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1.
Invest Ophthalmol Vis Sci ; 63(6): 4, 2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-35653120

RESUMO

Purpose: The purpose of this study was to identify the relationship between the gangion cell-inner plexiform layer (GC-IPL) and retinal vasculature in the context of the progression of diabetic retinopathy (DR). Methods: The subjects were divided into four groups according to DR stage: normal controls (group 1), patients with diabetes mellitus (DM) without DR (group 2), patients with mild or moderate nonprogressive DR (NPDR; group 3), and patients with severe NPDR (group 4). GC-IPL thickness, vessel density of superficial vascular plexus (SVD), and the GC-IPL/SVD ratio were compared among the groups. Results: A total of 556 eyes were enrolled; 288 in group 1, 140 in group 2, 76 in group 3, and 52 in group 4. The mean GC-IPL thicknesses were 83.57 ± 7.35, 82.74 ± 7.22, 81.33 ± 6.74, and 79.89 ± 9.16 µm in each group, respectively (P = 0.006). The mean SVDs were 20.40 ± 1.26, 19.70 ± 1.56, 18.86 ± 2.04, and 17.82 ± 2.04 mm-1 in each group, respectively (P < 0.001). The GC-IPL/SVD ratios were 4.11 ± 0.38, 4.22 ± 0.40, 4.36 ± 0.54, and 4.54 ± 0.55 in each group, respectively (P < 0.001). In Pearson's correlation analysis, DR stage was significantly correlated with the GC-IPL/SVD ratio (coefficient = 0.301; P < 0.001). Conclusions: As the DR stage progressed, the GC-IPL thickness tended to decrease, with the macular SVD showing a significant reduction. Additionally, the impairment of retinal vasculature was more prominent than GC-IPL thinning as DR progressed, which suggests that retinal vasculature changes may precede diabetic retinal neurodegeneration.


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Humanos , Fibras Nervosas , Retina , Células Ganglionares da Retina , Tomografia de Coerência Óptica
2.
Acta Ophthalmol ; 100(1): e150-e156, 2022 Feb.
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.


Assuntos
Hipertensão/complicações , Doenças Retinianas/diagnóstico , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Biometria , Pressão Sanguínea/fisiologia , Estudos Transversais , Feminino , Humanos , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Doenças Retinianas/etiologia
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.
Diabetes ; 70(11): 2663-2667, 2021 11.
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.


Assuntos
Diabetes Mellitus Tipo 2/patologia , Retinopatia Diabética/patologia , Hipertensão/patologia , Neurônios Retinianos/patologia , Idoso , Estudos Transversais , Feminino , Hemoglobina A Glicada , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia de Coerência Óptica , Acuidade Visual
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.
J Clin Med ; 10(15)2021 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-34362115

RESUMO

This study analyzed risk factors for extrusion of orbital implants after evisceration by comparing patients with and without implant extrusion. METHODS: We retrospectively reviewed the medical records of patients who underwent evisceration with primary implant placement by a single surgeon from January 2005 to December 2019 at the Chungnam National University Hospital. Age, sex, underlying systemic diseases, axial length of the fellow eye, the cause of evisceration, endophthalmitis type, implant type and size, and preoperative computed tomography findings were evaluated. Logistic regression analysis was used to identify the risk factors for implant extrusion. RESULTS: Of the 140 eyes of 140 patients, extrusion occurred in five eyes (3.6%). Endophthalmitis (odds ratio (OR), 15.49; 95% confidence interval (CI), 1.70 to 2038.56; p = 0.010), endogenous endophthalmitis (OR, 18.73; 95% CI, 3.22 to 125.21, p = 0.002), orbital cellulitis (OR, 320.54; 95% CI, 29.67 to 44801.64; p < 0.001), implant size (OR, 0.50; 95% CI, 0.30 to 0.79; p = 0.004), and hydroxyapatite for the implant (OR, 0.07; 95% CI, 0.00 to 0.66; p = 0.016) were risk factors for implant extrusion in univariate logistic regression analysis. Multiple logistic regression analysis identified orbital cellulitis as the only risk factor for extrusion (OR, 52.98; 95% CI, 2.18 to 15367.34; p = 0.009). CONCLUSIONS: Evisceration with primary orbital implantation is a feasible option in endophthalmitis, but the risk of extrusion should be taken into consideration. When performing evisceration in a patient with orbital cellulitis, secondary implantation should be carried out only after any infection is controlled.

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.


Assuntos
Hipertensão/fisiopatologia , Pressão Intraocular/fisiologia , Miopia/epidemiologia , Fibras Nervosas/patologia , Retina/patologia , Acuidade Visual/fisiologia , Estudos de Casos e Controles , Comorbidade , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miopia/patologia , República da Coreia/epidemiologia , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos
9.
J Glaucoma ; 30(8): 703-710, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34049348

RESUMO

PRECIS: The development of beta-zone peripapillary atrophy (ß-PPA) and focal lamina cribrosa defect (FLD) was significantly associated with decreased peripapillary optical coherence tomography angiography (OCTA) vessel parameters in young myopic eyes. PURPOSE: The purpose of this study was to investigate whether ß-PPA and FLD affect peripapillary vessel density (VD) or perfusion density (PD) from OCTA in young myopic eyes. MATERIALS AND METHODS: In a cross-sectional study, 330 eyes of 165 healthy volunteers with myopia were involved. Eyes underwent OCTA to measure peripapillary PD and VD. Eyes were grouped according to the presence of ß-PPA or FLD: eyes without ß-PPA or FLD (group A), eyes with ß-PPA but without FLD (group B), and eyes with both ß-PPA and FLD (group C). PD and VD were compared among 3 groups, and linear mixed-effect regression model was used to investigate the determinants of PD. RESULTS: ß-PPA was found in 219 eyes (66.4%), and FLD was detected in 27 eyes (8.2%). The average VD and PD were greatest in group A (19.13±2.04 mm-1 and 0.375±0.038), followed by group B (18.34±2.26 mm-1 and 0.363±0.042) and group C (16.71±2.81 mm-1 and 0.330±0.052) (P<0.001). The linear mixed-effect model demonstrated that presence of FLD (P=0.001) or ß-PPA (P<0.001), FLD count (P=0.004), and maximal ß-PPA width (P<0.001) were significantly associated with average PD after controlling for multiple confounding factors. CONCLUSIONS: Development of ß-PPA and FLD, which is closely related with axial elongation in myopic eyes, was significantly associated with reduced OCTA vessel parameters in young myopic eyes. OCTA may help to detect vascular changes and assess glaucoma risk in these eyes.


Assuntos
Miopia , Disco Óptico , Atrofia/patologia , Estudos Transversais , Humanos , Pressão Intraocular , Miopia/diagnóstico , Miopia/patologia , Disco Óptico/patologia , Tomografia de Coerência Óptica
10.
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.


Assuntos
Síndromes do Olho Seco/diagnóstico , Angiofluoresceinografia/métodos , Microvasos/diagnóstico por imagem , Vasos Retinianos/diagnóstico por imagem , Lágrimas/metabolismo , Tomografia de Coerência Óptica/métodos , Adulto , Síndromes do Olho Seco/metabolismo , Feminino , Seguimentos , Fundo de Olho , Humanos , Masculino , Estudos Retrospectivos , Adulto Jovem
11.
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
12.
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
13.
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.


Assuntos
Degeneração Macular/diagnóstico , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Idoso , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Fibras Nervosas/patologia , Estudos Prospectivos
14.
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
15.
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
16.
Br J Ophthalmol ; 105(6): 862-868, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-32703786

RESUMO

BACKGROUND: To investigate the relationship between estimated mean ocular perfusion pressure (MOPP) and peripapillary perfusion density (PD) or vessel density (VD) as measured by spectral-domain optical coherence tomography angiography (OCTA) in young healthy eyes. METHODS: 132 healthy participants (264 eyes) under 45 years of age underwent optic disc OCTA scan sized 3×3 mm to acquire PD and VD in the superficial vascular complex (SVC). Optic nerve head (ONH) parameters including retinal nerve fibre layer (RNFL) thickness, rim area and disc area were measured. MOPP was estimated from systemic blood pressure and intraocular pressure (IOP). A linear mixed model was used to find the systemic and ocular factors associated with PD and VD. RESULTS: The average age of the subjects was 25.8±6.5 years. PD and VD showed a significant correlation with RNFL thickness (r=0.224, p<0.001 and r=0.214, p<0.001, respectively), but with MOPP, the correlation was only marginally significant (r=0.105, p=0.09 and r=0.112, p=0.07, respectively). After controlling for confounding factors, including age, sex, IOP, central corneal thickness, axial length and OCTA signal strength, PD and VD were significantly associated with ONH parameters (all p<0.05) but not with estimated MOPP (all p>0.05). CONCLUSION: PD and VD in the SVC were significantly associated with ONH parameters while showing no association with estimated MOPP. OCTA-derived VD may not represent perfusion pressure, but is rather more dependent on peripapillary structure.


Assuntos
Angiofluoresceinografia/métodos , Pressão Intraocular/fisiologia , Disco Óptico/irrigação sanguínea , Células Ganglionares da Retina/patologia , Vasos Retinianos/fisiopatologia , Tomografia de Coerência Óptica/métodos , Campos Visuais , Adolescente , Adulto , Feminino , Fundo de Olho , Glaucoma de Ângulo Aberto/diagnóstico , Glaucoma de Ângulo Aberto/fisiopatologia , Voluntários Saudáveis , Humanos , Masculino , Fibras Nervosas/patologia , Estudos Prospectivos , Vasos Retinianos/diagnóstico por imagem , Tonometria Ocular , Adulto Jovem
17.
PLoS One ; 15(9): e0239555, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32966311

RESUMO

OBJECTIVE: To investigate the thicknesses of the ganglion cell-inner plexiform layer (GC-IPL) and retinal nerve fiber layer (RNFL) of the fellow eyes of patients with unilateral exudative age-related macular degeneration (AMD). METHODS: A total of 107 patients with unilateral exudative AMD [34 of typical choroidal neovascularization (tCNV), Group A; 73 of polypoidal choroidal vasculopathy (PCV), Group B] and 73 normal control eyes (Group C) were included. Drusen and subretinal drusenoid deposits were assessed in all participants using fundus photography, autofluorescence, and optical coherence tomography (OCT). The GC-IPL and RNFL thicknesses were measured using Cirrus HD-OCT and compared among groups. Linear regression analyses were used to evaluate the factors associated with GC-IPL thicknesses. RESULTS: The average GC-IPL thicknesses of Groups A, B, and C were 77.09 ± 3.87, 80.10 ± 6.61, and 80.88 ± 6.50 µm, respectively (p = 0.022). Sectoral GC-IPLs and central macular thicknesses (CMTs) were significantly different among groups (all, p <0.05), whereas none of the RNFL parameters differed significantly (all, p >0.05). Multivariate linear regression analyses revealed that age (p <0.001), CMT (p <0.001), and tCNV (p = 0.013) were significantly associated with average GC-IPL thickness, and the rate of reduction of GC-IPL thickness with increasing age in the fellow eyes of tCNV patients was higher than those in the PCV and control groups. CONCLUSIONS: Unilateral tCNV patients exhibited statistically significant reduction of the GC-IPL thickness in the fellow eyes, compared to values of the fellow eyes of unilateral PCV patients or control patients. RNFL values trended to be lower but did not reach statistical significance.


Assuntos
Degeneração Macular/diagnóstico por imagem , Retina/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Neovascularização de Coroide/diagnóstico por imagem , Neovascularização de Coroide/patologia , Feminino , Angiofluoresceinografia , Humanos , Degeneração Macular/patologia , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Retina/patologia , Células Ganglionares da Retina/patologia , Neurônios Retinianos/patologia , Estudos Retrospectivos , Tomografia de Coerência Óptica
18.
Invest Ophthalmol Vis Sci ; 61(10): 30, 2020 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-32797199

RESUMO

Purpose: To investigate the association between myopia and peripapillary retinal nerve fiber layer (pRNFL) thickness in diabetic patients without diabetic retinopathy (DR). Methods: A total of 271 eyes of 271 participants were included. They were divided into four groups according to the presence of myopia (≤ -3 diopters [D]) and diabetes without DR: (1) control group (n = 76), (2) myopia group (n = 57), (3) diabetes group (n = 82), and (4) diabetes + myopia group (n = 56). The peripapillary average and sector RNFL thicknesses were measured and compared among the four groups to determine the effects of myopia and diabetes. Covariates were adjusted using analyses of covariance. Linear regression analyses were fitted to evaluate the factors associated with pRNFL. Results: Spherical equivalents were 0.12 ± 1.31 D in the control group, -4.00 ± 1.47 D in the myopia group, 0.00 ± 1.05 D in the diabetes group, and -4.33 ± 1.70 D in the diabetes + myopia group (P < 0.001). The respective axial lengths (ALs) were 23.91 ± 0.99 mm, 25.16 ± 0.94 mm, 23.68 ± 0.77 mm, and 25.34 ± 1.33 mm (P < 0.001). The average pRNFL showed a progressive decrease from the control group (97.16 ± 8.73 µm) to the myopia group (94.04 ± 9.13 µm) to the diabetes group (93.33 ± 9.07 µm) to the diabetes + myopia group (91.25 ± 9.72 µm) (P = 0.009). Age, diabetes, hypertension, and AL were significantly correlated with the pRNFL. The rate of reduction of pRNFL with increasing age was higher in the diabetes + myopia group than in the other groups, and pRNFL in the diabetes groups decreased more steeply with increasing AL compared to the non-diabetic groups. Conclusions: Myopia and diabetes are important factors affecting pRNFL thickness, and the simultaneous presence of diabetes and myopia results in greater pRNFL damage than observed with either pathology alone.


Assuntos
Diabetes Mellitus Tipo 2/patologia , Miopia/patologia , Fibras Nervosas/patologia , Neurônios Retinianos/patologia , Fatores Etários , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miopia/complicações , Miopia/diagnóstico por imagem , Retina/diagnóstico por imagem , Retina/patologia , Tomografia de Coerência Óptica
19.
BMC Ophthalmol ; 20(1): 286, 2020 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-32660545

RESUMO

BACKGROUND: Although many studies have reported clinical features, surgical outcomes of rhegmatogenous retinal detachment (RRD), studies focusing on total RRD are rare. In this study, we investigate the clinical characteristics, risk factors, and prognosis of total RRD. METHODS: A retrospective chart review was performed on cases of 44 total RRD and an age- and sex-matched 88 partial RRD. Two groups were compared for clinical characteristics, risk factors, and prognosis. RESULTS: The prevalence of total RRD in all cases of retinal detachment was 4.4%. Pseudophakic eye, ocular trauma, and proliferative vitreoretinopathy (PVR) were significantly associated with a risk of total RRD (P = .002, P = .003, and P < .001, respectively). In the total RRD group, retinal breaks were located in both superior and inferior parts of the retina, and macular holes and giant retinal tears were frequently found. The best-corrected visual acuity (log MAR) before surgery and final best-corrected visual acuity after surgery were 2.23 ± 0.45 and 1.88 ± 0.96, which was significantly poorer than in the partial RRD group (P < .001). The success rate after primary surgery was 75.0% in the total RRD group, which was significantly lower than partial RRD group (P < .001). Old age, pseudophakic eye, and macular hole as the type of retinal break were highly associated with low success rate. (P = .010, P = .0500, and P = .002). CONCLUSIONS: Patients with total RRD had higher recurrence rate and poorer visual outcome after surgery than patients with focal RRD. Old age, pseudophakic eye, and presence of macular hole were important risk factors for recurrence after total RRD repair. Additional surgical procedures should be considered to combine with vitrectomy to achieve better surgical outcomes in these patients.


Assuntos
Descolamento Retiniano , Perfurações Retinianas , Estudos de Casos e Controles , Humanos , Prognóstico , Descolamento Retiniano/epidemiologia , Descolamento Retiniano/cirurgia , Perfurações Retinianas/diagnóstico , Perfurações Retinianas/epidemiologia , Perfurações Retinianas/cirurgia , Estudos Retrospectivos , Acuidade Visual , Vitrectomia
20.
PLoS One ; 15(6): e0234933, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584907

RESUMO

PURPOSE: To determine the repeatability of superficial vessel density measurements using Spectral domain Ocular coherence tomography angiography(SD-OCTA) in patients diagnosed with retinal vein occlusion(RVO). DESIGN: Prospective observational study. SUBJECTS: Patients who visited our retinal clinic from August 2017 to August 2018, diagnosed with RVO were recruited for the study. METHODS: Two consecutive 3×3 mm pattern scans were performed using the Cirrus HD-OCT 5000 along with AngioPlex software (Carl Zeiss Meditec) in each eye by single skilled examiner. All scans were analyzed using en face OCTA images to measure vessel density (VD) automatically. For further analysis of the effect of central macular thickness(CMT), eyes were divided into two groups according to CMT of 400µm (Group 1: CMT > 400µm, Group 2: CMT < 400µm). To identify factors affecting the repeatability of VD measurements, linear regression analyses were conducted for the coefficient of variation (CV) of VD by investigating demographics and ocular variables. MAIN OUTCOME MEASURES: The intraclass correlation coefficient (ICC), coefficient of variation (CV) of VD measurements. RESULTS: A total of 57 eyes from 57 patients were examined: 35 eyes with BRVO and 22 eyes with CRVO. In all 57 eyes with RVO, the ICC and CV of the full VD(VD of 3mm diameter circle) were 0.800 and 10.61%, respectively. Univariate analyses showed that the mean CMT (B, 0.001; p<0.001) and mean ganglion cell-Inner plexiform layer (GC-IPL) thickness (B, -0.002; p = 0.020) were significant factors that affected the repeatability. Multivariate analyses of these two factors showed that only mean CMT was a significant factor. The ICC and CV of the full VD in group 1 (CMT > 400µm) were 0.348 and 22.55% respectively. In group 2 (CMT < 400µm), the ICC and CV of the full VD were 0.910 and 7.76%, respectively. CONCLUSIONS: The repeatability of VD measurement in eyes with RVO was reasonably comparable to previous studies. Repeatability of VD measurement was significantly affected by central macular thickness.


Assuntos
Angiografia por Tomografia Computadorizada/métodos , Oclusão da Veia Retiniana/diagnóstico , Vasos Retinianos/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Idoso , Feminino , Angiofluoresceinografia , Fóvea Central/irrigação sanguínea , Fóvea Central/diagnóstico por imagem , Fundo de Olho , Humanos , Masculino , Memória Episódica , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes
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