Volume 50 · Issue 06 · 2014

With the enhanced depth imaging spectral-domain optical coherence tomography occurs , choroidal structures and thickness can be observed accurately.So far studies about this technology are focused on the changes of the choroidal thickness and its related factors.While as a non-invasive examination, this technique can also be used to observe structural features of choroidal lesions ;measure the diameter of choroidal vessels; study the pathogenesis of disease; differentiate a variety of fundus disease;and follow-up medical or surgical treatment.So it has great scientific value and broad application prospects.

Intravitreal administration of anti-vascular endothelial growth factor ( anti-VEGF) drugs has become the standard treatment for exudative age-related macular degeneration ( AMD) .However , there are some patients who do not have a sufficient response to the treatment , and some patients fail to respond to those drugs .The mechanisms of non-response to the treatment in these cases are poorly understood .These may be associated with wAMD types , vitreomacularabnormity , genetic factors, andtachyphylaxis , etc. Ophthalmologists should pay attention to those non-responders and give them the correct treatment , avoid the anti-VEGF drugs abuse and explore the best personalized treatment for those patients .

Vision is used to detect visual function, which can be divided into central vision and peripheral vision. The vision we are talking about generally refers to central vision, and peripheral vision is the field of vision. This is because only the visual acuity in the main visual direction of the retina, that is, the central visual acuity of the fovea, can be measured by the eye chart, while the peripheral visual acuity in the secondary visual direction of the retina outside the main visual direction cannot be measured. If peripheral vision is measured, the main viewing direction of the eye must be obscured. This is an example of pupil deviation, where the displaced iris blocks the center of the pupil (through the main viewing direction), and the measured visual acuity is peripheral visual acuity; If the pupil is dilated and the center of the pupil is exposed, the main visual direction will be restored, the central vision will be restored [1], and the visual examination results will be improved. Therefore, when checking the vision of patients with organic eye disease, it must be realized that there are two kinds of vision. All clinically measured visual acuity must not be regarded or consciously regarded as "central vision". These two different properties of vision must be distinguished, and this is what we call the analysis theory of the properties of vision of the two views of vision [1-3].

Objective To investigate the subfoveal choroidal thickness ( SFCT ) and its relationship to associated diseases , including diabetes mellitus , diabetic retinopathy , and glaucoma.Methods The population-based cross-sectional Beijing Eye Study 2011 included 3 468 individuals with a mean age of (64.6 ±9.8 ) years.A detailed ophthalmic examination was performed including spectral-domain optical coherence tomography with enhanced depth imaging model (EDI SD-OCT).246 patients with diabetes and 128 patients with glaucoma were enrolled in the study.Statistical analysis was performed by SPSS 20.0 to examined the mean values of SFCT and the prevalence rate of associated diseases ; an univariate and multivariate linear regression to analyse the relationship between SFCT and ocular or general factors .Results Mean SFCT was ( 253.8 ±107.4 )μm.In multivariate analysis , SFCT was significantly associated with younger age(b=-4.12, P<0.001), shorter axial length(b=-44.7, P<0.001), male gender(b=-28.5, P<0.001), deeper anterior chamber depth (b=39.3, P<0.001), thicker lens(b=26.8, P<0.001), flatter cornea(b=46.0, P<0.001) and better best corrected visual acuity (b=-48.4, P=0.001).Mean SFCT in diabetes mellitus group was (266 ±108) μm.In multivariate analysis, SFCT was significantly related to presence of diabetes mellitus (b=21.2, P=0.001); but neither presence (P=0.61) nor stage (P=0.14) of diabetic retinopathy was significantly associated with SFCT.Mean SFCT in glaucoma group was (201.4 ±102.4.1) μm.Mean SFCT in glaucoma group was (201.4 ±102.4.1) μm;for open angle glaucoma , mean SFCT was ( 210.1 ±104.7 ) μm; for primary close angle glaucoma , mean SFCT was (184.2 ±93.6 )μm.In multivariate analysis, SFCT was significantly associated with close angle glaucoma(b=-32.3, P=0.04), but was not related to open angle glaucoma (P=0.44).Conclusions Mean SFCT was ( 253.8 ±107.4 )μm.SFCT was increased with age and myopic refractive error; and associated with male gender , anterior chamber depth , lens thickness , flatter cornea , best corrected visual acuity.SFCT in patients of diabetes mellitus was slightly thicker than normal people ; but the presence and development of diabetic retinopathy were not related to SFCT.SFCT in patients with close angle glaucoma was thinner than control group;but for open angle glaucoma , SFCT was similar to the normal people.

Objective To investigate the correlation of amaurosis fugax and carotid stenosis as well as posterior ocular blood vessel hemodynamic changes.Methods Case series studies.32 patients (19 men and 13 women whose age were 50 to 80 years old and average age was 64.31 ±8.15) who were diagnosed as amaurosis fugax with 32 eyes were enrolled from 2011.5-2012.12.During the same period 30 cases without posterior ocular ischemic diseases were collected as the control group.Their ophthalmic artery , central retinal artery and carotid artery were examinated by color Doppler ultrasound , to detect vascular peak systolic velocity, end diastolic velocity, resistance index, the degree of carotid stenosis, carotid artery plaque area and type.All data were analyzed by chi-square test and t-test.Results PSV(25.95 ±2.45) cm/s,EDV (6.01 ±0.87) cm/s of the ophthalmic artery in AmF group were lower compared with the control group [PSV:(27.53 ±1.41) cm/s, EDV: (6.89 ±0.56) cm/s].The differences were statistically significant (t=3.087, 0.712, P=0.003, 0.048).There was no statistical difference of RI between AmF and the control group (t=0.188, P=0.852) .PSV(7.13 ±0.96) cm/s,EDV(1.78 ±0.26) cm/s of the central retinal artery in AmF group were lower compared with the control group [PSV:(8.23 ±0.92) cm/s, EDV:(2.13 ±0.29) cm/s].The differences were statistically significant (t=4.648, 4.976, P=0.000, 0.000).There was no statistical difference of RI between AmF and the control group ( t=0.180, P=0.855).Detection rate of carotid artery moderately and severe stenosis ( 59.4%) was significantly higher compared with the control group (6.7%).The difference was statistically significant (χ2 =19.205, P =0.000).Conclusions The blood flow velocity of ophthalmic artery and central retinal artery in amaurosis fugax patients reduced significantly , while the resistance was normal.About 60%of the patients had carotid artery moderately and severe stenosis.There was significant correlation between amaurosis fugax and carotid artery stenosis.