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Clinical & Experimental Optometry May 2012The aim of this study was to evaluate the relationship between structural and functional changes identified with the Rarebit fovea test (RFT) in diabetic patients over... (Review)
Review
BACKGROUND
The aim of this study was to evaluate the relationship between structural and functional changes identified with the Rarebit fovea test (RFT) in diabetic patients over two years. In addition, we evaluated whether the RFT changes at baseline can predict vascular changes detectable by conventional screening methods four to six years later.
METHODS
Forty-two patients with diabetes and 42 age-matched healthy subjects underwent an initial examination. Two years later, 25 of the diabetic patients and 20 of the controls were re-examined in the same way. Four to six years later, 40 of the diabetic patients underwent a standard screening examination including fundus photography. After two years, all subjects were examined with the RFT and visual acuity (VA) was assessed. In addition, optical coherence tomography (OCT) and fundus photography were performed on the diabetic patients. At a screening examination of the diabetic patients after four to six years, fundus photographs were reviewed.
RESULTS
After two years, a marked difference in RFT results was observed between the 20 normal subjects and the 25 patients with diabetes. Results from other tests (VA and central retinal thickness, as measured with OCT) were unchanged compared with the initial examinations. Fundus photography four to six years later of 40 of the 42 diabetic patients showed an increased incidence of retinopathy unrelated to the RFT findings at baseline.
CONCLUSIONS
The findings in the current study indicate that the RFT might detect macular dysfunction in diabetic eyes without microvascular changes. This dysfunction increased during a two-year period and presumably reflects neural impairment in diabetes mellitus but did not predict development of retinopathy during the four to six year period.
Topics: Adult; Diabetic Retinopathy; Diagnostic Techniques, Ophthalmological; Female; Humans; Macula Lutea; Male; Middle Aged; Photography; Tomography, Optical Coherence; Visual Acuity
PubMed: 22034970
DOI: 10.1111/j.1444-0938.2011.00678.x -
Ophthalmic Research 2022The main aim of this article was to study the retinal peripapillary and macular vascular structures in eyes with primary angle-closure suspects (PACS) using optical...
INTRODUCTION
The main aim of this article was to study the retinal peripapillary and macular vascular structures in eyes with primary angle-closure suspects (PACS) using optical coherence tomography angiography (OCTA).
METHODS
In this cross-sectional study, control and PACS subjects were recruited from a community screening. Only one eye per subject was used for analysis. All participants underwent a questionnaire survey, physical and ophthalmic examinations, ocular biometry measurements, and OCTA. We compared basic demographics and vessel structure parameters between control and PACS eyes. Univariate and multivariate linear regression analyses were performed to investigate factors associated with vascular parameters in both groups.
RESULTS
Data from 254 subjects including 155 PACS and 99 controls were analyzed. In the peripapillary region, PACS eyes showed similar retina nerve fiber layer (RNFL) and vessel densities (VDs) including and excluding large vessels compared to control eyes. Compared to control eyes, all macular OCTA parameters showed significant differences in PACS eyes, including decreased superficial VD (p = 0.006) and deep VD (p = 0.004), larger fovea avascular zone (FAZ) area (p = 0.006), and longer FAZ perimeter (p = 0.004). Gender (p = 0.039), age (p < 0.001), and Garway-Heath superior hemisphere RNFL (p < 0.001) were risk factors influencing optic disc VD excluding large vessels. Axial length was the major factor affecting macula superficial and deep VDs (p = 0.004 and 0.001 respectively), while PACS was an independent factor associated with larger FAZ perimeter (p = 0.046).
CONCLUSION
While PACS and control eyes have comparable RNFL and vascular structure around the optic nerve head, macular vascular structures are significantly different.
Topics: Humans; Cross-Sectional Studies; Macula Lutea; Optic Disk; Retinal Vessels; Tomography, Optical Coherence; Angiography
PubMed: 34649251
DOI: 10.1159/000520030 -
Indian Journal of Ophthalmology Mar 2022To identify factors other than macular edema and retinitis location responsible for poor visual outcomes in epidemic retinitis (ER). (Observational Study)
Observational Study
PURPOSE
To identify factors other than macular edema and retinitis location responsible for poor visual outcomes in epidemic retinitis (ER).
METHODS
A.
UNLABELLED
retrospective, observational, comparative study. Eyes with corrected distant visual acuity (CDVA) 20/200 or worse at resolution formed Group A. Eyes with central macular thickness (CMT) 600 μm or worse and retinitis within 1500 μm to foveal center at the presentation, but improved to CDVA 20/200 or better at the resolution formed Group B. The patient's history, clinical presentation, imaging, and treatment outcomes were studied and the factors responsible for the final visual outcomes were compared in both groups.
RESULTS
Groups A and B included 25 eyes each. The mean CDVA at the presentation was 20/400 (range: 20/125-20000) and 20/320 (range: 20/80-20000), and mean CMT at the presentation was 948.5 μm (range: 520-1553) and 912.2 μm (range: 615-1250) in Groups A and B, respectively. All eyes except 1 (Group A) had retinitis lesions within 1500 μm of foveal center. The mean CDVA at the resolution was 20/400 (range: 20/200-20/20000) and 20/40 (range: 20/20-20/80) in Groups A and B, respectively. Older age, male gender, diabetic status, delayed presentation, poor presenting CDVA, bilaterality, presence of keratic precipitates, disk pallor, retinal thinning, and subfoveal deposits had a statistically significant association, whereas the absence of skin rash, ellipsoid zone loss, negative WIDAL, Weil-Felix test, and delayed doxycycline therapy or use of steroids without doxycycline had a statistically insignificant association with poor visual outcomes.
CONCLUSION
Apart from presenting CMT and location of retinitis, multiple demographic, clinical, and imaging factors can be implicated for poor visual outcomes.
Topics: Fovea Centralis; Humans; Macular Edema; Male; Retinitis; Retrospective Studies; Tomography, Optical Coherence; Visual Acuity
PubMed: 35225539
DOI: 10.4103/ijo.IJO_1153_21 -
Chinese Medical Journal Feb 2017Morphological changes of the vasculature system in patients with myopia have been observed by Doppler ultrasound and fundus fluorescein angiography (FFA); however, these...
BACKGROUND
Morphological changes of the vasculature system in patients with myopia have been observed by Doppler ultrasound and fundus fluorescein angiography (FFA); however, these studies have limitations. Doppler ultrasound provides low-resolution images which are mainly obtained from visualized large vessels, and FFA is an invasive examination. Optic coherence tomography (OCT) angiography is a noninvasive, high-resolution measurement for vascular density. The purpose of this study was to investigate the change of vascular density in myopic eyes using OCT angiography.
METHODS
This cross-sectional study includes a total of 91 eyes from 47 participants including control, moderate, and high myopia that were evaluated by OCT angiography. Patients with myopia were recruited from the Refractive Department, Shenzhen Aier Eye Hospital, from August 5, 2015 to April 1, 2016. Emmetropic eyes were from healthy volunteers. The vascular density at macula and optic disc regions, ganglion cell complex (GCC) thickness, and retinal nerve fiber layer (RNFL) thickness were measured. Their relationships with axial length (AL) and refractive error were analyzed. One-way analysis of variance (ANOVA), Pearson's correlation, and generalized estimating equation were used for statistical analysis.
RESULTS
Both superficial and deep macular vascular density were highest in control (25.64% ± 3.76% and 37.12% ± 3.66%, respectively), then in moderate myopia (21.15% ± 5.33% and 35.35% ± 5.50%, respectively), and lowest in high myopia group (19.64% ± 3.87% and 32.81% ± 6.29%, respectively) (F = 13.74 and 4.57, respectively; both P < 0.001). Both superficial (β = -0.850 and 0.460, respectively) and deep (β = -0.766 and 0.396, respectively) macular vascular density were associated with AL and spherical equivalent (all P < 0.001). Superficial macular vascular density was associated with GCC thickness (β = 0.244, P = 0.040), independent of spherical equivalent. The vascular density in optic disc region had no difference among the three groups, and it was not associated with AL, spherical equivalent, or RNFL thickness.
CONCLUSION
Our results suggested that with the increase of myopia, the vascular density decreased in macular region, but not in optic disc region.
Topics: Adult; Cross-Sectional Studies; Eye; Female; Fluorescein Angiography; Humans; Macula Lutea; Male; Middle Aged; Myopia; Optic Disk; Prospective Studies; Retina; Retinal Ganglion Cells; Tomography, Optical Coherence; Young Adult
PubMed: 28218219
DOI: 10.4103/0366-6999.199844 -
Ophthalmology Feb 2020We determined the differential aging effects of the inner 6 layers of the macula in contrast to the minimum neuroretinal rim width (MRW) and peripapillary retinal nerve...
PURPOSE
We determined the differential aging effects of the inner 6 layers of the macula in contrast to the minimum neuroretinal rim width (MRW) and peripapillary retinal nerve fiber layer (RNFL) thickness.
DESIGN
Cross-sectional, multicenter study.
PARTICIPANTS
An approximately equal number of white subjects with a normal ocular and visual field examination in each decade group from 20 to 90 years.
METHODS
OCT of the macula, optic nerve head, and peripapillary retina.
MAIN OUTCOME MEASURES
Sectoral measurements of the inner 6 layers of the macula; age-related decline of each of these layers; strength of the associations with age of the macular parameters, MRW, and peripapillary RNFL thickness; and association between ganglion cell layer (GCL) thickness and MRW and peripapillary RNFL thickness.
RESULTS
The study sample comprised 1 eye of 246 subjects with a median (range) age of 52.9 (19.8-87.3) years. Of the 6 layers, there was a statistically significant decline with age of only the GCL, inner plexiform layer, and inner nuclear layer thickness with rates of -0.11 μm/year, -0.07 μm/year, and -0.03 μm/year, respectively. These rates corresponded to 2.82%, 2.10%, and 0.78% loss per decade, respectively, and were generally uniform across sectors. The rate of loss of MRW and peripapillary RNFL thickness was -1.22 μm/year and -0.20 μm/year, corresponding to 3.75% and 2.03% loss per decade. However, the association of GCL thickness change with age (R = 0.28) was approximately twice that of MRW and RNFL thickness (R = 0.14 for each).
CONCLUSIONS
In concordance with histopathologic studies showing age-related loss of retinal ganglion cell axons, we showed a significant decline in GCL thickness, as well as MRW and peripapillary RNFL thickness. The stronger relationship between aging and GCL thickness compared with the rim or peripapillary RNFL may indicate that GCL thickness could be better suited to measure progression of structural glaucomatous loss.
Topics: Adult; Aged; Aged, 80 and over; Aging; Cross-Sectional Studies; Female; Humans; Macula Lutea; Male; Middle Aged; Nerve Fibers; Optic Disk; Retina; Retinal Ganglion Cells; Young Adult
PubMed: 31668716
DOI: 10.1016/j.ophtha.2019.09.013 -
Middle East African Journal of... 2012To use spectral domain optical coherence tomography (OCT) to assess the features of the inner and outer layers of the macula in subjects with retinitis pigmentosa (RP). (Comparative Study)
Comparative Study
PURPOSE
To use spectral domain optical coherence tomography (OCT) to assess the features of the inner and outer layers of the macula in subjects with retinitis pigmentosa (RP).
DESIGN
Prospective observational comparative study.
MATERIALS AND METHODS
Subjects with RP with reduced central visual acuity and central macular thinning (RP group) underwent spectral domain OCT evaluation along with age-matched healthy control subjects (control group). Using the E-MM5 raster protocol, a 5 × 5 mm central macular cut was acquired with inner and outer macular volumes serving as the primary outcome measures. A structural analysis of the inner and outer retinal layers at the macula in the RP group was also performed using the HD cross-line protocol.
RESULTS
The RP group comprised six eyes of six RP subjects and control group comprised six eyes of six control subjects. The outer macular volume was significantly lower (P<0.05) in the RP group (2.01±0.44 mm(3)) compared to the control group (4.68±0.16 mm(3)). There was no difference in the mean inner macular volume between the RP group (2.46±0.24 mm(3)) and the control group (2.55±0.22 mm(3)). No significant structural alteration was noted in the inner retinal layers of the RP group. There was no significant correlation (r = -0.04, P>0.05) between best-corrected visual acuity and outer macular volume in the RP group.
CONCLUSIONS
Spectral domain OCT findings confirm that RP preferentially affects the outer retinal layers in the macula. Although the number of patients included in this study was small, it demonstrated relatively well-preserved volume and morphology of the inner retinal layers using spectral domain OCT.
Topics: Adult; Humans; Macula Lutea; Middle Aged; Prospective Studies; Reproducibility of Results; Retinal Ganglion Cells; Retinitis Pigmentosa; Tomography, Optical Coherence
PubMed: 22623864
DOI: 10.4103/0974-9233.95258 -
Ophthalmologica. Journal International... 2021To assess preoperative optical coherence tomography (OCT) findings of foveal-splitting retinal detachment (RD) and determine postoperative outcomes.
PURPOSE
To assess preoperative optical coherence tomography (OCT) findings of foveal-splitting retinal detachment (RD) and determine postoperative outcomes.
METHODS
Consecutive patients who underwent RD surgery over a 1-year period were included. Patients diagnosed with a detachment extending to the edge of the fovea on fundus examination (i.e., macula-On/Off) underwent macular OCT scanning. Visual acuity (VA) after 1 year of macula-On/Off, macula-On, and macula-Off eyes was compared.
RESULTS
A total of 85 eyes were included, 8 of which had a macula-On/Off RD. On preoperative OCT, all macula-On/Off RD eyes had foveal detachment extending beyond the foveal center over a median distance of 632 µm. Mean VA of the macula-On/Off eyes had improved from 20/160 to 20/40 at 1 year postoperatively (p = 0.035). The preoperative VA of macula-On/Off eyes was significantly better than macula-Off eyes (p = 0.032) and lower than macula-On eyes (p = 0.004). At 1 year, the VA of macula-On/Off eyes was no different from that of the macula-On eyes (p = 0.320), and tended to be better than that of the macula-Off eyes (p = 0.062).
CONCLUSION
Preoperative OCT revealed a shallow RD extending beyond the foveal center in eyes with clinical foveal-splitting RD. These eyes, termed macula-On/Off RD eyes, had a preoperative VA between macula-On and macula-Off eyes, while their final VA was close to those with macula-On RD.
Topics: Fovea Centralis; Humans; Macula Lutea; Retinal Detachment; Retrospective Studies; Tomography, Optical Coherence; Vitrectomy
PubMed: 32772030
DOI: 10.1159/000510726 -
Scientific Reports Jul 2021Many studies have demonstrated that rhegmatogenous retinal detachment (RRD) leads to impaired retinal circulation. However, the involvement of inflammation in the...
Many studies have demonstrated that rhegmatogenous retinal detachment (RRD) leads to impaired retinal circulation. However, the involvement of inflammation in the RRD-induced worsening of retinal circulation was obscure. This retrospective observational study included 150 patients with primary RRD (macula-on, n = 63; macula-off, n = 87) who underwent 25-gauge microincision vitrectomy surgery (25G MIVS). Total retinal blood flow was represented by the mean blur rate (MBR) of the optic nerve head vessel, measured by laser speckle flowgraphy preoperatively and until 6 months postoperatively. Aqueous humor samples were obtained during surgery to determine cytokine concentrations by enzyme-linked immunosorbent assay. At 3 and 6 months postoperatively, there were no significant differences between eyes with macula-on RRD and fellow eyes. However, in macula-off RRD, MBR remained significantly lower in RRD eyes 6 months postoperatively (P < 0.05). Log-transformed levels of soluble intercellular adhesion molecule-1 (sICAM-1) were negatively correlated with relative MBR (r-MBR, RRD eye/fellow eye) before surgery (r = - 0.47, P = 0.01) in macula-on, but not macula-off, RRD. Six months postoperatively, r-MBR correlated significantly with sICAM-1 levels (r = - 0.36, P = 0.02) in macula-off RRD. ICAM-1 may play a role in RRD-induced deterioration of retinal circulation.
Topics: Eye Diseases, Hereditary; Female; Humans; Intercellular Adhesion Molecule-1; Macula Lutea; Male; Middle Aged; Optic Disk; Retina; Retinal Detachment; Tomography, Optical Coherence; Visual Acuity; Vitrectomy
PubMed: 34321574
DOI: 10.1038/s41598-021-94993-w -
Scanning 2022In order to study the vascular density and retinal thickness of myopic children, a depth study was carried out on the basis of OCTA microscope. Through the methods of...
In order to study the vascular density and retinal thickness of myopic children, a depth study was carried out on the basis of OCTA microscope. Through the methods of prospective cross-sectional research, statistical analysis, and basic data comparison, the research examination of myopia children under OCTA was successfully analyzed. There were significant differences in the density of superficial capillaries in the whole macular region, inner ring, temporal side of inner ring, and nasal side ( = 0.033, 0.024, 0.018, 0.032), and there was no significant difference in other ranges ( > 0.05). Macular fovea, as the most sensitive part of the retina, has pathological changes, which will also lead to serious negative effects on vision. The limitations of cross-sectional studies include the results of a relatively small sample size. After the study of OCTA in the macular region of children with myopia, it is related to the progressive atrophy of the retina and choroid in the macular region. When there are obvious pathological changes in the macular region, the thickness of the macular region becomes significantly thinner. We found that there was a positive correlation between retinal vascular density and retinal thickness in the fovea and above of myopia. The retinal thickness of the whole macular region, the inner ring and its four quadrants, and the outer ring and its four quadrants were positively correlated with SE (standard error) (all < 0.05); Foveal ring retinal thickness was not associated with SE.
Topics: Child; Cross-Sectional Studies; Humans; Macula Lutea; Microvascular Density; Myopia; Prospective Studies; Retina; Tomography, Optical Coherence
PubMed: 35811761
DOI: 10.1155/2022/5038918 -
PloS One 2022Characterizing the effect of age and sex on macular retinal layer thicknesses and foveal pit morphology is crucial to differentiating between natural and disease-related...
Characterizing the effect of age and sex on macular retinal layer thicknesses and foveal pit morphology is crucial to differentiating between natural and disease-related changes. We applied advanced image analysis techniques to optical coherence tomography (OCT) to: 1) enhance the spatial description of age and sex effects, and 2) create a detailed open database of normative retinal layer thickness maps and foveal pit shapes. The maculae of 444 healthy subjects (age range 21-88) were imaged with OCT. Using computational spatial data analysis, thickness maps were obtained for retinal layers and averaged into 400 (20 x 20) sectors. Additionally, the geometry of the foveal pit was radially analyzed by computing the central foveal thickness, rim height, rim radius, and mean slope. The effect of age and sex on these parameters was analyzed with multiple regression mixed-effects models. We observed that the overall age-related decrease of the total retinal thickness (TRT) (-1.1% per 10 years) was mainly driven by the ganglion cell-inner plexiform layer (GCIPL) (-2.4% per 10 years). Both TRT and GCIPL thinning patterns were homogeneous across the macula when using percentual measurements. Although the male retina was 4.1 μm thicker on average, the greatest differences were mainly present for the inner retinal layers in the inner macular ring (up to 4% higher TRT than in the central macula). There was an age-related decrease in the rim height (1.0% per 10 years) and males had a higher rim height, shorter rim radius, and steeper mean slope. Importantly, the radial analysis revealed that these changes are present and relatively uniform across angular directions. These findings demonstrate the capacity of advanced analysis of OCT images to enhance the description of the macula. This, together with the created dataset, could aid the development of more accurate diagnosis models for macular pathologies.
Topics: Male; Humans; Young Adult; Adult; Middle Aged; Aged; Aged, 80 and over; Child; Nerve Fibers; Retinal Ganglion Cells; Fovea Centralis; Macula Lutea; Tomography, Optical Coherence
PubMed: 36520804
DOI: 10.1371/journal.pone.0278925