Dear Editor,I diopathic macular telangiectasia(MacTel)type 1 is a retinal vascular disease characterized by abnormal dilation of macular capillaries,leading to metamorphopsia,progressive vision loss,and temporal scoto...Dear Editor,I diopathic macular telangiectasia(MacTel)type 1 is a retinal vascular disease characterized by abnormal dilation of macular capillaries,leading to metamorphopsia,progressive vision loss,and temporal scotoma enlargement.Currently,there is no standardized treatment protocol for MacTel type 1[1-2].Treatment outcomes can vary significantly among individuals,highlighting the ongoing need for further exploration of new and more effective treatment options.This paper presents a case of refractory macular edema associated with MacTel type 1,which showed a favorable response to pars plana vitrectomy(PPV)and internal limiting membrane(ILM)peeling.展开更多
Objective To examine the vesicular glutamate transporters （VGluTs： VGluT 1-VGluT3） in the peripheral vestibular system. Methods The vestibular structures, including Scarpa＇s ganglion （vestibular ganglion, VG）, m...Objective To examine the vesicular glutamate transporters （VGluTs： VGluT 1-VGluT3） in the peripheral vestibular system. Methods The vestibular structures, including Scarpa＇s ganglion （vestibular ganglion, VG）, maculae of utricle and saccule, and ampullary cristae, from normal Sprague-Dawley rats were processed immunohistochemically for VGluTs, by avidin-biotinylated peroxidase complex method, with 3-3＇-diaminobenzidine （DAB） as chromogen. Results （1） VGluT 1 was localized to partial neurons of VG and to the putative primary afferent fibers innervating vestibular end-organs. （2） Intense VGluT3 immunoreactivity was detected in large number of sensory epithelia cells, and weak labeling of VGluT3- positive afferent fibers was in the maculae and ampullary cristae. （3） No or very weak VGluT2 immunoreactivity was observed in the VG and acoustic maculae. Conclusion These results provide the morphological support that glutamate exists in the peripheral vestibular system, and it may play an important role in the centripetal vestibular transmission.展开更多
AIM： To compare the incidence of persistent submacular fluid（SMF） and visual outcome after pars plana vitrectomy（PPV） for rhegmatogenous retinal detachment（RRD） in different preoperative macular status accordin...AIM： To compare the incidence of persistent submacular fluid（SMF） and visual outcome after pars plana vitrectomy（PPV） for rhegmatogenous retinal detachment（RRD） in different preoperative macular status according to optical coherence tomography（OCT）.METHODS： A non-randomized, retrospective review was performed for patients who underwent successful PPV for RRD. OCT exams were taken preoperatively and 1 mo after surgery, until SMF disappeared. According to the preoperative macular status on OCT, patients were divided into two groups： macula-off RRD（Group A） and maculaon RRD（Group B）. In Group A, there were two subgroups： macula partly detached（Group A1） and macula totally detached（Group A2）. The main outcome measures were the presence of SMF on OCT 1 mo after surgery, and the preoperative and postoperative best corrected visual acuities（BCVA）, among the different groups and depending on the presence or absence of persistent SMF.RESULTS： A total of 139 eyes of 139 patients were included in the study. Persistent SMF at 1 mo after surgery was 15.8%（22/139）, all occurring in Group A（22/101）; Group B had no SMF at 1 mo after surgery（0/38, P=0.002）. The incidence of persistent SMF at 1 mo after surgery in Group A1 was 50%（14/28）, and in Group A2 was 11.0%（8/73, P〈0.001）. Significant differences were shown between the presence and absence of persistent SMF on foveolaoff RRD, the preoperative BCVA, the 1 mo postoperative BCVA, and the degree of the BCVA improvement from 1 mo postoperatively to the final follow-up（P〈0.05）. However, there were no significant differences in the final BCVA（P〉0.05）.CONCLUSION： Persistent SMF after PPV for retinal detachment is associated with preoperative macular status. Macula-uninvolving RRD shows no persistent SMF after PPV. Macular partly detached RRD has a higher incidence of SMF than macula totally detached RRD after PPV. The persistence of SMF may be responsible for the delayed visual recovery, whereas there were no significant differences in the final visual acuity.展开更多
AIM:To investigate peripapillary retinal nerve fiber layer (RNFL), macula and ganglion cell layer thicknesses (GCC) in amblyopic eyes with spectral domain optical coherence tomography (SD-OCT). METHODS:Thirty six pati...AIM:To investigate peripapillary retinal nerve fiber layer (RNFL), macula and ganglion cell layer thicknesses (GCC) in amblyopic eyes with spectral domain optical coherence tomography (SD-OCT). METHODS:Thirty six patients with a history of unilateral amblyopia and thirty two children who had emmetropia without amblyopia were included in this study. In this institutional study, 36 eyes of 36 patients with amblyopia (AE), 36 fellow eyes without amblyopia (FE), and 32 eyes of 32 normal subjects (NE) were included. RNFL, GCC and macular thickness measurements were performed with RS-3000 OCT Retina Scan (Nidek Inc CA. USA). RESULTS:The mean global thicknesses of the RNFL were 113.22 ±21.47, 111.57 ±18.25, 109.96 ±11.31μm in the AE, FE, and NE, respectively. There was no statistically significant difference for mean global RNFL thickness among the eyes (P =0.13). The mean thicknesses of the macula were 258.25±18.31, 258.75±19.54, 248.62±10.57μm in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of macula among the eyes (P =0.06). The GCC was investigated into two parts:superior and inferior. The mean thicknesses of superior GCC were 102.57 ±13.32, 103.32 ±10.64, 100.52 ± 5.88μm in the AE, FE, and NE, respectively. The mean thicknesses of inferior GCC were 103.82 ±12.60, 107.82 ± 12.33, 105.86±10.79μm in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of superior and inferior GCC between the eyes (P =0.63, P =0.46). ·CONCLUSION:The macular thicknesses of AE and FE were greater than the NE, although it was not statistically significant. Amblyopia does not seem to have a profound effect on the RNFL, macula and GCC.展开更多
Stem cells have been confirmed to be involved in the occurrence and development of diabetic retinopathy;however,the underlying mechanisms remain unclear.In this study,we used Citespace software to visually analyze 552...Stem cells have been confirmed to be involved in the occurrence and development of diabetic retinopathy;however,the underlying mechanisms remain unclear.In this study,we used Citespace software to visually analyze 552 articles exploring the stem cell-based treatment of diabetic retinopathy over the past 20 years,which were included in the Web of Science Core Collection.We found the following:(1)a co-citation analysis of the references cited by all 552 articles indicated 15 clusters.In cluster#0,representing the stem cell field,some highly cited landmark studies emerged between 2009–2013.For example,endothelial progenitor cells and diabetic retinopathy gradually received the full attention of scholars,in terms of their relationship and therapeutic prospects.Some researchers also verified the potential of adipose-derived stem cells to differentiate into stable retinal perivascular cells,using a variety of animal models of retinal vascular disease.All of these achievements provided references for the subsequent stem cell research.(2)An analysis of popular keywords among the 552 articles revealed that,during the past 20 years,a relative increase in basic research articles examining stem cells and endothelial progenitor cells for the treatment of diabetic retinopathy was observed.The contents of these articles primarily involved the expression of vascular endothelial growth factor,vascular regeneration,oxidative stress,and inflammatory response.(3)A burst analysis of keywords used in the 552 articles indicated that genetic and cytological research regarding the promotion of angiogenesis was an issue of concern from 2001 to 2012,including several studies addressing the expression of various growth factor genes;from 2014 to 2020,mouse models of diabetic retinopathy were recognized as mature animal models,and the most recent research has focused on macular degeneration,macular edema,neurodegeneration,and inflammatory changes in diabetic animal models.(4)Globally,the current authoritative studies have focused on basic research towards the stem cell treatment of diabetic retinopathy.Existing clinical studies are of low quality and have insufficient evidence levels,and their findings have not yet been widely accepted in clinical practice.Major challenges during stem cell transplantation remain,including stem cell heterogeneity,cell delivery,and the effective homing of stem cells to damaged tissue.However,clinical trials examining potential stem cell-based treatments of diabetic retinopathy,including the use of pluripotent stem cells,retinal pigment epithelial cells,bone marrow mesenchymal stem cells,and endothelial progenitor cells,are currently ongoing,and high-quality clinical evidence is likely to appear in the future,to promote clinical transformation.展开更多
We report results in a 77-year-old male patient with visual loss from long-standing serpiginous choroidop- athy treated with bone marrow derived stem cells （BMSC） within the Stem Cell Ophthalmology Treatment Study ...We report results in a 77-year-old male patient with visual loss from long-standing serpiginous choroidop- athy treated with bone marrow derived stem cells （BMSC） within the Stem Cell Ophthalmology Treatment Study （SCOTS）. SCOTS is an Institutional Review Board approved clinical trial and the largest ophthal- mology stem cell study registered at the National Institutes of Health to date （ClinicalTrials.gov Identifier： NCT01920867）. Eight months after treatment by a combination of retrobulbar, subtenon, intravitreal and intravenous injection of BMSC, the patient＇s best corrected Snellen acuity improved from 20/80- to 20/60.1 in the right eye and from 20/50- to 20/20 3 in the left eye. The Early Treatment of Diabetic Retinopathy Study （ETDRS） visual acuity continued to improve over the succeeding 8 months and the optical coherence tomography macular volume increased. The increases in visual acuity and macular volume are encouraging and suggest that the use of BMSC as provided in SCOTS may be a viable approach to treating serpiginous choroidopathy.展开更多
Purpose: To evaluate the effects of surgical treatment on macular epiretinal membranes.Methods: Vitrectomy and membrane removal were undergone for idopathic or secondary macular epiretinal membrane.Results: Fourteen e...Purpose: To evaluate the effects of surgical treatment on macular epiretinal membranes.Methods: Vitrectomy and membrane removal were undergone for idopathic or secondary macular epiretinal membrane.Results: Fourteen eyes of 15 patients (93%) had vision improvement after operation in which 8 eyes (57%) increased 3 or more Senellen lines. Only one case suffered from paracentral scotoma. No other complications were noted. Conclusion: Surgical management of macular epiretinal membrane is safe and effective with good visual outcome and few complications. Eye Science 1996; 12:140 -144.展开更多
Age-related macular degeneration（AMD） is a leading cause of blindness and is becoming a global crisis since affected people will increase to 288 million by 2040.Genetics,age,diabetes,gender,obesity,hypertension,race...Age-related macular degeneration（AMD） is a leading cause of blindness and is becoming a global crisis since affected people will increase to 288 million by 2040.Genetics,age,diabetes,gender,obesity,hypertension,race,hyperopia,iris-color,smoking,sun-light and pyroptosis have varying roles in AMD,but oxidative stress-induced inflammation remains a significant driver of pathobiology.Eye is a unique organ as it contains a remarkable oxygengradient that generates reactive oxygen species（ROS） which upregulates inflammatory pathways.ROS becomes a source of functional and morphological impairments in retinal pigment epithelium（RPE）,endothelial cells and retinal ganglion cells.Reports demonstrated that hydrogen sulfide（H2S） acts as a signaling molecule and that it may treat ailments.Therefore,we propose a novel hypothesis that H2S may restore homeostasis in the eyes thereby reducing damage caused by oxidative injury and inflammation.Since H_2S has been shown to be a powerful antioxidant because of its free-radicals＇ inhibition properties in addition to its beneficial effects in age-relatedconditions,therefore,patients may benefit from H2S salubrious effects not only by minimizing their oxidant and inflammatory injuries to retina but also by lowering retinal glutamate excitotoxicity.展开更多
AIM: To test the hypothesis that amblyopic neuroretina may have an altered thickness when compared to the normal. METHODS: Twenty-five amblyopic, young patients between the ages of 7 and 11 years old were studied. The...AIM: To test the hypothesis that amblyopic neuroretina may have an altered thickness when compared to the normal. METHODS: Twenty-five amblyopic, young patients between the ages of 7 and 11 years old were studied. The interested neuroretina areas are defined into 10 sub-regions according to superior-inferior, nasal-temoral, and pen-para axis, which cross the fovela structure. The thicknesses of ten, defined macular regions were separately measured by optical coherence tomography (OCT) and analyzed by ttest. RESULTS: The average thickness of neuroretina in the exact foveola of the amblyopic eyes is larger than that of normal eyes (P<0.05), but the other nine regions have no significant difference. Interestingly, in both the normal and amblyopic eyes, the temporal area looks thinner than other quadrants (P<0.05). CONCLUSION: Thickness alteration may be associated with amblyopic disorders in young patients. Studying a larger volume of subjects of similar age is required to confirm this observation.展开更多
AIM: To evaluate the effect of femtosecond laser-assisted lens surgery(FLALS;cataract surgery or refractive lens exchange) on the structure of the optic nerve head and the macula.METHODS: This prospective longitudinal...AIM: To evaluate the effect of femtosecond laser-assisted lens surgery(FLALS;cataract surgery or refractive lens exchange) on the structure of the optic nerve head and the macula.METHODS: This prospective longitudinal study included healthy eyes undergoing FLALS. Eyes with glaucoma or any other ocular disease that could alter optical coherence tomography results were excluded. Retinal nerve fiber layer(RNFL), Bruch’s membrane opening-minimum rim width(BMO-MRW) and macular thickness(MT) were measured preoperatively, 1 and 6 mo after surgery using spectral-domain optical coherence tomography(SD-OCT). Changes between preoperative and postoperative values were evaluated.RESULTS: A total of 87 eyes of 46 patients were included in this study. Preoperative RNFL, BMO-MRW and MT in microns(μm) were 100.77±10.39, 330.31±49.99 and 276.30±33.39, respectively. Postoperative RNFL, BMO-MRW and MT were 104.74±11.55, 348.32±54.05 and 279.83±22.65 1 mo after surgery and 102.93±11.17, 343.11±53.4 and 278.90±22.19 6 mo after surgery, respectively;which equals an increase of 3.93%, 5.45% and 1.27%,respectively, 1 mo after surgery, and 2.14%, 3.87% and 0.94% 6 mo after surgery. The differences between the preoperative and the postoperative RNFL and BMO-MRW values were statistically significant(P<0.001). Regarding MT values, there were not statistically significant differences(P=0.26).CONCLUSION: Our study suggests that FLALS does not have a negative impact on the structural status of the optic nerve head in healthy eyes, assessed by SD-OCT. There is a slight increase in the values of RNFL, BMO-MRW and MT 1 mo and 6 mo after surgery.展开更多
AIM： To evaluate the vitreomacular interface in cases with wet age-related macular degeneration（AMD） and to compare them to eyes with dry AMD and normal eyes.METHODS： This was a cross-sectional comparative study t...AIM： To evaluate the vitreomacular interface in cases with wet age-related macular degeneration（AMD） and to compare them to eyes with dry AMD and normal eyes.METHODS： This was a cross-sectional comparative study that included 87 eyes with wet AMD,42 eyes with dry AMD and 40 eyes without AMD as a control group.Optical coherence tomography（OCT） examination was performed for all patients to assess the vitreomacular interface.RESULTS： In the wet AMD group,34.5% of cases had vitreomacular adhesion（VMA）.Only 14.3% of dry AMD cases and 10% of control cases had VMA.There was a significant difference between the control group and the wet AMD group（P=0.004） as well as the dry and wet AMD group（P=0.017）.There was also a significant difference between the incidence of VMA in patients with subretinal choroidal neovascularization（CNV,type 1） and intraretinal CNV（type 2 or type 3）（P=0.020）.CONCLUSION： There is an association between posterior vitreous attachment and AMD.There is also an increased incidence of VMA with intra-retinal CNV.展开更多
AIM: To investigate the macular changes in eyes filled with silicone oil(SO) and course of these changes after SO removal. METHODS: A retrospective optical coherence tomography scan review was conducted for twenty-fou...AIM: To investigate the macular changes in eyes filled with silicone oil(SO) and course of these changes after SO removal. METHODS: A retrospective optical coherence tomography scan review was conducted for twenty-four patients who underwent uncomplicated pars plana vitrectomy with SO tamponade for complex retinal detachments were detected with optical coherence tomography before, and one week, one month and three months after SO removal.RESULTS: Mean duration of SO tamponade was 3.6±1.0mo(range 3-7mo). Cystoid macular edema(CME) was detected in 3 eyes before SO removal. Submacular fluid was represented in 1 eye before silicone SO removal.Resolution of CME and submacular fluid was achieved1 mo after SO removal in all eyes. Mean best corrected visual acuity(BCVA) was 1.15 ±0.65(range, hand movement to 0.2) before SO removal in the eyes without macular changes. After SO removal, the mean BCVA values at 1wk and 1 and 3mo, and 0.82 ±0.23, 0.76 ±0.21,and 0.70 ±0.19, all of which were significantly better than baseline(P =0.030, 0.017, 0.006 respectively). In the eyes with macular CME and subretinal fluid the mean BCVA was significantly improved at 3mo after SO removal compared with baseline(P =0.037).CONCLUSION: Decreased visual acuity in eyes filled with SO could be caused by macular complications due to SO. CME and subretinal fluid may resolve without any additional macular surgery after SO removal.展开更多
Diabetes mellitus(DM)is a noncommunicable disease reaching epidemic proportions around the world.It affects younger individuals,including women of childbearing age.Diabetes can cause diabetic retinopathy(DR),which is ...Diabetes mellitus(DM)is a noncommunicable disease reaching epidemic proportions around the world.It affects younger individuals,including women of childbearing age.Diabetes can cause diabetic retinopathy(DR),which is potentially sight threatening when severe nonproliferative DR(NPDR),proliferative DR(PDR),or sight-threatening diabetic macular oedema(STDME)develops.Pregnancy is an independent risk factor for the progression of DR.Baseline DR at the onset of pregnancy is an important indicator of progression,with up to 10% of women with baseline NPDR progressing to PDR.Progression to sight-threatening DR(STDR)during pregnancy causes distress to the patient and often necessitates ocular treatment,which may have a systemic effect.Management includes prepregnancy counselling and,when possible,conventional treatment prior to pregnancy.During pregnancy,closer follow-up is required for those with a long duration of DM,poor baseline control of blood sugar and blood pressure,and worse DR,as these are risk factors for progression to STDR.Conventional treatment with anti-vascular endothelial growth factor agents for STDME can potentially lead to foetal loss.Treatment with laser photocoagulation may be preferred,and surgery under general anaesthesia should be avoided.This review provides a management plan for STDR from the perspective of practising ophthalmologists.A review of strategies for maintaining the eyesight of diabetic women with STDR with emphasis on prepregnancy counselling and planning,monitoring and safe treatment during pregnancy,and management of complications is presented.展开更多
AIM:To evaluate the retinochoroidal microvascular circulation and anatomical structure of diabetic and nondiabetic patients with epiretinal membrane(ERM)with the help of optical coherence tomography angiography(OCT-A)...AIM:To evaluate the retinochoroidal microvascular circulation and anatomical structure of diabetic and nondiabetic patients with epiretinal membrane(ERM)with the help of optical coherence tomography angiography(OCT-A)and compare them with healthy control subjects.METHODS:In this prospective,cross-sectional study,a total of 165 eyes were evaluated,including 50 eyes of patients with diabetic ERM,54 eyes of idiopathic ERM(iERM)patients,and 61 eyes of healthy controls.Macula and disc angiography was performed by OCT-A.Macular vessel density(VD)ratio was evaluated by dividing the VD of the foveal region by the VD of the parafoveal region.Statistical calculations were evaluated at the 95%confidence interval.RESULTS:Macula superficial VD values of ERM cases were lower than that in the control group,while foveal VD was higher in ERM cases.Macula deep VD values of ERM cases were lower in all quadrants,except the fovea.The width of the foveal avascular zone(FAZ)area was significantly lower in the ERM groups,and the FAZ width was lowest in iERM group.Macula superficial VD ratio was significantly higher in the ERM groups,but there was no significant difference between ERM groups.Macula deep VD ratio was significantly higher in the iERM group than in the control group.CONCLUSION:Diabetic and idiopathic ERMs differ in their mechanism of formation and clinical presentation,as well as their effect on retinal vascular structures.If the relationship of increase of retinal thickness with vascular integrity can be demonstrated with OCT-A,then,OCT-A can be used as a guide for ERM prognosis.展开更多
Loss of central vision critical to everyday activities such as reading,face-recognition and driving due to damage in the central retina (the macula) is the leading cause of irreversible blindness amongst adults in the...Loss of central vision critical to everyday activities such as reading,face-recognition and driving due to damage in the central retina (the macula) is the leading cause of irreversible blindness amongst adults in the developed world.This condition,termed age-related macular degeneration (AMD),is a complex,chronic degenerative disease driven by a combination of genetic and lifestyle risk factors.Early signs of retinal changes in people as young as 30–40 years have been reported,although these individuals appear to be asymptomatic.However,by the age of 65,the disease is present in ~3% of individuals,which increases dramatically to affect 1/3 of individuals by the eighth decade of life.Early to intermediate AMD is estimated to affect ~150 million individuals globally,with another 10 million individuals suffering from end-stage,sight-threatening forms.These terminal stages are broadly grouped into dry (geographic atrophy,GA) or wet (choroidal neovascular,CNV) AMD (Sarks et al.,1988;Bird et al.,2014),with similar frequencies reported in patients.Recent advances in identifying genetic risk factors,including our discoveries in this field,indicate an initial shared pathology before progressing to aforementioned late-stage phenotypes.Currently,GA patients have no effective treatment,which may in part be due to the lack of good in vivo models for GA studies.Here,we summarize our new findings that describe an altogether new mouse model with GA-like features which shows progressive outer retinal pathology (Ibbett et al.,2019) that can be used to gain novel insights into GA and potentially as a tool for drug development.展开更多
AIM:To evaluate the effect of vitrectomy combined with scleral shortening for eyes with myopic macular retinoschisis.METHODS:Thirty-seven patients with myopic macular retinoschisis who underwent pars plana vitrectomy(...AIM:To evaluate the effect of vitrectomy combined with scleral shortening for eyes with myopic macular retinoschisis.METHODS:Thirty-seven patients with myopic macular retinoschisis who underwent pars plana vitrectomy(PPV)combined with scleral shortening were reviewed.Axial length(AL),the height of macular retinoschisis,the height of retinal detachment if existed,the diameter of macular hole if existed and best corrected visual acuity(BCVA)were obtained.The preoperative and postoperative parameters were compared.RESULTS:At postoperative 24 mo,the mean AL and height of macular retinoschisis were reduced significantly by 0.79 mm and 256.51μm(t=8.064,P<0.0001;Z=-5.086,P<0.0001)respectively.In addition,the mean height of retinal detachment and diameter of macular hole were also reduced significantly by 365.38μm and 183.68μm(Z=-4.457,P=0.000008;Z=-2.983,P=0.003)respectively.Meanwhile,the postoperative BCVA was improved markedly(Z=-2.126,P=0.033).CONCLUSION:Vitrectomy combined with scleral shortening is an effective surgical method for eyes with myopic macular retinoschisis,whether or not macular hole and retinal detachment are present.展开更多
Diabetic macular edema （DME） is a retinal thickening involving the center of the macula. It is one of the serious eye diseases which affects the central vision and can lead to partial or even complete visual loss. T...Diabetic macular edema （DME） is a retinal thickening involving the center of the macula. It is one of the serious eye diseases which affects the central vision and can lead to partial or even complete visual loss. The only cure is timely diagnosis, prevention, and treatment of the disease. This paper presents an automated system for the diagnosis and classification of DME using color fundus image. In the proposed technique, first the optic disc is removed by applying some preprocessing steps. The preprocessed image is then passed through a classifier for segmentation of the image to detect exudates. The classifier uses dynamic thresholding technique by using some input parameters of the image. The stage classification is done on the basis of anearly treatment diabetic retinopathy study （ETDRS） given criteria to assess the severity of disease. The proposed technique gives a sensitivity, specificity, and accuracy of 98.27%, 96.58%, and 96.54%, respectively on publically available database.展开更多
AIM： To explore feasibility and practicability of macula localization independent of macular morphological features. METHODS： A novel method was proposed to identify macula in fundus images by using structure label...AIM： To explore feasibility and practicability of macula localization independent of macular morphological features. METHODS： A novel method was proposed to identify macula in fundus images by using structure label transfer. Its main idea was to match a processed image with the candidate images with known structures, and then transfer the structure label representing the macular to the processed image as a result of macula localization. In this way, macula localization couldn＇t be influenced by lesion or other interference any more. RESULTS： The average success rate in four datasets was 98.18%. For accuracy, the average error distance in four datasets was 0.151 optic disc diameter （ODD）. Even for severe lesion images, the proposed method can still maintain high success rate and high accuracy, e.g., 95.65% and 0.124 ODD in the case of STARE dataset, respectively, which indicated that the proposed method was highly robust and stable in the complicated situations. CONCLUSION： The proposed method can avoid the interference of lesion to macular morphological features in macula localization, and can locate macula with high accuracy and robustness, verifying its feasibility.展开更多
A 55-year-old male complained of right eye blurry vision for 3 days. His best-corrected visual acuity(BCVA) was 0.2 for the right eye and 1.0 for the left eye. Anterior segment and vitreous body examinations of both e...A 55-year-old male complained of right eye blurry vision for 3 days. His best-corrected visual acuity(BCVA) was 0.2 for the right eye and 1.0 for the left eye. Anterior segment and vitreous body examinations of both eyes were normal. Yellowish-white focal lesions in the macula of the right eye were observed and subtly changes of lesions were found along the superotemporal and inferotemporal arcades in the macula two days later. Fluorescein fundus angiography(FFA) revealed slight fluorescent leakage from the lesions in the macula of the right eye, and segmental venous leakage and optic disc hyperfluorescence were observed in both eyes. Indocyanine green angiography(ICGA) demonstrated that the lesions in the macula of the right eye had hypofluorescence at a late stage and spectral domain optical coherence tomography(SD-OCT) imaging of the macula showed focal impairment of the inner segment and outer segment(IS/OS). The blood investigation indicated a positive treponema pallidum hemagglutination assay(TPPA) and a rapid plasma reagin test(RPR) of 1:32. After antisyphilitica treatment for 6 weeks, the yellowish-white lesions had vanished and the BCVA was 1.2 followed by restoration of the IS/OS for the right eye, with an RPR of 1:4. In conclusion, ophthalmologists should alert unilateral focal lesions in the macula may be the first sign of syphilis. Prompt treatment is highly effective in resolving vision.展开更多
基金Supported by Science and Technology Project of Sichuan Provincial Health Commission(No.24WXXT13)North Sichuan Medical College Doctor Start-up Fund Project(No.CBY24-QDA01).
文摘Dear Editor,I diopathic macular telangiectasia(MacTel)type 1 is a retinal vascular disease characterized by abnormal dilation of macular capillaries,leading to metamorphopsia,progressive vision loss,and temporal scotoma enlargement.Currently,there is no standardized treatment protocol for MacTel type 1[1-2].Treatment outcomes can vary significantly among individuals,highlighting the ongoing need for further exploration of new and more effective treatment options.This paper presents a case of refractory macular edema associated with MacTel type 1,which showed a favorable response to pars plana vitrectomy(PPV)and internal limiting membrane(ILM)peeling.
文摘Objective To examine the vesicular glutamate transporters （VGluTs： VGluT 1-VGluT3） in the peripheral vestibular system. Methods The vestibular structures, including Scarpa＇s ganglion （vestibular ganglion, VG）, maculae of utricle and saccule, and ampullary cristae, from normal Sprague-Dawley rats were processed immunohistochemically for VGluTs, by avidin-biotinylated peroxidase complex method, with 3-3＇-diaminobenzidine （DAB） as chromogen. Results （1） VGluT 1 was localized to partial neurons of VG and to the putative primary afferent fibers innervating vestibular end-organs. （2） Intense VGluT3 immunoreactivity was detected in large number of sensory epithelia cells, and weak labeling of VGluT3- positive afferent fibers was in the maculae and ampullary cristae. （3） No or very weak VGluT2 immunoreactivity was observed in the VG and acoustic maculae. Conclusion These results provide the morphological support that glutamate exists in the peripheral vestibular system, and it may play an important role in the centripetal vestibular transmission.
基金Supported by the Platform Key Project of Medical Scientific Research Foundation of Zhejiang Province (No.2016ZDA016)
文摘AIM： To compare the incidence of persistent submacular fluid（SMF） and visual outcome after pars plana vitrectomy（PPV） for rhegmatogenous retinal detachment（RRD） in different preoperative macular status according to optical coherence tomography（OCT）.METHODS： A non-randomized, retrospective review was performed for patients who underwent successful PPV for RRD. OCT exams were taken preoperatively and 1 mo after surgery, until SMF disappeared. According to the preoperative macular status on OCT, patients were divided into two groups： macula-off RRD（Group A） and maculaon RRD（Group B）. In Group A, there were two subgroups： macula partly detached（Group A1） and macula totally detached（Group A2）. The main outcome measures were the presence of SMF on OCT 1 mo after surgery, and the preoperative and postoperative best corrected visual acuities（BCVA）, among the different groups and depending on the presence or absence of persistent SMF.RESULTS： A total of 139 eyes of 139 patients were included in the study. Persistent SMF at 1 mo after surgery was 15.8%（22/139）, all occurring in Group A（22/101）; Group B had no SMF at 1 mo after surgery（0/38, P=0.002）. The incidence of persistent SMF at 1 mo after surgery in Group A1 was 50%（14/28）, and in Group A2 was 11.0%（8/73, P〈0.001）. Significant differences were shown between the presence and absence of persistent SMF on foveolaoff RRD, the preoperative BCVA, the 1 mo postoperative BCVA, and the degree of the BCVA improvement from 1 mo postoperatively to the final follow-up（P〈0.05）. However, there were no significant differences in the final BCVA（P〉0.05）.CONCLUSION： Persistent SMF after PPV for retinal detachment is associated with preoperative macular status. Macula-uninvolving RRD shows no persistent SMF after PPV. Macular partly detached RRD has a higher incidence of SMF than macula totally detached RRD after PPV. The persistence of SMF may be responsible for the delayed visual recovery, whereas there were no significant differences in the final visual acuity.
文摘AIM:To investigate peripapillary retinal nerve fiber layer (RNFL), macula and ganglion cell layer thicknesses (GCC) in amblyopic eyes with spectral domain optical coherence tomography (SD-OCT). METHODS:Thirty six patients with a history of unilateral amblyopia and thirty two children who had emmetropia without amblyopia were included in this study. In this institutional study, 36 eyes of 36 patients with amblyopia (AE), 36 fellow eyes without amblyopia (FE), and 32 eyes of 32 normal subjects (NE) were included. RNFL, GCC and macular thickness measurements were performed with RS-3000 OCT Retina Scan (Nidek Inc CA. USA). RESULTS:The mean global thicknesses of the RNFL were 113.22 ±21.47, 111.57 ±18.25, 109.96 ±11.31μm in the AE, FE, and NE, respectively. There was no statistically significant difference for mean global RNFL thickness among the eyes (P =0.13). The mean thicknesses of the macula were 258.25±18.31, 258.75±19.54, 248.62±10.57μm in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of macula among the eyes (P =0.06). The GCC was investigated into two parts:superior and inferior. The mean thicknesses of superior GCC were 102.57 ±13.32, 103.32 ±10.64, 100.52 ± 5.88μm in the AE, FE, and NE, respectively. The mean thicknesses of inferior GCC were 103.82 ±12.60, 107.82 ± 12.33, 105.86±10.79μm in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of superior and inferior GCC between the eyes (P =0.63, P =0.46). ·CONCLUSION:The macular thicknesses of AE and FE were greater than the NE, although it was not statistically significant. Amblyopia does not seem to have a profound effect on the RNFL, macula and GCC.
基金This study was supported by the Natural Science Foundation of Jilin Province of China,No.20200201495JCJilin Province Health Technology Innovation Project,No.2017J089。
文摘Stem cells have been confirmed to be involved in the occurrence and development of diabetic retinopathy;however,the underlying mechanisms remain unclear.In this study,we used Citespace software to visually analyze 552 articles exploring the stem cell-based treatment of diabetic retinopathy over the past 20 years,which were included in the Web of Science Core Collection.We found the following:(1)a co-citation analysis of the references cited by all 552 articles indicated 15 clusters.In cluster#0,representing the stem cell field,some highly cited landmark studies emerged between 2009–2013.For example,endothelial progenitor cells and diabetic retinopathy gradually received the full attention of scholars,in terms of their relationship and therapeutic prospects.Some researchers also verified the potential of adipose-derived stem cells to differentiate into stable retinal perivascular cells,using a variety of animal models of retinal vascular disease.All of these achievements provided references for the subsequent stem cell research.(2)An analysis of popular keywords among the 552 articles revealed that,during the past 20 years,a relative increase in basic research articles examining stem cells and endothelial progenitor cells for the treatment of diabetic retinopathy was observed.The contents of these articles primarily involved the expression of vascular endothelial growth factor,vascular regeneration,oxidative stress,and inflammatory response.(3)A burst analysis of keywords used in the 552 articles indicated that genetic and cytological research regarding the promotion of angiogenesis was an issue of concern from 2001 to 2012,including several studies addressing the expression of various growth factor genes;from 2014 to 2020,mouse models of diabetic retinopathy were recognized as mature animal models,and the most recent research has focused on macular degeneration,macular edema,neurodegeneration,and inflammatory changes in diabetic animal models.(4)Globally,the current authoritative studies have focused on basic research towards the stem cell treatment of diabetic retinopathy.Existing clinical studies are of low quality and have insufficient evidence levels,and their findings have not yet been widely accepted in clinical practice.Major challenges during stem cell transplantation remain,including stem cell heterogeneity,cell delivery,and the effective homing of stem cells to damaged tissue.However,clinical trials examining potential stem cell-based treatments of diabetic retinopathy,including the use of pluripotent stem cells,retinal pigment epithelial cells,bone marrow mesenchymal stem cells,and endothelial progenitor cells,are currently ongoing,and high-quality clinical evidence is likely to appear in the future,to promote clinical transformation.
文摘We report results in a 77-year-old male patient with visual loss from long-standing serpiginous choroidop- athy treated with bone marrow derived stem cells （BMSC） within the Stem Cell Ophthalmology Treatment Study （SCOTS）. SCOTS is an Institutional Review Board approved clinical trial and the largest ophthal- mology stem cell study registered at the National Institutes of Health to date （ClinicalTrials.gov Identifier： NCT01920867）. Eight months after treatment by a combination of retrobulbar, subtenon, intravitreal and intravenous injection of BMSC, the patient＇s best corrected Snellen acuity improved from 20/80- to 20/60.1 in the right eye and from 20/50- to 20/20 3 in the left eye. The Early Treatment of Diabetic Retinopathy Study （ETDRS） visual acuity continued to improve over the succeeding 8 months and the optical coherence tomography macular volume increased. The increases in visual acuity and macular volume are encouraging and suggest that the use of BMSC as provided in SCOTS may be a viable approach to treating serpiginous choroidopathy.
文摘Purpose: To evaluate the effects of surgical treatment on macular epiretinal membranes.Methods: Vitrectomy and membrane removal were undergone for idopathic or secondary macular epiretinal membrane.Results: Fourteen eyes of 15 patients (93%) had vision improvement after operation in which 8 eyes (57%) increased 3 or more Senellen lines. Only one case suffered from paracentral scotoma. No other complications were noted. Conclusion: Surgical management of macular epiretinal membrane is safe and effective with good visual outcome and few complications. Eye Science 1996; 12:140 -144.
基金Supported in part by NIH Heart,Lung,and Blood Institute(No.HLO74815)Institute of Neurological Disorders and Stroke(No.NS-084823)
文摘Age-related macular degeneration（AMD） is a leading cause of blindness and is becoming a global crisis since affected people will increase to 288 million by 2040.Genetics,age,diabetes,gender,obesity,hypertension,race,hyperopia,iris-color,smoking,sun-light and pyroptosis have varying roles in AMD,but oxidative stress-induced inflammation remains a significant driver of pathobiology.Eye is a unique organ as it contains a remarkable oxygengradient that generates reactive oxygen species（ROS） which upregulates inflammatory pathways.ROS becomes a source of functional and morphological impairments in retinal pigment epithelium（RPE）,endothelial cells and retinal ganglion cells.Reports demonstrated that hydrogen sulfide（H2S） acts as a signaling molecule and that it may treat ailments.Therefore,we propose a novel hypothesis that H2S may restore homeostasis in the eyes thereby reducing damage caused by oxidative injury and inflammation.Since H_2S has been shown to be a powerful antioxidant because of its free-radicals＇ inhibition properties in addition to its beneficial effects in age-relatedconditions,therefore,patients may benefit from H2S salubrious effects not only by minimizing their oxidant and inflammatory injuries to retina but also by lowering retinal glutamate excitotoxicity.
基金Supported by Key Projects in the Medicine Health Science and Technology from Guangzhou, China(No.201102A211005)Fundamental Research Funds of State Key Laboratory of Ophthalmology, China
文摘AIM: To test the hypothesis that amblyopic neuroretina may have an altered thickness when compared to the normal. METHODS: Twenty-five amblyopic, young patients between the ages of 7 and 11 years old were studied. The interested neuroretina areas are defined into 10 sub-regions according to superior-inferior, nasal-temoral, and pen-para axis, which cross the fovela structure. The thicknesses of ten, defined macular regions were separately measured by optical coherence tomography (OCT) and analyzed by ttest. RESULTS: The average thickness of neuroretina in the exact foveola of the amblyopic eyes is larger than that of normal eyes (P<0.05), but the other nine regions have no significant difference. Interestingly, in both the normal and amblyopic eyes, the temporal area looks thinner than other quadrants (P<0.05). CONCLUSION: Thickness alteration may be associated with amblyopic disorders in young patients. Studying a larger volume of subjects of similar age is required to confirm this observation.
文摘AIM: To evaluate the effect of femtosecond laser-assisted lens surgery(FLALS;cataract surgery or refractive lens exchange) on the structure of the optic nerve head and the macula.METHODS: This prospective longitudinal study included healthy eyes undergoing FLALS. Eyes with glaucoma or any other ocular disease that could alter optical coherence tomography results were excluded. Retinal nerve fiber layer(RNFL), Bruch’s membrane opening-minimum rim width(BMO-MRW) and macular thickness(MT) were measured preoperatively, 1 and 6 mo after surgery using spectral-domain optical coherence tomography(SD-OCT). Changes between preoperative and postoperative values were evaluated.RESULTS: A total of 87 eyes of 46 patients were included in this study. Preoperative RNFL, BMO-MRW and MT in microns(μm) were 100.77±10.39, 330.31±49.99 and 276.30±33.39, respectively. Postoperative RNFL, BMO-MRW and MT were 104.74±11.55, 348.32±54.05 and 279.83±22.65 1 mo after surgery and 102.93±11.17, 343.11±53.4 and 278.90±22.19 6 mo after surgery, respectively;which equals an increase of 3.93%, 5.45% and 1.27%,respectively, 1 mo after surgery, and 2.14%, 3.87% and 0.94% 6 mo after surgery. The differences between the preoperative and the postoperative RNFL and BMO-MRW values were statistically significant(P<0.001). Regarding MT values, there were not statistically significant differences(P=0.26).CONCLUSION: Our study suggests that FLALS does not have a negative impact on the structural status of the optic nerve head in healthy eyes, assessed by SD-OCT. There is a slight increase in the values of RNFL, BMO-MRW and MT 1 mo and 6 mo after surgery.
文摘AIM： To evaluate the vitreomacular interface in cases with wet age-related macular degeneration（AMD） and to compare them to eyes with dry AMD and normal eyes.METHODS： This was a cross-sectional comparative study that included 87 eyes with wet AMD,42 eyes with dry AMD and 40 eyes without AMD as a control group.Optical coherence tomography（OCT） examination was performed for all patients to assess the vitreomacular interface.RESULTS： In the wet AMD group,34.5% of cases had vitreomacular adhesion（VMA）.Only 14.3% of dry AMD cases and 10% of control cases had VMA.There was a significant difference between the control group and the wet AMD group（P=0.004） as well as the dry and wet AMD group（P=0.017）.There was also a significant difference between the incidence of VMA in patients with subretinal choroidal neovascularization（CNV,type 1） and intraretinal CNV（type 2 or type 3）（P=0.020）.CONCLUSION： There is an association between posterior vitreous attachment and AMD.There is also an increased incidence of VMA with intra-retinal CNV.
文摘AIM: To investigate the macular changes in eyes filled with silicone oil(SO) and course of these changes after SO removal. METHODS: A retrospective optical coherence tomography scan review was conducted for twenty-four patients who underwent uncomplicated pars plana vitrectomy with SO tamponade for complex retinal detachments were detected with optical coherence tomography before, and one week, one month and three months after SO removal.RESULTS: Mean duration of SO tamponade was 3.6±1.0mo(range 3-7mo). Cystoid macular edema(CME) was detected in 3 eyes before SO removal. Submacular fluid was represented in 1 eye before silicone SO removal.Resolution of CME and submacular fluid was achieved1 mo after SO removal in all eyes. Mean best corrected visual acuity(BCVA) was 1.15 ±0.65(range, hand movement to 0.2) before SO removal in the eyes without macular changes. After SO removal, the mean BCVA values at 1wk and 1 and 3mo, and 0.82 ±0.23, 0.76 ±0.21,and 0.70 ±0.19, all of which were significantly better than baseline(P =0.030, 0.017, 0.006 respectively). In the eyes with macular CME and subretinal fluid the mean BCVA was significantly improved at 3mo after SO removal compared with baseline(P =0.037).CONCLUSION: Decreased visual acuity in eyes filled with SO could be caused by macular complications due to SO. CME and subretinal fluid may resolve without any additional macular surgery after SO removal.
基金National University of Malaysia,Bangi,Selangor,Malaysia for English Editing,No.GP-K009894(2015).
文摘Diabetes mellitus(DM)is a noncommunicable disease reaching epidemic proportions around the world.It affects younger individuals,including women of childbearing age.Diabetes can cause diabetic retinopathy(DR),which is potentially sight threatening when severe nonproliferative DR(NPDR),proliferative DR(PDR),or sight-threatening diabetic macular oedema(STDME)develops.Pregnancy is an independent risk factor for the progression of DR.Baseline DR at the onset of pregnancy is an important indicator of progression,with up to 10% of women with baseline NPDR progressing to PDR.Progression to sight-threatening DR(STDR)during pregnancy causes distress to the patient and often necessitates ocular treatment,which may have a systemic effect.Management includes prepregnancy counselling and,when possible,conventional treatment prior to pregnancy.During pregnancy,closer follow-up is required for those with a long duration of DM,poor baseline control of blood sugar and blood pressure,and worse DR,as these are risk factors for progression to STDR.Conventional treatment with anti-vascular endothelial growth factor agents for STDME can potentially lead to foetal loss.Treatment with laser photocoagulation may be preferred,and surgery under general anaesthesia should be avoided.This review provides a management plan for STDR from the perspective of practising ophthalmologists.A review of strategies for maintaining the eyesight of diabetic women with STDR with emphasis on prepregnancy counselling and planning,monitoring and safe treatment during pregnancy,and management of complications is presented.
文摘AIM:To evaluate the retinochoroidal microvascular circulation and anatomical structure of diabetic and nondiabetic patients with epiretinal membrane(ERM)with the help of optical coherence tomography angiography(OCT-A)and compare them with healthy control subjects.METHODS:In this prospective,cross-sectional study,a total of 165 eyes were evaluated,including 50 eyes of patients with diabetic ERM,54 eyes of idiopathic ERM(iERM)patients,and 61 eyes of healthy controls.Macula and disc angiography was performed by OCT-A.Macular vessel density(VD)ratio was evaluated by dividing the VD of the foveal region by the VD of the parafoveal region.Statistical calculations were evaluated at the 95%confidence interval.RESULTS:Macula superficial VD values of ERM cases were lower than that in the control group,while foveal VD was higher in ERM cases.Macula deep VD values of ERM cases were lower in all quadrants,except the fovea.The width of the foveal avascular zone(FAZ)area was significantly lower in the ERM groups,and the FAZ width was lowest in iERM group.Macula superficial VD ratio was significantly higher in the ERM groups,but there was no significant difference between ERM groups.Macula deep VD ratio was significantly higher in the iERM group than in the control group.CONCLUSION:Diabetic and idiopathic ERMs differ in their mechanism of formation and clinical presentation,as well as their effect on retinal vascular structures.If the relationship of increase of retinal thickness with vascular integrity can be demonstrated with OCT-A,then,OCT-A can be used as a guide for ERM prognosis.
基金supported by the Awards to JAR from the NC3R(NC/L0001152/1),Macular Society UK,National Eye Research Centre,Alzheimer’s Research UK(ARUK) South Coast Network,Fight for Sight,Retina UK and the Gift of Sight Appeal
文摘Loss of central vision critical to everyday activities such as reading,face-recognition and driving due to damage in the central retina (the macula) is the leading cause of irreversible blindness amongst adults in the developed world.This condition,termed age-related macular degeneration (AMD),is a complex,chronic degenerative disease driven by a combination of genetic and lifestyle risk factors.Early signs of retinal changes in people as young as 30–40 years have been reported,although these individuals appear to be asymptomatic.However,by the age of 65,the disease is present in ~3% of individuals,which increases dramatically to affect 1/3 of individuals by the eighth decade of life.Early to intermediate AMD is estimated to affect ~150 million individuals globally,with another 10 million individuals suffering from end-stage,sight-threatening forms.These terminal stages are broadly grouped into dry (geographic atrophy,GA) or wet (choroidal neovascular,CNV) AMD (Sarks et al.,1988;Bird et al.,2014),with similar frequencies reported in patients.Recent advances in identifying genetic risk factors,including our discoveries in this field,indicate an initial shared pathology before progressing to aforementioned late-stage phenotypes.Currently,GA patients have no effective treatment,which may in part be due to the lack of good in vivo models for GA studies.Here,we summarize our new findings that describe an altogether new mouse model with GA-like features which shows progressive outer retinal pathology (Ibbett et al.,2019) that can be used to gain novel insights into GA and potentially as a tool for drug development.
文摘AIM:To evaluate the effect of vitrectomy combined with scleral shortening for eyes with myopic macular retinoschisis.METHODS:Thirty-seven patients with myopic macular retinoschisis who underwent pars plana vitrectomy(PPV)combined with scleral shortening were reviewed.Axial length(AL),the height of macular retinoschisis,the height of retinal detachment if existed,the diameter of macular hole if existed and best corrected visual acuity(BCVA)were obtained.The preoperative and postoperative parameters were compared.RESULTS:At postoperative 24 mo,the mean AL and height of macular retinoschisis were reduced significantly by 0.79 mm and 256.51μm(t=8.064,P<0.0001;Z=-5.086,P<0.0001)respectively.In addition,the mean height of retinal detachment and diameter of macular hole were also reduced significantly by 365.38μm and 183.68μm(Z=-4.457,P=0.000008;Z=-2.983,P=0.003)respectively.Meanwhile,the postoperative BCVA was improved markedly(Z=-2.126,P=0.033).CONCLUSION:Vitrectomy combined with scleral shortening is an effective surgical method for eyes with myopic macular retinoschisis,whether or not macular hole and retinal detachment are present.
文摘Diabetic macular edema （DME） is a retinal thickening involving the center of the macula. It is one of the serious eye diseases which affects the central vision and can lead to partial or even complete visual loss. The only cure is timely diagnosis, prevention, and treatment of the disease. This paper presents an automated system for the diagnosis and classification of DME using color fundus image. In the proposed technique, first the optic disc is removed by applying some preprocessing steps. The preprocessed image is then passed through a classifier for segmentation of the image to detect exudates. The classifier uses dynamic thresholding technique by using some input parameters of the image. The stage classification is done on the basis of anearly treatment diabetic retinopathy study （ETDRS） given criteria to assess the severity of disease. The proposed technique gives a sensitivity, specificity, and accuracy of 98.27%, 96.58%, and 96.54%, respectively on publically available database.
基金Supported by the National Key Research and Development Program of China(No.2016YFB0201503,No.2017YFC0602203)the 13th Five-Year Plan of the Science and Technology Research of the Education Department of Jilin Province(No.2016433)+1 种基金the National Natural Science Foundation of China(No.60905022)the Ph D.Program Foundation of the Ministry of Education of China(No.20130061110054)
文摘AIM： To explore feasibility and practicability of macula localization independent of macular morphological features. METHODS： A novel method was proposed to identify macula in fundus images by using structure label transfer. Its main idea was to match a processed image with the candidate images with known structures, and then transfer the structure label representing the macular to the processed image as a result of macula localization. In this way, macula localization couldn＇t be influenced by lesion or other interference any more. RESULTS： The average success rate in four datasets was 98.18%. For accuracy, the average error distance in four datasets was 0.151 optic disc diameter （ODD）. Even for severe lesion images, the proposed method can still maintain high success rate and high accuracy, e.g., 95.65% and 0.124 ODD in the case of STARE dataset, respectively, which indicated that the proposed method was highly robust and stable in the complicated situations. CONCLUSION： The proposed method can avoid the interference of lesion to macular morphological features in macula localization, and can locate macula with high accuracy and robustness, verifying its feasibility.
文摘A 55-year-old male complained of right eye blurry vision for 3 days. His best-corrected visual acuity(BCVA) was 0.2 for the right eye and 1.0 for the left eye. Anterior segment and vitreous body examinations of both eyes were normal. Yellowish-white focal lesions in the macula of the right eye were observed and subtly changes of lesions were found along the superotemporal and inferotemporal arcades in the macula two days later. Fluorescein fundus angiography(FFA) revealed slight fluorescent leakage from the lesions in the macula of the right eye, and segmental venous leakage and optic disc hyperfluorescence were observed in both eyes. Indocyanine green angiography(ICGA) demonstrated that the lesions in the macula of the right eye had hypofluorescence at a late stage and spectral domain optical coherence tomography(SD-OCT) imaging of the macula showed focal impairment of the inner segment and outer segment(IS/OS). The blood investigation indicated a positive treponema pallidum hemagglutination assay(TPPA) and a rapid plasma reagin test(RPR) of 1:32. After antisyphilitica treatment for 6 weeks, the yellowish-white lesions had vanished and the BCVA was 1.2 followed by restoration of the IS/OS for the right eye, with an RPR of 1:4. In conclusion, ophthalmologists should alert unilateral focal lesions in the macula may be the first sign of syphilis. Prompt treatment is highly effective in resolving vision.
