Measurement of macular pigment optical density among healthy Chinese people and patients with early-stage age-related macular degeneration

AIMTo measure the macular pigment optical density (MPOD) in healthy Chinese people and patients with early age-related macular degeneration (AMD).METHODSCross-sectional population based study. Demographic and lifestyle characteristics were ascertained by questionnaire. A food frequency questionnaire was completed for all participants. Participants underwent general physical and ophthalmic examinations and MPOD was measured by heterochromatic flicker photometry. Foveal architecture was measured by optical coherence tomography.RESULTSMPOD of 225 participants (122 healthy and 103 early AMD) was 0.48±0.18. Patients with early AMD (0.52±0.19) tended to have higher MPOD levels than healthy people (0.47±0.17), but the difference was not statistically significant (P=0.06). Participants with carrot or corn oil intake every week tended to have higher levels of MPOD (P=0.002 and 0.008 respectively) while those with corn intake had relatively lower level of MPOD (P=0.01). MPOD increased with the center foveal thickness (P=0.01).CONCLUSIONOur findings show that there is no statistically significant association between MPOD and early AMD in the studied population. MPOD is related to center foveal thickness and diets would influence MPOD levels.

Association of macular pigment optical density with early stage of non-proliferative diabetic retinopathy in Chinese patients with type 2 diabetes mellitus

AIM：To detect the association between macular pigment optical density（MPOD）,which reflects the antioxidant ability of retina,and diabetic retinopathy（DR）and to investigate the correlated factors of MPOD.METHODS： Totally 435 subjects of urban Chinese were recruited to the study and divided into 3 groups： non-diabetes mellitus controls（NDM）,diabetic patients without retinopathy（DWR）,and patients with early stage of non-proliferative diabetic retinopathy（DR）.Demographic and lifestyle characteristics were ascertained by questionnaire.A food-frequency questionnaire,general physical and ophthalmic examinations were completed for all participants.MPOD was measured by heterochromatic flicker photometry.Foveal thickness was measured by optical coherence tomography.The difference of MPOD among 3 groups was analyzed by analysis of covariance.The correlation analyses of MPOD with the candidate influence factors were assessed using the generalized estimating equations（GEE） model.RESULTS： Of the 435 participants,34 could not perform the MPOD measurements.Final analysis included 401 subjects,including 48 were in DR group,134 in DWR group,and 219 in NDM group.MPOD was not significantly different among DR（0.49 ±0.21）,DWR（0.45 ±0.21）,and NDM（0.49±0.17） groups（P=0.24） after adjustment for fasting plasma glycemia,central foveal thickness,green vegetables,Chinese wolfberry,carotene and vitamin E.For all the 401 participants included,MPOD was positively associated with central foveal thickness（E=0.0007,P=0.001）,Chinese wolfberry（E=0.0345,P=0.01）,and green vegetables（E=0.0596,P〈0.001） intake.CONCLUSION： The data suggest that MPOD level is not statistically significantly influenced by the onset of diabetes or early stage of DR in the studied population.MPOD level is positively associated with thicker central foveal thickness and higher intake of foods containing carotenoids.

Identification of retinal thickness and blood flow in agerelated macular degeneration with reticular pseudodrusen

AIM:To investigate thickness characteristics and vascular plexuses in retinas with reticular pseudodrusen(RPD)as an early detection strategy for age-related macular degeneration(AMD).METHODS:This retrospective study included 24 subjects(33 eyes)with RPD and 25 heathy control subjects(34 eyes).The superficial capillary plexus(SCP)and the deep capillary plexus(DCP)of the retinal posterior poles were investigated with optical coherence tomography angiography(OCTA).Retinal thicknesses and vessel densities were analyzed statistically.RESULTS:The general retinal thicknesses of RPD eyes were significantly decreased(95%CI-14.080,-0.655;P=0.032).The vessel densities of DCP in RPD eyes were significantly increased in the global(95%CI 1.067,7.312;P=0.027),parafoveal(95%CI 0.417,5.241;P=0.022),and perifoveal(95%CI 0.181,6.842;P=0.039)quadrants.However,the vessel densities of the SCP were rarely increased in the eyes with RPD.CONCLUSION:The thinning of retinas in the RPD group suggests a reduction in the number of cells.Additionally,the increased vessel density of the DCP in retinas with RPD indicates a greater demand for blood supply,possibly due to the hypoxia induced RPD compensation caused by RPD in the outer retina.This study highlights the pathological risks associated with RPD and emphasizes the importance of early intervention to retard the progression of AMD.

Analysis of macular microvasculature and thickness after ICL implantation in patients with myopia using optical coherence tomography

AIM:To investigate changes in macular vessels and thickness in myopic eyes after intraocular collamer lens(ICL)implantation using quantitative optical coherence tomography angiography(OCTA).METHODS:This retrospective included 73 myopic eyes of 73 patients(average age,27.53±6.16 y)who underwent ICL implantation(28 eyes were Toric ICL).Axial length(AL),uncorrected visual acuity(UCVA),refractive dioptre(RD),intraocular pressure(IOP)and OCTA were measured and compared with before and 1 wk,1,and 3 mo after surgery.OCTA was used to image vessel density(VD)and skeleton density(SD)in both the superficial(SCP)and deep capillary plexus(DCP).Central retinal thickness(CRT)and ganglion cellinner plexiform layer thickness(GCT)were also measured.Changes between pre-and postoperative measurements were analysed by repeated measures analysis of variance.RESULTS:Compared with preoperative data,postoperative data on UCVA revealed significant improvements in all patients(P<0.05).However,there was no significant difference in IOP.After the operation,CRT and GCT exhibited significant changes(P<0.05).Among these measures,CRT was significantly higher at one and three months postoperative(all P<0.01).GCT was significantly higher at 1 wk,1,and 3 mo postoperative(all P<0.01).Changes in VD and SD were nonsignificant in both the SCP and DCP.There was no difference in postoperative changes between the ICL and Toric ICL groups.CONCLUSION:ICL and Toric ICL implantation both have good efficacy and safety for myopic eyes,but macular area changes that occur after surgery need attention.

Optical coherence tomography angiography metrics in different stages of diabetic macular edema

Background To investigate the optical coherence tomography angiography(OCTA)characteristics of diabetic macular edema(DME)at different stages.Methods This study was a cross-sectional study.Patients diagnosed with DME were recruited.DME was classified into early,advanced,and severe DME.The vessel density(VD)in the superficial vascular plexus(SVP),deep vascular plexus(DVP)and foveal avascular zone(FAZ)parameters,including FAZ area,FAZ perimeter,acircularity index and foveal VD in a 300-μm-wide region around the FAZ(FD-300),were calculated by the AngioVue software.A multivariate generalized estimating equation was used to evaluate the associations between visual acuity and OCTA metrics.Results Ninety-two eyes from 74 patients with DME were included in this study.Compared to early(P=0.006)and advanced DME(P=0.003),the acircularity index was higher in severe DME.Both whole and parafoveal VD in the DVP decreased in eyes with severe DME compared to early DME(P=0.018,P=0.005,respectively)and advanced DME(P=0.035,P=0.012,respectively).In the multivariate generalized estimating equation,DME severity,FAZ area and foveal thickness were positively associated with worse visual acuity(P=0.001,P=0.007 and P=0.001,respectively).Conclusion Compared to early and advanced DME,severe DME showed increased irregularity in the FAZ and more extensive vessel damage in the DVP.Greater severity level of DME,larger FAZ area,and increased foveal thickness could be risk factors for poor visual acuity.Trial registration The protocol was published in the Chinese Clinical Trial Registry(ChiCTR2000033082).

A decrease in macular microvascular perfusion after retinal detachment repair with silicone oil

AIM:To observe whether silicone oil(SO)tamponade could decrease macular perfusion after retinal detachment repair.METHODS:A prospective observational case-control study.Patients diagnosed with primary macular off rhegmatogenous retinal detachment undergoing successful retinal repair surgery with vitrectomy were strictly selected.Optical coherence tomography angiography findings were compared between SO and air tamponade groups.Two postoperative visiting points were set(1 and 3 mo).RESULTS:Totally 29 patients(29 eyes)were enrolled.Twenty cases had SO tamponade while 9 cases were with air tamponade.At the first visiting point,superficial parafoveal vessel density(PFSVD)significantly decreased in the SO group(P=0.0403),especially in the superior quadrant or superior-hemi area(P=0.0089,0.0426,respectively).Parafoveal deep vessel density(PFDVD)had no difference between the two groups.At the second visiting point,all quadrants of PFSVD reduced significantly in the SO group(P=0.0256,0.0001,0.0031,<0.0001 in temporal,superior,nasal,and inferior area,respectively),but PFDVD remained no different.In the air group,all areas of PFSVD showed significantly improving from the first visit to the second one(P=0.0324,0.0001,0.0371,0.0026,in temporal,superior,nasal,and inferior area,respectively);however,almost all quadrants of PFDVD showed no changes during this period.In the SO group,both PFSVD and PFDVD showed no obvious changes between the two visiting points.Besides,parafoveal full retinal thickness in the SO group reduced significantly at both visiting points over the air tamponade,while the foveal avascular zone area showed no difference in the two groups.CONCLUSION:After retinal detachment surgery with vitrectomy and SO tamponade,superficial macular perfusion and full retinal thickness could decrease obviously when compared to air tamponade.This reduction process could persist throughout the tamponade period.

Macular retinal thickness and flow density change by optical coherence tomography angiography after posterior scleral reinforcement

Optical coherence tomography angiography(Angio-OCT) has introduced a new non-invasive,quantitative method to assess superficial and deep capillary networks of the retina.In this study,we investigated macular retinal thickness and flow density change following posterior scleral reinforcement(PSR) surgery,using an RTVue XR Avanti Angio-OCT,in patients with pathological myopia.A total of 13 patients with pathological myopia were recruited and all patients completed the 6 months follow-up visit.Data from 22 eyes were used in this study.The mean age was 36.23±15.29 years,and 43%(n=6) were men.Spherical equivalent refractive error(SE) ranged from –8.0 to –24.0 D.Postoperative axial length,best-corrected visual acuity and SE did not change significantly at each follow-up,compared with pre-operative measures(P>0.05).Postoperative flow density of superficial and deep retinal layers at each sector did not change significantly at each follow-up,compared with preoperative measures(P>0.05).However,we found significant decrease in retinal thickness of parafovea-inferior sector after PSR surgery(P<0.01),indicating potential relaxation of vitreofoveal traction after PSR surgery.

Epiretinal membrane related vascular changes in diabetic eyes evaluated with optical coherence tomography angiography

AIM:To evaluate the retinochoroidal microvascular circulation and anatomical structure of diabetic and nondiabetic patients with epiretinal membrane(ERM)with the help of optical coherence tomography angiography(OCT-A)and compare them with healthy control subjects.METHODS:In this prospective,cross-sectional study,a total of 165 eyes were evaluated,including 50 eyes of patients with diabetic ERM,54 eyes of idiopathic ERM(iERM)patients,and 61 eyes of healthy controls.Macula and disc angiography was performed by OCT-A.Macular vessel density(VD)ratio was evaluated by dividing the VD of the foveal region by the VD of the parafoveal region.Statistical calculations were evaluated at the 95%confidence interval.RESULTS:Macula superficial VD values of ERM cases were lower than that in the control group,while foveal VD was higher in ERM cases.Macula deep VD values of ERM cases were lower in all quadrants,except the fovea.The width of the foveal avascular zone(FAZ)area was significantly lower in the ERM groups,and the FAZ width was lowest in iERM group.Macula superficial VD ratio was significantly higher in the ERM groups,but there was no significant difference between ERM groups.Macula deep VD ratio was significantly higher in the iERM group than in the control group.CONCLUSION:Diabetic and idiopathic ERMs differ in their mechanism of formation and clinical presentation,as well as their effect on retinal vascular structures.If the relationship of increase of retinal thickness with vascular integrity can be demonstrated with OCT-A,then,OCT-A can be used as a guide for ERM prognosis.

Retinal thickness and vascular parameters using optical coherence tomography in Alzheimer's disease:a meta-analysis

Examining the retinal tissue has the potential to provide a unique method and technique to quantify Alzheimer’s disease-related changes in participants at various stages of the disease.In this metaanalysis,we aimed to investigate the association of various optical coherence tomography parameters with Alzheimer’s disease and whether retinal measurements can be used to diffe rentiate between Alzheimer’s disease and control subjects.Scientific databases including Google Schola r,Web of Science,and PubMed were systematically searched for published articles that evaluated retinal nerve fiber layer thickness and retinal microvascular network in Alzheimer’s disease and control subjects.Seventy-three studies(5850 participants,including 2249 Alzheimer’s disease patients and 3601controls) were included in this meta-analysis.Relative to controls,Alzheimer’s disease patients had a significantly lower global retinal nerve fiber layer thickness(standardized mean difference [SMD]=-0.79,95% confidence intervals [CI]:-1.03 to-0.54,P <0.00001) as well as each quadrant being thinner in Alzheimer’s disease versus controls.Regarding macular paramete rs,values measured by optical coherence tomography were significantly lower in Alzheimer’s disease than controls for macular thickness(pooled SMD:-0.44,95% CI:-0.67 to-0.20,P=0.0003),foveal thickness(pooled SMD=-0.39,95% CI:-0.58 to-0.19,P <0.0001),ganglion cell inner plexiform layer(SMD=-1.26,95% CI:-2.24 to-0.27,P=0.01) and macular volume(pooled SMD=-0.41,95% CI-0.76 to-0.07,P=0.02).Analysis using optical coherence tomography angiography parameters revealed mixed results between Alzheimer’s disease and controls.Superficial vessel density(pooled SMD=-0.42,95% CI:-0.68 to-0.17,P=0.0001) and deep vessel density(pooled SMD=-0.46,95% CI:-0.75 to-0.18,P=0.001) were found to be thinner in Alzheimer’s disease patients whereas the foveal avascular zone(SMD=0.84,95% CI:0.17-1.51,P=0.01) was larger in controls.Vascular density and thickness of various retinal laye rs were decreased in Alzheimer’s disease patients compared to controls.Our results provide evidence for optical coherence tomography technology having the potential to detect retinal and microvascular changes in patients diagnosed with Alzheimer’s disease and aid in monito ring and early diagnosis methods.

Microvascular changes after conbercept therapy in central retinal vein occlusion analyzed by optical coherence tomography angiography

AIM: To investigate microvascular changes in eyes with central retinal vein occlusion(CRVO) complicated by macular edema before and after intravitreal conbercept injection and evaluate correlations between these changes and best-corrected visual acuity(BCVA) and retinal thickness. METHODS: Twenty-eight eyes of 28 patients with macular edema caused by CRVO were included in this retrospective study. All patients received a single intravitreal conbercept injection to treat macular edema. BCVA and the results of optical coherence tomography angiography(OCTA) automatic measurements of the vessel density in the superficial(SCP) and deep retinal capillary plexus(DCP), the foveal avascular zone(FAZ) area, the FAZ perimeter(PERIM), the vessel density within a 300-μm wide ring surrounding the FAZ(FD-300), the acircularity index(AI), the choriocapillaris flow area, and retinal thickness were recorded before and at one month after treatment and compared with the results observed in age-and sexmatched healthy subjects. RESULTS: The vessel density in the SCP and DCP, the FD-300, and the flow area of the choriocapillaris were allsignificantly lower in CRVO eyes than in healthy eyes, while the AI and retinal thickness were significantly higher(all P<0.05). After treatment, retinal thickness was significantly decreased, and the mean BCVA had markedly improved from 20/167 to 20/65(P=0.0092). The flow area of the choriocapillaris was also significantly improved, which may result from the reduction of shadowing effect caused by the attenuation of macular edema. However, there were no significant changes in SCP and DCP vessel density after treatment. The flow area of the choriocapillaris at baseline was negatively correlated with retinal thickness.CONCLUSION: OCTA enables the non-invasive, layerspecific and quantitative assessment of microvascular changes both before and after treatment, and can therefore be used as a valuable imaging tool for the evaluation of the follow-up in CRVO patients.

基于OCTA白内障术后黄斑血管密度变化的环形分区分析

目的分析白内障术前与术后视网膜黄斑中心凹的厚度、不同层次的血管密度(VD)和中央凹无血管区(FAZ)的变化。方法回顾性分析14例(16眼)接受白内障手术患者的临床资料。分别对黄斑中心4.5 mm×4.5 mm区域行光学相干断层血管造影检查,计算术前、术后1周、1个月、3个月的视网膜厚度、浅层毛细血管复合体及深层毛细血管复合体VD、FAZ面积等参数。采用自定义的环形分区分别计算并对比VD的变化。结果14例(16只眼)患者,术前术后视网膜厚度及FAZ无明显差异。浅层毛细血管复合体(SVC)的术后1周、1个月和3个月2 mm范围外的VD均值高于术前(P<0.05)。深层毛细血管复合体(DVC)术后3个月2 mm范围外VD均值高于术前(P<0.05)。结果视网膜内层VD的变化比外层VD的变化更明显。VD在外侧区域的变化比内侧区域更为明显。术后1周视网膜各层VD升高,术后1个月略有下降,3个月时仍超过基线水平。

Long-term outcomes of drusenoid pigment epithelium detachment in intermediate AMD treated with 577 nm subthreshold micropulse laser: a preliminary clinical study

AIM: To evaluate the long-term anatomical and visual outcomes of drusenoid pigment epithelial detachment(D-PED) in intermediate age-related macular degeneration(AMD) eyes treated with 577 nm yellow subthreshold micropulse laser(SML).METHODS: In this retrospective study, 21 eyes of 16 patients with D-PED in intermediate AMD were consecutively included and assessed.All the eyes were treated with 577 nm SML in several sessions according to D-PED growth status.The logarithm of the minimum angle of resolution(logMAR) best-corrected visual acuity(BCVA) were assessed at the initial visit and after treatment.Spectral-domain optical coherence tomography(SD-OCT) was performed to evaluate the D-PED lifecycle by volumetric calculations.Regression analysis was used to determine the breakpoint, growth, and collapse rate of the D-PED lesions.The progression to advanced AMD was also documented.RESULTS: All the eyes were treated with SML for 2.9±1.0 sessions.The mean follow-up period was 25.3±12.6 mo.The BCVA was stable from the baseline to final visit.All the eyes were categorized into two groups according to the anatomical changes of the D-PED lesion: the collapse group(n=6, 28.6%) and non-collapse group(n=15, 71.4%).The change in logMAR BCVA did not differ significantly between the collapse group 0.00(-0.31, 0.85) and non-collapse group 0.00(0.00, 0.00;P=1).Regression analysis showed that the growth rate was significantly higher in the collapse group(0.090±0.095 mm;/mo) than in the non-collapse group(0.025±0.035 mm;/mo;P<0.001).One eye(4.8%) developed macular neovascularization at 11 mo after SML treatment in the non-collapse group.Three eyes(14.3%) developed geographic atrophy(GA) in the collapse group.CONCLUSION: Compared to the natural course of D-PED reported by previous studies, our results preliminarily show that SML can alleviate visual loss and possibility of progression to advanced AMD in eyes with D-PED in intermediate AMD.A controlled clinical trial needs to further verify the benefit of the intervention.

中医针刺联合低浓度阿托品对低度近视儿童黄斑微循环的影响

[目的]探究中医针刺联合0.01%阿托品滴眼液对低度近视儿童黄斑血管密度及视网膜厚度的影响。[方法]将84例(156眼)首次诊断为低度近视的患儿随机分为实验组和对照组,实验组使用中医针刺联合0.01%阿托品滴眼液治疗,对照组使用0.01%阿托品滴眼液治疗。两组患儿治疗前及治疗6个月后进行眼科检查,包括裸眼远视力(uncorrected distance visual acuity,UCVA)、眼轴(axial length,AL)、等效球镜度数(spherical equivalent,SE)、裂隙灯检查,使用光学相干断层扫描(optical coherence tomography,OCT)常规模式测量黄斑神经节细胞-内丛状层(macular ganglion cell-inner plexiform layer,mGCIPL)厚度,使用光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)测量黄斑区血管密度、中心凹无血管区面积等,比较两组治疗前后各项指标的变化。[结果]治疗6个月后,两组患儿AL及SE均较治疗前增长,差异有统计学意义(P<0.01,P<0.01),但实验组AL、SE差值小于对照组,差异有统计学意义(P<0.05,P<0.05)。两组患儿眼压(intraocular pressure,IOP)较治疗前后无明显变化,差异无统计学意义(P>0.05)。与治疗前比较,实验组及对照组mGCIPL厚度均增加,差异有统计学意义(P<0.01,P<0.05);实验组中心圆黄斑血管密度(central circle macular vessel density,cCVD)增加,差异有统计学意义(P<0.01),外圆黄斑血管密度(outer circle macular vessel density,oCVD)、内圆黄斑血管密度(inner circle macular vessel density,iCVD)、全圆黄斑血管密度(whole circle macular vessel density,wCVD)及黄斑中心凹无血管区(foveal avascular zone,FAZ)无明显改变,差异无统计学意义(P>0.05)。治疗6个月后,实验组cCVD和AL、SE之间均无相关性(P>0.05),cCVD与mGCIPL厚度呈低度正相关(r=0.448,P<0.05)。[结论]中医针刺联合0.01%阿托品滴眼液能够进一步降低低度近视患儿AL增长及屈光度增长速度,并能够增加低度近视患儿cCVD及mGCIPL厚度。

基于OCTA技术的单侧RVO患者健侧眼黄斑区微血管血流密度、视网膜和脉络膜厚度变化

目的基于光学相干断层扫描血管成像(OCTA)技术,观察单侧视网膜静脉阻塞(RVO)患者健侧眼黄斑区微血管血流密度、视网膜和脉络膜厚度变化。方法单侧RVO患者38例共76只眼,其中患眼38只记为患侧眼组,健侧眼38只记为健侧眼组。另选取同期体检健康者25例的25只正常眼作为对照组。采用美国光视公司RTVue XR 100光学相干断层扫描仪进行黄斑区微血管血流密度、视网膜和脉络膜厚度测量,包括浅层毛细血管丛(SCP)全层、上半侧、下半侧、中心凹、旁中心凹、旁中心凹上半侧、旁中心凹下半侧、旁中心凹颞侧、旁中心凹上方、旁中心凹鼻侧、旁中心凹下方的血流密度(VD),深层毛细血管丛(DCP)全层、上半侧、下半侧、中心凹、旁中心凹、旁中心凹上半侧、旁中心凹下半侧、旁中心凹颞侧、旁中心凹上方、旁中心凹鼻侧、旁中心凹下方的VD,黄斑中心凹无血管区(FAZ)面积和周长、非圆度指数(AI),黄斑中心凹为中心周围300µm区域的视网膜(FD300)的VD,黄斑区视网膜厚度(CMT),黄斑中心凹下脉络膜厚度(SFCT)。结果与对照组组相比,健侧眼组SCP上半侧VD、SCP旁中心凹上半侧VD、DCP旁中心凹VD、DCP旁中心凹上方VD均降低(P均<0.05);与患侧眼组相比,健侧眼组SCP全层VD、SCP上半侧VD、SCP下半侧VD、SCP旁中心凹VD、SCP旁中心凹上半侧VD、SCP旁中心凹下半侧VD、SCP旁中心凹颞侧VD、SCP旁中心凹上方VD、SCP旁中心凹鼻侧VD、SCP旁中心凹下方VD、DCP全层VD、DCP上半侧VD、DCP下半侧VD、DCP旁中心凹VD、DCP旁中心凹上半侧VD、DCP旁中心凹下半侧VD、DCP旁中心凹颞侧VD、DCP旁中心凹上方VD、DCP旁中心凹鼻侧VD、DCP旁中心凹下方VD均升高,SCP中心凹VD、DCP中心凹VD、AI、CMT均降低(P均<0.05)。结论基于OCTA技术观察到单侧RVO患者的健侧眼黄斑区部分微血管血流密度已发生下降,但降低程度不及患侧眼,且健侧眼视网膜和脉络膜厚度变化不明显。

采用自适应光学扫描激光检眼镜系统观察健康成年人黄斑区视锥细胞的分布

目的:采用自适应光学扫描激光检眼镜(AO-SLO)系统观察不同年龄健康成年人黄斑区视锥细胞的分布,分析其与年龄的相关性。方法:选取2023-06/07于我院进行健康体检者100例200眼,根据年龄进行分组,其中A组年龄18-30岁,B组年龄31-40岁,C组年龄41-50岁,D组年龄51-65岁,每组各25例50眼。纳入研究对象双眼均行AO-SLO检查,测量视锥细胞密度。结果:各组研究对象双眼中心凹偏心率3°处2.4°×2.4°范围视锥细胞密度均有差异(P<0.001),且各区域视锥细胞密度均呈现较为规律的分布特点,均以颞侧视锥细胞密度最高,由高至低依次为颞侧>鼻侧>下方>上方。各组研究对象双眼黄斑区平均视锥细胞密度分别为14144.38±1082.40、13241.24±535.32、12930.29±727.73、10907.50±490.86 cell/mm 2(P<0.001),提示随着年龄的增长,视锥细胞密度呈下降趋势。相关性分析结果显示,纳入研究对象黄斑区平均视锥细胞密度与年龄呈负相关(r=-0.578,P<0.001)。结论:AO-SLO检查是一种可无创定量检测视锥细胞的方法,健康人群黄斑区视锥细胞密度与年龄呈负相关关系,50岁以上健康人群视锥细胞密度明显降低。

卵黄样黄斑营养不良的多模式影像特征观察

目的:观察卵黄样黄斑营养不良(BVMD,别称Best病)的多模式影像特征。方法:收集2016-06/2022-10于南京医科大学眼科医院确诊为Best病Ⅰ-Ⅳ期的患者30例60眼的临床资料进行回顾性分析,均双眼发病。所有患者均行最佳矫正视力(BCVA)、裂隙灯显微镜、间接眼底镜、眼压、眼底彩色照相、频域光学相干断层扫描(SD-OCT)、眼底自发荧光(FAF)、荧光素眼底血管造影(FFA)、眼电图(EOG)及光学相干断层扫描血管成像(OCTA)。结果:共纳入患者30例60眼,其中Ⅰ期8眼,Ⅱ期24眼,Ⅲ期22眼,Ⅳ期6眼,眼底彩色照相、FAF、FFA、SD-OCT的影像特征与既往文献报道基本一致,EOG显示Arden比均<1.55,OCTA能够发现早期病灶,观察到卵黄样物质、光感受器外节、液体的位置分布及有无CNV形成。结论:多模式影像有助于Best病的诊断,减少临床上漏诊、误诊,其中OCTA较其他检查有明显优势,快捷无创是其最大优势。

玻璃体激光消融治疗对黄斑微循环影响的临床研究

研究目的:研究YAG激光消融治疗对生理性玻璃体混浊黄斑微循环的影响。方法:筛选我院32例生理性玻璃体混浊患者,均行YAG激光消融治疗,术前检查最佳矫正视力(BCVA)、非接触眼压、眼部B超、间接眼底镜、OCTA测量黄斑中心凹无血管区(foveal avascular zone,FAZ)面积和黄斑区血流密度(macular vascular density,MVD),观察对比术后30 min、1周、1月、3月、6月以上检查的变化。结果:治疗前后患者的BCVA与非接触眼压无明显差异(P>0.05),玻璃体腔内的混浊物经治疗后明显变小,未发现明显的黄斑拱环形态改变及微血管异常改变。视网膜浅层黄斑区中心、内层、完整区域血管长度密度、血管灌注密度差异均无明显差异(P>0.05)。结论:YAG激光消融治疗能够安全有效改善玻璃体混浊症状,且对患眼视力、眼压和黄斑区微循环无不良影响。

光学相干断层扫描血管成像技术应用于糖尿病视网膜病变的临床价值

目的探讨光学相干断层扫描血管成像技术(OCTA)应用于糖尿病视网膜病变(DR)的临床价值。方法选取2021年12月至2022年12月于福州眼科医院就诊的80例2型糖尿病患者作为研究对象,根据国际糖尿病性视网膜病变(2002)的国际分级分为非增殖期糖尿病视网膜病变组(NPDR组,n=46)和糖尿病无视网膜病变组(无DR组,n=34)。另选取同期于福州眼科医院眼科中心检查视力的20名健康人作为对照组。所有受试者均进行OCT和OCTA检查,比较3组眼压、眼轴长度、黄斑血流密度、中心凹无血管区(FAZ)面积、中心凹脉络膜厚度(SFCT)。结果3组眼压比较差异无统计学意义;3组眼轴长度、旁中心凹区及中心凹周围区黄斑血流密度、FAZ面积及SFCT比较差异有统计学意义(P<0.05);NPDR组、无DR组眼轴长度均短于对照组,旁中心凹区及中心凹周围区黄斑血流密度均低于对照组,FAZ面积均大于对照组,SFCT均薄于对照组,且NPDR组旁中心凹区及中心凹周围区黄斑血流密度均低于无DR组,SFCT薄于无DR组,差异有统计学意义(P<0.05)。结论OCTA能准确检测黄斑血流密度、FAZ面积、SFCT,且随着病情加重黄斑血流密度显著升高,FAZ面积增大,SFCT变薄,OCTA在DR诊断中具有重要临床价值。

应用OCTA探究血管性麻痹性斜视黄斑区血流变化

目的利用光学相干断层扫描血管成像(OCTA)探究血管性麻痹性斜视患者麻痹期与恢复期黄斑区血管密度(VD)是否发生变化,分析血管性麻痹性斜视是否对黄斑区血流产生影响。方法本研究采用横断面观察实验设计,共纳入血管性麻痹性斜视患者30例,这些患者在2022年12月至2023年10月于内蒙古自治区人民医院眼科就诊。利用OCTA技术对麻痹期和恢复期患者进行黄斑区6 mm×6 mm扫描。对所得图像进行定量分析,计算视网膜浅层毛细血管(SCP)和深层毛细血管(DCP)的血流密度,以及无灌注区面积(FAZ)。结果30例血管性麻痹性斜视患者,平均恢复时间为(60.87±16.77)d。第六神经麻痹最常见。对比麻痹眼与非麻痹眼的OCTA结果发现,麻痹眼的SCP明显低于对侧眼,偏斜角度越大,眼动受限越严重,SCP血流密度越低。麻痹期与恢复期相比较,SCP恢复后明显增加。结论血管性麻痹性斜视患者麻痹眼黄斑区血流密度减低,缺血程度与眼运动受限程度相对应。

OCTA定量分析糖尿病视网膜病变患者黄斑区微循环变化

目的:通过光学相干断层扫描血管成像(OCTA)技术,评估糖尿病视网膜病变(DR)患者黄斑区微循环变化,并对可能影响黄斑区微循环的危险因素进行分析,为DR早期筛查、诊断及治疗干预提供临床依据。方法:回顾性研究。收集2022-05/10于西安市中心医院眼科门诊及病房就诊的2型糖尿病患者75例75眼,分为无DR(NDR)组28眼、非增殖型DR(NPDR)组25眼、增殖型DR(PDR)组22眼。应用OCTA对黄斑区视网膜行3mm×3mm血流成像扫描,自动获得浅层视网膜黄斑中心凹区、黄斑旁中心凹区(1~3mm)以及黄斑区3mm×3mm的血管密度(VD)和黄斑中心凹无血管区(FAZ)面积,分析黄斑区各参数在不同程度DR患者中的变化。结果:与NDR组相比,PDR组和NPDR组患者黄斑区3mm×3mm浅层视网膜毛细血管(SCP)的VD降低(均P<0.017),并且黄斑旁中心凹VD在各象限均降低(P<0.017),以PDR组降低最为显著。PDR组和NPDR组患者FAZ面积明显大于NDR组(P<0.017)。DR患者的年龄、同型半胱氨酸、最佳矫正视力(LogMAR)、眼轴、糖化血红蛋白(HbA1c)与黄斑中心凹区VD呈负相关(P<0.05),同型半胱氨酸、最佳矫正视力(LogMAR)、眼轴、糖尿病病程与黄斑区3mm×3mm VD呈负相关(P<0.05),甘油三酯、最佳矫正视力(LogMAR)、HbA1c与黄斑旁中心凹区VD呈负相关(P<0.05),总胆固醇、CMT与VD无明显相关(P>0.05)。结论:OCTA可以监测到DR患者黄斑区微循环变化,DR患者的全身情况与黄斑区微循环密切相关。