Rongping Dai

Natural course of vitreomacular traction syndrome observed by spectral-domain optical coherence tomography

OBJECTIVE Our study aimed to characterize the natural course of vitreomacular traction (VMT) syndrome, on which discrepancies have been reported in previous publications, by spectral-domain optical coherence tomography (SD-OCT). DESIGN Retrospective chart review. PARTICIPANTS A total of 23 eyes of 23 patients with idiopathic symptomatic VMT syndrome diagnosed and followed up in Peking Union Medical College Hospital from 2008 to 2013. METHODS Clinical records of all patients who underwent SD-OCT examination and were diagnosed and followed up as idiopathic VMT syndrome were reviewed. Those who had at least 2 visits were included. The median observation period of the patients was 8.2 ± 7.9 months. RESULTS The 23 eyes were categorized into 3 groups based on the follow-up results of SD-OCT: the posterior vitreous detachment (PVD) group comprised 4 eyes that developed complete PVD, the full-thickness macular hole (FMH) group included 4 eyes that formed FMH, and the persisted VMT (PVMT) group comprised the other 15 eyes with PVMT. Epiretinal membrane (ERM) persisted in all 5 eyes in the PVMT group. FMH occurred in 3 of 7 eyes with outer lamellar macular hole (LMH) at the first visit. CONCLUSIONS Spontaneous development of complete PVD in VMT syndrome during follow-up appeared to be more common in our study than in previous reports without SD-OCT. Persistence of ERM might be an unfavourable prognostic factor in the natural course of VMT syndrome. The outer LMH might be a risk factor for FMH formation.

Spectral Domain Optical Coherence Tomography of Vogt-Koyanagi-Harada Disease: Novel Findings and New Insights into the Pathogenesis

OBJECTIVE To provide novel spectral domain optical coherence tomography (SD OCT) findings of Vogt-Koyanagi-Harada (VKH) disease as well as new insights into the pathogenesis of this disease. METHODS Detailed SD OCT and fluorescein angiography (FA) findings of 18 consecutive VKH patients (11 women and 7 men) from December 2007 to April 2009 who were in acute uveitic stage at presentation were reviewed. All the patients had been followed up for at least 6 months with reevaluation(s) of SD OCT performed in 10 patients. RESULTS Intraretinal cysts were found to be located in various layers of the outer retina. In addition to the photoreceptor layer, they could also be found between the outer plexiform layer and the outer nuclear layer, or spanning the external limiting membrane. On FA, intraretinal cysts could be hypofluorescent, normofluorescent, or hyperfluorescent. Some intraretinal cysts had a characteristic FA pattern, in which a small round hypofluorescent area was surrounded by a ring of hyperfluorescence (donut-shaped dye pooling). Subretinal fibrinoid deposit appeared in acute uveitic stage in two severe VKH patients and seemed to develop from subretinal exudates and evolved into typical subretinal fibrosis. Gradual transfiguration/migration and progressive proliferation/pigmentation of the subretinal fibrinoid deposit/subretinal fibrosis was observed in one patient. CONCLUSIONS Intraretinal cysts could form in various layers of the outer retina and may result from extension of choroidal inflammation. Subretinal fibrosis may develop from subretinal exudates in VKH patients and may cause substantial visual impairment.

Recovery of Photoreceptor Layer on Spectral-Domain Optical Coherence Tomography After Vitreous Surgery Combined With Air Tamponade in Chronic Idiopathic Macular Hole

BACKGROUND AND OBJECTIVE Studies using sterilized air in chronic idiopathic macular holes show varying success rates, and the impact of a shorter duration of tamponade on photoreceptor layer recovery is not fully elucidated. PATIENTS AND METHODS Surgical outcomes of 35 cases (seven in stage 3 and 28 in stage 4) were assessed for best corrected visual acuity and with spectral-domain optical coherence tomography. RESULTS The primary closure rate was 91.4%, and the closed cases and unclosed cases were significantly different in the preoperative (P = .042) and postoperative (P = .040) diameter of the photoreceptor layer defect. After surgery, there was a significant improvement in best corrected visual acuity and a decrease in the photoreceptor layer defect. The postoperative logarithm of the minimal angle of resolution was significantly correlated with the preoperative hole diameter (P = .003) and the postoperative diameter of the photoreceptor layer defect (P = .005). CONCLUSION Air tamponade is a safe and effective treatment for chronic and severe macular holes, with several spectral-domain optical coherence tomography parameters highly predictive of postoperative visual acuity.

Spectral-domain optical coherence tomography characteristics of macular contusion trauma.

Purpose: To describe the characteristics of macular lesions after eye trauma using spectral-domain optical coherence tomography (OCT). Methods: We retrospectively reviewed and described 2-dimensional (2D) and 3-dimensional (3D) spectral-domain OCT characteristics of 24 consecutive eyes of 24 cases that were identified with macular lesions after eye trauma. Results: Spectral-domain OCT clearly demonstrated a variety of lesions: hemorrhage, epiretinal membrane formation, macular hole, retinal pigment epithelium (RPE) rupture combined with choroidal neovascularization formation, photoreceptor inner/outer surface changes, RPE detachment, scar formation with e.g. diffuse macular edema, macular distortion or macular atrophy. Main lesions were located in the fovea area in 11 eyes (45.8%), the parafovea in 3 eyes (12.5%) and the whole macular area in 10 eyes (41.7%). Conclusion: Spectral-domain OCT is a useful investigation providing refined and credible 2D/3D images, precisely locating macular lesions after contusion trauma.

Systemic lupus erythematosus and antiphospholipid syndrome related retinal vasculitis mimicking ocular cysticercosis: a case report.

Making accurate and timely diagnosis is often challenging when patients with a systemic disease first present with ocular manifestations. The possibility that vasculitis associated with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) can be misdiagnosed as cysticercosis has not been discussed in the literatures.

Subretinal Hypopyon in Sympathetic Ophthalmia

Purpose: To describe a rare case of sympathetic ophthalmia with subretinal hypopyon. Methods: Observational case report. Results: A 41-year-old man was diagnosed with sympathetic ophthalmia in his left eye. Oral prednisone was started. Three days later, he developed an inferior exudative retinal detachment with an underlying hypopyon. The exudative retinal detachment and hypopyon resolved completely within 48 hours. Conclusions: A subretinal hypopyon in sympathetic ophthalmia is a rare clinical finding. It is probably the result of acute inflammation in the subretinal space.

Intraocular Detection of Herpesviruses by xTAG Liquid Chip Technology in Patients with Acute Retinal Necrosis

ABSTRACT Purpose: To evaluate the performance of the xTAG liquid chip technology (xTAG-LCT) for etiological diagnosis of acute retinal necrosis (ARN). Methods: Fifteen vitreous and 3 aqueous samples from 18 ARN patients were analyzed by xTAG-LCT and multiplex PCR (mPCR)/quantitative PCR (qPCR). Results: xTAG-LCT revealed positive results in 17 of the 18 samples: 10 for Varicella Zoster Virus (VZV) alone; 5 for VZV and Epstein-Barr virus (EBV); 1 for herpes simplex viruses type 1 (HSV-1) and EBV; 1 for VZV, HSV-1 and EBV. While mPCR revealed the same results as xTAG-LCT for VZV and HSV-1 in all samples, only 2 of the 7 samples positive for EBV on xTAG-LCT were confirmed by qPCR. None of the 28 control vitreous samples from 8 non-ARN patients and 10 pair of cadaveric eyes was positive for any of the tested viruses. Conclusions: xTAG-LCT could be a useful alternative for etiological diagnosis of ARN.