Objective To observe the clinical features, the complications and treatment effects of intermediate uveitis. Methods The clinical data of 36 patients (66 eyes) with intermediate uveitis were retrospectively analyzed，including the clinical features, fundus fluorescein angiography (FFA) features, complications，treatment effects and prognosis. The patients, 21 males and 15 females, aged from 8 to 70 years，with the mean age of 34.8 years. There were 30 cases with bilateral lesions and 6 cases with unilateral lesions. Results The main clinical manifestation were vitreous opacity, peripheral retinal venous lesions, optic disc edema, macular edema and posterior subcapsular cataract. The results of FFA showed that peripheral retinal venous lesions, optic disc hyperfluorescence, cystoid macular edema and retinal vein staining. After the treatment, the visual acuity of 31 cases（60 eyes，90.9%) were improved, 4 cases（5 eyes，7.6%) were stable and 1 case（1 eye，1.5%) was worsening. The main complications were cystoid macular edema, posterior subcapsular cataract and vitreous hemorrhage which leads to visual damage. Conclusions Intermediate uveitis was a common bilateral and chronic progressive intraocular inflammation，the anterior vitritis, pars plana and peripheral retinal vascular changes were mainly involved. Early diagnosis and proper treatment may prevent the permanent visual damage.
ObjectiveTo observe the imaging features of cystoid macular edema (CME) in multicolor imaging (MC), and to evaluate the value of MC in the diagnosis of CME.MethodsDescriptive case series study. From August 2017 to June 2018, 42 eyes of 37 patients with CME diagnosed in the people's Hospital of Wuhan University were included in the study. Among them, there were 24 males and 13 females, with an average age of 48.51±10.29 years. There were 14 eyes with diabetic retinopathy, 14 eyes with central retinal vein occlusion, 8 eyes with branch retinal vein occlusion, 4 eyes with uveitis, and 2 eyes with Eales disease. The macular color fundus photography (CFP) was performed with Visucam 200 non-mydriatic fundus camera of Zeiss company in Germany. MC, frequnce domainoptical OCT (SD-OCT) and FFA were examined by Spectralis HRA2 + OCT of Heidelberg company in Germany. According to the MC standard method, five images, including 488 nm blue reflection (BR), 515 nm green reflection (GR), 820 nm infrared reflection (IR) imaging and standard MC and blue-green enhancement (BG), were obtained at the same time. Compared with SD-OCT, CFP and MC images were scored. Friedman M test and Wilcoxon signed rank test were used for statistical analysis.ResultsThe standard MC and BG images showed blue-green uplift area or petal-shaped appearance, surrounded by green reflection areas with clear boundaries. BR image can be seen in the low reflexes area. On the GR image, there were patches or cystic low reflection areas, surrounded by a slightly high reflection. On the IR image, patches or cystoid high reflexes can be seen, surrounded by low reflection dark areas with clear boundaries. The average scores of CFP, standard MC, GB, IR, GR and BR were 1.20±0.94, 3.05±0.99, 2.90±1.04, 2.55±1.27, 2.00±0.94, 0.51±0.85 respectively, and the differences were statistically significant (χ2= 151.61, P=0.000). The score of CFP were significantly lower than that of standard MC (Z=－5.421), BG (Z=－5.354), IR (Z=－4.714), GR (Z=－4.438) and higher than that of BR (Z=－3.435). The differences were statistically significant (P=0.000, 0.000, 0.000, 0.000, 0.001).ConclusionsThe quality of MC imaging is better than that of CFP. Combined with SD-OCT, it can be used as an assistant method to diagnose CME.
Objective To investigate the clinical features of polypoidal choroidal vasculopathy. Methods The clinical manifestations and the findings of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) of 7 eyes in 6 patients with polypoidal choroidal vasculopathy were analyzed retrospec tively.Results The ophthalmoscopic examination of PCV in this series of patients revealed orange-red lesions mainly in macular region in early stage, and then hemorrhage, exudation, edema, serous and (or) hemorrhagic detachment of retinal pigment epithelium in affected portions in advanced stage, and retinal and choroidal atrophy in late stage. FFA discovered the vascular dilation at the border of the choroidal vascular network in 1 eye, dotted hyperfluorescence in 6 eyes, and patches of hyperfluorescence in late phase. ICGA disclosed a vascular branching network in choroid with polypoid pattern of the terminal path of the vessels of network in early phase in 5 eyes, and the typical dotted or clustered polypoidal hyperfluorescence in 7 eyes in late phase.Conclusion The characteristic findings of FFA and ICGA are very diagnostic for PCV. (Chin J Ocul Fundus Dis，2003，19：269-332)
Objective To discuss the image of indocyanine green angiography (ICGA) about high myopia． Methods Tweenty-seven patients (54 eyes) with high myopia underwent ocular examination, funduscolorphotography, simultaneous ICGA and fluorescein angiograp hy (FFA) with theconfocalscanning laser ophthalmoscope．The findings for the two modes of amgiographies were compared． Results Lacquer crack was evident on ICGA in 19 eyes among which the focal, plaque choroidal neovascularization (CNV) were apparent in the middle part of lacquer cracks in 10 eyes (52．6%) ．In comparison the lacquer cracks were seen in only 7 eyes on FFA． Choroidal capillary atrophy was seen on ICGA and FFA in 14 eyes and ICGA shew thick choroidal vessels in 3 eyes． Conclusion ICGA is superior to FFA for showing choroidoretinal degeneration and atrophy,lacquer crack and CNV in high myopic eyes, and conduce to evaluating prognosis． (Chin J Ocul Fundus Dis, 2001,17:201-203
ObjectiveTo observe the effect of interventional thrombolytic therapy for central retinal artery occlusion (CRAO) with ipsilateral internal carotid artery occlusion via supratrochlear artery retrogradely or external carotid artery anterogradely.MethodsNine CRAO patients (9 eyes) were enrolled in this study, including 5 males and 4 females. The mean age was (45.2±18.1) years. The mean onset duration was 24 hours. There were 4 eyes with vision of no light perception, 3 eyes with light perception and 2 eyes with hand movement. Fundus fluorescein angiography (FFA) examination showed that the retinal artery was filled with delayed fluorescence. The peak of fluorescence was seen in the anterior part of the artery, and some of the eyes showed retrograde filling. The arm-retinal circulation time (A-Rct) was ≥35 s in 4 eyes, ≥35 s - ＜25 s in 5 eyes. The filling time of retinal artery and its branches (FT) was ≥15 s in 2 eyes, ≥12 s - ＜15 s in 3 eyes, ≥9 s - ＜12 s in 4 eyes. All the patients received the treatment of interventional thrombolytic therapy via supratrochlear artery retrogradely (8 eyes) or external carotid artery anterogradely (1 eye) according to the indications and contraindications of thrombolytic therapy in acute cerebral infraction patients. Urokinase (0.4 million U in total) was intermittently injected into the arteries. After artery thrombolysis, the changes of digital subtraction angiography (DSA), filling time of retinal artery and its branches on FFA within 24 hours and the visual acuity were observed. According to the A-Rct and FT on FFA, the therapeutic effects on retinal circulation were defined as effective markedly (A-Rct≤15 s, FT≤2 s) , effective (A-Rct was improved but in the range of 16 - 20 s, FT was in 3 - 8 s) and no effect (A-Rct was improved but ≥21 s, FT≥9 s). The related local or systemic complications were recorded.ResultsAfter the injection of urokinase into the catheter, the ophthalmic artery and its branches were increased in 6 eyes (66.7%), and the development of the eye ring was significantly more than that of the eyes before thrombolysis. The circulation time in ophthalmic artery was speeded up for 2 s before thrombolysis in 3 eyes, 3 s in 3 eyes, and 4 s in 2 eyes. Within 24 hours after thrombolysis treatment, the A-Rct was significantly decreased than that of before interventional therapy. The retinal circulation was effective markedly in 4 eyes (44.4%), effective in 4 eyes (44.4%) and no effect in 1 eyes (11.2%) . The vision was improved 3 lines in 4 eyes (44.4%), 2 lines in 3 eyes (33.3%), 1 line in 1 eye (11.2%) and no change in 1 eye (11.2%). There were no abnormal eye movements, vitreous hemorrhage and incision hematoma, intracranial hemorrhage, cerebral embolism, and other local and systemic adverse effectives during the follow-up.ConclusionsThe interventional thrombolytic therapy via supratrochlear artery retrogradely or external carotid artery anterogradely for CRAO with the ipsilateral internal carotid artery occlusion can improve retinal circulation and vision. There are no related local or systemic complications.