDI (147.23±51.04 μm vs 150.90±51.84 μm, P<0.001). The ICC was also excellent with the value of 0.960 to 0.987, the 95% LoA of global choroidal thickness was between -12.5 to 19.8 μm. CONCLUSION: Peripapillary circular OCT scan with or without EDI mode shows comparable results in the measurement of peripapillary RNFL and choroidal thickness.     

Optic disc and peripapillary changes by optic coherence tomography in high myopia

Myopia, a worldwide condition, is a multifactorial disease resulting in many ocular complications. Early onset of myopia has a great tendency to develop high myopia and pathological myopia later in life. The pathophysiology and progression of myopia is still unclear. Owing to its involving in visual function, optic disc and peripapillary change in high myopia can’t be neglected, and it may help in better understanding of the pathophysiology or mechanism of myopia progression. Recently, advanced imaging techniques have been developed, such as optical coherence tomography (OCT), allowing for better detecting of optic disc and peripapillary change. OCT is a high-resolution and noninvasive measurement for detection of ocular structure. Herein, we provide an updated review of optic disc and peripapillary change in OCT image, including its characteristics and clinical significance. We also propose some problems needed further investigation.     

图形视诱发电位对甲状腺相关眼病视神经病变的诊断价值

目的　评价图形视诱发电位(P -VEP)在甲状腺相关眼病视神经病变(DON)中的诊断价值及其影响因素。方法　对2 0 0 2年1月至2 0 0 3年12月收治的99例(188眼)TAO患者行常规P -VEP检查,比较矫正视力≥1. 0患眼与正常值之间以及矫正视力≥1 .0与<1. 0TAO患者之间P10. 0潜伏期及振幅变化;观察眶压、眼压及眼球突出对P10 .0潜伏期的影响;比较P -VEP与视野检查在DON中的诊断价值。结果　矫正视力≥1. 0组P10 .0平均潜伏期及振幅较正常值均有明显差异;视力≥1 .0组与<1 .0组比较,后者P10. 0潜伏期在中、高空间频率明显较前者延迟;眶压对P10. 0潜伏期影响最大;P -VEP较视野检查更灵敏,两者联合阳性率可达93 97%。结论　P -VEP视功能检查可以更敏感的较早发现DON的发生,并且可在一定程度上判断视神经的损伤程度;眶压在DON发生、发展中起关键性作用;P -VEP与视野检查联合应用可明显提高DON的诊断阳性率,是诊断DON较为灵敏和可靠的方法     

[In Press] Optical coherence tomography with or without enhanced depth imaging for peripapillary retinal nerve fiber layer and choroidal thickness

AIM: To assess peripapillary retinal nerve fiber layer (RNFL) and choroidal thickness obtained with enhanced depth imaging (EDI) mode compared with those obtained without EDI mode using Heidelberg Spectralis optical coherence tomography (OCT). METHODS: Fifty eyes of 25 normal healthy subjects and 32 eyes of 20 patients with different eye diseases were included in the study. All subjects underwent 3.4 mm diameter peripapillary circular OCT scan centered on the optic disc using both the conventional and the EDI OCT protocols. The visualization of RNFL and choroidoscleral junction was assessed using an ordinal scoring scale. The paired t-test, intraclass correlation coefficient (ICC), 95% limits of agreement (LoA), and Bland and Altman plots were used to test the agreement of measurements. RESULTS: The visibility score of RNFL obtained with and without EDI was of no significant difference(P=0.532), the visualization of choroidoscleral junction was better using EDI protocol than conventional protocol (P＜0.001). Peripapillary RNFL thickness obtained with EDI was slightly thicker than that obtained without EDI (103.25±9.42 μm vs 101.87±8.78 μm, P=0.010). The ICC of the two protocols was excellent with the value of 0.867 to 0.924, the 95% LoA of global RNFL thickness was between -10.0 to 7.4 μm. Peripapillary choroidal thickness obtained with EDI was slightly thinner than that obtained without EDI (147.23±51.04 μm vs 150.90±51.84 μm, P＜0.001). The ICC was also excellent with the value of 0.960 to 0.987, the 95% LoA of global choroidal thickness was between -12.5 to 19.8 μm. CONCLUSION: Peripapillary circular OCT scan with or without EDI mode shows comparable results in the measurement of peripapillary RNFL and choroidal thickness.     

Optical coherence tomography angiography of optic disc perfusion in non-arteritic anterior ischemic optic neuropathy

AIM: To compare the optic disc blood flow of non-arteritic ischemic optic neuropathy (NAION) eyes with normal eyes. METHODS: The optic disc blood flow densities of diagnosed non-acute phase NAION eyes (21 eyes, 14 individuals) and normal eyes (19 eyes, 12 individuals) were detected via Optovue optical coherence tomography angiography (OCTA). The optic disc blood flow was measured via Image J software. Correlations between optic disc perfusion and visual function variables were assessed by linear regression analysis. RESULTS: The average percentage of the optic disc non-perfusion areas in the non-acute phase NAION patients (17.84%±6.18%) was increased, when compared to the normal control eyes (8.61%±1.65%), and the difference was statistically significant (P<0.01). Moreover, there was a proportional correlation between the visual field mean defect (MD) and the optic disc non-perfusion area percentage, and the relationship was statistically significant (t=3.65, P<0.01, R2=0.4118). In addition, the critical correlation between the best corrected visual acuity (BCVA) and the optic disc non-perfusion area percentage was statistically significant (t=4.32, P<0.01, R2=0.4957). CONCLUSION: The optic disc non-perfusion area percentages detected via OCTA in NAION eyes were significantly increased when compared with the normal eyes. Both the BCVA and MD were correlated with the optic disc flow detected, revealing that OCTA may be valuable in the diagnosis and estimation of NAION.     

CT features of exophthalmos in Chinese subjects with thyroid-associated ophthalmopathy

AIM:To investigate computed tomography (CT) features of exophthalmos in Chinese subjects with thyroid-associated ophthalmopathy (TAO).METHODS:A total of605 eyes of 325 patients with exophthalmos due to TAO were classified as grade I (mild exophthalmos) or II (severe exophthalmos) based on orbital CT imaging. The increased orbital volume features, such as changes from extraocular muscles, orbital fat, or both, were analyzed.RESULTS: A total of 605 eyes were analyzed, among them 62.98% presented grade I exophthalmos, while 36.02% showed grade II exophthalmos.#$TAB In grade I, 56.69% showed orbital fat change, and in grade II, 89.29% exhibited extraocular muscle enlargement.CONCLUSION: Orbital fat and extraocular muscle enlargement are likely to be observed on CTs of subjects with mild and severe exophthalmos, respectively. Our results suggest that CT findings may guide TAO clinical therapy recommendations and prognosis.     

定量分析糖尿病视网膜病变患者视盘周围视网膜和脉络膜血流灌注

目的 定量分析不同阶段糖尿病视网膜病变(DR)患者视盘周围视网膜和脉络膜变化。方法 对90例(90眼)患者进行横断面研究。受试者分为3组：对照组(n=30)、无DR(NDR)组(n=30)和非增生型DR(NPDR)组(n=30)。比较不同组别受试者视盘周围视网膜血流灌注(RP)、视网膜血管密度(RVD)、视网膜神经纤维层厚度(RNFL)、脉络膜血管体积(CVV)、脉络膜血管指数(CVI)、脉络膜厚度(CT)。结果 与对照组相比,NDR组患者RP[(13.16±0.98)mm²]、RVD[(61.80±5.29)%]、RNFL[(75.41±11.19)μm]均显著降低(均为P<0.05),NPDR组患者RP[(11.70±1.53)mm²]、RVD[(56.92±5.61)%]、RNFL[(68.77±9.61)μm]和CVI(0.16±0.05)均降低(均为P<0.05)。与NDR组相比,NPDR组患者RP、RVD、RNFL和CVI均降低(均为P<0.05)。结论 NPDR期患者视盘周围视网膜和脉络膜血流已发生变化。扫频O...     

应用EDI-OCT 检测NAION患者脉络膜厚度的研究

目的：评价利用光学相干断层扫描增强深部成像(enhanced depth imaging optical coherence tomography,EDI-OCT)测量非动脉炎性前部缺血性视神经病变(nonarteritic anterior ischemic optic neuropathy, NAION)脉络膜厚度的临床意义。

方法：选取2014-12/2016-10门诊就诊的NAION患者(对侧眼未受累)共30例30眼,选取与病例组性别、年龄、屈光度相匹配的正常对照组60例60眼,应用EDI-OCT分别测量患病眼、对侧眼及对照组右眼的脉络膜厚度。

结果：患病组与对照组相比,年龄、性别、屈光度无统计学差异(P>0.05)。经统计学检验,患病眼、对侧眼中心凹附近及视盘盘周各部位脉络膜厚度均小于对照组,差异有统计学意义(P<0.01),而患病眼与对侧眼脉络膜厚度比较差异无统计学意义(P>0.05)。

结论：NAION患者患病眼、对侧眼脉络膜厚度较正常对照组明显减低,提示睫状后短动脉小血管的阻塞可能影响脉络膜的血供,进而影响脉络膜厚度。     

Predictive parameters on CT scan for dysthyroid optic neuropathy

AIM: To quantitatively evaluate the effect of the combined use of 577-nm subthreshold micropulse laser (SML) and multi-point mode pan retinal laser photocoagulation (PRP) on severe non-proliferative diabetic retinopathy (NPDR) with central-involved diabetic macular edema (CIDME) using optical coherence tomography angiography (OCTA). METHODS: In this observational clinical study, 86 eyes of 86 NPDR patients with CIDME who underwent SML and PRP treatment were included. Images were obtained 1d before laser and post-laser (1d, 1wk, 1, 3, and 6mo) using AngioVue software 2.0. LogMAR best corrected visual acuity (BCVA), foveal avascular zone area (FAZ), choriocapillary flow area (ChF), parafoveal vessel density (PVD), capillary density inside disc (CDD), peripapillary capillary density (PCD), macular ganglion cell complex thickness (mGCCT), central macular thickness (CMT), and subfoveal choroidal thickness (ChT) were compared between pre- and post-laser treatment. RESULTS: BCVA remained stable during 6mo post-laser therapy (pre-laser vs 6mo post-laser: 0.53±0.21 vs 0.5±0.15, P>0.05). PVD, ChF, ChT, CMT, and mGCCT significantly increased 1d post-laser therapy (pre-laser vs 1d post-laser: superficial PVD, 40.51±3.42 vs 42.43±4.68%; deep PVD, 42.66±3.67 vs 44.78±4.52%; ChF, 1.72±0.21 vs 1.9±0.12 mm2; ChT, 302.45±69.74 vs 319.38±70.93 μm; CMT, 301.65±110.78 vs 320.86±105.62μm; mGCCT, 105.71±10.72 vs 115.46±9.64μm; P<0.05). However, PVD, ChF and ChT decreased to less than baseline level at 6mo post-laser therapy (pre-laser vs 6mo post-laser: superficial PVD, 40.51±3.42 vs 36.32±4.19%; deep PVD, 42.66±3.67 vs 38.76±3.74%; ChF, 1.72±0.21 vs 1.62±0.09 mm2; ChT, 302.45±69.74 vs 289.61±67.55μm; P<0.05), whereas CMT and mGCCT decreased to baseline level at 6mo post-laser therapy (CMT, 301.65±110.78 vs 297.77±90.23μm; mGCCT, 105.71±10.72 vs 107.05±11.81μm; P>0.05). Moreover, FAZ continuously increased while CDD and PCD continuously decreased in 6mo after laser therapy. CMT and ChT had a significant positive correlation with ChF and PVD in most post-laser stages. CONCLUSION: During a 6-month follow-up period after combined use of SML and PRP therapy, BCVA remain stable and there is a decreased trend in macular edema. Blood flow increases at 1d post-laser therapy and reduces at 6mo post-laser therapy.     

急性原发性闭角型青光眼首次发作后1年内视盘周围脉络膜厚度的变化

目的：探讨急性原发性闭角型青光眼(APACG)首次发作后1a内视盘周围脉络膜厚度(pCT)的变化规律。

方法：前瞻性队列研究。选取2015-10/2019-09于石家庄市人民医院眼科诊治的APACG患者31例(发作眼组31眼,对侧临床前期眼组31眼),正常对照组30例30眼,三组均在APACG发作期,术后1wk,1、3、6mo,1a测量pCT。

结果：发作眼组pCT在术后1wk时比发作期增厚,之后1a内持续变薄(P<0.05)。发作眼组pCT较其余两组：在发作期,术后1wk时增厚,1a时变薄(P<0.05)。发作眼组发作期平均pCT与高眼压持续时间正相关,与前房深度负相关(P<0.05)。

结论：首次发作的APACG患者,pCT在发作期和术后1wk弥漫增厚,1mo恢复正常,1a时变薄。发作期平均pCT与高眼压持续时间正相关,脉络膜厚度在APACG的发作中可能有重要作用。