ObjectiveTo observe the application value of RetCam Ⅲ in the diagnosis of retinoblastoma (RB). MethodsThe clinical data of 125 eyes from 94 patients with RB were retrospectively analyzed. According to the International Intraocular Retinoblastoma Classification, the results of binocular indirect ophthalmoscope and RetCam Ⅲ was compared. The consistency between RetCam Ⅲ and binocular indirect ophthalmoscope was analyzed by Kappa test. The detectable rates of tumor between binocular indirect ophthalmoscope, RetCam Ⅲand B scan ultrasound were comparatively analyzed. ResultsBy binocular indirect ophthalmoscope, there were 18 eyes (14.4%) in stage A, 15 eyes (12.0%) in stage B, 10 eyes (8.0%) in stage C, 28 eyes (22.4%) in stage D, and 54 eyes (43.2%) in stage E. Using RetCam Ⅲ, the classification was 18 eyes (14.4%) in stage A, 16 eyes (12.8%) in stage B, 11 eyes (8.8%) in stage C, 27 eyes (21.6%) in stage D, and 53 eyes (42.4%) in stage E. The RB classification of RetCam Ⅲ was quite consistent with binocular indirect ophthalmoscope (Weighted Kappa Coefficient=0.979 8, 95% confidence interval=0.960 1-0.999 5). A total of 150 tumors from stage A-D were observed by binocular indirect ophthalmoscope. In which, 147 tumors (98.0%) were found by RetCam Ⅲ, 122 tumors (81.3%) were found by B scan ultrasound. No serious complication was found in these patients. ConclusionsRetCam Ⅲ can detect RB of different stage in clinic. It is quite consistent with binocular indirect ophthalmoscope.
Diabetic retinopathy (DR) is one of the most common causes of visual impairment and blindness in diabetic patients. It is particularly important to set up simpler, safer, non-invasive and highly effective methods for diagnosis as well as monitoring DR. A variety of new fundus imaging techniques show great advantages in early diagnosis, treatment and monitoring of DR in recent years. The main characteristics of wide-field scanning laser imaging system is achieving a large range of retinal image in a single photograph and without mydriasis. It provides several options for color images, FFA and FAF, which satisfy to detect the retina, choroid and vascular structure. Multi spectral fundus imaging system is suitable for DR screening, because it is able to recognize the typical characteristics of DR, such as microaneurysms, hemorrhage and exudation, and is non-invasive and convenient. OCT angiography is a quantitative examination that provides foveal avascular zone area, macular blood flow density, which provides strong evidence for DR diagnosis. The improvement of these new techniques will help us to build up a personalized evaluation system of DR.
Objective To investigate the feasibility and clinical significance of monitoring diabetic macular edema by Heidelberg retina tomograph Ⅱ (HRT). Methods The diabetic macular edema (DME) was diagnosed by slit-lamp microscopy combined with three-mirror contact lens examination and fundus fluorescein angiography (FFA). The exponential of macular edema (e value) of healthy people and patients with DME or without DME (NDME) (the total number is 77 individuals and 120 eyes) were detected by HRT Ⅱ. All of the 77 people were divided into three groups. In DME group, there were 23 patients (40 eyes), including 13 males (23 eyes) and 10 females (17 eyes), at the age of 44-68 (average of 55.17plusmn;8.26). In NDME group, there were 32 patients (40 eyes), including 18 males (22 eyes) and 14 females (18 eyes), at the age of 44-68 (average of 55.17plusmn;6.5). In normal control group, there were 22 patients (40 eyes), including 10 males (19 eyes) and 12 females (21 eyes), at the age of 42-65 (average of 53.32plusmn;6.04). According to the results of FFA, the 40 eyes in DME group were divided into: grade 1 of FFA in 9 eyes, with macular suspicious leakage or the area of leakage of lt;25%; grade 2 of FFA in 10 eyes, with the area of leakage between 25% and 66%; grade 3 of FFA in 21 eyes, with the area of leakage of gt;66%. The differences of sex and age among the 3 groups were not significant (Pgt;0.05). The relationship among e value, leakage area, and visual acuity was observed. Results There was a significant difference of e value (the macular diameter was 1, 2, and 3 mm) among the 3 groups(Plt;0.05). The e value in normal control group didnrsquo;t differ much from which in NDME group (Pgt;0.05), but was statistically different from which in DME group (Plt;0.05). Significant difference of e value was also found between NDME group and DME group (Plt;0.05). There was a correlation between visual acuity and e value in DME group (Plt;0.05). In DME group, the difference of e value among FFA grade 1, 2, and 3 groups was found according to the variance analysis; the macular leakage area in FFA grade 3 group differed much from which in grade 1 (Plt;0.05) and grade 2 group (Plt;0.05), while no significant difference was found between grade 1 and grade 2 group. The result was not correlated with the macular diameter. Conclusion E value in the macular module of HRT Ⅱ can detect and evaluate the degree of DME. (Chin J Ocul Fundus Dis,2007,23:252-255)
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.
With the renovations of modern retinal imaging modality, such as video ophthalmoscopy, fundus photography, fundus fluorescein angiograph and spectral domain optical coherence tomography, it is possible to get high resolution and reproducible in vivo imaging of retina from neonates to improve the diagnosis and treatment of pediatric retinal disease. Now we have a better tool to investigate the early development of human retina, the pathogenesis and progression of pediatric retinal diseases, and to monitor the treatment efficacy and prognosis of these diseases. To expand these technologies in the diagnosis and treatment of pediatric retinal disease, we need simple, safe, comprehensive and objective applications which can only be achieved through multi-disciplinary cooperation.
ObjectiveTo compare the imaging characteristics and detection of various types of lesions in diabetic retinopathy (DR) with colorful laser scanning fundus imaging (MSLI) and traditional color fundus photography (CFP).MethodsProspective case series observational study. A total of 38 eyes of 38 patients with DR diagnosed by clinical examination were included in the study. Among them, 21 were male and 17 were female; the mean age was 62.6±11.2 years; the average duration of diabetes was 14.3±7.5 years. All the patients were performed CFP, MSLI, frequency domain optical coherence tomography (SD-OCT), fluorescein angiography (FFA) examination. Using the Helielberg Spectralis HRA+OCT MSLI inspection, one scan simultaneously obtained 488 nm blue reflection (BR), 515 nm green light reflection (GR), 820 nm infrared light reflection (IR), and multicolor image (MC). The detection of traditional CFP and MC on microaneurysm (MA), hard exudation (HEX), cotton plaque (CWS), intraretinal hemorrhage (IRH), intraretinal microvascular abnormality (IRMA), venous bead (VB), venous ring (VL), macular edema (DME), macular anterior membrane (MEM) and laser photocoagulation (LB) were comparatively observed. The results of FFA examination were used as the diagnostic criteria for lesions. SD-OCT was used to determine the location and depth of lesions and the diagnostic reference for DME and MEM.ResultsThe numbers of eyes with MA (χ2=10.460), DME (χ2=4.006), MEM (χ2=4.444) was significantly higher in MC than that of traditional CFP. But the number of eyes with IRH (χ2=0.103), CWS (χ2=1.515), HEX (χ2=0.227), IRMA (χ2=0.051), VB (χ2=0.001), VL (χ2=0.149), VH (χ2=0.693) and LB (χ2=0.720) were not statistically significant between two methods (P>0.05). The imaging quality of MSLI mode is obviously better than that of traditional CFP. Among them, GR imaging shows the best structural changes of superficial retina in MA, CWS, HEX, MEM, etc. IR imaging shows clear depth in deep retina such as LB. DME was green on MC and the weak low-reflection dark area was visible on the IR image, which were consistent with the DME range indicated by the SD-OCT examination.ConclusionsCompared with the traditional CFP, the MSLI can clearly show the DR lesion. The number of checkouts is high on MA, DME and MEM by MC image.
Objective To observe the characteristics of images of ocular fundus obtained by computer-assisted imaging system of binocular indirect ophthalmosco p y (CABIO) in the healthy premature infants and the ones with retinopathy of prem aturity(ROP), and evaluate the value of the clinical practice of CABIO in ROP s creening. Methods From January, 2006 to December, 2006, we exa mined 150 prematur e infants in ROP screening procedure by using the computerassisted imaging sys t em of binocular indirect ophthalmoscope, beginning at the infantsprime;age of postn a tal 4-6 weeks or the corrected age above 32 weeks. The follow-up duration was co nfirmed according to the first examination results. The procedure of the operati on was recorded and the typical pictures were shot to obtain the images of the o cular fundus of the healthy premature infants and the ones with ROP. The charact eristics of the images were retrospectively analyzed and compared. Resu lts The typical images of normal ocular fundus and that with ROP in the 150 premature i nfants were successfully obtained by indirect ophthalmoscope. In normal fundus o f infants, the color of optic disc was pale, peripheral retina was not completel y vascularized and presented gray-tone in color;while all stages of ROP present ed dif ferent appearances under the indirect ophthalmoscope. Conclusions Computer-ass isted imaging system of the binocular indirect ophthalmoscopy can clearly observ e the characteristics of normal ocular fundus of premature infants and the ocula r fundus with ROP, and can save the objective examination results, which may pro vide significant references in screening and treating ROP.