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AIM: To summarize the clinical features, systemic associations, risk factors and choroidal thickness (CT) changing in posterior scleritis (PS) with serous retinal detachment. METHODS: This retrospective study included 23 patients diagnosed PS with retinal detachment from August 2012 to July 2017. All patients' medical history and clinical features were recorded. The examinations included best corrected visual acuity (BCVA), intraocular pressure (IOP), fundus examination, and routine eye examinations. Posterior coats thickness (PCT) was determined by B-scan ultrasound, the CT was measured by enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) and clinical data were compiled and analyzed. RESULTS: After application of extensive exclusion criteria, 23 patients with PS remained (13 females, 10 males). The average age at presentation was 29.5±9.24 years old. Ocular pain and blurred vision were the two most common complained symptoms by patients. Anterior scleritis occurred in 12 patients, which was confirmed by ultrasound biomicroscopy (UBM) examination. Despite all patients displaying serous retinal detachment in their macula, no fluorescein leakage was observed in the macular area. Optic disc swelling was documented in 10 of the 23 eyes. From B-scan ultrasound examination, the PCT increased with fluid in Tenon's capsule demonstrated as a typical T-sign. The average PCT was 2.51±0.81 mm in the PS-affected eyes and only 1.09±0.29 mm in the unaffected eye (P<0.0001). The subfoveal CT was 442.61±55.61 µm, which correlated with axis length (r=-0.65, P=0.001) and PCT (r=0.783, P<0.001). The BCVA and IOP did not correlate with either CT or PCT. CONCLUSION: PS with serous retinal detachment presented a variety of symptoms, such as pain, visual loss, and physical indicators. Typical T-sign detected by B-scan ultrasound is a useful confirmatory sign for PS diagnosis. Pathological increases in CT might be a potential predictive factor for inflammation.
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BACKGROUND: Thyroid cartilage is an important barrier in anterior cervical approach surgery. The objective of this study is to establish normative values for thyroid cartilage at three planes and to determine their significance on preoperative positioning and intraoperative traction in surgery via the anterior cervical approach. METHODS: Neck CT scans were collected from 600 healthy adults who did not meet any of the exclusion criteria. Transverse diameters (D1, D2, and D3) of the superior border of the thyroid cartilage (SBTC), inferior border of the thyroid cartilage (IBTC), and the trachea transverse diameters of the inferior border of the cricoid cartilage (IBCC) were measured on a horizontal plane. RESULTS: All measured variables had intra-class correlation coefficients (ICCs) of ≥ 0.7. The differences in transverse diameters on the same plane between males and females were significantly different (all p < 0.001). The SBTC is most often at C4 in women (59.5%) and C4/5 in men (36.4%), the IBTC is most often at C5 in women (48.1%) and men (46.2%), and the IBCC is primarily located at C6 in women (45.2%) and C6 or C6/7 in men (34.4%) (all p < 0.001). CONCLUSION: We present normative values for thyroid cartilage at three planes of SBTC, IBTC, and IBCC in Chinese individuals. The individual and gender differences in the location of the thyroid cartilage and the size of the thyroid cartilage and the cricoid cartilage provide an anatomical basis to localize the skin incision, to predict the difficulty of intraoperative exposure and retractor pulling, and to identify that the thyroid cartilage protected the pharyngoesophageal wall.