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The macula is a critical anatomical structure for primates to acquire high-resolution spatial and color vision, with macula lesions posing a significant threat to patients' visual function and quality of life. Non-human primate (NHP) are the only mammals with a macular structure that is closest to that of humans, thus offering substantial value in the study of macular diseases. Currently, various methods, including spontaneous occurrence, gene editing, drug-induced, light-induced, and mechanical injury, can be employed to screen and establish NHP models for investigating conditions such as oculocutaneous albinism, achromatopsia, retinitis pigmentosa, age-related macular degeneration, and certain rare ocular syndromes. When constructing NHP models, due consideration should be given to other animal models to facilitate complementary research across different model systems. Additionally, leveraging the advantages of NHP and establishing genetically controlled NHP strains is a goal to strive for to achieve sustainable utilization of these resources in research.
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@#In clinical practice, many macular diseases in advanced stages such as age-related macular degeneration(ARMD)and Stargardt disease are manifested reduced visual acuity, unstable and even paracentral fixation resulting from the central scotoma followed by the scarring of neovascular fibres or the impairment of photoreceptors and retinal pigment epithelium, which cause great distress to patients' life, work and psychology. For a long time, there have been limited rehabilitation treatments for such patients. However, recent articles have indicated that biofeedback training by using microperimetry is expected to enhance neurosensory adaptation by achieving cortical plasticity, and makes better use of residual retinal function to help those with low vision associated with central scotoma consolidate or establish stable central or paracentral fixation, thereby improving visual function including visual acuity and reading speed. In order to improve the understanding of this rehabilitation therapy, this article will overview the mechanism and protocol of microperimetric biofeedback training(MBFT), the selection of the preferred retinal locus, the clinical application in macular diseases and its prospects.
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The threshold micropulse laser is widely used in clinical practice as a safe,non-invasive laser for avariety of macular diseases.Compared with the conventional laser therapy,the subthreshold micropulse laser is selectively absorbed by the RPE and therefore it does not cause retinal damage.To explore the therapeutic mechanism and the safety,development of threshold micropulse laser in the treatment of various common macular diseases,and further clarify its indications and advantages,which are helpful for its wider clinical application.
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Optical coherence tomography is a quick, non invasive and reproducible imaging tool for macular lesions and has become an essential part of retina practice. This review address the common protocols for imaging the macula, basics of image interpretation, features of common macular disorders with clues to differentiate mimickers and an introduction to choroidal imaging . It includes case examples and also a practical algorithm for interpretation.
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Objective To analyse the detection of The Heidelberg Retina Tomograph Ⅱ (HRT-II ) for macular diseases. Design Retrospective observational case series. Participants 110 patients(201 eyes). Methods Fifty-two normal eyes, 74 eyes with macular edema, 23 eyes with macular hole, 31 eyes with macular premembrane and 21 eyes with choroidal neovascularization were examined with macular edema module(MEM) of HRT-Ⅱ. Main Outcome Measures Edema index (E value), signal width value (W value) and features of reflectance pictures. Results In normal eyes, E value and W value of some areas in macula were partly associated with age(r=0.207-0.359). E value and W value in macular diseases were significantly different from normal eyes (P=0.000). HRT-II could display macular edema cysts, configuration and size of macular holes, extension of macular premembrane and its relationship with retina and druen or subretinal neovascularization in age-related degeneration. Conclusion The reflectance pictures of HRT-Ⅱ have characteristic appearances in different macular diseases, and the measurements of E value and W value altered in pathologic stage of macular diseases. Especially E value of central zone can reflect changes of retinal thickness and light reflectance in macula, and it is obviously different in macular edema.
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Advantages and disadvantages of morphologic and functional examinations for macular disease were reviewed. These examinations included optical coherence tomography(OCT), Heidelberg retina tomograph(HRT), and multifocal electroretinography (mfERG), etc. It is very important to improve ability of diagnosis and management of macular disease by choosing examination logically and integrating morphologic examination with functional examination on the basis of disease.