Anterior segment optical coherence tomography

前段光学相干断层扫描
  • 文章类型: Case Reports
    称为Sturge-Weber综合征(SWS)的罕见神经皮肤疾病的特征是软脑膜,或影响面部的血管瘤,眼睛,和大脑。我们报告了一个新诊断的病例,该病例来到我们的研究所,抱怨过去1年来视力下降。经检查,患者巩膜呈蓝色变色,角膜尺寸的增加,以及脸上特有的葡萄酒色斑(PWS)。使用压平眼压计,眼压BE为30mmHg。眼底镜检查的杯盘比率为0.9RE和0.8LE,特征性青光眼盘改变为BE。这个孩子接受了抗青光眼药物治疗。缩写:SWS=Sturge-Weber综合征,PWS=葡萄酒污渍,中枢神经系统=中枢神经系统,CT=计算机断层扫描,IOP=眼内压,OCT=光学相干断层扫描,RE=右眼,LE=左眼,BE=双眼,ASOCT=前段光学相干断层扫描。
    The rare neurocutaneous condition known as Sturge-Weber syndrome (SWS) is characterized by leptomeninges, or angiomas affecting the face, eyes, and brain. We report a newly diagnosed case that came to our institute complaining of a diminution of vision BE that had been going on for the past 1 year. Upon examination, the patient exhibited bluish discoloration of the sclera, an increase in the size of the cornea, and the characteristic port wine stain (PWS) on the face. Intraocular pressure BE was 30 mmHg with an applanation tonometer. The cup disc ratio on fundoscopy was 0.9 RE and 0.8 LE with characteristic glaucomatous disc changes BE. The child was treated with antiglaucoma medications. Abbreviations: SWS = Sturge-Weber syndrome, PWS = Port wine stain, CNS = Central nervous system, CT = Computed Tomography, IOP = Intraocular pressure, OCT = Optical coherence tomography, RE = Right eye, LE = Left eye, BE = Both eyes, ASOCT = Anterior segment optical coherence tomography.
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  • 文章类型: Case Reports
    一名36岁的患者在玻璃体腔中存在硅油12年后,右眼出现广泛的“白色疤痕”而没有疼痛。裂隙灯显微镜检查显示广泛的角膜白斑和轻度的角膜缘新生血管形成。前段光学相干断层扫描显示上皮下明显偏心增厚,基质厚度正常。我们首先进行硅油去除和眼内和前房灌洗,3个月后行上皮病变切除联合羊膜移植。患者对透明的角膜外观感到满意。
    A 36-year-old patient presented with a complaint of an extensive \"white scar\" in his right eye without pain after silicone oil presence in the vitreous cavity for 12 years. Slit-lamp microscopy revealed extensive corneal leukoplakia and mild limbus neovascularization. Anterior segment optical coherence tomography revealed marked eccentric thickening of the subepithelium and normal thickness of the stroma. We proceeded with silicone oil removal and intraocular and anterior chamber lavage at first, followed by epithelial lesion excision combined with amniotic membrane transplantation 3 months later. The patient was satisfied with the clear cornea appearance.
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  • 文章类型: Case Reports
    背景:探讨下植入XEN63凝胶支架治疗1例小梁切除术失败和玻璃体视网膜手术硅油填塞术后难治性青光眼的疗效。
    方法:我们报告一例73岁男性,有难治性开放性青光眼伴小梁切除术失败病史。他经历了硅油填塞的复发性视网膜脱离,硅油去除后眼内压(IOP)不受控制。由于前房存在油乳剂,选择的XEN63植入位置是颞下象限.术后可见轻度前房积血和玻璃体出血,而是自我限制。在第1周,眼内压为8mmHg,在眼前段光学相干断层扫描(AS-OCT)中可见形成良好的气泡。随访6个月时,患者维持IOP为12mmHg,未使用局部降压药.裂隙灯检查显示,出现气泡,没有炎症迹象。
    结论:在这种情况下,在玻璃体切除的眼睛中出现了难治性青光眼,即使在6个月的随访中,XEN63凝胶支架的下方放置也能提供足够的眼压,AS-OCT可见弥漫性功能性鼻下出血。
    BACKGROUND: To discuss the efficacy of an inferior implant of XEN 63 gel stent in a patient with refractory glaucoma after trabeculectomy failure and vitreoretinal surgery with silicone oil tamponade.
    METHODS: We report the case of a 73-year-old man with a history of refractory open glaucoma with trabeculectomy failure. He experienced recurrent retinal detachments with silicone oil tamponade, with uncontrolled intra-ocular pressure (IOP) after silicone oil removal. Due to the presence of oil emulsion in the anterior chamber, the chosen location for XEN 63 implantation was the infero-temporal quadrant. Mild hyphema and vitreous hemorrhage were seen post-operatively, but were self-limiting. At week 1, the intraocular pressure was 8 mmHg with a well-formed bleb seen in anterior segment optical coherence tomography (AS-OCT). At 6 month follow up, the patient maintained a IOP of 12 mmHg without topical hypotensive drugs. Slit lamp examination revealed a widespread, developed bleb with no signs of inflammation.
    CONCLUSIONS: In this case of refractory glaucoma in a vitrectomized eye with previous oil tamponade, the inferior placement of the XEN 63 gel stent delivered an adequate intraocular pressure even at 6-months follow up, with a diffuse functional infero-nasal bleb seen with AS-OCT.
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  • 文章类型: Journal Article
    背景:本研究的目的是确定中央性浆液性脉络膜视网膜病变(CSCR)患者与正常个体的前巩膜厚度(AST)是否有显著差异。通过超声生物显微镜(UBM)与眼前节光学相干断层扫描(ASOCT)验证巩膜厚度的测量。
    方法:这项病例对照研究分析了50例CSCR患者(病例)的50只眼,并将其与50例年龄和性别匹配的对照组的50只眼进行了比较。在案例中,通过ASOCT和UBM在距颞侧巩膜骨刺1毫米和2毫米处测量AST。在控件中,AST仅通过ASOCT测量。在所有参与者中,后脉络膜厚度(CT)在中心凹下测量,通过增强深度成像光学相干断层扫描,鼻部1毫米和颞部至中央凹1毫米。
    结果:平均AST,根据ASOCT在病例和对照组中的测量,分别为703.86μm和667.54μm,分别为(P=0.006)。ASOCT和UBM的平均AST分别为703.86μm和657.42μm,分别(P=0.001)。ASOCT和UBM的AST检测结果呈正相关(r=0.431,P=0.000)。病例和对照组的平均CT为443.56μm和373.88μm,分别为(P=0.000)。我们发现病例呈弱正相关(r=0.11),对照组呈弱正相关,通过ASOCT测量的CT和AST之间。
    结论:我们的研究结果表明,与正常个体相比,CSCR患者的AST有显著差异。当通过ASOCT和UBM测量时,我们发现AST的一致性很差。
    BACKGROUND: The aim of this study was to determine whether anterior scleral thickness (AST) varies significantly between patients with central serous chorioretinopathy (CSCR) versus normal individuals. To validate scleral thickness measurements by ultrasound biomicroscopy (UBM) vis a vis anterior segment optical coherence tomography (ASOCT).
    METHODS: This case-control study analyzed 50 eyes of 50 patients with CSCR (cases) and compared it with that of 50 eyes of 50 age- and gender-matched controls. In cases, AST was measured at 1 mm and 2 mm temporal to the temporal scleral spur by ASOCT and UBM. In controls, AST was measured only by ASOCT. In all participants, posterior choroidal thickness (CT) was measured subfoveally, 1 mm nasal and 1 mm temporal to fovea by enhanced depth imaging optical coherence tomography.
    RESULTS: The mean AST, as measured by ASOCT among cases and controls was 703.86 μm and 667.54 μm, respectively (P = 0.006). The mean AST by ASOCT and UBM in cases were 703.86 μm and 657.42 μm, respectively (P = 0.001). AST measurement by ASOCT and UBM showed a positive and statistically significant correlation (r = 0.431, P = 0.000). The mean CT among cases and controls was 443.56 μm and 373.88 μm, respectively (P = 0.000). We found a weak positive correlation (r = 0.11) in cases and weaker positive correlation in controls, between CT and AST measured by ASOCT.
    CONCLUSIONS: Our findings suggest that AST varies significantly between patients with CSCR versus normal individuals. We found poor agreement of AST when measured by ASOCT and UBM.
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  • 文章类型: Case Reports
    UNASSIGNED:报告与双侧屈光性角膜切除术(PRK)后1天意外暴露于局部米诺地尔5%溶液相关的单侧中心性角膜病变(CTK)的临床发现。
    UNASSIGNED:前段裂隙灯摄影,眼前节光学相干断层扫描(AS-OCT),测厚图,上皮图,并记录了明显的折射。
    UNASSIGNED:这是一例27岁男性患者,接受了双侧PRK,术后5天表现为左眼视力(LE)急性下降。据报道,他的LE在术后第1天暴露于局部乙醇基米诺地尔5%,他将其用作移植后治疗。临床检查显示远视移位,视力差,中央角膜混浊,上皮不规则,中央角膜变薄,在AS-OCT上变平。这些发现与CTK的诊断一致。患者接受保守治疗监测,6个月后完全康复。
    未经评估:建议警告接受过屈光手术的患者使用含乙醇的药物,比如米诺地尔溶液,因为CTK的可能风险,没有正式承认的并发症。
    UNASSIGNED: To report the clinical findings of unilateral central toxic keratopathy (CTK) associated with inadvertent exposure to topical minoxidil 5% solution 1 day after bilateral photorefractive keratectomy (PRK).
    UNASSIGNED: Anterior segment slit-lamp photography, anterior segment optical coherence tomography (AS-OCT), pachymetry map, epithelial map, and manifest refractions were recorded.
    UNASSIGNED: This is a case of a 27-year-old male who underwent bilateral PRK and presented 5 days after surgery with the complaint of acute decreased visual acuity in the left eye (LE). His LE was reportedly exposed to topical ethanol-based minoxidil 5% on postoperative day 1, which he was using as a posthair transplant treatment. Clinical examination showed hyperopic shift, poor visual acuity, central corneal opacity, epithelial irregularity, central corneal thinning, and flattening on AS-OCT. These findings were consistent with a diagnosis of CTK. The patient was monitored with conservative treatment and demonstrated full recovery after 6 months.
    UNASSIGNED: It is recommended to warn patients who have undergone refractive surgery concerning the use of ethanol-containing agents, such as minoxidil solution, because of the possible risk of CTK, a complication not formally recognized.
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  • 文章类型: Case Reports
    背景:我们报告了一例自发性脱粒膜脱离(DMD)的临床特征和治疗方法。
    方法:我们描述了一例罕见的前葡萄膜炎患者的自发性DMD病例,并对目前的文献进行了综述。一名20岁的女性,既往有前葡萄膜炎病史,左眼视力下降。裂隙灯检查显示DMD继发角膜水肿,经眼前节光学相干断层扫描(AS-OCT)证实。患者接受了20%六氟化硫(SF6)的前房内注射,并完全消除了DMD。虽然罕见,文献中已经报道了几例自发性DMD,主要发生在眼内手术后。我们在Pubmed数据库(1949-2021)中搜索了与自发性DMD主题相关的同行评审出版物。
    结论:自发性DMD的发病机制复杂,取决于多种因素。它可能是由于解剖异常而发生的,炎症性疾病,创伤,化学损伤,和手术或激光手术。在大多数情况下,早期诊断和适当的管理导致解决。
    BACKGROUND: We report a case and discuss the clinical characteristics and treatment of spontaneous Descemet membrane detachment (DMD).
    METHODS: We describe a rare case of spontaneous DMD in a patient with prior anterior uveitis and provide a review of the current literature. A 20-year-old woman with a prior history of anterior uveitis presented with vision loss in the left eye. The slit-lamp examination showed corneal edema secondary to DMD, confirmed by anterior segment optical coherence tomography (AS-OCT). The patient underwent an intracameral injection of 20% sulphur hexafluoride (SF6) with complete resolution of the DMD. Although rare, several cases of spontaneous DMD have been reported in the literature, mostly occurring after intraocular surgery. We searched the Pubmed database (1949-2021) for peer-reviewed publications relevant to the topic of spontaneous DMD.
    CONCLUSIONS: The pathogenesis of spontaneous DMD is complex and depends on several factors. It can occur due to anatomical anomalies, inflammatory disease, trauma, chemical injuries, and surgical or laser procedures. In most cases, early diagnosis and appropriate management led to resolution.
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  • 文章类型: Case Reports
    肾病综合征是一种由于血液中蛋白质丢失而导致体内液体潴留的疾病,这可能导致黄斑浆液性视网膜脱离(SRD)。我们报告了一例由于肾病综合征引起的睫状体水肿而导致的双眼严重SRD和闭角。一名57岁的男子被送进我们医院的肾内科,对他的全身性水肿进行彻底检查。他被诊断为肾病综合征,但被证明对类固醇治疗无效。由于住院第30天双眼出现扭曲症状,病人被转介到我们部门。右眼最佳矫正视力(BCVA)为0.8,左眼为1.0。裂隙灯检查和前节段光学相干断层扫描(OCT)显示双眼浅前房。眼底和黄斑OCT显示双眼后极严重SRD。在观察到低蛋白血症的存在后,我们考虑了由与肾病综合征相关的渗漏引起的睫状水肿引起的SRD和房角闭合的可能性.此后,与超滤和低密度脂蛋白单采术相关的全身症状改善以及眼部发现改善.在住院的第60天,他的双眼BCVA都提高到1.2,SRD消失了,前房深度正常化。此病例证明了认识到与睫状体水肿相关的SRD和闭角是与肾病综合征相关的并发症的重要性。
    Nephrotic syndrome is a disease that causes fluid retention in the body due to loss of protein in the blood, which can lead to serous retinal detachment (SRD) in the macula. We report a case of severe SRD in both eyes and angle closure due to ciliary body edema caused by nephrotic syndrome. A 57-year-old man was admitted to the Department of Nephrology in our hospital for a thorough examination of his generalized edema. He was diagnosed with nephrotic syndrome but proved to be refractory to steroid treatment. Due to distortion symptoms in both eyes on the 30th day of hospitalization, the patient was referred to our department. Best-corrected visual acuity (BCVA) was 0.8 in the right eye and 1.0 in the left eye. Slit lamp examination and anterior segmental optical coherence tomography (OCT) showed shallow anterior chambers in both eyes. Fundus and macular OCT demonstrated severe SRD in the posterior pole of both eyes. After observing the presence of hypoalbuminemia, we considered the possibility of SRD and angle closure due to ciliary edema that resulted from the leaks associated with the nephrotic syndrome. Thereafter, ocular findings improved in conjunction with systemic symptom improvements associated with ultrafiltration and low-density lipoprotein apheresis. On the 60th day of hospitalization, his BCVA improved to 1.2 in both eyes, SRD disappeared, and the anterior chamber depth normalized. This case demonstrates the importance of recognizing SRD and angle closure associated with ciliary body edema as complications linked with nephrotic syndrome.
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  • 文章类型: Case Reports
    未经授权:报告一例伴有瞳孔阻滞的双侧复杂性葡萄膜型青光眼(UG),晶状体前囊破裂,一名年轻高度近视患者的恶性青光眼,并报告最初和手术后的眼前节光学相干断层扫描(AS-OCT)发现。
    未经证实:一名21岁的高度近视女性,有前房葡萄膜炎伴广泛的后房粘连病史,出现急性双侧眼部疼痛,发红,双侧Nd:YAG激光周边虹膜切开术(LPI)后视力模糊。
    未经授权:视敏度仅限于双眼(OU)的光感,平坦的前房(AC)和晶状体碎片的前脱位。眼内压(IOP)超过60mmHgOU。AS-OCT显示平坦AC内的闭合角度和超反射异质材料。将虹膜和晶状体碎片铺在角膜内皮OU上。我们进行了与晶状体切除术相关的紧急平坦部玻璃体切除术。在OU是平安无事的。重复的AS-OCT显示深AC,广泛开放的角度,和无晶状体。OU的眼压降低至9mmHg,视力提高至5/10。
    未经授权:在存在广泛的后粘连的UG的情况下,执行LPI可能是有害的,导致复杂机制的青光眼伴房水误导综合征与前晶状体脱位引起的瞳孔阻滞相关,即使是高度近视的眼睛。Nd:YAGLPI不应在OU中同时进行,尤其是在病态的眼睛中,预防双侧视力威胁并发症。AS-OCT帮了大忙,允许对ACs进行简单详细的超微结构评估,手术前后虹膜角膜角度。
    UNASSIGNED: To report a case of a bilateral complex uveitic glaucoma (UG) with pupillary block, rupture of the anterior lens capsule, and malignant glaucoma in a young high-myopic patient and to report anterior segment optical coherence tomography (AS-OCT) findings initially and following surgery.
    UNASSIGNED: A 21-year-old high-myopic woman who had a history of anterior uveitis with extensive posterior synechiae, presented with acute bilateral ocular pain, redness, and blurred vision following bilateral Nd: YAG laser peripheral iridotomy (LPI).
    UNASSIGNED: Visual acuity was limited to light perception in both eyes (OU), with a flat anterior chamber (AC) and anterior luxation of lens fragments. Intraocular pressure (IOP) was over 60 mmHg OU. AS-OCT showed closed angles and hyperreflective heterogeneous material within the flat AC. The iris and lens fragments were plated against the corneal endothelium OU. We performed an urgent pars plana vitrectomy associated with lensectomy. It was uneventful in OU. Repeated AS-OCT revealed a deep AC, widely open angles, and aphakia. IOP was lowered to 9 mmHg and visual acuity improved to 5/10 in OU.
    UNASSIGNED: Performing LPI might be harmful in the presence of UG with extensive posterior synechia, resulting in complex mechanism glaucoma with aqueous misdirection syndrome associated with a pupillary block due to anterior lens luxation, even in high-myopic eyes. Nd: YAG LPI should not be performed simultaneously in OU, especially in pathologic eyes, to prevent bilateral vision-threatening complications. AS-OCT was of great help, allowing easy and detailed ultrastructural assessment of the ACs, and iridocorneal angles before and after surgery.
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  • 文章类型: Case Reports
    目的:本研究报告一例原发性翼状胬肉自发性撕脱伴眼前节光学相干断层扫描(AS-OCT)表现。
    方法:一名72岁女性主诉左眼急性疼痛。4个月前初次检查时,双眼均发现原发性翼状胬肉。裂隙灯显微镜显示鼻角膜上皮缺损,和左眼角膜缘卷曲的隆起病变。她被诊断为角膜翼状胬肉头部自发性撕脱。然后撕脱的翼状胬肉头部缓慢复发。另一只眼的翼状胬肉头部在上皮下方有黄白色的隆起性病变,血管分布不良。AS-OCT显示上皮下方的高反射灶,对应于黄白色的升高病变。
    结论:本病例显示翼状胬肉头部自发性撕脱导致角膜上皮缺损和眼部疼痛,而对眼的翼状胬肉头部在AS-OCT上显示上皮下高反射灶,怀疑球样变性。在这种情况下,翼状胬肉头部自发撕脱的原因可能是球形变性导致的角膜粘连较弱。
    结论:此病例是原发性翼状胬肉,导致自发性撕脱,在OCT中发现了高反射灶。
    OBJECTIVE: This study reports a case of the spontaneous avulsion of primary pterygium with anterior segment optical coherence tomography (AS-OCT) findings.
    METHODS: A 72-year-old woman complained of acute pain of the left eye. Primary pterygia were noted in both eyes on the initial examination 4 months ago. Slit-lamp microscopy revealed a nasal corneal epithelial defect, and the rolled elevated lesion in the corneal limbus of the left eye. She was diagnosed with a spontaneous avulsion of the corneal pterygium head. Then the avulsed pterygium head slowly recurred. The pterygium head of the fellow eye had a yellow-whitish elevated lesion beneath the epithelium with poor vascularity. AS-OCT revealed hyper-reflective foci beneath the epithelium corresponding to the yellow-whitish elevated lesion.
    CONCLUSIONS: The present case revealed the spontaneous avulsion of the pterygium head leading to the corneal epithelial defects and ocular pain, while the pterygium head of the fellow eye showed subepithelial hyper-reflective foci suspicious of spheroidal degeneration on AS-OCT. In this case, the cause of spontaneous avulsion of the pterygium head might be potentially weak adhesion to the cornea due to spheroidal degeneration.
    CONCLUSIONS: This case is a primary pterygium leading to spontaneous avulsion, in which hyper-reflective foci were noted in OCT.
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  • 文章类型: Case Reports
    目的:在新发病的急性狼疮脉络膜病变病例中,使用激光耀斑测光法进行前房耀斑和使用眼前节光学相干断层扫描(AS-OCT)进行纤毛脉络膜脱离。
    方法:一名57岁的重度肾炎女性,胸腔积液,腹水被转诊到我们的眼科诊所,因为双侧视力模糊和眼睑肿胀的快速发作。她有一个双侧高爆发,浅前房,双侧纤毛脉络膜脱离,使用激光耀斑测光和AS-OCT显示。她还患有浆液性视网膜脱离和椎间盘黄斑视网膜裂隙,脉络膜较厚,布鲁赫膜呈波浪状。吲哚菁绿血管造影术(ICGA)在早期阶段显示出部分的低氰化,在中期至晚期阶段显示出多个高氰化点,这是典型的狼疮脉络膜病变。诊断出系统性红斑狼疮,在脉冲甲基强的松龙和脉冲环磷酰胺治疗后,所有的眼睛发现在一个月内完全解决,所有其他体征和症状都有所改善。
    结论:狼疮脉络膜病变,比视网膜病变更不常见,可能由于难以评估而被诊断不足。虽然ICGA是诊断狼疮脉络膜病变的金标准,前房的高度耀斑和脉络膜脱离可能与狼疮视网膜病变不同。激光耀斑测光和AS-OCT可以是非侵入性的,纵向评估患者对治疗反应的有用工具。
    OBJECTIVE: To report anterior chamber flare using laser flare photometry and ciliochoroidal detachment using anterior segment optical coherence tomography (AS-OCT) in a new onset acute lupus choroidopathy case.
    METHODS: A 57-year-old woman with severe nephritis, pleural effusion, and ascites was referred to our ophthalmology clinic for rapid onset of bilateral blurred vision and eyelid swelling. She had a bilateral high-flared, shallow anterior chamber, and bilateral ciliochoroidal detachment, which was revealed using laser flare photometry and AS-OCT. She also had a serous retinal detachment and disc-macular retinoschisis with a thicker choroid and waved Bruch\'s membrane. Indocyanine green angiography (ICGA) demonstrated partial hypocyanescence in the early phase and multiple hypercyanescent spots at the intermediate to late phase, which are typical of lupus choroidopathy. Systemic lupus erythematosus was diagnosed, and after the administration of pulse methylprednisolone and pulse cyclophosphamide therapies, all eye findings completely resolved in a month, and all other signs and symptoms improved.
    CONCLUSIONS: Lupus choroidopathy, which is less common than retinopathy, might be under-diagnosed because of its difficult evaluation. Although ICGA is the gold standard for diagnosing lupus choroidopathy, a high flare of the anterior chamber and ciliochoroidal detachment might be different from lupus retinopathy. Laser flare photometry and AS-OCT can be non-invasive, helpful tools for the longitudinal evaluation of the patient\'s response to therapy.
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