ObjectivesTo evaluate the reproducibility of Heidelberg retina tomograph (HRT) macular edema module(MEM) measuring the macular retinal thickness.MethodsSixty-two healthy volunteers (9-68 years old) were examined by HRT-II procedure. The retinal signal width (SW) at macula and fovea and macular edema index (E) were recorded for t-test, Pearson linear-correlation analysis. Intra-subject variation repeatedly measured was analyzed with coefficient of variation, 95% tolerance limits of change (TC), and intraclass coefficient of correlation (ICC). ResultsIn healthy individuals, retinal SW was (0.734±0.236) mm at macula，and (0.781±0.243) mm at fovea; macular E was (1.169±0.619). The coefficient of variation repeatedly measured: retinal SW was (8.7±68)%，retinal SW at the fovea was (8.5±6.7)%, and the average was (15.6±13.9)%; 95%TC of intra-subject sequential repeated measurement was 0.131 (8.9%) of retinal SW, 0.137 (10.5%)of fovea SW，and 0.198 (7.4%) of average E. ICC of one individual repeatedly measured by one operator was 0.950 of macular SW, 0.949 of fovea SW, and 0.898 of average edema index.ConclusionsHRT-II MEM is noninvasive, fast and highly reproducible, which provides a new technique to monitor the objective quantification of macular diseases related to retinal thickness. ( Chin J Ocul Fundus Dis, 2005,21:103-105)
Objective To explore the positive rate of scanning laser ophthalmoscope in the retromode (RM-SLO) in different types of diabetic macular edema (DME), and to analyze its correlation with foveal thickness (CMT) and macular volume. MethodsFrom March to May 2021, 40 patients (65 eyes) were diagnosed as DME by fundus examination combined with optical coherence tomography (OCT) in Affiliated Eye Hospital of Wenzhou Medical University at Hangzhou were included in the study. All eyes underwent best corrected visual acuity (BCVA), OCT and RM-SLO fundus imaging examinations, 47 eyes underwent fluorescein fundus angiography (FFA) examination. RM-SLO fundus imaging examinations were performed with Mirante SLO, including retro mode illumination deviated right (RMDR) and retro mode illumination deviated left (RMDL). If one or more of the RMDR and RMDL of the examined patient can identify macular edema, RM-SLO was considered to be able to identify macular edema. The macular volume at CMT and 6 mm from the fovea was measured by OCT software. DME were divided into 3 types based on OCT images: diffuse retinal thinkening (DRT) type; cystoid macular edema(CME) type; serous retinal detachment (SRD) type, focal leakage type, diffuse leakage type and diffuse cystic leakage type. The consistency of RMDR and RMDL in the diagnosis of DME in RM-SLO fundus imaging was evaluated, as well as their positive rate in different classifications of DME. The correlation between the detection of macular edema by RM-SLO and the DME type, CMT and foveal volume, and the correlation between BCVA and edema type, CMT and macular volume were analyzed. ResultsAmong 65 eyes, the positive rates of RMDR and RMDL fundus imaging to detect DME were 46 (70.77%, 46/65) and 48 (73.85%, 48/65), respectively. There was good consistency in identifying DME (Kappa value=0.770; P＜0.001). The positive rates of RMDR and RMDL fundus imaging DRT, CME and SRD type of DME were 42.11% (8/19), 57.89% (11/19), 77.78% (28/36), 77.78% (28/36), 100.00% (10/10), 90.00% (9/10), respectively. In the FFA classification of them, the positive rates of focal leakage, diffuse leakage and diffuse cystic leakage were 68.75% (11/16), 62.50% (10/16), 68.00% (17/25), 76.00% (19/25), 100.00% (6/6), 100.00% (6/6), respectively. The results of Spearman correlation analysis showed that whether RM-SLO could identify DME was associated with CMT and OCT classification (r=0.310, 0.365; P=0.120, 0.003); there was no correlation between FFA classification and macular volume (r=0.113, 0.117; P=0.449, 0.352). BCVA was correlated with CMT and macular volume (r=0.307, 0.269; P=0.013, 0.030), however, there was no significant correlation with OCT type, angiographic type (r=0.051, 0.175; P=0.684, 0.240). ConclusionThe diagnostic agreement of DME are good between RMDR, RMDL of RM-SLO image. DME of DRT type and patients with smaller CMT in OCT are difficult to identified by RM-SLO fundus imaging.
Objective To verify the applicable significance of confocal scanning laser retinal tomography in agerelated macular degeneration (AMD). Methods Heidelberg confocal scanning laser tomography was used to measure 75 eyes of 59 patients with AMD, including 25 eyes of 20 patients with exudative AMD, 25 eyes of 16 patients with atrophic AMD, and 25 eyes of 23 patients with macular drusen. The differences of the width, volume and maximum height of Z profile signal of macula were analyzed. Results Z profile signal width in macular tomography of exudative AMD was wider than that of macular drusen; maximum height and volume in macular tomography of exudative AMD were larger than that of macular drusen (P＜0.01); Z profile signal width, maximum height，and volume in macular tomography of atrophic AMD were wider and larger than that of macular drusen (P＜0.05). Macular volume of exudative AMD was obviously larger than that of atrophic AMD (P＜0.01). Conclusion Confocal scanning laser tomography may be one of the useful methods for objective evaluation of morphologic change for the development of AMD. (Chin J Ocul Fundus Dis, 2002, 18: 262-265)
The pathogensis of choroidal vascular changes in traumatic rtinopethy remains uncertain.We performed scanning electron micrmcopie (SEM) observation of methyl methalerylare vascular corrosion casts in a rabbi model with severe retinal contusion. Areas of filling defects in corrosion casts of the choriocapillaries, correspending to the areas of impact retinal lesions were noted in the traumatized eyes one to 28 days after trauma.No neovascularization was found in the eyes 56 days after trauma. The results confirm that obstruction and disappearance of involved choriocapillaries are the main changes of choroidal vasculatrue in severe blunt tram. The changes may be associated with continuous necrosis, of the photoreceptors 4 weeks after injury. （Chin J Ocul Fundus Dis,1993,9:5-7）
Purpose To observe the pathologic changes of retinal photic injury in mice. Methods A light damaged trunk was designed by ourselves.The mice were given an intermitent light exposure for 3 days,12 hours light exposure every day and 12 hours dark adaption before every exposure.Experimental animals were sacrificed on the 1st,6th,12th,18th and 30th day after light injury,and the eyes were enucleated for light and electronic microscopy observation. Results The early pathologic changes including disc membrance swelling,disorganization in outer segments,and mitochondrial swelling,spherical change in inner segments．Then the chromatin densification,liquefaction and margination,and the shrinkage of nuclear membrance were found in the nuclear layer.Finally the outer nuclear layer became thin and disappeared.The apical microvill of RPE cell disappeared and basic fold became flat in some samples. Conclusion The photoreceptor degeneration was the pathologic characteristic of retinal photic injury in mice. (Chin J Ocul Fundus Dis,1998,14:215-218)
Objective To observe the effect of scanning laser ophthalmoscope (SLO) measuring macular light sensibility on evaluating the visual function in idiopathic epiretinal membrane (IERM), and analyze the relationship among the macular light sensibility, central visual acuity, and the thickness of fovea. Methods Procedure of microperimetry of SLO was performed on 44 patients (55 eyes) with IERM diagnosed by indirect and direct ophthalmoscope and optical coherence tomography (OCT). The light sensibility at 10deg;macular central area was measured. The results were compared with 31 healthy control eyes which underwent the same examinations simutaneously. The correlation among the macular light sensibility, the thickness of fovea measured by OCT, and the results of logarithm visual acuity was anaylzed. Results Compared with the control eyes, macular light sensibility decreased in IERM eyes significantly (F=47.265, Plt;0.01), which had the positive correlation with the decrease of visual acuity (r=0.687, P=0.000) and negative correlation with the retinal thickness of macular fovea (r=-0.532,P=0.003). The mean macular light sensitivity in patients with metamorphopsia decreased obviously compared with which in patients without (t=7.039, P=0.000). The mean macular light sensitivity in patients with prolifertive IERM decreased compared with which in patients with dropsical IERM without statistical difference (t=-1.706, P=0.094). Conclusion Microperimetry of SLO may sensitively reflect the macular visual function of eyes with IERM and quantificationally evaluate the changes of macular light sensibility. The changes of macular light sensitivity correlates with the central visual acuity and retinal thickness of macular fovea. (Chin J Ocul Fundus Dis, 2006, 22: 100-102)
Objective To observe the corneal nerve fibres damage in different stage of diabetic retinopathy (DR) with type 2 diabetes. Methods A cross-sectional study. One hundred and twenty eyes of 120 patients with type 2 diabetes served as diabetes group. According to International Clinical Diabetic Retinopathy Disease Severity Scales (2002), diabetes patients were classified into 4 subgroups: patients without diabetic retinopathy (NDR), patients with mild or moderate non-proliferative diabetic retinopathy (mNPDR), patients with severe non-proliferative diabetic retinopathy (sNPDR) and patients with proliferative diabetic retinopathy (PDR), each subgroup has 30 eyes of 30 patients. Another 30 eyes of 30 healthy participants served as control group. All eyes were scanned with HRT3 in vivo corneal confocal microscopy. Images of sub-basal nerve plexus were quantified including nerve fiber length (NFL), nerve fiber density (NFD), nerve fiber branch density (NFB), and nerve tortuosity (NT). The correlations of corneal nerve fiber with age, duration of diabetes and glycated hemoglobin (HbA1c) were analyzed using Spearman correlation analysis. Results NFL, NFD and NFB were found to be significantly lower in diabetic patients (F=147.315, 142.586, 65.898;P=0.000, 0.000, 0.000), NT was significantly greater in diabetic patients (F=39.431,P=0.000), when compared to control group. In diabetic patients, NFL, NFD and NFB were gradually reduced with DR severity, NT was gradually increased with DR severity. While the difference of NFL, NFD, NFB, NT was not statistically significant between sNPDR and PDR subgroups (P＞0.05), but was statistically significant between other subgroups (P＜0.05). Spearman correlation analysis results showed that age (r=－0.071, －0.080, 0.001, 0.100;P=0.391, 0.328, 0.991, 0.224) and HbA1c (r=－0.109, －0.115, －0.126, 0.025;P=0.238, 0.211, 0.169, 0.781) had no correlation with NFL, NFD, NFB, NT. Duration of diabetes was negatively correlated with the NFL, NFD (r=－0.212, －0.264;P= 0.020, 0.004), positive correlated with NT (r=0.261,P=0.004), and had no correlation with NFB (r=－0.119,P=0.194). Conclusions Corneal nerve fiber loss and nerve tortuosity increased were found in patients with type 2 diabetes, and even without diabetic retinopathy. The progress of corneal neuropathy was correlated with the severity of DR, but it was not change significantly between sNPDR and PDR.
Objective To study the progressive development of the retinas through an observation on the histological changes of the retinas from neonatal mice of different day-ages. Methods The retinas from the mice of 1 to 20 days of age were examined by light microscopy,and from 1 to 3 days,by autoradiography. Results The retinas of the mice below 3 days of age only had the RPE cells layer,the neuroblast layer and the ganglion cell layer.With the increase in dayage,the retinas developed gradually and would be mature in the 20th day. Conclusions The retinas of mice is a kind of immature tissue before the 20th days,so it can be considered as transplantation donors. (Chin J Ocul Fundus Dis, 1999, 15: 174-176)
ObjectiveTo compare the imaging characteristics and detection of various types of lesions in diabetic retinopathy (DR) with colorful laser scanning fundus imaging (MSLI) and traditional color fundus photography (CFP).MethodsProspective case series observational study. A total of 38 eyes of 38 patients with DR diagnosed by clinical examination were included in the study. Among them, 21 were male and 17 were female; the mean age was 62.6±11.2 years; the average duration of diabetes was 14.3±7.5 years. All the patients were performed CFP, MSLI, frequency domain optical coherence tomography (SD-OCT), fluorescein angiography (FFA) examination. Using the Helielberg Spectralis HRA+OCT MSLI inspection, one scan simultaneously obtained 488 nm blue reflection (BR), 515 nm green light reflection (GR), 820 nm infrared light reflection (IR), and multicolor image (MC). The detection of traditional CFP and MC on microaneurysm (MA), hard exudation (HEX), cotton plaque (CWS), intraretinal hemorrhage (IRH), intraretinal microvascular abnormality (IRMA), venous bead (VB), venous ring (VL), macular edema (DME), macular anterior membrane (MEM) and laser photocoagulation (LB) were comparatively observed. The results of FFA examination were used as the diagnostic criteria for lesions. SD-OCT was used to determine the location and depth of lesions and the diagnostic reference for DME and MEM.ResultsThe numbers of eyes with MA (χ2=10.460), DME (χ2=4.006), MEM (χ2=4.444) was significantly higher in MC than that of traditional CFP. But the number of eyes with IRH (χ2=0.103), CWS (χ2=1.515), HEX (χ2=0.227), IRMA (χ2=0.051), VB (χ2=0.001), VL (χ2=0.149), VH (χ2=0.693) and LB (χ2=0.720) were not statistically significant between two methods (P>0.05). The imaging quality of MSLI mode is obviously better than that of traditional CFP. Among them, GR imaging shows the best structural changes of superficial retina in MA, CWS, HEX, MEM, etc. IR imaging shows clear depth in deep retina such as LB. DME was green on MC and the weak low-reflection dark area was visible on the IR image, which were consistent with the DME range indicated by the SD-OCT examination.ConclusionsCompared with the traditional CFP, the MSLI can clearly show the DR lesion. The number of checkouts is high on MA, DME and MEM by MC image.
Confocal scanning laser ophthalmoscope imaging superimpose two or three kinds of lasers to obtain images of different layers of retina, and then synthesize a pseudo-color fundus image by computer. Confocal scanning laser ophthalmoscope is widely used in outpatient fundus pre-examination and epidemiological screening of large samples due to its features of non-mydriatic, fast imaging, simple operation and high degree of patient cooperation. It has good clinical and scientific application value in the diagnosis and treatment of a variety of fundus diseases. Because of there is still a lack of unified standards for laser fundus photos in China, it is necessary to correctly identify the common fundus lesions in confocal scanning laser ophthalmoscope and to summarize and popularize the method of reading the photos in layers. In addition, we should give full play to the its advantage of layering and locating, and reasonably choose the combination of OCT, OCT angiography, FFA, ICGA, ultrasonography, so as to maximize its clinical application value and help clinical diagnosis.