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AIM: To observe the retinal and choroidal circulations in patients with non-arteritic permanent central retinal artery occlusion (NA-CRAO) via optical coherence tomography angiography (OCTA) and analyze their correlation with visual acuity. METHODS: Sixty-two eyes with clinically confirmed acute NA-CRAO were included in the study and divided into: A type (mild n=29), B type (moderate n=27) and C type (severe n=6) based on the degree of visual loss, retinal edema, and arterial blood flow delay in fundus fluorescence angiography (FFA). Contralateral healthy eyes were used as the control group. Best-corrected visual acuity (BCVA), slit lamp microscopy, indirect ophthalmoscopy, fundus color photography, OCTA, and FFA were performed. Spearman's correlation analysis was used to determine the correlations between retinal and choroidal vessels and visual acuity. RESULTS: There were no statistically significant differences in age, gender, and intraocular pressure among the three types and the control group (P>0.05). Vessel density in deep capillary plexus (VD-DCP) significantly decreased (P<0.05) in all three types of NA-CRAO patients compared to the control group. Vessel density in superficial vascular plexus (VD-SVP) significantly decreased (P<0.05) in type A patients and choriocapillaris flow area significantly decreased (P<0.05) in type B and type C patients compared to the control group; while outer retinal flow areas significantly increased in the type A (P<0.05) and decreased in type C patients (P<0.05). The retinal thickness significantly increased in type C group (P<0.05). The VD-SVP at fovea in the type A was significantly lower than both of type B and C. The VD-SVP at nasal parafovea in type A and B was significantly lower than type C (P<0.05). The logMAR BCVA of type A was significantly better than that of type B and C groups (P<0.05). Spearman's correlation analysis showed that the logMAR BCVA was positively correlated with VD-SVP at fovea (r=0.679, P=0.031) and nasal parafovea (r=0.826, P=0.013). CONCLUSION: OCTA is valuable for assessing retinal ischemia, and evaluating visual impairment. Deep retinal vasculature is commonly affected in all NA-CRAO types. VD-SVPs at fovea and nasal parafovea can serve as reliable markers of visual impairment in NA-CRAO.
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BACKGROUND: Non-arteritic anterior ischemic optic neuropathy (NAION) is an independent disease characterized by edematous optic discs. In eyes with branch retinal vein occlusion (BRVO), the arteries and veins in the ethmoid plate of the optic disc are relatively crowded; however, a combination of the two is clinically uncommon. Herein, we reported a patient with NAION and concealed BRVO, for which the treatment and prognosis were not similar to those for NAION alone. CASE SUMMARY: Herein, we report a case of NAION with concealed BRVO that did not improve with oral medication. A week later, we switched to intravenous drug administration to improve circulation, and the patient's visual acuity and visual field recovered. Hormonal therapy was not administered throughout the study. This case suggested that: (1) Fundus fluorescein angiography (FFA) can help detect hidden BRVO along with the NAION diagnosis; (2) intravenous infusion of drugs to improve circulation has positive effects in treating such patients; and (3) NAION with concealed BRVO may not require systemic hormonal therapy, in contrast with the known treatment for simple NAION. CONCLUSION: NAION may be associated with hidden BRVO, which can only be observed on FFA; intravenous therapy has proven effectiveness.
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We demonstrated a high average power, narrow-linewidth, quasi-CW diode-pumped Nd:YAG 1064 nm laser with near-diffraction-limited beam quality. A symmetrical three-mirror ring cavity with unidirectional operation elements and an etalon was employed to realize the narrow-linewidth laser output. Two highly efficient laser modules and a 90° quartz rotator for birefringence compensation were used for the high output power. The maximum average output power of 62.5 W with the beam quality factor M(2) of 1.15 was achieved under a pump power of 216 W at a repetition rate of 500 Hz, corresponding to the optical-to-optical conversion efficiency of 28.9%. The linewidth of the laser at the maximum output power was measured to be less than 0.2 GHz.
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We present a compact high-efficiency and high-average-power diode-side-pumped Nd:YAG rod laser oscillator operated with a linearly polarized fundamental mode. The oscillator resonator is based on an L-shaped convex-convex cavity with an improved module and a dual-rod configuration for birefringence compensation. Under a pump power of 344 W, a linearly polarized average output power of 101.4 W at 1064 nm is obtained, which corresponds to an optical-to-optical conversion efficiency of 29.4%. The laser is operated at a repetition rate of 400 Hz with a beam quality factor of M(2)=1.14. To the best of our knowledge, this is the highest optical-to-optical efficiency for a side-pumped TEM(00) Nd:YAG rod laser oscillator with a 100-W-level output ever reported.