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1.
Am J Ophthalmol ; 2022 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-35038416

RESUMO

PURPOSE: To identify how the Weiss ring affects the measurement of mean and sectoral peripapillary retinal nerve fiber layer (pRNFL) thicknesses. DESIGN: Retrospective cross-sectional study. METHODS: Subjects were divided into two groups: controls (control group) and subjects in which a Weiss ring was visible on optical coherence tomography fundus images (WR group). Mean and sectoral pRNFL thicknesses were compared between the two groups. RESULTS: A total of 205 eyes were enrolled: 131 eyes in the control group and 74 eyes in the WR group. The mean pRNFL thicknesses of the control group and WR group were 97.2 ± 6.7 and 94.6 ± 10.8 µm, respectively (P = 0.042). In sectoral thickness, the inferior sector of the WR group was 112.1 ± 23.2 µm, which was significantly thinner than that of the control group (125.5 ± 13.3 µm, P < 0.001). The Weiss ring was located in 10 eyes (13.5 %) in the superior sector, 7 eyes (9.5 %) in the temporal sector, 40 eyes (54.1 %) in the inferior sector, and 17 eyes (23.0 %) in the nasal sector. In analyses of reproducibility, the coefficient of variation and intraclass coefficient of the inferior sector measurement was 10.90 % and 0.409, respectively, indicating low reliability of the measurement. CONCLUSIONS: Eyes with a Weiss ring showed thinner mean and inferior pRNFL thicknesses than normal controls, which would be a measurement error caused by the Weiss ring. This could be a major confounding factor for analyses of pRNFL changes, especially in glaucoma patients.

2.
Sci Rep ; 11(1): 23832, 2021 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-34903817

RESUMO

This is a prospective observational study to establish the short- and long-term repeatability of measurements of peripapillary optical coherence tomography angiography (OCTA) parameters in healthy eyes and identify factors affecting long-term repeatability. We enrolled 84 healthy eyes. Participants with a history of any ophthalmic disease (except high myopia) or intraocular surgery were excluded from the study. An experienced examiner performed OCTA using disc-centered 6 × 6 mm scans. All examinations were conducted twice at 5-min intervals at the initial visit and repeated at least 6 months later. For short-term repeatability, the coefficient of variation (CV) was 2.94-4.22% and the intraclass correlation coefficient (ICC) was 0.840-0.934. For long-term repeatability, the CV was 2.73-3.84% and the ICC was 0.737-0.934. Multivariate analyses showed that the axial length (AL) (B = 0.970; p = 0.002) and mean signal strength (SS) (B = - 2.028; p < 0.001) significantly affected long-term repeatability. Measurements of peripapillary OCTA parameters exhibited excellent short-term and good long-term repeatability in healthy individuals. The mean SS and AL affected long-term repeatability and should be considered while interpreting peripapillary OCTA images.

3.
PLoS One ; 16(10): e0258479, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34648529

RESUMO

OBJECTIVE: To investigate the effects of axial length (AL) on the peripapillary microvascular density acquired from optical coherence tomography angiography (OCTA). METHODS: Retrospective observational study. A total of 111 eyes from 111 normal healthy subjects were examined. The subjects were divided into three groups according to the AL: Group 1 (AL: < 24.0 mm; 35 eyes), Group 2 (AL: 24.0-25.99 mm; 37 eyes), and Group 3 (AL: ≥ 26 mm; 39 eyes). Peripapillary OCTA images were acquired using 6× 6 mm angiography scans, and vessel density (VD) and perfusion density (PD) of the superficial capillary plexus were calculated automatically. VD and PD were compared among the three groups according to the distance from the optic disc (inner and outer rings). Linear regression analyses were also performed to identify clinical factors associated with average VD. RESULTS: The average ALs of Groups 1-3 were 23.33± 0.57, 25.05± 0.60, and 27.42± 0.82, respectively. Average VD (P = 0.009) and PD (P = 0.029) in the inner ring increased with increasing AL. However, average VD (P < 0.001) and PD (P < 0.001) in the outer ring decreased with AL increased; the same trends were found for the full areas (VD, p<0.001; PD, p = 0.001). Average VDs in the inner and outer rings were not associated (P = 0.938). CONCLUSIONS: Peripapillary VD and PD were significantly associated with AL. Depending on the distance from the disc, peripapillary VDs and PDs of the inner and outer rings were differentially affected by AL. Physicians should therefore consider the effects of AL in the analyses of peripapillary microvasculature.


Assuntos
Microvasos/fisiologia , Tomografia de Coerência Óptica/métodos , Adulto , Estudos de Casos e Controles , Feminino , Angiofluoresceinografia , Humanos , Modelos Lineares , Masculino , Microvasos/diagnóstico por imagem , Pessoa de Meia-Idade , Disco Óptico/fisiologia , Estudos Retrospectivos
4.
Medicine (Baltimore) ; 100(37): e27206, 2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34664854

RESUMO

RATIONALE: We report a new scleral buckling technique using a 27-gauge endoilluminator and a wide-field viewing system to overcome the limitations of conventional indirect ophthalmoscope-methods and "chandelier-assisted" surgery. PATIENT CONCERNS: A 26-year-old female patient visited the local clinic for floaters and lower visual field defects in her left eye that had occurred 5 days prior. DIAGNOSES: On fundus examination, upper retinal detachment without macular involvement and an atrophic hole was observed in her left eye. INTERVENTIONS: Under general anesthesia and after perilimbal conjunctival incision, extraocular muscle isolation, and traction with black silk, a 27-gauge trocar-cannula was inserted 90° away from the retinal break, 4 mm away from the limbus. Under wide-field viewing using a contact lens, the fundus was observed through a surgical microscope. Retinal break was evaluated and cryopexy was performed with careful movement of the endoilluminator, paying attention to damage to the lens. The surgeon could accurately and freely control the direction of the illumination tip to obtain a brighter view of the region of interest. OUTCOMES: There were no complications associated with trocar cannula incision or the illuminator. The retina was successfully reattached. LESSONS: Twenty seven gauge endoilluminator-assisted scleral buckling is an easy and safe procedure and provides better control over and free adjustment of the light direction, thus overcoming the limitations of chandelier-assisted surgery.


Assuntos
Recurvamento da Esclera/métodos , Adulto , Feminino , Humanos , Iluminação/instrumentação , Iluminação/normas , Microscopia/instrumentação , Microscopia/métodos , Recurvamento da Esclera/instrumentação , Cirurgia Assistida por Computador/instrumentação , Cirurgia Assistida por Computador/métodos
5.
Invest Ophthalmol Vis Sci ; 62(12): 21, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34546323

RESUMO

Purpose: To identify the impact of hypertension (HTN) on macular microvasculature in type 2 diabetes (T2DM) patients without clinical diabetic retinopathy. Methods: In this retrospective cross-sectional study, subjects were divided into three groups: controls (control group), patients with T2DM (DM group), and patients with both T2DM and HTN (DM + HTN group). The vessel length density (VD) was compared among the groups. Linear regression analyses were performed to identify factors associated with VD. Results: The VD in the control, DM, and DM + HTN groups was 20.43 ± 1.16, 19.50 ± 1.45, and 18.19 ± 2.06 mm-1, respectively (P < 0.001). The best-corrected visual acuity (B = -9.30; P = 0.002), duration of T2DM (B = -0.04; P = 0.020), HTN (B = -0.51; P = 0.016), signal strength (B = 1.12; P < 0.001), and ganglion cell-inner plexiform layer thickness (B = 0.06; P < 0.001) were significant factors affecting VD in patients with T2DM. Additionally, the hemoglobin A1c (HbA1c) (B = -0.49; P = 0.016) was significantly associated with VD in patients with both T2DM and HTN. Conclusions: Patients with T2DM had impaired macular microvasculature, and patients with T2DM with HTN exhibited greater impairment of the microvasculature than did patients with T2DM only. Additionally, physicians should be aware that the macular microvasculature would be more vulnerable to hyperglycemic damage under ischemic conditions by HTN.


Assuntos
Diabetes Mellitus Tipo 2/fisiopatologia , Retinopatia Diabética/fisiopatologia , Hipertensão/fisiopatologia , Disco Óptico/irrigação sanguínea , Vasos Retinianos/fisiopatologia , Idoso , Pressão Sanguínea/fisiologia , Estudos Transversais , Feminino , Angiofluoresceinografia , Hemoglobina A Glicada/metabolismo , Humanos , Masculino , Microvasos/fisiopatologia , Pessoa de Meia-Idade , Células Ganglionares da Retina/patologia , Estudos Retrospectivos , Tomografia de Coerência Óptica , Acuidade Visual/fisiologia
6.
J Clin Med ; 10(18)2021 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-34575366

RESUMO

BACKGROUND: We aimed to study the bilateral choroidal thickness (CT) symmetry and difference in uncomplicated pachychoroid subjects using wide-field swept-source optical coherence tomography (SS-OCT). METHODS: All subjects underwent a wide-field 16-mm one-line scan using SS-OCT. Bilateral CT was measured at, and compared among, the following 12 points: three points at 900-µm intervals from the nasal optic disc margin (nasal peripapillary area), one point at the subfovea, six points at 900-µm intervals from the fovea to the nasal and temporal areas (macular area), and two peripheral points 5400 and 8100 µm from the fovea (peripheral area). RESULTS: There were no statistically significant differences in CT between the right and left eyes in any area (all p > 0.05); they all showed significant positive correlations (all p < 0.01). However, the correlation coefficients (ρ) were smaller for the nasal peripapillary and peripheral areas compared to the macular area. CONCLUSIONS: The CTs in each region were bilaterally symmetrical in subjects with uncomplicated pachychoroid. However, interocular difference in CT increased from the center to the periphery, indicating that the anatomical variation of the nasal peripapillary and peripheral choroid was greater than that of the macula.

7.
Diabetes ; 70(11): 2663-2667, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34475099

RESUMO

Type 2 diabetes mellitus (T2DM) and hypertension (HTN) are both relatively common systemic diseases and cause damage to the retina, such as inner retina reduction and microvascular impairment. The purpose of this study was to identify peripapillary retinal nerve fiber layer (pRNFL) damage by diabetic neurodegeneration and the effects of HTN on the pRNFL thickness in patients with T2DM without clinical diabetic retinopathy. Subjects were divided into three groups: healthy control subjects (group 1), patients with T2DM (group 2), and patients with both diabetes and HTN (group 3). The pRNFL thickness was measured using optical coherence tomography and compared among each group. Linear regression analyses were performed to identify factors associated with pRNFL thickness. A total of 325 eyes were included: 143 eyes in the group 1, 126 eyes in group 2, and 56 eyes in group 3. The mean pRNFL thicknesses of each group were 96.1 ± 7.7, 94.4 ± 8.6, and 91.6 ± 9.6 µm, respectively (P = 0.003). In multivariate linear analyses, diabetes duration (ß = -0.236; P = 0.018) and HTN (ß = -3.766; P = 0.008) were significant factors affecting the pRNFL thickness in groups 2 and 3. Additionally, the HTN duration was significantly correlated with pRNFL thickness in group 3 (R 2 = 0.121; P = 0.008). In conclusion, patients with T2DM with HTN showed thinner pRNFL thickness than those with T2DM only. Additionally, the duration of HTN was significantly correlated with pRNFL thickness in patients with both diabetes and HTN.

8.
PLoS One ; 16(8): e0256131, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34388218

RESUMO

PURPOSE: To identify the impacts of hypertension (HTN), high myopia, and the combination thereof on peripapillary retinal nerve fiber layer (pRNFL) thickness. METHODS: All subjects were divided into four groups: control (group 1); patients with HTN without high myopia (group 2); patients with high myopia without HTN (group 3); and patients with both HTN and high myopia (group 4). The pRNFL thicknesses were compared using a one-way analysis of variance. Univariate and multivariate linear regression analyses were used to identify factors affecting pRNFL thickness in subjects with and without HTN. RESULTS: The mean pRNFL thicknesses were 93.9±8.8, 88.7±6.8, 86.4±8.1, and 82.5±9.6 µm in group 1, 2, 3, and 4, respectively, and differed significantly (P<0.001). On multivariate linear regression analyses, age (ß = -0.181, P = 0.044), axial length (ß = -1.491, P<0.001), and HTN (ß = -4.876, P = 0.044) significantly affected pRNFL thickness. Additionally, age and axial length affected the pRNFL thickness in subjects with HTN (age, ß = -0.254, P = 0.020; axial length, ß = -1.608, P<0.001) much more than in subjects without HTN (age, ß = -0.028, P = 0.712; axial length, ß = -1.324, P<0.001). CONCLUSIONS: High myopia and HTN affected pRNFL reduction and a combination of the 2 diseases exacerbated pRNFL damage. This could be a confounding factor in interpreting pRNFL thickness in patients with ophthalmic diseases affecting the pRNFL thickness when combined with the 2 diseases.

9.
Retina ; 41(11): 2301-2309, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-33830961

RESUMO

PURPOSE: It is hypothesized that an unstable tear film would affect the quality and repeatability of optical coherence tomography angiography (OCTA). Therefore, OCTA repeatability according to tear break-up time (TBUT) was compared. METHODS: The 3 × 3 OCTA was performed twice and, the eyes were divided into 3 groups according to the TBUT (Group 1: TBUT ≤ 5 seconds, 43 eyes; Group 2: 5 seconds < TBUT ≤ 10 seconds, 35 eyes; Group 3: TBUT > 10 seconds, 34 eyes). The intraclass correlation coefficient, coefficient of variation, and test-retest SD were calculated and compared. RESULTS: The signal strengths of OCTA were 9.1 ± 1.2, 9.5 ± 0.8, and 9.5 ± 0.8 in each group from Groups 1, 2, and 3, respectively, which showed significant difference (P = 0.049). The intraclass correlation coefficient of vessel density were 0.733, 0.840, and 0.974 in Groups 1 to 3, respectively, and the values increased in the order of Groups 1, 2, and 3. The coefficient of variation were 6.41 ± 6.09, 3.29 ± 2.22, and 1.30 ± 1.17, and the test-retest SD were 0.83 ± 0.70, 0.47 ± 0.31, and 0.19 ± 0.17 in Groups 1, 2, and 3, respectively. The coefficient of variation and test-retest SD values decreased in the order of Groups 1, 2, and 3, and showed a significant difference (all, P < 0.05). CONCLUSION: The repeatability of OCTA tended to decrease with a shorter TBUT. When the TBUT is <5 seconds, care must be taken to interpret the OCTA results correctly.

10.
Acta Ophthalmol ; 2021 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-33884766

RESUMO

PURPOSE: Acute and chronic hypertension may have different pathophysiological mechanisms in the retina. Here, we compared the retinal nerve fibre layer (RNFL)/ganglion cell-inner plexiform layer (GC-IPL) thickness ratios of patients with 'relieved' severe hypertensive retinopathy (relieved HTNR) and chronic hypertension without retinopathy (chronic HTN) to those of normal controls. METHODS: We performed cross-sectional study. The eyes were divided into the following groups: normal controls (Group A, age ≥50 years; Group D, age <50 years); chronic HTN (Group B, <10 years of HTN; TNHT; Group C, ≥10 years of HTN); and relieved HTNR (previously diagnosed with grade IV HTNR and relieved retinopathy for >1 year; Group E), and the RNFL/GC-IPL thickness ratio was compared among Groups A-C and between Groups D and E. RESULTS: A total of 379 eyes were included in this study. Groups A-E consisted of 145, 59, 63, 60 and 52 eyes, respectively. The RNFL/GC-IPL thickness ratios were 1.161 ± 0.093, 1.158 ± 0.082 and 1.162 ± 0.089 in groups A-C, respectively, and did not showed a statistically difference (p = 0.966). The RNFL/GC-IPL thickness ratio of groups D and E were 1.169 ± 0.080 and 1.221 ± 0.080, respectively, and showed a statistically difference (p = 0.001). CONCLUSIONS: The RNFL/GC-IPL thickness ratios of the chronic HTN group did not show a difference compared with the normal controls. However, relieved HTNR patients showed a higher ratio than the normal controls. Physicians should be aware that acute hypertensive injury could affect the RNFL/GC-IPL thickness ratio.

11.
Graefes Arch Clin Exp Ophthalmol ; 259(10): 2879-2886, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33914158

RESUMO

PURPOSE: To evaluate the functional and anatomical outcomes of a treat-and-extend (TAE) regimen with aflibercept for treatment-naive macular edema (ME) secondary to branch retinal vein occlusion (BRVO). METHODS: This was a prospective, multicenter, noncomparative, open-label clinical trial. Forty-eight eyes of 48 patients received three monthly intravitreal aflibercept injections prior to the TAE regimen. However, if the best-corrected visual acuity (BCVA) was ≥ 20/20 and the central macular thickness (CMT) was < 250 µm during the loading phase, the patient immediately proceeded to the TAE regimen. The treatment interval was adjusted by 4 weeks based on changes in CMT. The primary outcome was the mean change in BCVA from baseline to 52 weeks. RESULTS: The mean change in BCVA was 23.6 ± 14.2 letters. The proportion of patients with BCVA gain ≥ 15 letters was 77.1% at 24 weeks and 72.9% at 52 weeks. The mean reduction in CMT was 326.2 ± 235.6 µm at 24 weeks and 324.2 ± 238.0 µm at 52 weeks. The mean number of injections was 6.7 ± 1.2 (range: 6-11, all patients received three monthly intravitreal aflibercept injections) over 52 weeks, and 34 patients (70.8%) reached the maximal extension interval of 16 weeks at 52 weeks. CONCLUSIONS: The TAE regimen using aflibercept for ME secondary to BRVO, which has a treatment interval of up to 16 weeks, showed comparable efficacy to the fixed-dosing regimen along with reduced treatment burden.


Assuntos
Edema Macular , Oclusão da Veia Retiniana , Inibidores da Angiogênese/uso terapêutico , Humanos , Injeções Intravítreas , Edema Macular/diagnóstico , Edema Macular/tratamento farmacológico , Edema Macular/etiologia , Estudos Prospectivos , Receptores de Fatores de Crescimento do Endotélio Vascular/uso terapêutico , Proteínas Recombinantes de Fusão/uso terapêutico , Oclusão da Veia Retiniana/complicações , Oclusão da Veia Retiniana/diagnóstico , Oclusão da Veia Retiniana/tratamento farmacológico , Resultado do Tratamento , Acuidade Visual
12.
Invest Ophthalmol Vis Sci ; 62(2): 9, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33733716

RESUMO

Purpose: The purpose of this study to identify the effects of prolonged type 2 diabetes (T2DM) on the peripapillary retinal nerve fiber layer (pRNFL) and peripapillary microvasculature in patients with prolonged T2DM without clinical diabetic retinopathy (DR). Methods: Subjects were divided into 3 groups: controls (control group; 153 eyes), patients with T2DM < 10 years (DM group 1; 136 eyes), and patients with T2DM ≥ 10 years (DM group 2; 74 eyes). The pRNFL thickness and peripapillary superficial vessel density (VD) were compared. Linear regression analyses were performed to identify factors associated with peripapillary VD in patients with T2DM. Results: The mean pRNFL thicknesses of the control group, DM group 1, and DM group 2 were 96.0 ± 7.9, 94.5 ± 0.9, and 92.2 ± 8.2 µm, respectively (P < 0.001). The VDs were 18.24 ± 0.62, 17.60 ± 1.47, and 17.15 ± 1.38 mm-1 in the control group, DM group 1, and DM group 2, respectively (P < 0.001). In multivariate linear regression analyses, visual acuity (B = -2.460, P = 0.001), axial length (B = -0.169, P = 0.008), T2DM duration (B = -0.056, P < 0.001), and pRNFL (B = 0.024, P = 0.001) were significant factors affecting the peripapillary VD in patients with T2DM. Conclusions: Patients with T2DM without clinical DR showed thinner pRNFL and lower peripapillary VD and perfusion density (PD) compared with normal controls, and such damage was more severe in patients with T2DM ≥ 10 years. Additionally, peripapillary VD was significantly associated with best-corrected visual acuity (BCVA), axial length, T2DM duration, and pRNFL thickness in patients with T2DM.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Retinopatia Diabética/diagnóstico , Microvasos/patologia , Disco Óptico/irrigação sanguínea , Células Ganglionares da Retina/patologia , Vasos Retinianos/patologia , Acuidade Visual , Estudos Transversais , Retinopatia Diabética/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Estudos Retrospectivos , Tomografia de Coerência Óptica
13.
Semin Ophthalmol ; 36(8): 728-733, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-33750260

RESUMO

PURPOSE: To investigate the surgical outcomes of vitrectomy for macular hole-induced retinal detachment(MHRD), with respect to the surgical adjunctive method used. METHOD: We performed retrospective multicenter study of patients who underwent vitrectomy for MHRD. The visual/anatomical outcomes after vitrectomy were analyzed. We also analyzed these outcomes according to surgical method and the presence of persistent macular hole after the vitrectomy. RESULT: Thirty-four patients (34 eyes) from 6 hospitals were included in this study. The mean age of the patients was 64.56 ± 12.23 years; 31 patients (91.2%) were female. The mean LogMAR best-corrected visual acuity (BCVA) significantly improved 6 months after vitrectomy (p < .001). Retinal detachment completely improved in 32 eyes (94.1%). The visual prognoses and macular hole closure rates were not different depending on subretinal fluid drainage site. The presence or absence of a persistent macular hole after vitrectomy did not affect the visual outcomes. However, the recurrence of MHRD was significantly higher in eyes with persistent macular holes(p = .015). CONCLUSION: The surgeries to treat MHRD differed in terms of the procedure depending on the surgeons, but the visual outcomes did not differ depending on the surgical adjunctive method employed. There were no differences in the visual prognoses, regardless of whether there was a persistent macular hole; however, recurrence was significantly higher in eyes with persistent macular holes. Therefore, further surgical treatment might be considered for eyes with persistent macular holes after MHRD surgery.


Assuntos
Miopia Degenerativa , Descolamento Retiniano , Perfurações Retinianas , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Miopia Degenerativa/cirurgia , Descolamento Retiniano/etiologia , Descolamento Retiniano/cirurgia , Perfurações Retinianas/diagnóstico , Perfurações Retinianas/etiologia , Perfurações Retinianas/cirurgia , Estudos Retrospectivos , Tomografia de Coerência Óptica , Resultado do Tratamento , Acuidade Visual , Vitrectomia
14.
Invest Ophthalmol Vis Sci ; 62(3): 5, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33656554

RESUMO

Purpose: The purpose of this paper was to study the bilateral choroidal thickness (CT) symmetry and differences in healthy individuals using wide-field swept-source optical coherence tomography (SS-OCT). Methods: All participants underwent a wide-field 16-mm 1-line scan using SS-OCT. CTs were measured at the following 12 points: 3 points at 900 µm, 1800 µm, and 2700 µm away from the nasal optic disc margin (nasal peripapillary area), 1 point at the subfovea, 6 points at 900 µm, 1800 µm, and 2700 µm away from the subfovea to the nasal and temporal areas (macular area), and 2 peripheral points at 2700 and 5400 µm from temporal point 3 (peripheral area). Bilateral CTs were measured; their correlations and differences in the corresponding regions were analyzed. Results: There were no statistically significant differences in CTs between the right and left eyes in all corresponding areas (all P > 0.05); they all showed significant positive correlation coefficients (r) (all P < 0.001). However, the nasal peripapillary and peripheral areas had relatively low correlation coefficients, compared to the macular areas. In addition, the bilateral CT differences were 32.60 ± 25.80 µm in the macular area, 40.67 ± 30.58 µm in the nasal peripapillary area, and 56.03 ± 45.73 µm in the peripheral area (all P < 0.001). Conclusions: Overall, the CTs of each region were bilaterally symmetrical. However, the differences in CTs increased from the center to the periphery, which indicated that the anatomic variation of the nasal peripapillary and peripheral choroid was greater than that of the macula.


Assuntos
Corioide/anatomia & histologia , Corioide/diagnóstico por imagem , Tomografia de Coerência Óptica , Adulto , Comprimento Axial do Olho/anatomia & histologia , Estudos Transversais , Feminino , Voluntários Saudáveis , Humanos , Pressão Intraocular/fisiologia , Masculino , Tamanho do Órgão , Reprodutibilidade dos Testes , Estudos Retrospectivos , Acuidade Visual/fisiologia
15.
Sci Rep ; 11(1): 6813, 2021 03 24.
Artigo em Inglês | MEDLINE | ID: mdl-33762673

RESUMO

To identify the effects of prolonged type 2 diabetes (T2DM) on changes in peripapillary retinal nerve fiber layer (pRNFL) thickness in patients without clinical diabetic retinopathy. Subjects were divided into two groups: controls and patients with T2DM (DM group). After the initial visits, the pRNFL thicknesses were measured three more times at 1-year intervals. Subgroup analyses were performed in patients with T2DM duration ≥ 10 years. The mean pRNFL thickness at each visit was 95.8 ± 8.1, 95.4 ± 8.3, 94.9 ± 8.1, and 94.5 ± 8.3 µm in the control group (P = 0.138) (n = 55); and 93.4 ± 9.1, 92.1 ± 9.3, 90.9 ± 9.3, and 89.5 ± 9.2 µm in the DM group (P < 0.001) (n = 85). The estimated rate of reduction in mean pRNFL thickness was - 0.45 µm/year in the control group and - 1.34 µm/year in the DM group, respectively. In the DM group, the BCVA and HbA1c (both P = 0.001) were significant factors associated with pRNFL reduction. In patients with T2DM duration ≥ 10 years, the estimated pRNFL reduction rate was - 1.61 µm/year, and hypertension was a significant factor affecting the pRNFL reduction (P = 0.046). We confirmed rapid pRNFL reduction over time in T2DM, and the reduction rate was higher in patients with T2DM ≥ 10 years. Additionally, BCVA and HbA1c levels were significantly associated with the change in pRNFL thickness in T2DM patients.


Assuntos
Diabetes Mellitus Tipo 2/fisiopatologia , Fibras Nervosas/fisiologia , Retina/fisiologia , Idoso , Diabetes Mellitus Tipo 2/complicações , Retinopatia Diabética/etiologia , Feminino , Hemoglobina A Glicada/análise , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Disco Óptico/diagnóstico por imagem , Disco Óptico/patologia , Tomografia de Coerência Óptica , Acuidade Visual
16.
Acta Ophthalmol ; 99(7): e1056-e1062, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33555661

RESUMO

PURPOSE: To determine longitudinal changes of the ganglion cell-inner plexiform layer (GC-IPL) thickness in patients with non-exudative age-related macular degeneration (AMD) without other ophthalmic disease. METHODS: Thirty-three eyes of 33 patients with early and intermediate non-exudative AMD (non-exudative AMD group) and 33 normal control eyes were followed for 2 years, and GC-IPL thickness was measured by spectral domain optical coherence tomography at 1-year intervals. The mean rate of GC-IPL reduction was estimated using a linear mixed model and compared between two groups. RESULTS: The mean age of patients in the non-exudative AMD group and control groups were 68.82 ± 6.81 years and 67.73 ± 5.87 years, respectively (p = 0.488). The mean GC-IPL thickness at the first visit was 76.61 ± 16.33 µm in the non-exudative AMD and 81.76 ± 3.69 µm in control group (p = 0.387), and these values significantly decreased over time, with an average reduction rate of average GC-IPL -0.86 µm/year in the non-exudative AMD group and -0.32 µm/year in the control group. The difference between two groups was statistically significant (p < 0.001), and there was also a significant interaction between group and duration in linear mixed models in mean GC-IPL thickness (p = 0.001). CONCLUSIONS: The reduction rate of the GC-IPL thickness was greater in non-exudative AMD eyes, even at relatively early stages of the disease. Physicians should maintain awareness of the presence of non-exudative AMD in various cases of ophthalmic diseases where GC-IPL thickness evaluation is necessary.

17.
Eye (Lond) ; 35(11): 3064-3070, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-33423044

RESUMO

PURPOSE: To compare visual improvements between initial intravitreal t-PA with gas injection before anti-vascular endothelial growth factor (VEGF) and anti-VEGF injection monotherapy for submacular haemorrhage (SMH) associated with age-related macular degeneration (AMD). METHODS: We retrospectively reviewed medical records of naive patients treated with intravitreal t-PA with gas injection before anti-VEGF (Group 1) or only with intravitreal anti-VEGF injection (Group 2) for SMH [disc area (DA) ≥ 2] associated with AMD from two institutions. Both groups received 3 monthly loads of anti-VEGF injections followed by injections as needed for AMD treatment. Changes in best-corrected visual acuity (BCVA, logMAR) between the initial visit and after 6 months of treatment were compared between two groups. RESULTS: A total of 82 patients were enroled. Of these, 32 patients and 50 patients were grouped in Groups 1 and 2, respectively. The mean change in BCVA over 6 months for Group 1 was -0.52 ± 0.88, which was significantly larger (p = 0.044) than the mean change for Group 2 (-0.15 ± 0.58). We compared visual improvements between the two groups based on the following SMH size categories: ≤5, >5, and ≤15, and >15 DA. When the SMH size was ≤5, or >5 and ≤15 DA, the mean change in BCVA was larger for Group 1 than for Group 2, but this difference was not significant. When SMH size was >15 DA, Group 1 patients exhibited a mean visual improvement of -0.79 ± 0.80, which was significantly greater (p = 0.029) than that of Group 2 (-0.06 ± 0.67). CONCLUSIONS: Patients that were primarily treated for SMH associated with AMD using t-PA and gas injection (followed by anti-VEGF injection) exhibited better visual improvement than those treated with anti-VEGF monotherapy, especially in patients exhibiting larger SMH sizes (>15 DA) at the initial visit.


Assuntos
Degeneração Macular , Ativador de Plasminogênio Tecidual , Fibrinolíticos/uso terapêutico , Angiofluoresceinografia , Humanos , Degeneração Macular/complicações , Degeneração Macular/tratamento farmacológico , Hemorragia Retiniana/tratamento farmacológico , Hemorragia Retiniana/etiologia , Estudos Retrospectivos , Acuidade Visual
18.
Ophthalmic Plast Reconstr Surg ; 37(3S): S44-S47, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32773515

RESUMO

PURPOSE: To evaluate the efficacy of triamcinolone-soaked nasal packing in endoscopic dacryocystorhinostomy (EDCR). METHODS: Patients who underwent EDCR between September 2012 and August 2017 were included. They were assigned to triamcinolone (201 eyes) or control (206 eyes) group based on the order of surgery. Granulation occurrence and outcome were assessed at 3 and 6 months postoperatively, respectively. RESULTS: The success rates were 94.3% (overall anatomical success), 90.4% (complete anatomical success), 92.1% (overall functional success), and 76.7% (complete functional success). The overall functional success rate was significantly higher in the triamcinolone group (95.0% vs. 89.3%, p = 0.033). The overall anatomical success rate (96.0% vs. 92.7%, p = 0.149) and complete functional success rate (79.6% vs. 73.8%, p = 0.166) were also higher in the triamcinolone group, but this difference was not statistically significant. Granulation occurred in 62 eyes (15.2%); the incidence was significantly lower in the triamcinolone group (10.0% vs. 20.4%, p = 0.003). CONCLUSION: The authors suggest that use of triamcinolone-soaked nasal packing in EDCR is effective in significantly reducing the incidence of postoperative granulation and epiphora.


Assuntos
Dacriocistorinostomia , Doenças do Aparelho Lacrimal , Endoscopia , Epistaxe , Humanos , Estudos Retrospectivos , Resultado do Tratamento , Triancinolona
19.
Acta Ophthalmol ; 99(1): e117-e123, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32573109

RESUMO

PURPOSE: We investigated the wide-field choroidal thickness (CT) using swept-source optical coherence tomography (SS-OCT) and compared the characteristics of the choroidal layer between pachychoroid and normochoroid groups. METHODS: A total of 120 eyes from 120 normal subjects were included. All subjects were divided into two groups according to the subfoveal CT (≥300 µm, pachychoroid group; <300µm, normochoroid group). All subjects underwent an HD spotlight 16 mm scan using SS-OCT. The CT was measured at the following 12 points: subfoveal, 3 points in the nasal peripapillary area, 6 points in the macular area and 2 peripheral points at 5400 and 8100 µm from the fovea. The CT measurements were compared between the two groups, and statistical analyses were performed to determine clinical factors associated with each point of the CT. RESULTS: The CT in the pachychoroid group was thicker than that in the normochoroid group at all points (p < 0.01). The CTs of the two groups in the macular area were highly associated with the subfoveal CT. However, the CTs of the nasal peripapillary and peripheral areas showed lower associations with the subfoveal CT and lower diagnostic abilities for the pachychoroid group. The existence of pachyvessels was found to be a significant factor causing the regional variations. CONCLUSIONS: The CTs in the peripapillary and peripheral areas showed different patterns than the subfoveal CT. Regional variations by pachyvessels were more frequent in the peripapillary and peripheral areas than in the macular area, and the subfoveal CT did not represent the whole choroidal area.


Assuntos
Corioide/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Adulto , Feminino , Seguimentos , Humanos , Masculino , Reprodutibilidade dos Testes , Estudos Retrospectivos
20.
J Clin Med ; 9(11)2020 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-33138005

RESUMO

PURPOSE: To determine the long-term reproducibility of axial length measurements and mean postoperative prediction errors after combined phacovitrectomy in patients with idiopathic epiretinal membranes. DESIGN: Retrospective cohort study. METHODS: The study included 43 patients who underwent combined phacovitrectomy and 30 patients who underwent only phacoemulsification. To determine the effect of vitrectomy, we compared patients treated with phacoemulsification only versus those treated with combined phacovitrectomy. Axial lengths were measured three times with a one-year interval, and the intraclass correlation coefficient (ICC), coefficient of variation (CV), and test-retest standard deviation (TRTSD) were assessed. RESULTS: There was no significant change in axial length, and axial length measurements showed high reproducibility in all groups. ICC, CV, and TRTSD values were 0.997, 0.24%, and 0.056, respectively, for the vitrectomized eyes. The mean postoperative prediction error was -0.37 diopters(D) in vitrectomized eyes (p < 0.001), while it was +0.11 D in patients with phacoemulsification (p = 0.531). The myopic shift was more obvious in eyes with a shallower anterior chamber (p = 0.008) and a thicker lens (p = 0.025). CONCLUSIONS: Axial length measurements showed excellent long-term reproducibility at 2 years after combined phacovitrectomy. Myopic shifts were observed after combined phacovitrectomy, which was probably due to changes in the effective lens position after combined phacovitrectomy, rather than to changes in the axial length.

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