Quantitative analysis of macular retinal thickness and macular volume in diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM:To evaluate and characterize the macular thickness and macular volume in patients of different stages of diabetic retinopathy with special - domain optical coherence tomography( SD-OCT) .·METHODS: Totally 40 patients ( 78 eyes ) with diabetic retinopathy were recruited in the study from January 2016 to January 2017 in our hospital. According to the international clinical classification of diabetic retinopathy, 20 cases (40 eyes) were categorized as non-proliferative diabetic retinopathy ( NPDR ) group and 20 cases proliferative diabetic retinopathy (PDR) group (38 eyes). All subjects were examined and analyzed with Early Treatment Diabetic Retinopathy Study ( ETDRS ) subfields, which were embedded in HS ( Haag-Streit ) with diameter of 1, 3 and 6mm. The changes of retinal thickness and volume of the macular center were measured.·RESULTS: The thickness of macular foveolar in NPDR group and PDR group were 252. 57 ± 31. 36μm, 362. 47 ± 20. 81μm. The retinal thickness of inner superior subfield (ISM) and inner nasal subfield(INM) were the thickest;that of inner inferior subfield ( IIM ) was next to ISM and INM, and that of inner temporal subfield was the thinnest. Of the outer subfields, the retinal thickness of outer superior subfield ( OSM ) was the thickest;that of outer nasal subfield( ONM) was next to OSM, and that of outer temporal subfield(OTM)and outer inferior subfield ( OIM ) was the thinnest. The value of macular central concave thickness and retinal thickness in each quadrant of the NPDR group were less than those of the PDR group, the difference was statistically significant ( P <0. 05). The volume (V) of macular center in NPDR group and PDR group were 0. 20±0. 02mm3, 0. 28±0. 16mm3, the upper and nasal sides of the middle part of the partition were the largest, the inferior and the temporal side were the smallest. The nasal side of the outer loop was the largest, the upper was the second, the temporal side and the inferior were the smallest. The volume of macular central fovea and the retinal volume in each quadrant of the NPDR group were smaller than those of the PDR group, the difference was statistically significant (P<0. 05).·CONCLUSION: The changes of retinal thickness and volume in macular central fovea were related with the progression of diabetic retinopathy. Using OCT to analyze the macular thickness and macular volume in different stages of diabetic retinopathy, helps physicians to understand the morphological changes of macular region and its surrounding macular degeneration with the severity of diabetic retinopathy, and provide a basis for better analysis of the changes of the structure of macular in different severity diabetic retinopathy.

[Morphological monitoring indexes in anterior segment with primary acute angle closure glaucoma].

OBJECTIVE: To investigate morphological monitoring indexes of anterior segment in AACG. METHODS: Case-controlled study was conducted in the following groups: 55 eyes of 55 patients with unilateral AACG in first attack, 60 eyes of 60 cases with shallow anterior chamber, and 60 eyes of 60 cases with normal individuals. Images of anterior chamber angle in each group were collected by OCT. Using software of Photoshop, the opening degree of anterior chamber angle was quantified. Anterior chamber depth (ACD), lens thickness (LT), lens position (LP), and chamber crowding rate (CCR) were measured by A-ultrasound. Anterior segment biometric parameters among the three groups were compared using one-way ANOVA test. RESULTS: LT, LP, and CCR were significantly (LT: F = 27.73, LP: F = 47.33, CCR: F = 79.22; P < 0.05) different between AACG, narrow angle and normal group in age group ranged from 50 to 59 [LT: (5.72 ± 0.22) mm, (5.57 ± 0.28) mm, (4.55 ± 0.36) mm, LP: (4.33 ± 0.24) mm, (4.63 ± 0.20) mm, (5.71 ± 0.34) mm, and CCR: 3.28 ± 0.16, 2.64 ± 0.19, 1.70 ± 0.10, respectively] and significantly different (LT: F = 22.51, LP: F = 56.67, CCR: F = 74.84; P < 0.05) in age group ranged from 60 to 69 [LT: (5.81 ± 0.37) mm, (5.72 ± 0.41) mm, (4.98 ± 0.59) mm, LP: (4.26 ± 0.18) mm, (4.51 ± 0.14) mm, (5.62 ± 0.19) mm and CCR: 3.39 ± 0.35, 2.74 ± 0.37, 1.86 ± 0.36, respectively]. However, in age group ranged above 70 group, LP and CCR (LP: F = 23.09, CCR: F = 60.08; P < 0.05) were significantly changed [LP: (4.25 ± 0.30) mm, (4.46 ± 0.22) mm, (5.49 ± 0.23) mm, CCR: 3.48 ± 0.21, 2.85 ± 0.30, 2.03 ± 0.17, respectively], but not LT [(5.85 ± 0.27) mm, (5.74 ± 0.21) mm, (5.43 ± 0.36) mm] (F = 8.29, P > 0.05). CONCLUSIONS: The study results indicate that LT, LP and CCR, are useful indicators to observe the anterior chamber status in AACG by using Stratus OCT-3.

[Clinical and pathological features in 138 cases of drug-induced liver injury].

OBJECTIVE: To explore the categories of drugs causing hepatotoxicity and analyze the clinical and histological features of the corresponding drug-induced liver injury (DILI), in order to gain insights into potential diagnostic factors for DILI. METHODS: A total of 138 DILI patients treated at our hospital from April 2008 to April 2010 were retrospectively analyzed. The responsible drug for each DILI case was recorded. The Roussel Uclaf Causality Assessment Method (RUCAM) had been used to diagnose DILI. Only cases that had scored as highly probable or probable (more than or equal to 6 points by RUCAM) were included in this study. The patients' general condition, clinical manifestations, and serum biochemical and immunological parameters were assessed. Sixty-six of the patients underwent liver biopsy, and were assessed for liver pathological changes. Clinical and laboratory test data were collected and used to classify the total 138 cases as hepatocellular injury, cholestatic, or mixed hepatocellular-cholestatic types. RESULTS: Within our patient population, the leading cause of DILI was Chinese herb medicine, accounting for 53.62% of cases. Antibiotics were implicated in 7.97% of cases, and dietary supplement in 6.52% of cases. Correlation between the clinical features and histological injury pattern was stronger at the time of biopsy (more than or equal to 3 days after laboratory results) (kappa = 0.63, P less than 0.05) than at the onset of DILI (kappa = 0.25, P less than 0.05). All modified hepatic activity index (HAI) necroinflammatory scores and fibrosis scores were more severe in the cholestatic and mixed injury types than in the hepatocellular injury type (P less than 0.01 and P less than 0.05, respectively). CONCLUSION: Chinese herbal medicine, dietary supplements and antibiotics were the main causes of DILI in our patient population. The clinical and histological features correlated well, especially at later stages of DILI. The degree of inflammation and fibrosis was significantly higher in cholestatic and mixed hepatocellular-cholestatic injury types than in the hepatocellular injury type. Assessment of both clinical and pathological features may represent a more accurate diagnostic method for DILI.