Objective To observe the time-intensity curve characteristics of contrast agents in intraocular tumor. Methods A total of 236 patients (238 eyes) with intraocular tumor were enrolled in this study. All the patients received regular ophthalmologic examination, two dimensional ultrasound, color doppler ultrasonography and contrast-enhanced ultrasonography. There were 166 patients (166 eyes) with choroidal melanoma, 16 patients (18 eyes) with choroidal metastatic carcinoma, 52 patients (52 eyes) with choroidal hemangioma, two patients (two eyes) with retinal hemangioma. The whole process of contrast-enhanced ultrasound were recorded, and exported as t images of Dicom format. These images were processed by Sonoliver software (Tomteck Company, Germany) to drawn the time-intensity curve of contrast agents in the intraocular tumors. Results All intraocular lesions were completely filled with contrast agent, concentric filling from the periphery to the center can be documented in some cases. The time-intensity curve of choroidal hemangioma and retinal hemangioma were basically the same. The time-intensity curve of choroidal melanoma and choroidal metastatic carcinoma were also basically the same. In the filling phase, all tumors were rapid filling type. In the regression phase, contrast agent subsided earlier than in control tissue within the melanoma or metastatic carcinoma lesions, but subsided synchronous or slightly faster than in control tissue within the choroidal hemangioma and retinal hemangioma lesions. Among 166 eyes with choroidal melanoma, 138 eyes (83.1%) were in full compliance with the above changes, 28 eyes (16.9%) were largely in line with these changes. All the eyes (100.0%) with choroidal metastatic carcinoma, choroidal hemangioma and retinal hemangioma were in full compliance with the above changes. Conclusion Time-intensity curve is quickly filling and fast regression for malignant intraocular tumors, but is quickly filling and slow regression for benign intraocular tumors.
Objective To detect the value of three-dimensional (3D) ultrasound diagnosis in common ocular fundus diseases. Methods Two-dimensional (2D) images of 38 patients with common ocular fundus diseases were three-dimensionally reconstructed via 3D ultrasound workstation. The 3D images reflecting the ocular diseases were analyzed. Result In 38 patients with common ocular fundus diseases, there was vitreous hemorrhage in 16 patients, retinal detachment in 12, choroidal detachment in 5, and intraocular space occupying lesion in 5. Compared with the 2D images, 3D reconstructed images reflect the lesions more intuitionistically, displayed the relationship between the lesions and the peripheral tissues more clearly, and revealed the blood flow more specifically. During a scanning examination, 3D reconstructed technology provided the diagnostic information of section of X, Y and Z axises simultaneously which shortened the time of examination; the condition of any point of lesions and the relation between the lesion and the peripheral tissues could be gotten by the tools like cut and chop provided by 3D imaging software itself, which avoided detecting the same lesion with different angles and lays and proved the diagnostic efficacy. Conclusions 3D ultrasound diagnosis is better than 2D in diagnosis of vitreous, retina, choroid, and intraocular space occupying lesion. 3D ultrasound diagnosis is a complementarity for the 2D one, and the Z axis changes the former observational angles which may provide the new way of precise diagnosis. (Chin J Ocul Fundus Dis, 2005, 21: 381-383)
ObjectiveTo observe the morphologic characteristics of color Doppler flow imaging (CDFI) and blood stream in patients with retinopathy of prematurity, and provide the new clinical diagnostic gist.MethodsCDFI was performed on 78 patients (156 eyes) with ROP at Ⅳ and Ⅴ stage, who had the diseases history such as prematurity and low birthweight which had been diagnosed by indirect ophthalmoscope, underwent the examination of CDFI. Morphologic characteristics of the results of CDFI and features of blood flow of the pathological changes were observed. ResultsIn the patients with ROP at the Ⅳ stage, a weak zonal echo originated from one side of peripheral wall of eye ball in the vitreous body, and extended to the echo of post pole and wall of eye ball and joined the echo of optic disc. In the patients with ROP at the V stage, lumplike echo connected closely with echo of lens and the circumambience was surrounded; the focus looked like lotus when combined with retinal detachment: the swelled “corona” wrapped and tightly connected with the lens, and the thin “caulis” showed weak zonal echo which attached to the optic disc. The features of blood flow showed the signal of blood stream connected with central retinal artery at the “caulis”, which was analyzed by Doppler spectrum as the bloodflow spectrum of artery and vein in the same direction which was the same as the central retinal artery and vein.ConclusionsIn patients with ROP at the IV and V stage, the results of CDFI mainly shows zonal or lumplike echo, in which the bloodflow signal extended with central retinal artery could be seen. The morphological changes of CDFI and the features of blood flow are useful in diagnosis of ROP. (Chin J Ocul Fundus Dis, 2005,21:282-284)
ObjectiveTo investigate the clinical, ophthalmological and pathological features of primary uveal lymphoma.MethodsRetrospective clinical study. From 2012 to 2018 in Beijing Tongren Eye Cener, 4 cases and 4 eyes of patients with primary uveal lymphoma were included in the study. Among them, 3 cases were male and 1 case was female. The average age was (54 ± 13.58) years old. The average time from initial diagnosis to pathological diagnosis was (18.50 ± 9.29) months. 3 cases were enucleated and 1 case was biopsied. Extranodal marginal zone lymphoma (EMZL) of the mucosa associated lymphoid tissue (MALT) was confirmed by pathological examination. BCVA, fundus color photography, color Doppler ultrasound and orbital MRI were performed in all eyes. UBM, OCT, FFA and ICGA were performed in 2 eyes, 3 eyes, 3 eyes and 2 eyes respectively. The clinical, imaging and pathological changes were observed. Following up time was ≥ 6 months.ResultsAt the initial diagnosis, BCVA was 0.6, 0.02 and 0.01 in 1, 2 and 1 eye respectively. Choroid, ciliary body and iris were involved in 3 eyes, choroid in 1 eye. The fundus of the eyes showed infiltration of choroid in yellow and white color, and the lesions were beyond the vascular arch to the equator and peripheral areas. Color Doppler ultrasonography showed that choroidal diffuse thickening and extrascleral extension (ESE) which was the corresponding hypoechoic areas behind the sclera. Among them, ESE showed crescent thickening in 1 eye and nodular thickening in 3 eyes. UBM showed that the echo of ciliary body was thicken and the internal echo was decreased with the iris involved. OCT showed that RPE was wavy and local retinal neuroepithelial layer detached. FFA showed that the early lesions were mottled with strong and weak fluorescence, and the late fluorescence leakage. The posterior wall of the eyeball was thickened and enhanced in MRI.ConclusionThe clinical manifestations of uveal lymphoma are various, color Doppler ultrasound has characteristic manifestations and ESE of crescent or nodular thickening is valuable in diagnosis.
ObjectiveTo observe the application value with color Doppler flow imaging (CDFI) in the detection of macular diseases in senile cataract.MethodsA cross-sectional descriptive study. From December 1 to December 30, 2017, 720 senile cataract patients (1380 eyes) diagnosed in Beijing Tongren Eye Center were included in this study. There were 330 males (629 eyes) and 390 females (751 eyes), with the mean age of 70.35±19.05 years. There were 716 right eyes and 664 left eyes, with the visual acuity 0.05-0.8. The fundus of all the patients can be observed. All patients were examined by OCT using Cirrus HD-Model 5000 produced by German Carl Zeiss company and CDFI using MyLab90 color Doppler ultrasound system produced by ESAOTE S.P.A. Comparing the detection rate of macular lesions between the two methods by using χ2 test. Using statistical methods to evaluate diagnostic tests, a crosstabulation was made to compare the consistency of frequency-domain OCT and CDFI in the diagnosis of macular lesions. Logistic regression analysis of correlation between detection of CDFI macular lesions and central foveal thickness (CFT), average thickness (AT), with or without macular anterior membrane, retinal folds, retinal cystoid edema, hard exudation, macular hole or lamellar macular hole, superficial detachment of neuroepithelium, detachment of pigment epithelium, vitreous macular traction.ResultsTwo hundreds and thirty-nine eyes (17.3%) showed macular disease by OCT, and 161 eyes (11.7%) showed the abnormal echo in the macular region by CDFI. The detection rate of the macular disease between two methods were statistically significant (χ2=851.661, P＜0.001), however, the consistency was well (κ=0.766, P=0.000). Logistic analysis showed that the detection rate of macular lesions was related to retinal folds, cysts in retina and CFT (r=1.396, 1.041, 0.12; P＜0.01).ConclusionCDFI can effectively detect macular lesions that affect the visual prognosis of senile cataract patients.