Objective To observe the prognosis of visual acuity (VA) of patients with different classification of polypoidal choroidal vasculopathy (PCV). Methods Sixty-seven PCV patients (68 eyes) diagnosed by fundus photography, fundus fluorescein angiography, indocyanine green angiography (ICGA) and ocular coherence tomography were enrolled in this retrospective study. The patients were classified into static, exudative, small hemorrhage and large hemorrhage according to activity and pathological characteristics of lesions. The patients were classified into aciniform, single or several single, combined branching choroidal vascular network (BVN) according to morphological characteristics and combination with BVN of lesions on ICGA. The patients also were classified into macular, vascular arcade, peripapillary and mixing zone according to distribution of lesions. The VA of all the types were observed. Results There were 16, 19, 19, 14 eyes in the type of static, exudative, small hemorrhage and large hemorrhage PCV, which with logMAR VA of 0.34plusmn;0.52, 0.70plusmn;0.98, 0.60plusmn;0.50, 0.91plusmn;0.75 respectively. The VA of static PCV patients was better than that in exudative, small hemorrhage and large hemorrhage PCV patients (q=4.75, 4.26, 5.13; P＜0.05). There was no significant difference of VA between exudative and small hemorrhage PCV patients (q=0.98, P＞0.05). There were 22, 38 and eight eyes in the type of aciniform, single or several single, combined BVN PCV, which with logMAR VA of 0.52plusmn;0.55, 0.59plusmn;0.43, 0.80plusmn;0.95 respectively. The VA of combined BVN PCV patients was worse than that in aciniform and single or several single PCV patients (q=3.81, 3.02;P＜0.05). There were 34, 13, 8 and 13 eyes in the type of macular, vascular arcade, peripapillary and mixing zone PCV, which with logMAR VA of 0.78plusmn;0.43, 0.57plusmn;0.37, 0.38plusmn;0.27, 0.74plusmn;0.41 respectively. The VA of macular PCV patients was less than that in vascular arcade and peripapillary PCV patients (q=4.61,5.11;P＜0.05). There was no significant difference of VA between macula and mixing zone PCV patients (q=0.73,P＞0.05). Conclusions The VA of PCV patients is variable.It is related to activity and pathological characteristics of lesions, morphological characteristics and combination with BVN of lesions on ICGA, and distribution of lesions.
Purpose
To discuss changes of macular choriocapillaris hemodynamics in AMD.
Methods
Eighty-six eyes of 86 patients underwent ICGA,including macular drusen in 15 eyes of 15 patients,exudative AMD in 52 eyes of 52 patients,atrophic AMD in 19 eyes of 19 patients,for the observation of macular choriocapillaris perfusion.
Results
Choriocapillaris filling phase (CFP) of exudative AMD was obviously longer than that of eyes with normal, atrophic AMD and drusen groups (P＜0.05). Forty eyes had local or extensive choroidal filling deficiency and prolongation, including 24 eyes of exudative AMD, 12 eyes of atrophic AMD,and 4 eyes of drusen group.
Conclusion
CFP of macula is prolonged and choriocapillaris perfusion is abnormal in AMD and macular drusen eyes.
(Chin J Ocul Fundus Dis, 2002, 18: 116-118)
Purpose
Observation on changes of choroidal circulation in 21 cases (42 eyes) of retinal dystrophies.
Methods
Fundus fluorescein angiography (ICGA) were used for comparartive analyses of the retinal and choroidal blood circulation of 21 cases (42 eyes) of retinal dystrophic diseases.
Results
The changes of choroidal circulation,i.e.slow perfusion or filling defects were observed in four kinds of retinal dystrophies.
Conclusion
ICGA may assist in providing valuable informations on choroidal circulation of retinal dystrophic diseases.
(Chin J Ocul Fundus Dis,1998,14:88-91)
Objective
To investigate the value of indocyanine green angiography(ICGA) in evaluating circumscribed choroidal hemangiomas.
Methods
Color photography,funds fluorescein angiography(FFA) and (ICGA) were performed in 10 caese (10 eyes) of circumscribed choroidal hemangiomas.
Results
Among 10 affected eyes examined in this series,the tumors were better defined in this series,the FFA in 8 of them.ICGA showed the tumors were composed of irregular choroidal vasculature in earlyphase (1-5 seconds) of ICGA and quot;washed outquot; phenomenon in late phase of ICGA in all of 10 affected eyes.An adjacent disturbances of choroidal circulation in a sector downstream from the tumors in 9 eyes.
Conclusion
ICGA is useful in diagnosis and differential diagnosis of circumscribed choroidal hemanfiomas and helpful in the laser photocagulation treatment of the tumor.
(Chin J Ocul Fundus Dis,1998,14:81-83)
Purpose
To define the morphometric characteristic s and the implication of simultaneous fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) in traumatic choroidal rupture.
Methods
Simultaneous FFA and ICGA were carried out in 17 patient s (17 eyes) with traumatic choroidal rupture.
Results
Choroidal ruptures were shown as hyperfluorescence region in the early pha se of FFA,and as hyperfluorescence in the late phase of FFA but in ICGA were shown as hypofluorescence region in both early and late phases.The rupture regions in ICG A were longer than that in FFA in 5 patients (5 eyes).The rupture regions in 6 patients (6 eyes) with hemorrhage could be shown in ICGA,but couldn't be shown in FFA .
Conclusion
ICGA is helpful in diagnosing minor choroidal ruptures,in defining the extent of traumatic choroidal ruptures,and in further understanding the pathological changes of choroidal ruptures.
(Chin J Ocul Fundus Dis, 2001,17:30-32)
Objective To investigate the clinical features of polypoidal choroidal vasculopathy (PCV) in Chinese patients.Methods The clinical data of 71 continuous patients (142 eyes) who were diagnosed with PCV by fundus photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT) were analyzed retrospectively.Results Eleven patients (11 eyes) of 71 patients (142 eyes) were diagnosed with PCV to make up 15.49% and 7.75% of the numbers of patients and affected eyes respectivery. The patients included 7 males (63.6%)and 4 females (36.4%). The predominant location for these lesions was the macular region in 10 eyes (90.9%). Fundus examination demonstrated the reddish-orange nodular elevations in 6 eyes. ICGA revealed umbrellalike or twiglike branching vascular networks and polypoidal dilations at the vascular terminals of the branches in all patients, and feeder vassels within choroidal vascular networks were found in 8 eyes. OCT images of retinochoroidal structures showed prominent anterior protrusion of the orange subretinal mass corresponding to the polypoidal structure in the indocyanine green angiogram. An apparent discontinuity was observed in the highly reflective layer which delineates the polypoidal structure.Conclusions PCV mainly affects the male over 50 years and the eyes involved were mostly unilateral. Most of polypoidal vascular lesions are present in the macul ar area. (Chin J Ocul Fundus Dis，2003，19：269-332)
Objective
To investigate the cilinical value of indocyanine green angiography(ICGA) in patients with Vogt-Koyanagi-Harada syndrome(VKH).
Methods
Fundus fluorescein angiography(FFA) and indocyanine green angiography(ICGA) were used for comparative analyses in 26 cases(52 eyes)of VKH.
Results
In the acute stage of VKH,FFA revealed the multifocal leakage in the pigment epithelium and the multifocal serous retinal detachment,and the typical FFA manifestations disappeard following treatment．In the acute stage of the disease the ICGA showed:(1)numerous patchy areas of hypofluorescence and decreased flurescence in large and middle choroidal vessels(66.7%);(2)dilatation of the choroidal vessels(70.8%)and(3)in latephase of ICGA,the patchy areas of hyperfluorescence(79.2%).During the recovery stage of the disease,the abnormal undings in ICGA were resolved slower than those found in FFA.
Conclusions
ICGA may assist in providing valuable informations on choroidal circulation of VKH and be useful in evaluating the curative effects．
(Chin J Ocul Fundus Dis,20000,16:9-11)
Purpose
To investigate the clinical characteristics of the Stargardt is disease and to evaluate the value of the fundus fluorescein angiography (ICGA) in Stargardt is disease.
Methods
Routine eye examination,VEP,ERG,EOG,and perimetry were performed in 25 cases(30 eyes) of Stargardtprime;s disease (15 men and 10 women) aged 12-41,on an average of 23.FFA was done in 15 cases (30eyes),and ICGA was done in 10 cases (20 eyes).
Results
Visual acuity was below 0.1 for 90.0% of the cases.Every eye showed macular lesions that wrere horizontal ellipse in shape,1.3-3.2PD in horizontal diameter and tinged with metal or beated copper color.Fundus flavimaculatus was found in 84.0% of the cases.On fluorescein angiography,window defect hyperfluorescence was found in the macular lesion of ocular fundus,with typical quot;bullprime;s eyequot; pattern.A quot; dark choroidquot; was revealed in 91.70% of the whole cases.On indocyanine green angigraphy,hypofluorescent area appeared at the macula in the early phase,even in very early stage of the Stargardtprime;s disease.Areas of fundus flavimaculatus were also hypoflurescent that became more apparent in the later phase.
Conclusion
Fluorescein angiography combined with indocyanine green angiography was useful for studying the clinical features and the pathological mechnism of the Stargardtprime;s disease.
(Chin J Ocul Fundus Dis,1998,14:72-75)
Objective To compare the consistency and difference of optical coherence tomography angiography (OCTA) and traditional multimodal fundus imaging in the diagnosis and activity evaluation of choroidal neovascularization (CNV) in exudative age-related macular degeneration (AMD). Methods A total of 112 exudative AMD patients (130 eyes) were included in this retrospective study, 62 were men (71 eyes) and 50 were women (59 eyes). The mean age was (68.250±9.789) years (range 50 – 91 years). All patients were underwent traditional multimodal fundus imaging including fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and spectral domain optical coherence tomography (OCT); OCTA was performed at the same time. The CNV type was divided into active and non-active according to the results of traditional multimodal fundus imaging. The vascular pattern was divided into active and non-active according to the results of OCTA. Using traditional multimodal fundus imaging as the standard, the sensitivity and specialty of OCTA was evaluated. Results In 130 eyes, CNV was visualized on traditional multimodal fundus imaging in 109 eyes (83.8%); CNV was visualized on OCTA in 103 eyes (79.2%), which including 7 eyes of false negative and 1 eye of false positive. The sensitivity of OCTA for CNV diagnosis was 93.6%, with specificity of 95.2%. The CNV detection rate between two methods had no significant difference (Youden index=0.89,Kappa value=0.796,P=0.07). In 109 eyes diagnosed with CNV by traditional multimodal fundus imaging, 73 eyes (67.0%) were active CNV and 36 eyes (33.0%) were non-active CNV; the vascular pattern was active in 60 eyes (55.0%) and non-active in 49 eyes (45.0%). The sensitivity of OCTA for the detection of active CNV was 82.2%, with specificity of 100.0%. The active CNV detection rate between two methods had no significant difference (Youden index=0.82,Kappa value=0.753,P=0.00). Conclusion In the diagnosis and activity evaluation of CNV in exudative AMD, there is remarkable consistency between OCTA and traditional multimodal fundus imaging.
ObjectivesTo evaluate the effect of peeling of internal limiting membrane (ILM) on the postoperative visual acuity in patients with diabetic macular edema, and to detect the role indocyanine green (ICG) plays in the surgery of peeling of ILM. MethodsThirty patients (31 eyes) with diabetic retinopathy at proliferative stage with macular edema underwent vitrectomy. The patients were randomly divided into two groups: 16 eyes in group A underwent single vitrectomy with panretinal photocoagulation and ocular filling with 20% SF6; 15 eyes in group B underwent vitrectomy and peeling of ILM after the posterior pole was stained with ICG. All of the patients were asked to keep the posture of facing down for 10-14 days. The follow-up lasted 3-12 months.ResultsIn 16 eyes in group A, the visual acuity increase of 2 or more lines in 10 (62.5%) and alleviation of macular edema in 9 (56.2%) were found; the postoperative average macular retinal thickness examined by optic coherence tomography (OCT) was 393 μm. In 15 eyes in group B, the visual acuity increase of 2 or more lines in 14 (93.3%) and alleviation of macular edema in 14 (93.3%) were found; the postoperative average macular retinal thickness was 319 μm. The postoperative improvement of visual acuity in group B was much better than that in group A (X2=4.210, P=0.05), while the postoperative macular retinal thickness in group B was obviously lower than that in group A (P＜0.01). The operative sample was proved to be the ILM.
ConclusionsVitrectomy is effective for diabetic macular edema and the curative effect may be improved by peeling of ILM; ICG can dye ILM well, which ensures the safe and accurate peeling of ILM.(Chin J Ocul Fundus Dis, 2005,21:138-141)
