Purpose
To investigate the expression of intercellular adhesion molecules ICAM-1 and Mac-1，in epiretinal membanes (ERM) of eyes wi th proliferative vitreoretinopathy (PVR)．
Methods
Twenty epiretinal membranes were obtained from eyes undergone vitrectomy for retinal detachment complicated with PVR and observed by immunohistochemical examination．
Results
Expressions of ICMA-1 and Mac-1 were observed in 18 and 15 membranes respectively．Expression of both adhesion molecules in 12 membranes．
Conclusion
The findings indicate that adhesion molecules might be involved in the development of PVR．
(Chin J Ocul Fundus Dis，2000，16：71-138)
ObjectiveTo observe the diagnostic value of six classification intelligent auxiliary diagnosis lightweight model for common fundus diseases based on fundus color photography. MethodsA applied research. A dataset of 2 400 color fundus images from Nanjing Medical University Eye Hospital and Zhejiang Mathematical Medical Society Smart Eye Database was collected, which was desensitized and labeled by a fundus specialist. Of these, 400 each were for diabetic retinopathy, glaucoma, retinal vein occlusion, high myopia, age-related macular degeneration, and normal fundus. The parameters obtained from the classical classification models VGGNet16, ResNet50, DenseNet121 and lightweight classification models MobileNet3, ShuffleNet2, GhostNet trained on the ImageNet dataset were migrated to the six-classified common fundus disease intelligent aid diagnostic model using a migration learning approach during training as initialization parameters for training to obtain the latest model. 1 315 color fundus images of clinical patients were used as the test set. Evaluation metrics included sensitivity, specificity, accuracy, F1-Score and agreement of diagnostic tests (Kappa value); comparison of subject working characteristic curves as well as area under the curve values for different models. ResultCompared with the classical classification model, the storage size and number of parameters of the three lightweight classification models were significantly reduced, with ShuffleNetV2 having an average recognition time per sheet 438.08 ms faster than the classical classification model VGGNet16. All 3 lightweight classification models had Accuracy > 80.0%; Kappa values > 70.0% with significant agreement; sensitivity, specificity, and F1-Score for the diagnosis of normal fundus images were ≥ 98.0%; Macro-F1 was 78.2%, 79.4%, and 81.5%, respectively. ConclusionThe intelligent assisted diagnosis of common fundus diseases based on fundus color photography is a lightweight model with high recognition accuracy and speed; the storage size and number of parameters are significantly reduced compared with the classical classification model.
Ultra-wide-field fluorescein angiography (UWFA) can obtain very wide retinal images (up to 200°), and is a very helpful tool to detect peripheral retinal lesions which cannot be found by other imaging methods. Analyzing the characteristics of the UWFA images may improve our understanding, treatment outcomes and management strategies of ocular fundus diseases. However this technology is still in its premature stage, there is still a lot of work to be done to improve its clinical application and study the characteristics and clinical meanings of these peripheral retinal lesions.
Paediatric retinal disease is the most important part of paediatric ophthalmology. It usually manifests as leukocoria or yellow pupil, typically in retinopathy of prematurity, familial exudative vitreoretinopathy, persistent hyperplastic primary vitreous, Coats disease and retinoblastoma. It also can be manifested as nystamus poor visual fixation or progressive worsening of visual function, typically in Leber congenital amaurosis, Stargardt disease, Best disease and cone and rod dystrophy. Paediatric retinal diseases can be roughly divided into acquired, hereditary and congenital developmental abnormalities. With the development of gene and stem cell technologies, the advent of new medicine, equipments and new techniques, the concept of diagnosis and treatment in paediatric retinal diseases is also changing. In China, the level is improving progressively in both clinical and research areas of paediatric retinal diseases.
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).
ObjectiveTo observe the safety of 2-port non-vitrectomized subretinal injection (SRI) for the treatment of Bietti crystalline dystrophy (BCD). MethodsA exploratory clinical study. From February to May 2023, 6 BCD patients with 6 eyes who were confirmed by examination in Xiamen Eye Center of Xiamen University and were treated with SRI adeno-associated virus vector transgenic drugs were included in the study. Among them, 2 males had 2 eyes and 4 females had 4 eyes. Age were 34-60 years old. The study eye underwent adeno associated virus gene therapy via 2-port non-vitrectomized SRI. Two scleral ports were created using 25G vitrectomy trocar to place the light pipe and injection cannula. Anterior chamber paracentesis was performed to lower intraocular pressure. Under the silicone oil infusion mode of the vitrectomy machine, a 38G injection cannula penetrated the retina to reach the subretinal space. The injection speed was controlled by the foot pedal of the vitrectomy machine, and the drug was slowly injected into the subretinal space to create a subretinal bleb. if intra-ocular pressure assessed by finger palpation was high at the end of injection, drainage of the aqueous humor can be made by compressing the cornea incision until the intraocular pressure was normal. Patients were followed for 9-12 months and be examined using the same equipment and methods as before. ResultsRetinal pigment epithelium and choroidal atrophy were observed in all 6 eyes of 6 patients were graded as stage Ⅲ by the fundus examination revealing atrophy of retinal pigmented epithelium and choroid, with or without yellow-white crystals and/or complex lipid. The range were operation time 9-14 minutes. No vitreous prolapse, retinal hemorrhage, or retinal tear was observed during surgery. After 24 hours, optical coherence tomogrophy examination showed absorption of subretinal fluid and retinal reattachment. None of the six patients showed corneal keratic precipitates, anterior chamber cells, vitreous cells, inflammation, high intraocular pressure, or retinal tear within the 9-month follow-up. ConclusionSubretinal injection without vitrectomy using two ports is a safe and feasible alternative for adult gene therapy, and it shortens the surgical time.
ObjectiveTo investigate the clinical characteristics and surgical management of the familial exudative vitreoretinopathy (FEVR)-associated rhegmatogenous retinal detachment (RRD).
MethodsRetrospective noncomparative case series. Thirty-three eye of 32 patients were diagnosed FEVR-associated RRD by Fluorescein fundus angiography. There were 26 males and 6 females. The male to female ratio is 4.3:1 with an average age of 19.35±8.83 years. The detection of best corrected visual acuity (BCVA), refraction status, fundus photograph and fluorescein fundus angiography(FFA)were underwent in all patients. FEVR was confirmedby FFA and positive family history. The BCVA, refraction status, morphology of retinal detachment, location, size and shape of retinal hole, presence and grade of proliferative vitreoretinopathy (PVR), and subretinal proliferation were recorded.
ResultsAs for the refractive status, the scope of refraction was +2.0 D to-13.0 D andthe BCVA were range from light perception to 0.7. Atrophy holes which located at the temporal half were responsible for retinal detachment in all cases. Besides, horseshoe tears were noted in 6 eyes (18.18%), while macular tears were noted in 2 eyes of RRD (6.06%). The PVR greater than stage C2 was noticed in 10 eyes (30.30%), while subretinal proliferation was presented in 23 eyes (69.70%).
ConclusionsMale predominance, juvenile onset and associated with moderate to high myopia are the main characteristics in FEVR-associated RRD. Atrophy holes at the temporal half and the subretinal proliferations were most commonly in FEVR-associated RRD. Detailed fuduns and FFA examination of the fellow eye should be undergone to avoid misdiagnosis.
ObjectiveTo observe the clinical features of familial exudative vitreoretinopathy (FEVR).
Methods202 FEVR patients (404 eyes) from 84 families were included in this retrospective study, all the clinical diagnosis was made by the same expert in our Department. All patients were examined with slit lamp microscope, indirect ophthalmoscopy, children's retinal imaging system or Heidelberg HR2 fundus cameras for fundus photographs. Fluorescein angiography (FFA) was also performed for all patients, for those≤7 years old it was performed under general anesthesia. Data collected from charts included gender, age at presentation and family history. According to the fundus presentation and FFA results, FEVR was classified into 0-5 stages. Stage 0 (normal) is for the health fellow eye in unilateral FEVR; stage 1: retinal peripheral avascular zone with no fluorescence leakage in FFA; stage 2: retinal peripheral avascular zone, with fluorescence leakage in FFA; stage 3: partial retinal detachment not involving the macular; stage 4: partial retinal detachment involving the macular; stage 5: total retinal detachment.
ResultsThere were 119 male patients and 83 females. The average age of diagnosis was 16 months, the average gestational age was 39 weeks and the average birth weight was 3223 g in the proband. At the first clinical visit, there was clear family history of FEVR in 4 patients (1.98%); family history of other eye disease (nystagmus, cataract, small eyes, strabismus and others) in 25 patients (12.38%); not family history of eye disease in 173 patients (85.64%). FEVR family history was confirmed by fundus examination and FFA for the family members. In all 404 eyes, 9 eyes (2.23%) was normal, 162 eyes (40.10%) was stage 1, 97 eyes (24.01%) was stage 2, 72 eyes (17.82%) was stage 3, 20 eyes (4.95%) was stage 4, and 44 eyes (10.89%) was stage 5. In 202 patients, 59 cases (29.21%) was asymmetry bilateral disease with different stage for each eye. In 404 eyes, retinal fold was found in 74 eyes (18.32%).
ConclusionsFEVR was common in full-term and/or normal birth weight newborns. More than half of patients are in stage 1 and 2 without any clinical features. 29.21% eyes were asymmetry bilateral diseases.
Objective
To analyze and summarize the clinical regulation and ocular fundus characteristics of the Coats diseases paients.
Methods
The clinical data of 205 Coats diseases (211 eyes) which including sex, age, which-eye and visual distribution were retrospectively analyzed. To analyze the region,scope, and degree of the disease according to the ophthalmoscopy, ocular fundus photography, and fundus fluorescein angiography results, in additon to invistigate the distribution and development rule of lesions.
Results
In 205 cases, Coats disease was diagnosed at a median age of 28 years old. There were 54.2% patients over 20 years old. It occurred in 76.1% males，and was unilateral in 97.1% patients. In 211 eyes, the visual acuity was below 0.3 in 67.3% eyes. The retinal telangiectasia occurred in all eyes, with yellow white lipid exudation in 90.5% eyes; located in temporal fundus in 90.1% eyes, in front of midperipheral 73.9% eyes; spread over one sector in 72.5% eyes. Conclusions
Coats disease occurs mostly in males; it can occurrs in any age; it almost occurrs in unilateral. The essential characteritics are abnormal expansion of microvascular, mostly located in temporal fundus and in front of midperipheral, with yellow white lipid exudation, spread macular and damage visual function seriously.
（Chin J Ocul Fundus Dis，2008，24：276-278）
Multicolor imaging (MCI) based on confocal scanning laser ophthalmoscopy can gather more diagnostic information than traditional fundus photographs through utilizing three wavelengths of laser to scan posterior retina, which gain different layer reflected signal since the depth of penetration into retina is different for each wavelength. Currently, it provides important information and reference value for diagnose of different layer diseases on retina or choroid combining MCI with OCT, FAF, FFA and so on. However, there are still misunderstandings in the diagnosis of retinal diseases with MCI. Careful observation of retinal details in MCI, CFP and other imaging methods is more conducive to the correct diagnosis of fundus ophthalmopathy.
