Objective To observe the location of the watershed zones of the choroidal blood supply relative to the optic disc in glaucoma by indocyan ine green angiography, and to investigate the mechanisms in the development of glaucomatous neuropathy. Method Simultaneous ICGA and FFA were performed on 31 eyes of 31 patients with glaucoma (17 of POAG, 14 of NTG) and 37 eyes of 37 control subjects. The watershed zones were classified into three types according to their location relative to the optic disc: by type I, no water shedzone around the optic disc; type II, the optic disc surrounded partially by watershed zone; type III, the optic disc surrounded completely by watershed zone. Each of the watershed zone types was scored (i.e., type I=1, type II=2, type III=3). Results In 87.1% of the glaucomatous eyes , the watershed zones included or partially included the optic disc. However, the figure in the control group was 56.8%. The glaucoma group had a higher score of watershed zone type than the control group. Conclusions The mechanisms in the development of glaucomatous neuropathy are correlative to the choroidal blood supply around the optic disc. (Chin J Ocul Fundus Dis，2004，20：218-220)
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 study the characteristics of choroidal circulation in RP. Methods Using ICGA to obse rve 37 cases of RP and compare with healthy volunteers. Results ① The earliest fluorescein filling time of the choroidal arteries in RP group was (14.38plusmn;3.95) seconds,the choroidal veinous in RP group was (17.27plusmn;5.94) seconds,and there was no obvious difference between RP and control group.②The fluorescein failing time of choroidal vein in RP group was (475.75 plusmn;153.70)seconds.③The area of the bright fluorenscence in posterior fundus in RP group was (41.20plusmn;19.99) mm2,and compared with the control group,there was significant difference (P＜0.0001). ④In the mid to late phase during ICGA，in RP group the veillike hypofluorescence was found in 61 e yes (84.7%),plaque hyperfluorescence in posterior fundus in 21 eyes (29.2%),and leakage of heperfluorescence in 4 eyes(5.6%). Conclusion ①The perfusion pressure of choroidal vessels in RP reveals no c hange.②The blood volume of choroidal vessels becomes decreased in RP.③The choroidal capillaries become atrophic in RP.④Choroidal neovascularization may occur in patients with RP. (Chin J Ocul Fundus Dis, 2001,17:26-29)
Objective To observe and analyze the configuration and distribution of vortex veins by indocyanine green angiography (ICGA) combining with widefield contact lens system. Methods A total of 28 patients (32 eyes), including 16 females (19 eyes) and 12 males (13 eyes) with the age of 28-84 (average 71), were examined by ICGA combing with widefield contact lens. The patients were divided into high myopia group (15 eyes with diopter ge;-6.0 D) and non high myopia group (17 eyes with diopter lt;-6.0 D or normal sight). Results A total of 166 vortex veins were detected, including 118 circinate veins (71.1%), 34 thick-stripe-like veins (20.5%), and 14 irregular vein (8.4%). There are 71 vortex veins in the right eyes with average 5.07 vortex veins in each eye; and 95 veins in the left eyes with average 5.28 vortex veins in each eye. The number of vortex veins at in the inferior temporal, inferior-nasal, over-temporal and over-nasal retina was 47, 42, 39, and 38, respectively, with average 1.34 vortex veins in each quadrant (the inferiortemporal was the most: average 1.53). A total of 160 vortex veins came out from the scleral around the equator area 46 disc diameter (DD) away from the optic disc (964%); the other 6 vortex veins came out at the point 3-4 DD away from the optic disc (3.6%). A total of 123 (74.1%) vortex veins had ampullae with different directions. Horizontal and vertical ampullae were most common. There was no difference in numbers and configuration of vortex veins beween the two groups. Conclusion The vortex veins has circinate, thick-stripe-like, and irregular configurations; the distribution of vortex veins in eyes with high myopia or non high myopia is almost accordant. ICGA combining with the wide-field contact lens examination can observe all of the vortex veins within a single visual field.
Objective To observe the characteristics of indocyanine green angiography in exudative age-related macular degeneration. Methods Thirty one cases(36 eyes)were diagnosed as exudative age-related macular degeneration by ocular examination,fundus color photography,fundus fluorescein angiography(FFA)and indocyanine green angiography(ICGA).Their ages ranged from 50 to 82 years.The visual acuities were FC/30cm before eye to 0.7.We analyzed and compared the characteristics of ICGA and FFA in these patients. Results Of 26 eyes with occult choroidal neovascularization(CNV)by FFA,15(57.7%)had classic CNV.Of 4 eyes with serous retinal pigment epithelial detachment(PED)without CNV by FFA,l had serous PED with classic CNV.The hyperfluorescence of the scar stain was defected by ICGA. Conclusion ICGA adds clinically useful information and is important in laser treatment of patients with occult CNV in AMD. (Chin J Ocul Fundus Dis,1998,14:76-80)
Purpose To investigate the clinical features and pathogenesis of acute posterior multifocal placoid pigment epitheliopathy(APMPPE). Methods To observe the features in 8 eyes of 6 cases of APMPPE with fundus fluorescein angiography(FFA) and indocyanine green angiography(ICGA).One of the cases had been observed continuously for 160 days. Results 1.FFA: at the acute stage of APMPPE,the affected foci showed low fluorescence in the early phase and stained gradually in 3 eyes;the fluorescence of recessive foci were still lower in 4 eyes,and the stale one showed window defect fluorescence due to some RPE fading and fluorescence sheltering due to pigment deposit.2.ICGA:at acuted stage,the fluorescence of choroid lobules was ofen defected untill in late period of pathogenical changes. Conclusion The findings demonstrate the obstruction of choriocapillaries may be the primary pathogenesis of APMPPE. (Chin J Ocul Fundus Dis,1998,14:84-87)
Using optical imaging equipment with different wavelength and computer technology, fundus optical imaging diagnostic techniques can record fundus reflected light, auto fluorescence and emitted light after excitation by external light source in order to observe and analyze the structure and pathological process of retina and choroid. Advances in fundus optical image capture technology (including laser, confocal laser, spontaneous auto-fluorescence, multispectral imaging) and storage and analysis technology, promote this field into a high-definition digital imaging era, with features of rapid, non-invasive, wide-angle three-dimensional multi-level integration, dynamic automatic navigation location tracking and combined application of a variety of optical imaging diagnostic techniques. In order to promote clinical and scientific research of ocular fundus diseases, we need to understand the development trend of optical imaging diagnostic technique, interpret the fundus imaging features appropriately, reasonably chose different inspection techniques, establish standardized diagnosis criteria and continue to expand clinical applications.
ObjectiveTo observe the characteristics of indocyanine green angiography (ICGA) and optical coherence tomography angiography (OCTA) in polypoidal choroidal vasculopathy (PCV). Methods17 patients (17 eyes) with PCV referred to Peking Union Medical College Hospital from November 2014 to February 2015 were included in this cross-sectional study. There were 9 males (9 eyes) and 8 females (8 eyes), aged from 55 to 79 years, with the mean of (68.24±6.80) years. There were 10 right eyes and 7 left eyes. All patients were examined by fundus fluorescein angiography combined with ICGA, and OCTA was performed within 1 hour. ResultsICGA showed 5 eyes with branching vascular network (BVN), 7 eyes with polyps, only 1 eye with both BVN and polyps. 4 eyes showed no positive findings, 3 of them with large hemorrhage. 5 eyes with BVN shared the similar location and range of the lesions in ICGA and OCTA. 7 eyes with polyps showed hot spot in OCTA, 5 of them shared the similar lesions with ICGA, the other 2 eyes showed slightly different in ICGA and OCTA. 1 eye showed both BVN and polyps, OCTA and ICGA were consistent for this. In the 3 eyes with large hemorrhage, 2 of them showed hot spot below pigment epithelial detachment, 1 eye show no positive findings in both ICGA and OCTA. ConclusionsPCV patients with BVN shared similar findings in ICGA and OCTA, PCV patients with polyps showed highlight spot in OCTA. OCTA can visualize BNV and polyps of choroidal capillary, and it can showed the similar site and range of lesions in ICGA.
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)