Idiopathic intracranial hypertension (IIH) is a neurological disease, characterized by increased intracranial pressure and papilledema, and often associated with headache, transient loss of vision and pulsatile tinnitus. IIH typically occurs in women of childbearing age. Over 90.0% of patients are with obesity or over weighted. Loss of sensory visual function is the major morbidity associated with IIH and some patients even develop into blindness. Most patients will have varied degrees of visual impairment, or even a few become blind. Frisén grading system, visual field examination and spectral-domain optical coherence tomography can be used to evaluate and monitor the IIH papilledema functionally and morphologically. In recent years, IIH treatment trials in other countries confirmed that, weight loss and low-salt diet combined with acetazolamide treatment has a clear improvement for IIH patients with mild visual impairment. In-depth understanding of the etiology, clinical manifestations, diagnostic criteria and the main treatment has important clinical significance for IIH patients
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 evaluate the correlation between retinal thickness (RT) at the macular area
and the axial length (AL) in myopia.
Mehtods
Optical coherence tomography (OCT) was used to detect the RT at the macular
fovea, and at the superior, nasal, inferior, and temporal side of the fovea and
parafovea area. The AL of the examined eye was measured by IOL master
measuring machine, and the correlation between RT at the macular area and the Al was evaluated.
Results
The minimum RT in the macular area in the eyes with myopia was (150.90plusmn;22.10)mu;m.The retina at the temporal side of parafovea was the thinnest. The average RT in the areas around the fovea was negatively correlated with the AL, and there
was no correlation among the minimum RT, the mean RT at the fovea, and the AL of eye.
Conclusions
As the AL of eye increases, the RT at the parafovea decreases, while the minimum and the average RT at the fovea remain unchanged.
(Chin J Ocul Fundus Dis, 2006, 22: 397-399)
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.
Fundus photograph, angiography, optical coherence tomography, ultrasonography and other image technology and visual electrophysiology can provide a wealth of information for the diagnosis and treatment of pediatric retinal diseases. However, it put forward higher requirements on pediatric retinal imaging equipment and techniques which will be quite different from adult, because of pediatric retinal disease has its own characteristics, such as disease spectrum, pathogenesis, and pathophysiology. The principles and methods of image results interpretation on adult were not quite ready for children. It is necessary to further study the fundus imaging techniques suitable for children, gradually establish standardized examination procedures and clinical interpretation system, to promote the diagnosis of retinopathy in children.
ObjectiveTo investigate the relationship of the age-related maculopathy susceptibility 2 (ARMS2) A69S polymorphism and polypoidal choroidal vasculopathy (PCV), and to explore the distribution of risk allele in PCV and exudative age-related macular degeneration (wAMD).
MethodsThis is a systemic review and meta-analysis. A literature research was performed in Pubmed, Embase, Web of Knowledge, Chinese national Knowledge Infrastructure and Wanfang Medicine Database by the key words of "ARMS2, LOC387715, A69S, rs10490924, age related macular degeneration, polypoidal choroidal vasculopathy, single nucleotide polymorphism". Case-control studies were included, while review, case report, or systemic reviews were excluded. The latest one of multiple articles was included only which published by the same group. The results of individual studies were pooled using the software Review Manager 5.1.4, and the correlation between allele frequencies, genotype and phenotype were analyzed.
ResultsA total of 14 articles, consisting 2007 PCV patients, 1308 wAMD patients and 3286 controls were recruited. The pooled odds ratio (OR) in random-effects models for genotype TT versus wild homozygous genotype GG is 5.20 (95% CI: 3.90-6.95). Heterozygous genotype GT mildly increased the risk in affecting PCV, and the OR of GT versus GG is 1.85 (95% CI: 1.42-2.40. The frequency of T allele in wAMD was higher than in PCV, pool OR=1.60 (95% CI: 1.31-1.96).
ConclusionsThe ARMS2 A69S variant is associated with PCV. Genotypes of TT and GT had an effect in increasing the risk of PCV, and the effect is even greater in genotype of TT. T allele had an effect in increasing the risk of PCV and wAMD, and the risk for wAMD is slightly greater than for PCV.
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.
ObjectiveTo evaluate the spectral domain optical coherence tomography (SD-OCT) characteristics of polypoidal choroidal vasculopathy (PCV) and its correlation with the visual acuity after photodynamic therapy (PDT) combined with intravitreal ranibizumab.
MethodsTwenty-six eyes of 26 patients with PCV diagnosed by indocyanine green angiography (ICGA) were enrolled in this study. All the patients were examined for best corrected visual acuity (BCVA), slit lamp microscope, SD-OCT, fundus fluorescein angiography (FFA) and ICGA before and 1, 3 months after treatment. The mean baseline BCVA was (31.46±16.87) letters, mean central retinal thickness (CRT) was (581.19±309.05) μm, and mean subfoveal choroidal thickness (SFCT) was (248.92±95.45) μm. Patients were divided into 2 groups according to the final visual improvement after 6 month of treatment: GR or sensitive Group (17 eyes) and PR or non-sensitive Group (9 eyes). GR group included 12 males and 5 females, with a mean age of (65.24±7.03) years, a mean CRT of (619.06±335.07) μm and a mean SFCT of (271.24±106.61) μm. There were 4 eyes with subretinal hemorrhage (SRH), 2 eyes with interface retinal fluid (IRF), 13 eyes with subretinal fluids (SRF) and 15 eyes with pigment epithelial detachment (PED). PR group included 8 males and 1female, with a mean age of (64.00±7.02) years, a mean CRT of (509.67±255.21) μm and a mean SFCT of (271.24±106.61) μm. There were 6 eyes with subretinal hemorrhage (SRH), 5 eyes with interface retinal fluid (IRF), 6 eyes with subretinal fluids (SRF) and 8 eyes with pigment epithelial detachment (PED). The difference of sex, age, CRT and SFCT between these two groups was not significant (P>0.05). The relationship of baseline SD-OCT and post-treatment BCVA was analyzed.
ResultsOn 1, 2, 3, 6 months after treatment, the BCVA were (38.46±19.81), (40.04±20.80), (42.96±21.63), (43.77±20.91) letters respectively. On 6 months after treatment, the mean CRT in GR and PR group were (360.71±276.54), (341.44±193.68) μm respectively (P>0.05). 64.71% (11/17) eyes in GR group and 22.22% (2/9) eyes in PR group had a SFCT thicker than 263μm. The difference was statistical significant between two groups [odds ratio (OR):0.052, 95% confidence interval (CI):0.005-0.533; P=0.013]. Logistic regression analysis showed that existence of IRF (OR=9.375, 95% CI: 1.299-67.645; P=0.026) or SRH (OR=6.500, 95% CI: 1.094-38.633; P=0.040) at baseline was negative prognostic factor to treatment.
ConclusionThick SFCT is a protective factor, however, existence of IRF or SRH at baseline is negative prognostic factor of final visual improvement.
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.
Objective
To investigate the relationship of clinical indexes between retinopathy in systemic-lupus-erythematosus （SLE）nephritis and SLE，and to discuss its clinical significance.
Method
The clinical data of 43 cases of SLE nephritis with ocular fundus diseases were retrospectively analyzed.The relationships between retinopathy and kidney defect，general lesions，SLEDAI grade，antinuclear antibody （ANA），anti-double stranded DNA，complement 3 and antiphospholipid antibodies were analyzed with Logistic regression respectively.
Results
In 86 eyes of the43paitents，there were retinal cotton wool spots in51eyes（59.3%），edema of optic disk in 43 eyes（50.5%），retinal haemorrhage in 12 eyes（14.0%），retinal artery occlusion in 5 eyes（5.8%），central retinal vein occlusion in 2 eyes（2.3%），retinal detachment in 3 eyes（3.5%），optic atrophy in 2 eyes（2.3%），and neovascularization in 2 eyes（2.3%）.Logistic regression analysis revealed that SLEDAI grade had linear dependent relation with cotton wool spots and optic disk edema（chi;2=42.154，6.498;P＜0.001），and didnrsquo;t have any correlation with proteinuria，hematuria and kidney function.Linear relation between retinal vascular occlusion and antiphospholipid antibodies was found（chi;2=24.475，P＜0.001）.Retinal haemorrhages，retinal detachment，optic atrophy and neovascularization did not correlate with clinical features.
Conclusion
SLEDAI grade had linear dependent relation with cotton wool spots and optic disk edema in patients with SLE nephritis，and Linear relation between retinal vascular occlusion and antiphospholipid antibodies is ascertained. Ocular fundus diseases are clinically important for evaluating the therapeutic responses and prognosis in lupus nephritis.
(Chin J Ocul Fundus Dis, 2006, 22: 239-241)
