Vessel Density and Structural Measurements in Primary Angle-Closure Suspect Glaucoma Using Optical Coherence Tomography Angiography.

PURPOSE: To measure the macular retinal vessel density (VD) and peripapillary retinal nerve fiber layer (RNFL) in primary angle-closure suspects (PACS) by Angio-OCT to be compared with normal subjects. METHODS: Primary angle-closure suspect patients and normal subjects were enrolled in this study. The demographic and clinical characteristics of all subjects, such as RNFL thickness, retinal vessel density, and ocular perfusion pressure, were compared. RESULTS: No significant difference was found in both groups on age, sex distribution, intraocular pressure (IOP), and retinal vessel density. The PACS group exhibited significantly thicker RNFL thickness compared with the control group. The deep vessel density was negatively associated with age (P = -0.034), while IOP had negative association with ACD (P = -0.019). OPP was independently associated with RNFL (B = 0.334, P = 0.038) in the PACS group. CONCLUSIONS: OCTA showed significant thicker change on RNFL in the PACS group. Only OPP was independently associated with RNFL in the PACS group.

Evaluation of choroidal thickness in amblyopia using optical coherence tomography.

OBJECTIVE: To investigate the choroidal thickness in children with amblyopia through spectral-domain optical coherence tomography. METHODS: A total of 31 children with unilateral amblyopia and 31 right eyes of controls with normal vision were enrolled in the study. The choroidal thickness was measured directly below the fovea and at 12 other locations: 1, 2 and 3 mm superior, temporal, inferior, and nasal to the fovea. All the parameters were compared between amblyopic eyes, fellow eyes, and control eyes. RESULTS: The mean subfoveal choroidal thickness was 398.03 ± 74.60, 354.13 ± 81.78, and 328.12 ± 65.93 µm in amblyopic eyes, fellow eyes, and control eyes, respectively. Significant difference was found in choroidal thickness among three groups at subfoveal choroidal thickness, N1, and S1 using multivariate analysis of covariance after adjusting for axial length. Significant negative correlation was found only between subfoveal choroidal thickness and axial length in amblyopic eyes (r = -0.463, p = 0.01). CONCLUSION: The subfoveal choroid is significantly thicker in amblyopic eyes than control eyes only at subfoveal choroidal thickness, N1, and S1. The choroidal thickness was thickest in the subfoveal region and thinnest in the nasal region. There are other changes in choroidal structure associated with amblyopia.

Longitudinal Changes in Diffusion Tensor Imaging Following Mild Traumatic Brain Injury and Correlation With Outcome.

The chronic consequences of traumatic brain injury (TBI) may contribute to the increased risk for early cognitive decline and dementia, primarily due to diffusion axonal injury. Previous studies in mild TBI (mTBI) have been controversial in describing the white matter tract integrity changes occurring at acute and subacute post-injury. In this prospective longitudinal study, we aim to investigate the longitudinal changes of white matter (WM) using diffusion tensor imaging (DTI) and their correlations with neuropsychological tests. Thirty-three patients with subacute mTBI and 31 matched healthy controls were studied with an extensive imaging and clinical battery. Neuroimaging was obtained within 7 days post-injury for acute scans and repeated at 1 and 3 months post-injury. Using a region-of-interest-based approach, tract-based spatial statistics was used to conduct voxel-wise analysis on diffusion changes in mTBI and was compared to those of healthy matched controls, scanned during the same time period and rescanned with an interval similar to that of patients. We found decreased fractional anisotropy (FA) values in the left anterior limb of internal capsule (ALIC) and right inferior fronto-occipital fasciculus (IFOF) during the 7 days post-injury, which showed longitudinal evidence of recovery following 1 month post-injury. Increased FA values in these two tracts at 1 month post-injury were positively associated with better performance on cognitive information processing speed at initial assessment. By contrast, there were also some tracts (right anterior corona radiata, forceps major, and body of corpus callosum) exhibiting the continuing loss of integrity sustaining even beyond 3 months, which can predict the persisting post-concussion syndromes. Continuing loss of structural integrity in some tracts may contribute to the persistent post-concussion syndromes in mTBI patients, suggesting certain tracts providing an objective biomarker for tracking the pathological recovery process following mTBI.

Lower Posttraumatic α-Synuclein Level Associated With Altered Default Mode Network Connectivity Following Acute Mild Traumatic Brain Injury.

This study aimed to investigate the changes of α-synuclein in serum and its relationship with default mode network (DMN) connectivity after acute mild traumatic brain injury (mild TBI). Fifty-two patients with mild TBI at the acute phase and 47 matched healthy controls were enrolled in the study. All participants received resting-state functional magnetic resonance imaging (fMRI) and neuropsychological assessments. Relations between the levels of α-synuclein in serum and clinical assessments were obtained using multivariate linear regression. Results showed that the patients with lower α-synuclein presented more complaints on post-concussion symptoms and depression. Moreover, patients with high levels of α-synuclein exhibited significantly decreased functional connectivity in the left precuneus and increased functional connectivity in both the left anterior cingulate cortex and ventro-medial prefrontal cortex (MPFC) compared with patients with low levels of α-synuclein. These findings supported that α-synuclein may modulate the functional connectivity within the DMN and suggest the feasibility of using α-synuclein as an objective biomarker for diagnosis and prognosis of mild TBI.

Posterior pole asymmetry analysis and retinal nerve fibre layer thickness measurements in primary angle-closure suspect patients.

PURPOSE: To measure peripapillary retinal nerve fiber layer (RNFL) thickness and posterior pole retinal thickness in primary angle-closure suspects (PACS) by Spectral domain optical coherence tomography (SD-OCT) and to be compared with normal subjects. METHODS: Thirty five primary angle-closure suspect patients and thirty normal subjects were enrolled in this study. Peripapillary RNFL and posterior pole retinal thickness by posterior pole asymmetry analysis (PPAA) in SD-OCT were measured. RESULTS: No significant difference was found in both groups on age, sex distribution, refractive error, intraocular pressure (IOP) and axial length. The PACS group exhibited significantly thinner macular retinal thickness and larger asymmetry on posterior pole region compared with the control group. Yet no significant difference of peripapillary RNFL parameters was found between PACS group and normal control group. A negative correlation was observed between the total retinal thickness on posterior pole region and age when all the PACS participants were analyzed. CONCLUSIONS: Posterior pole retinal thickness measurements obtained by Heidelberg Spectralis SD-OCT using PPAA showed significant thinner change in PACS group than healthy controls. Only age seemed to be an indicator in the occurrence of glaucomatous damage in PACS patients.

Sex differences in cerebral perfusion changes after mild traumatic brain injury: Longitudinal investigation and correlation with outcome.

Cerebral blood flow (CBF) is known to have marked developmental sex differences. We investigated whether gender differences exert modulatory effect on mild traumatic brain injury (mTBI) from both neuropsychological testing and brain CBF changes using a longitudinal design from acute stage to subacute 1 month post-injury. Our results supported that cognitive information processing speed (IPS), as one of core cognitive impairments following mTBI, were at least partially independent from other self-reported syndromes, such as post concussive symptom and posttraumatic stress disorder, and that it can be selectively impaired in specific male mTBI individuals. The gender difference of this cognitive domain in healthy control attenuated following mTBI and only male patients showed impaired language fluency accompanying with increased CBF changes compared with male controls. The increased CBF in the posterior parietal cortex (PPC) can predict much worse cognitive IPS performance in male patients. In contrast, female patients with mTBI displayed no impairments on any neuropsychological performance, and female sex may be a protective factor against neuropsychological impairments. Moreover, the significant interaction effect of time and gender exhibited in the left inferior frontal cortex (Broca's area). Simple effect test suggested gender differences in this area was mainly derived from the patients group at later subacute but not acute phase, for the reduced CBF at subacute mainly in the male patients. Thus, the current findings suggest that regional CBF may provide an objective biomarker for tracking gender modulatory effect on mTBI and its potentially pathological recovery process.

Evaluation of peripapillary choroidal distribution in children by enhanced depth imaging optical coherence tomography.

BACKGROUND: To evaluate the peripapillary choroidal thickness (PPCT) in Chinese children aged 6 to 12 years old and to analyze correlative factors. METHODS: PPCT was measured with enhanced depth imaging optical coherence tomography (EDI-OCT) in 154 children (76 myopes and 78 emmetropia) aged 6 to 12 years, with spherical equivalent refractive errors between + 0.50 and - 5.50 diopters(D). Peripapillary choroidal imaging was performed using circular scans of a diameter of 3.4 mm around the optic disc. PPCT and the corresponding peripapillary retinal thickness (PPRT) were measured by EDI-OCT at nine positions: I, inferior; IN, inferonasal; IT, inferotemporal; N, nasal; T, temporal; S, superior; SN, superonasal; ST, superotemporal, and the Fovea Centralis. RESULTS: The mean global PPCT was 165.80 ± 39.86 µm.The mean global PPRT was 101.47 ± 10.74 µm. The Inferior had the thinnest PPCT but the thickest PPRT (p < 0.001), while the Nasal had thickest PPCT but the thinnest PPRT (p < 0.001). Significant differences in RT between the myopic group and the emmetropic group were found at all positions except T, TS, S and the fovea. Myopic group had thinner choroidal thickness (CT) than that of emmetropic group at all measured positions. Choroidal thickness had negative relation with the corresponding retinal thickness, age and axial length. CONCLUSION: The peripapillary choroid was thicker nasally and thinner inferiorly, while the peripapillary retina was thickest inferiorly and thinnest nasally. Myopic group had thinner PPCT. The axial length was found to be negatively correlated to PPCT.

Axial Length and Ocular Development of Premature Infants without ROP.

PURPOSE: To investigate the ocular parameters of premature infants without ROP at gestational age (GA) more than 28 weeks and their relationship with growth parameters. METHODS: 76 preterm infants without ROP and 65 term infants were involved to undergo portable slit lamp, RetCam3, ultrasonic A-scan biometry, and cycloplegic streak examination at their 40 weeks' postconceptional ages (PCA). Ocular parameters of infants' right eye and growth parameters were used for analysis. RESULTS: All the infants were examined at 40 weeks' PCA. No significant difference was found between male and female in axial length of preterm infants (p = 0.993) and term infants (p = 0.591). Significant differences were found in axial length (AL), anterior chamber depth (ACD), lens thickness (LT), and vitreous depth (VD) between preterm and term infants. No significant correlation was found between AL and spherical equivalent in preterm infants' group. In preterm group, AL was significantly correlated with gestational age (GA), birth weight (BW), and head circumference (HC). CONCLUSIONS: Preterm infants had shorter AL, shallow ACD, thicker LT, and thinner VD compared to term infants. Refractive error in preterm infants at GA between 28 to 37 weeks was not related to axial length. Among all the growth parameters of preterm infants, GA, BW, and HC had effect on axial length.

Evaluation of myopia on retinal nerve fiber layer thickness measured by Spectralis optical coherence tomography.

The aim of the present study was to evaluate the retinal nerve fiber layer (RNFL) thickness of myopic subjects using Spectralis optical coherence tomography (OCT) and to determine variations with age and sex. A total of 271 Chinese participants with a spherical equivalent <+0.50 diopters were enrolled in the research. All subjects underwent a full ophthalmic examination. RNFL thickness was measured and compared according to sex, age and spherical equivalent. No significant difference was demonstrated between RNFL thickness in males and females. No significant difference was observed between RNFL thickness of the two age groups (≤12 years old and >12 years old). Significant differences were observed in all subfields of RNFL thickness among different spherical equivalent groups (P<0.05). In conclusion, myopia did have special influence on RNFL thickness, which was not related to sex or age.

[Moderate and severe persistent allergic rhinitis treated with acupoint application therapy of the different intensity: a randomized controlled trial].

OBJECTIVE: To evaluate the clinical therapeutic effects and safety on moderate and severe persistent allergic rhinitis treated with acupoint application therapy of the different intensity during the dog days. METHODS: One hundred and sixty patients of moderate and severe persistent allergic rhinitis were randomized into a No.1 treatment group, a No.2 treatment group, a No.3 treatment group and a placebo group, 40 cases in each one. The same acupoints were used in the four groups, named Dazhui (GV 14), Dingchuan (EX-B1), Feishu (BL 13), Pishu (BL 20), Mingmen (GV 4), Gaohuang (BL 43), Shenshu (BL 23) and Qihai (CV 6). In the three treatment groups, the fine powder of the ingredients (semen brassicae, radix angeliceae, asarum sieboldii, rhizome corydalis) of compound baijiezi formula was used. In the No.1 treatment group, the herbal paste (ginger-prepared paste) was prepared with ginger juice and the above herbal powder. In the No.2 and No.3 treatment groups, the herbal paste (honey-prepared paste) was prepared with honey with the above herbal powder. In the placebo group, the pseudo-herbal paste of the same appearance was prepared with millet powder and distilled water. The acupoint application was given for 2 h in the No.1 and No.2 groups and was for 6 h in the No.3 treatment group and the placebo group. The acupoint application therapy was given once every week during the dogdays, continuously for 5 weeks. The total nasal symptom score (TNSS), the score of the rhinoconjunctivitis quality of life questionnaire (RQLQ) and the count of blood eosinophils (EOS) were observed in the patients of the 4 groups before and after treatment. The clinical therapeutic effects were compared among the 4 groups. The incidences of the skin adverse reactions were observed in each treatment group. RESULTS: After treatment, the scores of TNSS and RQLQ were all reduced as compared with those before treatment in the three treatment groups (P<0.05, P<0.01), in which, the improvements in the No.3 treatment group were better than those in the No.1 treatment group and the No.2 treatment group (both P<0.05). After treatment, the count of EOS was all reduced as compared with that before treatment in the three treatment groups (all P<0.05). The differences were not significant statistically among the three treatment groups (all P>0.05). The total effective rate was 85.0% (34/40) in the No.3 treatment group, better than 76.3% (29/38) in the No.1 treatment group, 71.8% (28/39) in the No.2 treatment group and 5.0% (2/40) in the placebo group (P<0.05, P<0.01). The incidences of the skin adverse reaction in the No.3 treatment group and the No.2 treatment group were lower than those in the No.1 treatment group (both P<0.01). CONCLUSION: The acupoint application of the different intensity relieves the symptoms and improves the living quality in the patients of moderate and severe persistent allergic rhinitis. The stimulation of the ginger-prepared herbal paste is strong and induces skin blisters after 2 h herbal application. The stimulation of the honey-prepared herbal paste is moderate and does not induce blisters. The 6 h stimulation of the honey-prepared herbal paste is mild and the therapeutic effect is optimal.