Objective To evaluate the characteristics of two angiographic manifestation of ocular fundus in choroidal metastatic carcinomas. Methods Fundus fluoresein angiography (FFA) and indocyanine green angiography (ICGA) were performed on 17 patients (24 eyes) with choroidal metastatic carcinomas, and the characteristics of these two kinds of angiograms were analyzed and compared each other. Results According to various clinical features, e.g., locations of metastatic tumor in ocular fundus, disease course, and different kinds of original malignancy, the findings of ocular fundus were divided into (1) Isolation type: FFA showed pinpoint and mottled leaks against hypofluorescence background, increased and confluent fluoresecence in later stage. ICGA showed the similar images as in FFA, except later appearance of leaks and the choroidal vesseles could be seen beneath the thin metastatic tumor mass.(2) Diffusion type: Tumors showed hypofluorescence in early stage and uneven ill-defined hyperfluorescence both in FFA and in ICGA. (3) Small metastatic carcinomas: Hypofluorescence in early stage and mild mottled hyperfluorescence were found in FFA as well as in ICGA. Conclusion Both FFA and ICGA are helpful in the diagnosis of choroidal metastatic tumors and ICGA may be conducive if there are some troubles in diagnosing the tumors with FFA. (Chin J Ocul Fundus Dis, 2002, 18: 92-95)
Optical coherence tomography angiography (OCTA) is a new and non-invasive imaging technique that is able to detect blood flow signal in the retina and the choroid within seconds. OCTA is different from the traditional angiography methods. The major advantages of OCTA are that it can observe blood flow signal in different layers of the retina and the choroid without injecting any dye, provide blood flow information that traditional angiography cannot provide, and enrich pathophysiological knowledge of the retinal and choroidal vascular diseases., which help us to make an accurate diagnosis and efficient evaluation of these diseases. However there is a large upgrade potential either on OCTA technique itself or on clinical application of OCTA. We need to fully understand the advantage and disadvantage, and differences of OCTA and traditional angiography. We also need to know how to interpret the result of OCTA. With that we could make a fast diagnosis in a non-invasive way and improve our knowledge of the retinal and choroidal vascular diseases.
Objective To investigate the manifestations of indocyanine green an giography (ICGA) of the choroidal neovascular membrane (CNV) and the relationship with histopathological changes in patients with age-related macular degeneration (AMD). Methods Twenty-one eyes of 21 patients with AMD diagnosed by ICGA were classified into three types based on ICGA findings: developing type in 9 eyes , degenerating type in 9, and stabilizing type in 3. CNV was extracted by vitrectomy and the histopathological characteristics of CNV was observed under the light and electron microscope. Results The histopathological characteristics of the specimens of developing type revealed abundant CNV partly enwrapped with non-pigmental cells and fibrous tissue or a few pigmental cells; degenerating type revealed reduced activation duration of CNV, many pigmental cells and a little fibrous tissue; stabilizing type revealed a mass of fibrous tissue，few CNV and nonexistence of pigmental cells. Conclusion The histopathological characteristics of exudative AMD may be related to the manifestations of ICGA. (Chin J Ocul Fundus Dis，2004，20：71-74)
ObjectiveTo investigate the change of subfoveal choroidal thickness (SFCT) and the relationship between SFCT and the severity of the diabetic retinopathy using enhanced depth imaging optical coherence tomography (EDI-OCT). MethodsA total of 164 eyes (93 patients) of type 2 diabetes mellitus (DM) were included in this study. The patients included 34 males and 59 females, with an average age of (59.3±5.6) years, with an average diabetes duration of (5.11±4.64) years. The patients were divided into 4 groups according to international classification standards of DR, including non-diabetic retinopathy (NDR) group (64 eyes), mild non-proliferative diabetic retinopathy (NPDR) group (33 eyes), moderate NPDR group (37 eyes), and severe NPDR group (30 eyes). The control group included 25 normal subjects (42 eyes). All patients underwent visual acuity, intraocular pressure, slit lamp microscope, indirect ophthalmoscope, A/B-type ultrasound scan, frequency domain optical coherence tomography (SD-OCT) examination, as well as fasting blood glucose and mean arterial blood pressure measurement. The mean axial length was (23.04±0.78) mm, mean fasting blood glucose was (8.88±2.59) mmol/L, mean arterial pressure was (100.44±9.63) mmHg. SFCT of all eyes were measured by EDI-OCT. The relationship between SFCT and the severity of the diabetic retinopathy, DM duration, fasting blood glucose, the mean arterial pressure, axial length was analyzed by one-way ANOVA. ResultsThe mean SFCT was (224.24±42.10) μm in DM group and (276.77±48.07) μm in normal control group, the difference was statistically significant (F=23.86, P < 0.05). The mean SFCT was also statistically significant between all DM groups (P < 0.05). There were negative linear correlation between SFCT of all patients and the severity of retinal lesions (r=-0.555, P=0.000), and between SFCT and DM duration (r=-0.332, P < 0.05). But SFCT was independent of fasting plasma glucose (r=-0.123, P > 0.05), mean arterial pressure (r=-0.116, P > 0.05), and axial length (r=-0.018, P > 0.05). ConclusionsSFCT in DM eyes is thinner than that in normal controls. SFCT is different in the NDR, mild NPDR, moderate NPDR, severe NPDR patient. Severe DR patients have much thinner SFCT.
The pathogenesis of polypoidal choroidal vasculopathy (PCV) is still controversial. More evidence of clinical and basic research is needed to distinguish PCV from an independent disease to a subtype of age-related macular degeneration. Not only that, there are also many puzzles in the diagnosis, treatment options and prognosis of PCV. In addition to these common problems, we also face a large population with risk factors, a large number of PCV patients with multiple and complex challenges in China. There is a long way to go to reduce the damage effects of PCV on visual function. To fulfil this goal, we need make full use of the huge resources of PCV patients and turn these challenges into opportunities, and contribute the improvement of diagnosis and better understanding of PCV pathogenesis.
Purpose To evaluate the safety and efficacy of draining subretinal fluid with transchoroidal probing by using the traditional needling and diode endolaser probing. Methods The investigation included 70 consecutive patients(74 eyes) with rhegmatogenous retinal detachment undergoing scleral buckling surgery.Seventy cases were randomly divided into 2 groups,group A 34 cases(36 eyes)with the needle drainage procedure and group B 36 cases(38 eyes) with the diode probe respectively.The safety and efficacy were compared in between the 2 groups. Results No operative failure was found in these 2 groups.In group A,subretinal hemorrhage occurred in 3 eyes,and retinal incarceration,retinal preforation in one eye. No significant complication occurred in group B. Conclusion Diode laser drainage has the advantage in that it may reduce the incidence of operative complication with drainage.This technique might be used in any case requiring drainage of subretinal fluid especially of rhegmat ogenous retinal detachment in cases of shallow retinal detachment. (Chin J Ocul Fundus Dis,1998,14:202-203)
PURPOSE:To observe the clinical features of the macular hemorrhage in myopes. METHOD:Twenty-four patients(30 eyes)with myopic macular hemorrhage were examined with slitlamp biomicroscopy,funduscope,A/B ultrasonography,and fundus fluorecein angiography(FFA). The patients were followed up for 3~18 months(average 12 months). RESULTS: Four of 26 eyes with macular hemorrhage examined with FFA were found to be due to choroidal neovaseulature,and they were associated with posterior staphyloma. The other 22 eyes without neovascular change were thought to be simple type,and 19 of them were associated with lacquer cracks. The hemorrhage in simple type cases deminished usually within 1~3 months. CONCLUSION:Myopic macular hemorrhagic eyes of neovascular type resulted usually in recurrent hemorrhage and worse prognosis in visual acuity than those of simple type. （Chin J Ocul Fundus Dis,1996,12: 220-222）