Background Myopic foveoschisis (MF) is among the leading causes of visual loss in high myopia. However, it remains controversial whether internal limiting membrane (ILM) peeling or gas tamponade is necessary treatment option for MF. Methods PubMed, EMBASE, CBM, CNKI, WANFANG DATA and VIP databases were systematically reviewed. Outcome indicators were myopic foveoschisis resolution rate, visual acuity improvement and postoperative complications. Results Nine studies that included 239 eyes were selected. The proportion of resolution of foveoschisis was higher in ILM peeling group than non-ILM peeling group (OR = 2.15, 95% CI: 1.06–4.35; P = 0.03). The proportion of postoperative complications was higher in Tamponade group than non-Tamponade group (OR = 10.81, 95% CI: 1.26–93.02; P = 0.03). However, the proportion of visual acuity improvement (OR = 1.63, 95% CI: 0.56–4.80; P = 0.37) between ILM peeling group and non-ILM peeling group and the proportion of resolution of foveoschisis (OR = 1.80, 95% CI: 0.76–4.28; P = 0.18) between Tamponade group and non-Tamponade group were similar. Conclusions Vitrectomy with internal limiting membrane peeling could contribute to better resolution of myopic foveoschisis than non-peeling, however it does not significantly influence the proportion of visual acuity improvement and postoperative complications. Vitrectomy with gas tamponade is associated with more complications than non-tamponade and does not significantly influence the proportion of visual acuity improvement and resolution of myopic foveoschisis.

To characterize macular thickness (MT) changes in Leber’s hereditary optic neuropathy (LHON) patients by cirrus HD-optical coherence tomography (OCT), and to study the correlation between MT and best corrected visual acuity (BCVA). Fifty-two eyes from 52 consecutive LHON patients and 14 eyes from 14 age- and sex-matched healthy controls were scanned by OCT. Affected eyes were classified into five groups according to disease duration (1st group: ≤3 months; 2nd group: 3–6 months; 3rd group: 6–9 months; 4th group: 9–12 months; and 5th group: >12 months). MT was compared and analyzed. The correlation between BCVA and MT was calculated. Less than six months after LHON onset, the cube average thickness (CAT) and the MT in the superior, nasal, inferior, and temporal quadrants of the inner ring and the MT in the nasal quadrant of the outer ring were decreased (P < 0.005); at 3–6 months onset, the MT of the temporal quadrants of the outer ring was decreased (P = 0.045); after 6 months, the MT was significantly thinner in all measurements (P < 0.01) except for the central ring. The BCVA was significantly different between each group and controls (P < 0.05), but there was no significant correlation among the five groups (P = 0.666). There was no significant correlation between the BCVA and CAT (P = 0.893). The MT thinned before the retinal nerve fiber layer and this occurred with a particular sequence. Our results provide potential diagnostic information for LHON.

To demonstrate the differences of retinal and choroidal structure changes in internal carotid artery (ICA) patients of China by enhanced-depth imaging optical coherence tomography (EDI-OCT). A retrospective review was conducted of 46 patients with a diagnosis of ICA stenosis greater than 65% on only one side (the opposite ICA Stenosis had less than 40% stenosis) from June 2015 through June 2016. All of the patients were combined with amaurosis fugax, but without any abnormality with other ocular examination. Thickness and volume of choroid and retina were manually measured by EDI-OCT. Differences were compared between ICA stenosis eyes and fellow eyes. There were no significant differences in the retinal thickness, macular retinal nerve fiber layer (mRNFL) thickness, inner thickness, or outer retinal thickness between the ICA Stenosis group and the control group (P=0.834, 0.187, 0.552, and 0.903, respectively). The mean central choroidal thickness of the ICA Stenosis group was significantly lower than that of the control group (239.70±23.76 µm vs 257.46±22.13 µm, P<0.001). The percentage of ICA stenosis was significantly associated with the central choroidal thickness, central retinal thickness, foveal center choroidal volume, and foveal center retinal volume (r=0.854, 0.678, 0.729, and 0.785, respectively; P<0.001). There were no significant differences in the retinal and choroidal volume values in the 4 inner and 4 outer sectors between the two groups. The choroidal thickness in severe ICA stenosis eyes is lower than in fellow eyes. The choroidal thinning may occur before the retinal changes in patients with ocular ischemic syndrome. Evaluations of choroidal thickness may be useful to choose the optimal therapeutic schedule for ICA patients.

The following study investigates the involvement of optic neuropathy in IgG4-related ophthalmic diseases (IgG4-ROD) based on the magnetic resonance imaging (MRI) data, and different imaging features of IgG4-ROD related optic neuropathy related to other orbital diseases. This retrospective study included 225 patients with IgG4-RD admitted at two ophthalmology centers between January 2014 and December 2017. Twenty-six patients had both pre-therapeutic orbital MRI and optic never injury. The causes of optic neuropathy were analyzed, and the special sign in MRI to diagnose IgG4-ROD was also evaluated. Twelve cases had inflammation of the optic nerve sheath, while 14 cases had compression due to extraocular muscles and pseudo tumor masses. Two cases had hypertrophic cranial pachymeningitis, while one case had hypophysis involving optic chiasma. The most common causes of optic nerve injury in IgG-4 ROD are inflammation of optic nerve sheath, compression of extraocular muscles, pseudo tumor mass and hypertrophic cranial pachymeningitis, and hypophysis involving optic chiasma.

Objectives. To assess the underlying mechanisms of OIS and confirm the haemodynamic and retinal structure changes of early OIS. Methods. An observational cross-sectional study was conducted of 60 internal carotid artery (ICA) stenosis patients, and they were divided into OIS and control group. Colour doppler imaging, optical coherence tomography, and fundus fluorescein angiography were performed. Results. The middle cerebral artery (MCA) stenosis differs significantly between the two groups. More OIS patients had new collateral patency of posterior communicating artery (PCoA) and retrograde flow via the ophthalmic artery (OA) (p<0.001). The peak systolic velocity (PSV) in central retinal artery (CRA) and choroidal thickness (CT) was significantly reduced in OIS patients (p=0.001 and p<0.001). The arm-retina time (ART) and the retinal arteriovenous passage time (AVP) were prolonged in OIS patients (p<0.001 and p=0.001). CT, ART, and PSV of the CRA showed high sensitivity, while ART and ICA stenosis grade showed high specificity for the diagnosis of OIS according to ROC curve. Conclusions. Patients who suffered from severe ipsilateral ICA stenosis, new collateral patency of PCoAs, and MCA stenosis may be more susceptible to OIS. The most sensitive sign is PSV of CRA and CT, and the most specific sign is ART.