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 study the human optic canal and its inner structures, and provide anatomic knowledge of this area for optic nerve decompression and further study in pathologic mechanisms of indirect optic nerve injury. Methods Serial sections of the 18 optic canals of adults were made at orbital, middle and cranial parts. Quantitative measurements of the canal wall thickness, canal transverse area, dural sheath transverse area, optic nerve transverse area, and subarachnoid space transverse area were done by means of IMAGEPRO morphometric analysis system. Subarachnoid space transverse area to canal transverse area ratio (SSTA/CTA) and subarachnoid space transverse area to dural sheath transverse area ratio (SSTA/DSTA) were calculated. Results The middle portion of medial wall is the thinnest part of the canal (0.35plusmn;0.48)mm. The middle part of the optic canal was the narrowest part and the transverse area was (17.54plusmn;2.12)mm2. From cranial end to orbital end, SSTA/CTA, SSTA/DSTA and the subarachnoid space transverse area became smaller and smaller. Conclusion Since the potential space is limited, even a tiny amount of blood or sweling of the nerve may cause optic compression. Due to the potential space gradually decreases from cranial end to orbital end and the narrowest portion of the canal is in the middle part, the middle part and the anterior part of the optic canal are critical in optic narve decompression. (Chin J Ocul Fundus Dis,1999,15:24-26)
Objective To evaluate the influence of the location of retinal vessel trunk on neuroretinal rim width of inferior and superior sectors of optic disc, and explore its role in the diagnosis of glaucomatous optic nerve lesion. Methods The photographs of ocular fundus from 459 patients with clear location of retinal vessel trunk, including large disc in 131, medium disc in 145, horizontally oval disc in 75, and small disc in 108 were evaluated. Independent-sample t test was used to compare the difference of the superior and inferior rim widths between the higher-vessel group and the lower-vessel group, and to compare the difference of superior and inferior vessel distances between the narrow-superior-rim-width group and the narrow inferior-rim-width group. Results In most of the patients, or the ones with large and small disc, the ratio of superior rim width to summation of superior and inferior rim widths in the higher-vessel group（0.467plusmn;0.051，0.445plusmn;0.040，0.508plusmn;0.056）were less than which in the lowervessel group（0.500plusmn;0.066，0.474plusmn;0.062，0.546plusmn;0.048）, and the differences were significant（P=0.000, 0.045, 0.018）; the ratio of superior vessel distance to summation of superior and inferior vessel distance in the narrow-superior-rim-width group（0.510plusmn;0.051，0.508plusmn;0.055，0.512plusmn;0.036）were less than which in the narrow-inferior-rim-width group（0.528plusmn;0.045，0.533plusmn;0.048，0.534plusmn;0.045）, and the differences were significant（P=0.000, 0.046, 0.022）. Conclusions The position of optic disc vessel trunk influences its superior and inferior rim width. The rim closer to vessel trunk position has narrower width than which comparatively far away from the position. In patients with large, medium, horizontally oval optic disc, glaucoma optic nerve lesion would be considered if the optic disc has the shape of narrower inferior rim, broader superior rim, and vessel location in the superior half of the disc. In the ones with small disc, the optic disc with the shape of narrower superior rim, broader inferior rim, and vessel location in the inferior half of the disc may suggest glaucoma optic nerve lesion. (Chin J Ocul Fundus Dis, 2007, 23: 118-121)
Objective To reveal the fibrillar network in vitreous and the effect of plasmin on this network.Methods 20 vitreous gels of freshly slaughtered pigs were divided into 2 groups, the gels in first group were digested by 3 Uplasmin (3 U/ml) at 37c for 24 hours respectively, the second group received the same PBS as control. After digestion, gels were fixed in neutral buffered formalin solution. Samples from vitreous base, cortex and the central region were observed by the technique of freeze etching electron microscopy.Results In vitreous collagen fibril network was in a three-dimensional array, collagen fibril density showed marked differences, central vitreous had the sparse fibril density, the cortex denser and the basal vitreous densest. After digestion by plasmin, the collagen fibrillar network was destructed.Conclusion Collagen fibrils in vitreous present spatial arrangement regularly, plasmin can lead to destruction of the fibrillar network.(Chin J Ocul Fundus Dis，2003，19：179-181)
PURPOSE:To evaluated the luminal characteristics of the elderly central retinal vessels in the anterior optic nerves. METHODS:Serial sections of 15 central retinal arteries(CRA)and 23 central retinal veins (CRA)of 18 eyes of the aged 60 to 82 years old without anatomic malformation were examined by image analysis to investigate their luminal dimensional differences at the sites of lamina cribrosa and just anterior and posterior to it. RESULTS:The average values of the mean area of the CRA in the prelaminar,laminar,retrolaminar portions were separately(12.70,17.40,18.00)times;10-3mm2 and the mean perimetric length 0.56,0.56,0.57mm.No significant difference was detected in these three sites.The average values of the mean area of the CRV were respectively(7.00,5.40,7.90)）times;10-3mm2 and the mean perimetric length 0.44,0.38,0.41mm.There were marked differences between the prelaminar value and the laminar one,and between the laminar value and retrolaminar one by comparison. CONCLUSION:The CRA has a uniform radius from prelaminar to retrolaminar positions,and tube radius of the CRV at the level of the lamina cribrosa is the least. （Chin J Ocul Fundus Dis,1997,13: 213-214 ）
Objective To review the research progress of pathological changes of glenohumeral capsule in patients with recurrent shoulder anterior dislocation (RSAD). Methods The literature on shoulder capsules, both domestic and international, was reviewed. The anatomy, histology, and molecular biology characteristics of the glenohumeral capsule in RSAD patients were summarized. Results Anatomically, the glenohumeral capsule is composed of four distinct parts: the upper, lower, anterior, and posterior sections. The thickness of these sections is uneven, and the stability of the capsule is further enhanced by the presence of the glenohumeral and coracohumeral ligaments. Histologically, the capsule tissue undergoes adaptive changes following RSAD, which improve its ability to withstand stretching and deformation. In the realm of molecular biology, genes associated with the regulation of structure formation, function, and extracellular matrix homeostasis of the shoulder capsule’s collagen fibers exhibit varying degrees of expression changes. Specifically, the up-regulation of transforming growth factor β1 (TGF-β1), TGF-β receptor 1, lysyl oxidase, and procollagen-lysine, 2-oxoglutarate 5-dioxygenase 1 facilitates the repair of the joint capsule, thereby contributing to the maintenance of shoulder joint stability. Conversely, the up-regulation of collagen type Ⅰ alpha 1 (COL1A1), COL3A1, and COL5A1 is linked to the recurrence of shoulder anterior dislocation, as these changes reflect the joint capsule’s response to dislocation. Additionally, the expressions of tenascin C and fibronectin 1 may play a role in the pathological processes occurring during the early stages of RSAD. ConclusionGlenohumeral capsular laxity is both a consequence of RSAD and a significant factor contributing to its recurrence. While numerous studies have documented alterations in the shoulder capsule following RSAD, further research is necessary to confirm the specific pathological anatomy, histological, and molecular biological changes involved.
Objective To observe the digital subtraction angiography (DSA) characteristics of ophthalmic artery and its main branches in ischemic cerebrovascular disease (ICVD). Methods The internal carotid arteries, external carotid arteries and ophthalmic arteries of 32 ICVD patients were examined for DSA. The characteristics of ophthalmic artery origin, trail and main branches were observed. Results Among 64 carotid arteries of 32 patients, there was one carotid artery with internal occlusion, there was no severe stenosis in the other 63 carotid arteries. The 63 ophthalmic arteries originated all from supraclinoidal and ophthalmic segments of internal carotid arteries. 58 ophthalmic arteries were single branch from the internal carotid artery. 5 ophthalmic arteries had 2 branches, one come from the internal carotid artery, the other come from the middle meningeal artery (external carotid artery branch ) in 4 cases or from the anterior cerebral artery (carotid artery branch) in 1 case. The main branches of ophthalmic artery included central retinal artery, posterior ciliary artery, lacrimal gland artery, ocular muscular artery; anterior ethmoid artery, posterior ethmoid artery, supraorbital artery, dorsal nasal artery, supratrochlear artery and eyelid artery. The beginning point of each branches were variable. Conclusions Ophthalmic arteries of ICVD patients primary arise from the internal carotid artery. It most often appears as single branch and occasionally as double branches. The beginning points of major branches of ophthalmic artery are variable.
Objective To observe the characteristics of morphosis parameter of the optic disc of physiologic large cup. Methods 100 eyes with physiologic large cup and 74 eyes with normal cup were examined by Heidelberg Retina Tomograph (HRT ). The differences of morphosis parameters between two groups were analyzed comparatively on disc area (DA), cup volume (CV), cup/disc area ratio (C/DR), rim area (RA), cup volume (CV), rim volume (RV), mean cup depth (MeCD), maximum cup depth (MxCD), cup shape measure (CSM), height variation contour (HVC), mean retinal nerve fiber layer thickness (mRNFLt), and retinal nerve fiber layer cross-section area (RNFLcsa). The characteristics of the inferior, superior, nasal, and temporal quadrants of the physiologic large cups were analyzed. Results DA, CA, C/DR, CV, MeCD, CSM （P=0.00, respectively）and MxCD （P=0.04）were significantly larger in eyes with physiologic large cup than in eyes with normal cup. RA, RV, HVC, mRNFLt, RNFLcsa （P=0.00, respectively) were significantly smaller in eyes with physiologic large cup than in eyes with normal cup. The temporal quadrant of RV of the physiologic large cup is the narrowest. RNFLcsa decreased as the fol lowing order: superior, inferior, nasal, and temporal（P＜0.05）. Conclusions Mo rphosis parameter of the optic discs of physiologic large cup has its own repres entation on characteristics. Compared to normal cups, physiologic large cups had larger discs but smaller mRNFLt. The nasal quadrant of DA was larger than the i nferior quadrant. （Chin J Ocul Fundus Dis，2008，24：213-216）
ObjectiveTo observe the macular morphological development and thickness of retinal layers in infants. MethodsFifty-eight infants (86 eyes) were randomly selected from neonatal intensive care unit. They were divided into 4 groups according to the corrected gestational age, including <32 weeks group (10 cases, 14 eyes), 33 to 36 weeks group (26 cases, 39 eyes), 37 to 41 weeks group (12 patients, 18 eyes) and ≥42 weeks group (10 cases,15 eyes). Twelve health adults (22 eyes) were randomly selected as adult group. All infants and adults underwent a portable optical coherence tomography (OCT) examination, focus on the macular morphology. The thickness of 9 retinal layers at fovea and parafovea (750 μm, 1500 μm from central fovea) were measured, including retinal neurepithelium layer, the inner retina, the outer retina, nerve fiber layer, ganglion cell layer, inner plexiform layer, inner nuclear layer, outer plexiform layer and inner nuclear layer. The correlation between retinal thickness and corrected gestational age was analyzed. ResultsMacular fovea was shallow in early infancy, and then form a mature macular fovea finally with corrected gestational age. The outer retina structure was more mature than the inner retina of infants. With the increase of the corrected gestational age, the following structures gradually developed including the outer limiting membrane (OLM), the junction of inner and outer segment of photoreceptor (IS/OS), the outer segment of photoreceptor/retinal pigment epithelium layer (OS/RPE). The earliest corrected gestational age to detect the OLM, IS/OS, OS/RPE was 32+6, 35, 47+6 weeks respectively. The RPE and choroid layer became thicker gradually. There were no statistical differences between infants group and adults group (P>0.01) for the following thickness measurements, including inner retina at 750 μm parafovea, nerve fiber layer at 1500 μm parafovea, ganglion cell layer at central fovea and parafovea (750 μm, 1500 μm). The thickness of other retinal layers was different between different sites, between different corrected gestational ages, and between infants and adults groups (P<0.01). Correlation analysis found that, except of retinal ganglion cell layer, the thickness of other retinal layers was correlated with the corrected gestational age (P<0.05). ConclusionsMacular fovea is shallow in early infancy, and then form a mature macular fovea finally with corrected gestational age. At infant's early stage, the outer retina of macular is gradually thickening, of which the most obvious variation are the inner nuclear layer and outer nuclear layer. But the development speed of all layers is inconformity.
ObjectiveTo evaluate the repeatability and reproducibility of macular ganglion cell-inner plexiform layer (GCIPL) thickness measurement using spectral-domain optical coherence tomography (Cirrus HD-OCT). MethodOne hundred and eight eyes of 54 normal subjects (26 males and 28 females) between 19 and 75 years of age were included. Each eye underwent macular scanning using Cirrus HD-OCT Macular Cube 512×128 protocol by two operators. Three scans of each eye were obtained by each operator. For the right eye of each subject, three extra scans were obtained using Macular Cube 200×200 protocol by one operator. The average, minimum, superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal GCIPL thickness was analyzed and the repeatability of GCIPL thickness measurement was evaluated with intra-operator, inter-operator, intra-protocol, and inter-protocol intraclass correlation coefficients (ICC). Ten extra scans were obtained from the left eyes of 10 randomly selected subjects for reproducibility assessment with coefficients of variation (CV). ResultsThe intra-operator ICC of macular GCIPL measurement using Macular Cube 512×128 protocol by two operators were 0.959-0.995 and 0.954-0.997, respectively; and the inter-operator ICC were 0.944-0.993. All intra-and inter-operator ICC were > 0.800 with the highest and lowest records of the average and minimum GCIPL thickness, respectively. The intra-protocol ICC of Macular Cube 512×128 protocol and Macular Cube 200×200 protocol were 0.986-0.996 and 0.927-0.997, respectively; and the inter-protocol ICC were 0.966-0.994. All intra-and inter-protocol ICC were > 0.800. CV of GCIPL thickness measurement using Macular Cube 512×128 protocol were (0.70±0.31)%-(1.35±0.86)%. ConclusionCirrus HD-OCT can measure macular GCIPL thickness in normal eyes with excellent repeatability and reproducibility.