Macular Structural Changes Research Articles

Research advances of macular structural and functional damage in glaucoma

Generally, peripheral visual function damage was the major sign of early glaucoma, while the central visual function damage happened until the late stage of glaucoma. In recent years, with the development of optical coherence tomography and microperimetry, it has been proven that macular structure and function were affected in early stage of glaucoma. Macular structural and functional changes helped monitoring the development of the disease. Research advances of macular structural and functional damage in glaucoma were reviewed in this article.

Correlation between macular structural changes and functional outcomes in idiopathic macular epiretinal membranes

Objective To investigate the correlation between macular structural changes and functional outcomes in idiopathic macular epiretinal membranes (IMEM). Methods Clinical data of 85 patients with monocular IMEM admitted from April 2013 to April 2014 were retrospectively analyzed. The diseased eyes(85 eyes)were studied as observation group and the normal eyes(85 eyes)served as control group. The results of routine eye examinations, optical coherence tomography (OCT) and multifocal electroretinography (mfERG) were compared between observation and control groups. Results The preoperative best corrected visual acuity (BCVA) in observation group was lower than that in control group (0.55±0.17 vs. 0.92±0.14, P 0.05). BCVA in observation group was negatively correlated with CRT(r=-2.16, P<0.05). Conclusions The central retinal thickness is negatively correlated with the best corrected visual acuity, but not correlated with center mfERG in patients with IMEM. Key words: Macular degeneration; Tomography, optical coherence; Electroretinography

Longitudinal analysis of the structural pattern of pseudophakic cystoid macular edema using multimodal imaging.

To describe the relationship between pseudophakic cystoid macular edema (CME) progression and retinal structural changes observed by spectral-domain optical coherence tomography (SD-OCT) and fluorescein angiography. Retrospective, consecutive, longitudinal imaging analysis of patients with acute pseudophakic cystoid macular edema. Two observers at two study centers evaluated all images and categorized the macular structural features based on the retinal layer involved with cystic changes and/or subretinal fluid. A time series of the structural pattern and visual acuity was constructed for 1-month intervals over a 6-month study period. Thirty nine patients presented with CME. The mean time since cataract extraction was 48 ±38 days (range 5-71). CME included inner nuclear layer (INL) cystic changes, outer plexiform layer (OPL) cystic changes, and subretinal fluid. Isolated INL changes were observed in four phakic fellow eyes. Isolated OPL morphology was not observed, and additional inner layers remained uninvolved. Resolution occurred rapidly following administration of periocular glucocorticoids, and typically demonstrated a reverse structural pattern or delayed subretinal fluid resolution. Isolated subretinal fluid or a combined INL and subretinal fluid structure indicated CME resolution. Acute and recurrent pseudophakic CME involves a directional progression of the retinal layer involved with cystic changes and a clinical course. CME begins with INL cystic changes, progresses to combined INL and OPL morphology, and may continue to involve subretinal fluid. The inner nuclear layer is the most frequently involved layer, and isolated INL cysts may occur in phakic fellow eyes. A three-layer structure, the presence of OPL morphology, or isolated INL early in the postoperative period indicates disease activity.

Detection of macular and circumpapillary structural loss in normal hemifield areas of glaucomatous eyes with localized visual field defects using spectral-domain optical coherence tomography

To investigate thickness of the macular ganglion cell complex (mGCC) and circumpapillary retinal nerve fiber layer (cRNFL) in retinal segments without visual field (VF) loss in glaucomatous eyes in which localized VF defects were confined to a single hemifield, using spectral-domain optical coherence tomography (SD-OCT). Seventy-one Asian glaucomatous patients and 64 normal subjects underwent mGCC and cRNFL imaging employing RTVue-100 SD-OCT. We compared both thickness parameters in retinal segments without VF defects with those in segments in which such defects were evident, and in matched segments of normal controls. Linear regression analysis was used to investigate the relationship between mGCC and cRNFL thickness parameters of segments with or without VF defects, and glaucoma status based on Humphrey field analyzer (HFA) indices. Mean mGCC thickness in the hemiretinae of glaucomatous eyes without VF defects was 87.2 ± 9.3 μm, significantly lower than in matched control hemiretinae (96.2 ± 5.0 μm; p < 0.001), but significantly higher than in glaucomatous hemiretinae with VF defects (76.4 ± 9.9 μm; p < 0.001). A similar trend was also noted with mean cRNFL thickness. There were significant associations between both thickness parameters in glaucomatous hemiretinae with or without VF loss and degree of VF damage at initial presentation. Perimetrically normal hemifields of glaucomatous eyes had significantly lower mGCC and cRNFL thicknesses than did the corresponding retinal regions of healthy eyes. SD-OCT may be a useful ancillary diagnostic tool for evaluation of early macular and circumpapillary structural changes in glaucomatous eyes with localized VF defects.

Structural and Functional Correlation in Sickle Cell Retinopathy Using Spectral-Domain Optical Coherence Tomography and Scanning Laser Ophthalmoscope Microperimetry

To correlate macular structural changes by spectral-domain optical coherence tomography (SD-OCT) with functional changes by scanning laser ophthalmoscope (SLO) microperimetry testing in patients with sickle cell hemoglobinopathies. Prospective, investigational study. Patients with electrophoretic confirmation of sickle cell hemoglobinopathies and normal subjects underwent SD-OCT and microperimetry testing with the OPKO Spectral OCT/SLO instrument. Based on SD-OCT findings, patients were grouped into those with focal macular thinning (Group A) and those without (Group B). Main outcome measure were mean retinal sensitivities measured by microperimetry and mean macular thicknesses in the 9 Early Treatment Diabetic Retinopathy Study (ETDRS)-like subfields. Thirty-seven eyes of 19 patients with sickle cell hemoglobinopathies (SS, SC, and S-thalassemia) and 34 eyes of 34 age-similar normal controls were included. Mean age and mean logMAR best-corrected visual acuity between Groups A and B were not statistically different (39.7 years vs 36.5 years, P = .64 and 0.015 vs 0.016, P = .93, respectively). Group A had significantly thinner retinas compared to Group B in the parafoveal superior (P = .019), parafoveal temporal (P < .004), parafoveal inferior (P = .003), perifoveal superior (P = .04), perifoveal temporal (P = .0005), and perifoveal inferior (P = .045) subfields. The overall mean microperimetry retinal sensitivities of Group A were significantly less than those of Group B (14.2 dB vs 16.5 dB, P = .00005). However, there was no statistical difference between Group B and controls (16.5 dB vs 16.7 dB, P = .63). Sickle cell patients with focal macular thinning present on SD-OCT have significantly decreased retinal sensitivities compared to those without focal thinning or normal controls based on mean microperimetry sensitivities, despite similar age and visual acuity. Microperimetry is a sensitive measurement of macular function in patients with sickle cell hemoglobinopathies.

Macular structural changes in eyes of multiple sclerosis patients assessed by optical coherence tomography

Macular structural changes in eyes of multiple sclerosis patients assessed by optical coherence tomography

Internal limiting membrane peeling and perfluoropropane tamponade for macular retinoschisis with high myopia

Objective To evaluate the efficacy of vitrectomy with internal limiting membrane(ILM) peeling and perfluoropropane tamponade (C3F8) to treat macular retinoschisis in high myopic eyes. Methods 33 eyes of 31 consecutive high myopia patients with macular retinoschisis were selected randomly; all had posterior staphyloma without retinal detachment. The preoperative refractive errors ranged from -9.5 D to -21.0 D with the mean of -(13.1±3.6) D. The preoperative axial lengths ranged form 26 mm to 32 mm with the mean of (28.3±2.1 mm. Conventional 20-G vitrectomy was performed with ILM peeling and 10 % C3 F8 infusion, ILM was labeled by Triamcinolone (TA). The best corrected visual acuity (BCVA) and macular structural changes were observed before the surgery, and at 1, 2, 3, 4, 8 months after the surgery. Results Beginning from 1 month after surgery all patients had significant improvement of the macular retinoschisis and BCVA. The macular structure changed very slightly along with the time. The foveal thickness were (327.62±51.7), (165.2±22. 6), (159.3±28.7), (167.7±17.1), (142.7±13.8) and (169.1±19.6) μm respectively before surgery and 1, 2, 3, 4, 8 months after surgery. The mean foveal thickness was reduced significantly at 1-8 months follow-up compared with the preoperational result (t = 9.21,9.23,9.21,10. 67,9.21; P<0.05). The foveal thickness had no significant change at each time-point after surgery. From 4 months after surgery, recurrence of macular retionoscbisis was found in 3 eyes (9.1%). Conclusion Vitrectomy with ILM peeling and C3F8 tamponade is useful to treat macular retinoschisis in high myopic eyes. Key words: Myopia; degenerative/complications; Retinosehisis/surgery; Vitrectomy