Objective To observe the autofluorescence of dated fundus hemorrhage excited by the excitaton light with different wavelength. Methods A total of 23 patients (23 eyes) with dated fundus hemorrhage were observed. The blue light under the fundus fluorescence angiography (FFA) mode of Topcon 50IA fundus camera was the excitation light, and the whiteandblack images of 4 patients and colorized images of 16 patients were collected, respectively. The autofluorescence of dated fundus hemorrhage in other 3 patients was observed by excitation of scanning laser with the wavelength of 488 nm and 795 nm emitted from Heidelberg retina angiography apparatus (HRA2). Results The black and white images showed the b red autofuorescence of dated fundus hemorrhage in 4 patients, while the colorized ones revealed the red autofluorescence in 16 patients. The hemorrhage autofluorescence could be also excited by blue laser (488 nm) and infrared laser (795 nm) using HRA2, but with different extent and intensity. Conclusions Due to the complex composition of dated fundus hemorrhage, different excitation light can excite the autofuorescence with different wavelength.
ObjectiveTo observe the multimodal imaging characteristics of multiple evanescent white dot syndrom (MEWDS).MethodsThis was a retrospective series case study. Eighteen patients (18 eyes) diagnosed with MEWDS in Eye Center of The Second People’s Hospital of Foshan from September 2015 to April 2017 were enrolled in this study. There were 12 females and 6 males, with the mean age of 35.9 years. The disease course ranged from 3 to 90 days, with the mean of 14 days. All the patients underwent BCVA, slit-lamp microscope with +90D preset lens, fundus photography, spectral domain OCT (SD-OCT) and FAF examinations. FFA was simultaneously performed in 6 eyes, FFA and ICGA were simultaneously performed in 12 eyes. Ten patients received the treatment of glucocorticoids and vasodilator substance, and other 8 patients without any treatment. The follow-up duration was 4.5 months. The multimodal imaging characteristics were reviewed and analyzed.ResultsFundus color photography showed a variable number of small dots and large spots lesions (14 eyes), and/or fovea granularity (7 eyes) and disk swelling (5 eyes). A variable number of little dots and larger spots lesions showed respectively in FFA, FAF and ICGA were needle-like dots distributed in a wreathlike pattern and a large plaque occasionally confluent of early highly fluorescent, highly autofluorescence and hypofluoresence. Combined hypofluorescent spots with overlying dots were observed in 10 eyes of the late stages of the ICGA. Black lesions in the gray background show in ICGA were the most obvious and the most extensive, gray-white lesions in the gray-black show in FAF were the second, light gray-black lesions in the gray show in FFA were the least. Gray-white lesions in an orange background show in fundus photography were not obvious and transient. SD-OCT showed disruption of the ellipsoid zone and/or accumulations of hyperreflective material from the ellipsoid layer toward the outer plexiform layer and vitreous cells. During the period of following-up, some patients were prescribed low-dose glucocorticoid and some not, almost all the patients except one patient experienced recovery in BCVA and the lesions in fundus imaging.ConclusionsThe lesions in MEWDS eyes in modern multimodal imaging modalities among fundus photography (fovea granularity), FFA (needle-like dots distributed in a wreathlike pattern and a large plaque occasionally confluent of early highly fluorescent), ICGA (flake hypofluorescent) and SD-OCT (disruption of the ellipsoid zone) showed good consistency. Almost eyes were recovery.
Objective To cpmpare the assessment of retinal and choroidal disease using confocal scanning laser ophthalmoscope (cSLO) imaging and color fundus camera. Methods Sixty-seven patients (90 eyes) with fundus diseases were included in this study. There were 35 males (51 eyes) and 32 female (39 eyes), mean age was 51.32 years. All subjects underwent fundus imaging using cSLO technology and traditional color fundus camera, positive numbers of every retinal pathological change were calculated and compared. Spectral domain-optical coherence tomography (SD-OCT) was also done to compare the accordance rate between two modes of fundus imaging (cSLO technology and traditional color fundus camera) and SD-OCT in choroidal changes. Results The positive numbers of retinal microaneurysm (χ2=4.157, P < 0.05) and epiretinal membrane (χ2=5.428, P < 0.05) using cSLO fundus imaging were significantly higher than traditional color fundus camera, while the positive numbers of cotton wool spots (χ2=0.523), retinal hemorrhage (χ2=0.117), hard exudates (χ2=0.325) and macular hole (χ2=0.070) were no significant different (P > 0.05). The SD-OCT accordance rate of choroidal pathological changes using cSLO technology was higher than traditional color fundus camera (χ2=9.143, P=0.007). Conclusion In retinal and choroidal diseases, the imaging quality of cSLO fundus imaging technology is better than the traditional color fundus camera technology.
PURPOSE:To inquire into diagnosis and differentiation method for full thickness macular hole,lamellar macular hole and cystoid macular degeneration. METHODS:Amsler grid,Watzke' s sign and laser aiming beam test were performed in the patients:30 with full-thickness macular hole, 12 with lamellar macular hole and 8 with cystoid macular degeneration. The results were analyzed statistically with method of four table precise probability. RESULTS:The positive rate of Amsler grid,watzke's sign and laser aiming beam test was 100% in ail of the full thickness macular holes,and it was 85%，65%and 0 in lamellar macular holes and cystoid macular degeneration respectively. CONCLUSION: Amsler grid testing was sensitive but not specific,Watzke's sign was more sensitive and specific,and the laser aiming beam tesl was extremely sensitive and specific in clinical diagnosis of full thickness macular hole. （Chin J Ocul Fundus Dis,1996,12: 208-210）
Objective To investigate the characteristics of congenital retinoschisis of optical coherence tomography(OCT) and its clinical application. Methods Eight cases(15 eyes) which were diagnosed as or suspected to retinoschisis in clinic were examined by OCT,direct ophthalmoscopy and color fundus photograph.Three cases(6 eyes) were examined by electroretinogram(ERG) and fundus fluorescein angiography(FFA). Results The typical characteristic OCT images of congenital retinoschisis were cystic maculopathy with tilted and vertical connective filaments,typical split in innner retinal layers in posterior retina and thickening of neurosensory retina with the split of outer retinal layers in membranous remnants. Conclusions OCT can display the characteristics of congenital retinoschisis．It is potentially useful as a new technique for the diagnosis of congenital retinoschisis. (Chin J Ocul Fundus Dis, 1999, 15: 209-211)
With the rapid development of ophthalmic imaging methods, there are many ways of examination in the diagnosis and treatment of fundus diseases, such as FFA, ICGA, FAF, OCT and emerging blood vessels by OCT angiography in recent years. Multi-model image can understand the changes of anatomical structure and function of different levels and parts of the fundus from different aspects. A variety of imaging examinations are combined and complemented each other, which makes us have a further understanding of the location and pathological changes of many fundus diseases. But at the same time, the emergence of multi-modal images also brings a series of problems. How to standardize the use of multi-modal imaging platform to better serve the clinic is a problem that ophthalmologists need to understand.
Ultra-wide-field fluorescein angiography (UWFA) is a novel breakthrough in ocular fundus imaging technology, which can capture a single, high-resolution, 200° wide image of the ocular fundus that traditional fluorescein angiography cannot reach. This technology has important impacts on the screening, diagnosis, staging, treatment and follow-up of vascular diseases involving peripheral retina (such as diabetic retinopathy, age-related macular degeneration, retinal vein occlusion, uveitis and so on).
The retinal vessel changes are the primary and major features of retinal vascular diseases. The retinal vessel is part of systemic vessels with its own characteristics to sustain normal retinal function. These basic characteristics are important to the correct understanding and proper treatment of retinal vascular diseases. Always keep in mind that the retinal vessels is one part of the systemic vascular system, thus retinal vascular diseases may have systemic etiology, and systemic drug administration may have a profound effects to the whole body. However retinal vascular system also has its own structural and functional characteristics, thus retinal vascular diseases are also different from the systemic diseases. Finally the main function of retinal vascular network is to maintain the neuro-retinal function, thus we should balance the vision protection and treatments against abnormal retinal blood vessels. Over-treatments may damage the retinal vision.
With the renovations of modern retinal imaging modality, such as video ophthalmoscopy, fundus photography, fundus fluorescein angiograph and spectral domain optical coherence tomography, it is possible to get high resolution and reproducible in vivo imaging of retina from neonates to improve the diagnosis and treatment of pediatric retinal disease. Now we have a better tool to investigate the early development of human retina, the pathogenesis and progression of pediatric retinal diseases, and to monitor the treatment efficacy and prognosis of these diseases. To expand these technologies in the diagnosis and treatment of pediatric retinal disease, we need simple, safe, comprehensive and objective applications which can only be achieved through multi-disciplinary cooperation.
Objective To observe the characteristics of spectraldomain optical coherence tomography (SD-OCT) and fundus autofluorescence (FAF) in acute and chronic central serous chorioretinopathy (CSC).Methods Seven-three eyes of 67 patients with CSC diagnosed by slit-lamp microscopy, fundus photochromy, fundus fluorescein angiography (FFA) and indocyanine green angiography were enrolled in this study. All the patients were examined for FAF and SD-OCT. The patients were divided into acute CSC group (37 patients, 37 eyes) and chronic CSC group (30 patients,36 eyes) according to the clinical features and FFA images. According to the OCT feature in retinal detachment area, they were divided into three categories, which including intact, non-intact and atrophy outer segment, respectively. According to the FAF characteristics, they were divided into hyper-FAF, hypo-FAF and mixed type, respectively. The characteristics of SD-OCT and FAF of both acute and chronic CSC patients were evaluated and analyzed. Results In acute CSC group, 19 eyes (51.35%) were hypo-FAF, 18 eyes (48.65%) were hyper-FAF. In chronic CSC group, two eyes (5.56%) were hypo-FAF, 16 eyes (44.44%) were hyper-FAF, and 18 eyes (50.00%) were mixed type. There was significant difference between both groups (chi;2=31.872,P=0.000). The SD-OCT results showed that in acute group, 15 eyes (40.54%) were intact outer segment, 18 eyes (48.65%) were non-intact outer segment, and four eyes (10.81%) were atrophy outer segment. In chronic group, five eyes (13.89%) were intact outer segment, 17 eyes (47.22%) were non-intact outer segment, and 14 eyes (38.89%) were atrophy outer segment. There was significant difference between both groups (chi;2=10.572,P=0.005). Conclusions The FAF characteristics of acute and chronic CSC mainly manifests hypo-FAF and mixed type, respectively. The OCT characteristics of acute CSC mainly manifests intact outer segment and non-intact outer segment, but non-intact outer segment and atrophy outer segment in chronic CSC.