Objective To explore the relationship between the classification of diabetic macular edema（DME）and the stages of the diabetic retinopathy (DR) , the diabetic duration and the visual loss.Methods Retrospectively analyzed the clinical data of fundus fluorescein angiography (FFA) and other related information of 1521 patients who were diagnosed as DR. Classified DR according to national standard of the diagnosis and classification of DR, and classified DME according to the standard made by the early treatment diabetic retinopathy study research group of United States. The occurrence of DME in DR in each stage and the relationships between DME and the disease course and the vision were analyzed.Results In 1521 patients, 791 eyes in 468 patients had DME ( 30.77%), including 361 eyes (45.64%) with focal DME and 430 eyes (54.36%) with diffuse DME. The occurrence of DME was 1.13% in I-stage DR, 7.84%in II-stage DR, 41.98% in III-stage DR, and 48.93% in IV-stage DR. Focal and diffuse DME usually occurred at the III and IV stage of DR respectively, with 178 eyes (22.51%) with focal macular edema at the III stage of DR, and 249 eyes (31.48%) with diffuse DME at the IV-stage of DR. Patients with DME were hardly found at the V and VI stage of DR because of retinal proliferation and vitreous hemorrhage or other complications which made the condition of macula region blurred. The visual acuity of diffuse DME was worse than focal DME. DME often occurred within 10 years in the diabetic duration, and its severity and incidence increased year by year.Conclusions DME is the main cause of visual impairment of DR. The incidence of DME increased as the course of the DR prolonged. Along with the development of retinopathy, the incidence of DME increased, and the severity of DME aggravated, but the development of DME and its classification can not be brought into definite correspondence or unification with the classification of DR, hence the typing of DME in another individual classification in DR is of course necessary. (Chin J Ocul Fundus Dis，2003，19：83-86)
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.
Objective To observe and estimate the image characters of indocyanine green angiography (ICGA) and fundus fluorescein angiography (FFA) in atrophic age-related macular degeneration(AMD) and macular drusen. Methods FFA, ICGA and fundus photography were performed on 95 eyes of 73 atrophic AMD patients, in cluding 19 patients (26 eyes) with depigmentation and atrophy of retinal pigment epithelium (RPE), 15 (30 eyes) with macular drusen, and 39 (39 fellow eye) with unilateral exudative AMD.Results In 26 eyes with depigmentation and atrophy of RPE, the result of FFA of 24 eyes with depigmentaion showed patch hyperfluore scence, and of ICGA showed patch hyperfluorescence and hypofluorescence on the late photographs; in 2 eyes with maplike atrophy of RPE, the result of FFA showed patch hyperfluorescence, and of ICGA showed choriocapillaris defect with sharply demarcated boundaries and hypofluorescence of large choroidal vessels. In 30 eyes with macular drusen, the result of FFA of 8 eyes with hard drusen showed hyperfluorescence, and of ICGA showed patch and spot hyperfluorescence; the result of FFA of 16 eyes with soft drusen showed hyperfluorescence, and of ICGA showed persistent patch hypofluorescence intermixed with cluster hyperfluorescence; and the result of FFA of 6 eyes with both soft and hard drusen showed hyperfluorescence, and of ICGA showed patch hyperfluorescence intermixed with hypofluorescence. When it was hypofluorescence in ICGA in patients with macular drusen, larger quantity and range of fluorescence were found in FFA than in ICGA; when it was hyperfl uorescence in ICGA, smaller quantity and range of fluorescence were found in FFA than in ICGA. In 39 fellow eyes of unilateral exudative AMD, 32 or 31 eyes, examined by ICGA or FFA, had abnormal fluorescence of drusen and depigmentation and atrophy of RPE damage.Conclusions Simultaneous examination of IC GA and FFA can be useful for accurate evaluation of fundus image characters of types of angiography in atrophic AMD.(Chin J Ocul Fundus Dis，2003，19：79-82)
Objective To observe and analysis the features of images of fundus fluorescein angriography (FFA) in low-perfused retinopathy caused by cephalo-cervical peripheral vascular stenosis or occlusion. Methods The results of FFA of 27 patients diagnosed with carotid artery stenosis or occlusion by digital subtraction angiography (DSA) and examination of Doppler and vascular-pulsation were retrospectively analyzed. Result All of the patients had a delayed arm-retinal circulation duration from 20.0 to 81.08 seconds with the mean of 32.1 seconds; a delayed retinal arteriovenous filling duration from 6 to 64.0 seconds with the mean of 24.2 seconds. Delayed arm-retinal circulation duration and retinal a rteriovenous filling duration in 10 cases (37.0%); microangioma, vascular wall staining, nonperfused capillary area in 11 (40.7%); and anterior ischemic syndrome in 6 (22.2%) were found. In the 6 patients with anterior ischemic syndrome, 4 cases had narrow retinal artery, segmental changes of blood stream, vascular atresia, and abnormal arterio-venous anastomosis, and 2 cases had bold vascular loops. Conclusions The main manifestations of FFA in patients with low-perfused retinopathy are malperfusion and retinal ischemia, whose degrees relate to the extend of carotid artery stenosis or atresia, and the process of the disease.Serious retinal ischemia may combined with anterior ischemic syndrome. (Chin J Ocul Fundus Dis，2004，20：84-86)
PURPOSE:To search for the occult choroidal neovascularization(CNV)of age-related macular degeneration (AMD)with macular hemorrhage using indocyanine green angiography(ICGA).
METHODS:FFA and ICGA were performed in a series of 22 cases(24 eyes)of AMD with macular hemorrhage,and the findings of both angiograms were compared each other.
RESULTS :ICGA was found to be superior than FFA in evaluating the occult CNV of AMD with hemorrhage owing to the following outstanding findings in this series,i.e,in judging the presence,position,number and range of the occult CNV.
CONCLUSION:ICGA is an important technique in diagnosing the subretinal occult CNV in AMD with macular hemorrhage,and useful in selecting therapeutic measures including photocoagulation and surgical treatment.
（Chin J Ocul Fundus Dis,1997,13: 146-149）
Objective
To investigate the clinical features of multifocal choroiditis (MC) and guide the diagnosis and treatment.
Methods
Retrospective analysis of clinical data of 18 MC cases (28 eyes) who were diagnosed through fluorescein angiography (FFA) or indocyanine green angiography (ICGA) and fundus characteristics.
Results
Multiple round to oval lesions scattered throughout the posterior pole and peripheral areas of ocular fundi of all of the 28 eyes(binocular in 10 and monocular in 8) were found. Active focal lesions of ocular fundi were seen in 8 patients and inactive lesions in 10 patients. active and 10 cases were inactive. Choroidal neovascularization(CNV) in macular area was found in 7 patients. The images of FFA of the legions showed hypofluorescence in the early phase, with late leakage and gradual staining or window is defect in the late phase.
Conclusions
MC is a rare disease and often misdiagnosed to other disease and FFA helpful in diagnosis.
(Chin J Ocul Fundus Dis, 2005, 21: 367-370)
Objective
To investigate the clinical characteristics and the related factors of peripapillary subretinal hemorrhage (PPSRH).
Methods
The clinical documents of fundus fluorescein angiography (FFA) of 23 patients (23 eyes) with PPSRH were retrospectively analyzed.
Results
All of the 23 eyes was myopes with middle or slight degree, and the corrected visual acuity was≥1.0. Among the 23 patients, 9 eyes were PPSRH, 13 eyes were PPSRH with disc hemorrhage, and 1 eye was PPSRH with disc and vitreous hemorrhage. All of the PPSRH was localed at the nasal edge of optic disc. Through FFA the hemorrhage showed blocked fluorescence and the optic disc showed nodular hyperfluorescence at the late phase, and nothing abnormal in the unaffected eyes.
Conclusion
PPSRH might be related to buried optic disc drusen.
(Chin J Ocul Fundus Dis, 2002, 18: 96-97)
Purpose
To observe the changes of choroidal circulati on and the retinal lesions caused by ocular contusion with indocyanine green ang iography (ICGA).
Methods
ICGA examination was performed on 30 cases (30 eyes) of various traumatic condition in conjunction with fundus fluorescein angiography (FFA).
Results
FFA of 19 cases (63.3%) showed the hypofluorence in quadrant or whole disc in accordance with the area of delayed filling of choroid. Twentysix cases (86.2%) showed d efected choroidel perfusion in ICGA,among them 16 cases showed localized delayed perfusion, in which the shortest perfusion time was 1 min 50 s and the l ongest time was 5 min.43 s,and 10 patients showed localized perfusion defect,and reversed filling time of retinochoroid vessels in 6 patients. Five cases (16.6%) had delayed filling time in both choroidal and central retinal vessels . Damage of retinal pigment epithelium was found in the areas of choroidal abnor mal perfusion.
Conclusion
ICGA combined with simultane ously FFA, is valuable in evaluating blunt injury of the ocular fundus and ben eficial to its diagnosis and treatment.
(Chin J Ocul Fundus Dis, 2001,17:122-124)
Objective To investigate the characteristics of the ocular fundus of Chinese patients with polypoidal choroidal vasculopathy (PCV).Methods The photographs of ocular fundus of 42 Chinese patients (48 eyes) with PCV diagnosed by fundus photography, fundus fluorescein angiography (FFA), and indocyanine green angiography (ICGA) were analyzed.Results In 48 eyes with PCV, 35 (72.9%) had subretinal hemorrhage, 13 (27.1%) had yellow-white exudation, 7 (14.6%) had subretinal tuberculum-like focus in tangerine peel at the posterior pole, and 26 (54.2%) had hemorrhagic or serous pigment epithelium detachment (PED). Thirty-six eyes（75.0%）had polypoidal dilations with branching vascular network, and the other 12 (25.0%) had scattered polypoidal dilations without identifiable continuous branching vascular network. The location for these lesions were at the macular region in 30 eyes (62.5%), arcade region in 6 (12.5%), peripapillary region in 3 (6.3%), and combination region in 9 (18.8%).Conclusions Most of the lesions in Chinese patients with PCV locate at the macular region and temporal vascular arcade. Most eyes are characterized by branching choroidal vessels with polyplike terminal aneurysmal dilations in ICGA. (Chin J Ocul Fundus Dis，2003，19：269-332)
Objective To explore the clinical manifestations and the characteristics of images of indocyanine green angiography (ICGA) and fundus fluorescein a ngiography(FFA) of multifocal choroiditis. Methods Eight patie nts (10 eyes) with multifocal choroiditis were gathered. The clinical manifestations and the images of ICGA and FFA were analyzed. Results Foci of multifocal choroiditis were found in posterior pole and peripheral areas of ocular fundi of all of the 10 eyes. The images of ICGA revealed hypofluorescence in focal area. The images of FFA showed hypofluorescence at the early phase and fluorescein leakage at the late phase in the active focus, and fluorescein staining and window defect fluor escence in the inactive focus. Conclusions The clinical manife stations of multifocal choroiditis varied with disease course, location and numbers of the lesions. ICGA and FFA can show the development of the disease clearly, which may guide the treatment. (Chin J Ocul Fundus Dis，2004，20：87-89)
