Objective
To investigate the clinical manifestation and histopathologic changes of the fungal necrotizing retinochoroiditis.
Methods
Collecting 7 cases of fungal retinochoroiditis with severe immunodepression and loss of visual acuity.Seven removed eyeballs were stained with HE,PAS and silver methenamine,and observed by light microscopy,and in addition,2 of them examined by electron microscopy.Also fungal cultures of blood and affected tissues were performed.
Results
The chief clinical macnifestation included ciliary injection of conjunctiva,opaque aqueous fluid and vitreous and diffuse hemorrhage and greyt white opacity with retinal detachment in severe cases.Pathologic changes included hemorrhage in the retina,chorioretinal tissue necrosis,hyphae in the blood vessels,affected tissue and vitreous.Fungal culture of blood was positive in three cases.Culture of affected tissues was positive in all cases.
Conclusions
Eedogenous fungal infection of choroid and retina may be due to the severe immunodepression of the sufferers and usually causes chorioretinal tissue destruction and blind.
(Chin J Ocul Fundus Dis, 1999, 15: 235-237)
Purpose
To investigate the pattern of subretinal neovascular membrane(SRNVM)in central exudative chorioretinitis(CEC). Methods
With the help of a PC microcomputer,we performed a quantitative measurement of SRNVM in 32 eyes of 32 patients with Rieger is CEC. Results
SRNVM-optic disc area ratio were 0.1151plusmn;0.0842．The foveola was on the top of SRNVM in 7 cases．The other 25 of SRNVMs were scattered in macular area around foveola,and 2 of them were nasal to it．The distance between the edge of SRNVM and foveola was less than 175mu;m in 13 cases,175～300mu;m in 4 cases and more than 300mu;m in 15 cases． Conclusion
To be compared with the previous data,the present results suggested that laser photocoagulation might be one of the most important therapies for SRNVM in Rieger is CEC． (Chin J Ocul Fundus Dis,1998,14:114-115)
Objective
To evaluate the therapeutic effect of vitrectomy on bullous retinal detachment.
Methods
The clinical data of 7 patients (9 eyes) with bullous retinal detachment who had undergone vitrectomy due to useless photocoagulation were retrospectively analyzed. Bullous retinal detachment of the patients had been diagnosed by examination of slit-lamp microscope, three-mirror gonioscope, indirect ophthalmoscope, B-mode ultrasound, and fundus fluorescein angiography. All of the affected eyes underwent vitrectomy with closed triple incisions through the pars plana after release of subretinal liquid under the local anaesthesia. The cortex of vitreous body was taken out, and exsuction of subretinal liquid was carried out via retinal incision. Photocoagulation closed the incision and the effusion area of the retina, and intraocular filling matter was injected after exchange of air and liquid. The follow-up period lasted 3 months to 8 years with the average period of 47 months.
Results
Reattached retina was found in all of the affected eyes during the follow-up period. One eye underwent a second vitrectomy due to local retinal redetachment caused by a new retinal hole formed by the pull of pre-retinal proliferative membrane and a silicon vesicle entered the subretinal space, but the retina reattached after 1-year follow-up examination. The visual acuity impr oved in different degree after the operation in 8 eyes, but remained unchanged in 1 eye.
Conclusion
Vitrectomy for terminal bullous retinal detachment may promote the reattachment of retina safely and effectively, and save partial visual acuity of the affected eyes.
(Chin J Ocul Fundus Dis, 2006, 22:299-301)
Objective To compare the characteristics of fundus angiograms of central serous chorioretinopathy (CSC) with exudative agerelated macular degeneration (AMD) in patients more than 45. Methods The colorized photographs of ocular fundus, and results of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) of 32 patients (39 eyes) with CSC and 20 patients (22 eyes) with exudative AMD more than 45 were collected and analyzed retrospectively. Results In 39 eyes with CSC, the results of FFA revealed classic CSC in 11 (28.2％) and diffuse retinal pigment epitheliopathy (DRPE) in 28 (71.8％); the results of ICGA showed localized choroidal delayed filling associated with dilated vessels in 39 (100％) in the early phase, choroidal hyperpermeability in 39 (100％), identifiable hyperfluorescence of leakage from RPE in 16 (41.0％) was observed in the middle phase, and a distinctive silhouetting of the larger choroidal vessels in 5 (12.8％) was detected in the late phase. In 22 eyes with exudative AMD without evident hemorrage, the results of ICGA exhibited focal CNV in 13 (59.1％), plaque CNV in 8 (36.4%), and combination CNV in 1 (4.5%)；choroidal delayed filling around macular region vicariously was found in 5 (22.7％) in the early phase, choroidal hyperpermeability was not observed in the middle phase and silhouetting of the larger choroidal vessels was not showed in the late phase. Conclusions The differences of the ICGA features between CSC and exudative AMD in patients more than 45 include focal or multifocal hyperfluorescence of leakage from RPE, multifocal choroidal hyperpermeability in the middle phase, silhouetting of the larger choroidal vessels in the late phase, and no focal or plaque CNV.
Objective
To assess the effectiveness of transpupillary thermotherapy (TTT) for the treatment of central exudative chorioretinopathy.
Methods
Tweenty-nine eyes with central exudative chorioretinopathy were treated with Iris 810 nm diode laser TTT. The laser beam size was 1.0, 2.0 or 3.0 mm with power settings between 80-300 mW and treatment time 60 sec. The follow up periods were wihzin 4-40 weeks. The therapeutic effect was accessed by visual acuity examination,dinect ophthalmoscopy and fluorescein or indocyanine green angiography.
Results
The visual acuity improved in 8 eyes (28%), remained no change in 19 eyes (65%) and decreased in 2 eyes (7%). Choroidal neovascularization were closed in 12 eyes in fundus angiography. The symptoms alleviated in 10 patients.
Conclusion
Transpupillary thermotherapy is a potential treatment for the central exudative chorioretinopathy.
(Chin J Ocul Fundus Dis, 2002, 18: 184-186)
Objective
To observe the findings of indocyanine green angiography(ICGA) and fundus fluorescein angiography (FFA) of the patients with multifocal posterior pigment epitheliopathy(MPPE).
Methods
ICGA and FFA were performed in 6 cases(7 eyes)of MPPE and the findings were analysed and compared between these examinations.
Results
Five cases(5 eyes)were found to be in the active stage of the disease under FFA,and among them 4 eyes(80%)showed delayed choroidal perfusion at the early stage of ICGA.During the active stage of the disease,ICGA showed leakage relative to FFA leakage,and there were diffuse hyperfluorescence around the points of leakages as well as in the posterior pole of ocular fundus．In convulescence,although FFA revealed no obvious leakage,ICGA still denoted the presence of leakages.
Conclusions
MPPE was considered to be the more serious type of central serous chorioretinopathy showing the same but more extensive ICGA abnormality.
(Chin J Ocul Fundus Dis,2000，16：6-8)
Objective To analyze the etiology of central exudative chorioretinopathy（CEC）. Methods A total of 32 CEC patients were asked the medical history, and underwent examination of purified protein derivative（PPD）test, chest Xray, blood routine test, Creactive protein, erythrocyte sedimentation rate, TORCH test and rapid plasma regain cirde card test, to determine the possible causes of CEC. Results Thirty-two patients didnprime;t have the history of tuberculosis, and no evidence of systemic active tuberculosis was found in the chest X-ray examination. the results of PPD test showed the positive rate was 37.5％. The disease condition of paitents with positive result of PPD test was stable or was alleviated after anti-tuberculosis therapy. All the results in IgM of TORCH test and rapid plasma regain cirde card test were negative. Conclusion No infectious factors related to CEC was found, thus choroidal neovascularization of CEC might be idiopathic.
Objective To evaluate the clinical features and treatment outcomes of ocular posterior segment syphilis. Methods The clinical data of 24 patients with active ocular syphilis were retrospectively reviewed. The diagnosis was made first in eye clinic，and verified by treponema pallidum particle agglutination (TPPA) and rapid plasma reagin (RPR). The patients, 17 males and 7 females, aged from 30 to 63 years with an average of 47.6 years. The duration of symptoms ranged from 3 days to 2 years with an average of 5.8 months (le;1 month, 7 cases; 1-3 month, 5 cases; 3-6 months, 5 cases; ＞6 months, 7 cases). There were 18 bilateral cases and 6 unilateral cases. The result of human immunodeficiency virus (HIV) test was negative for all cases. Twenty-three patients received systemic penicillin therapy and 1 patient was treated with oral erythromycin due to penicillin allergy. Before treatment, the mean visual acuity was 0.17plusmn;0.19，the mean titer of RPR was 1:84。The follow-up period was half a year. Results The major ocular manifestations included bilateral (16 cases) or unilateral (1 case) chorioretinitis, unilateral retinal vasculitis (2 cases), unilateral neuroretinitis (2 cases), and bilateral (2 cases) or unilateral (1 case) optic neuritis. The mean follow-up visual acuity was 0.60plusmn;0.29，the mean follow-up titer of RPR was1:18.8. Some patients had got the diagnosis and prompt treatment at the early stage of the disease and their visual acuity recoveried very well. Conclusions The major manifestion of ocular posterior segment syphilis is chorioretinitis. It is important to consider the possibility of syphilis when patients have inflammation of posterior segment. Prompt serology examination and penicillin treatment are the keys to cure ocular syphilis.
