Objective To evaluate the therapeutic effect of vitrectomy on bullous retinal detachment. Methods The clinical data of 7 patients (9 eyes) with bullous retinal detachment who had undergone vitrectomy due to useless photocoagulation were retrospectively analyzed. Bullous retinal detachment of the patients had been diagnosed by examination of slit-lamp microscope, three-mirror gonioscope, indirect ophthalmoscope, B-mode ultrasound, and fundus fluorescein angiography. All of the affected eyes underwent vitrectomy with closed triple incisions through the pars plana after release of subretinal liquid under the local anaesthesia. The cortex of vitreous body was taken out, and exsuction of subretinal liquid was carried out via retinal incision. Photocoagulation closed the incision and the effusion area of the retina, and intraocular filling matter was injected after exchange of air and liquid. The follow-up period lasted 3 months to 8 years with the average period of 47 months. Results Reattached retina was found in all of the affected eyes during the follow-up period. One eye underwent a second vitrectomy due to local retinal redetachment caused by a new retinal hole formed by the pull of pre-retinal proliferative membrane and a silicon vesicle entered the subretinal space, but the retina reattached after 1-year follow-up examination. The visual acuity impr oved in different degree after the operation in 8 eyes, but remained unchanged in 1 eye. Conclusion Vitrectomy for terminal bullous retinal detachment may promote the reattachment of retina safely and effectively, and save partial visual acuity of the affected eyes. (Chin J Ocul Fundus Dis, 2006, 22:299-301)
Objective To investigate the clinical manifestation and histopathologic changes of the fungal necrotizing retinochoroiditis. Methods Collecting 7 cases of fungal retinochoroiditis with severe immunodepression and loss of visual acuity.Seven removed eyeballs were stained with HE,PAS and silver methenamine,and observed by light microscopy,and in addition,2 of them examined by electron microscopy.Also fungal cultures of blood and affected tissues were performed. Results The chief clinical macnifestation included ciliary injection of conjunctiva,opaque aqueous fluid and vitreous and diffuse hemorrhage and greyt white opacity with retinal detachment in severe cases.Pathologic changes included hemorrhage in the retina,chorioretinal tissue necrosis,hyphae in the blood vessels,affected tissue and vitreous.Fungal culture of blood was positive in three cases.Culture of affected tissues was positive in all cases. Conclusions Eedogenous fungal infection of choroid and retina may be due to the severe immunodepression of the sufferers and usually causes chorioretinal tissue destruction and blind. (Chin J Ocul Fundus Dis, 1999, 15: 235-237)
Objective To investigate the relationship between the level of testosterone and estradiol in serum and central serous chorioretinopathy (CSC).Methods The clinical data of 200 patients with active phase CSC who diagnosed by clinical manifestation, examination of fundus and fluorescence fundus angiography (FFA), were retrospectively analyzed. Two hundreds healthy people were collected as a control group. The blood of ulnar vein was collected and the method of magnetic homogeneous enzyme immunoassay was used to detect the level of testosterone and estradiol in serum of two groups. The results were analyzed statistically by t test.Results The values of testosterone and estradiol of male were all higher in CSC group than that in control group，the differences were statistical significance（t=2.804，2.913；P=0.010，0.008）；it was also higher in female（t=2.078，2.807；P=0.049，0.010）. The value of testosterone/estradiol of male was higher than that of female in CSC group，the difference was statistical significance(t=2.231，P=0.046).Conclusions The level of testosterone and estradiol in serum of CSC group increased obviously, especially the value of testosterone/estradiol. The increase of estradiol and testosterone/estradiol may be an etiological factor of CSC.
Objective To compare difference of the cross-sectional pathological imaging and quantitative measurement of central serous chorioretinopathy (CSC) between time- and fourier-domain optical coherence tomography (OCT). Methods Consecutive 26 patients (26 eyes) with unilaterial CSC were subsumed. Bilateral eyes of all the patients underwent time- and fourier-domain OCT. Horizontal and vertical line scanning and radial six-line scanning protocols were used for timedomain OCT examination; horizontal and vertical high resolution five-line scanning and macular cube scanning protocols were used for fourier-domain OCT examination. The characteristics of OCT images, retinal segmentation and the quantitative measurement were compared between these two methods. Results Fourier-domain OCT could yield the three-dimensional images of surface of inner limiting membrane (ILM) and RPE. The band of external limiting membrane (ELM) of normal subjects and CSC patients, and the inner segment and outer segment (IS/OS) of normal subjects could be clearly shown by fourier-domain OCT. However, the band of IS/OS disappeared in 65.4% of the CSC patients. The outer boundary of retina was defined in front of the retinal pigmental epithelia (RPE) by fourier-domain OCT. The foveal thickness of normal subjects and CSC patients was (180.50plusmn;12.69) and (158.41plusmn;34.20) mu;m, respevtively. The height of detachment of neural epithelial layer was (245.84plusmn;154.61) mu;m measured by fourier-domain OCT. The band of IS/OS of normal subjects could be clearly shown by time-domain OCT. However, the band of IS/OS disappeared in 73.4% of the CSC patients, which showed no difference with fourier-domain OCT (Z=-0.108, P=0.914). The outer boundary of retina was defined in front of the IS/OS band by OCT. The foveal thickness of normal subjects was (141.16plusmn;12.75) mu;m, which was thinner than that measured by fourier-domain OCT (t=20.671，P=0.000). The foveal thickness and the height of detachment of neural epithelial layer was (146.40plusmn;36.28) mu;m and (240.32plusmn;156.82) mu;m measured by time-domain OCT, respectively, which showed no significant difference with which measured by fourier-domain OCT (t value was from 0.026 to 1.517, P value was from 0.144 to 0.980). Conclusions Fourier-domain OCT yields better visualization of intraretinal layers and more accurate definition of outer boundary of retina than time-domain OCT. Thus the measurements by fourier-domain OCT were more accurate. Moreover, three-dimensional images of CSC shown by fourier-domain OCT enable the comprehensive observation of pathological morphology and location.
Objective To observe the findings of indocyanine green angiography(ICGA) and fundus fluorescein angiography (FFA) of the patients with multifocal posterior pigment epitheliopathy(MPPE). Methods ICGA and FFA were performed in 6 cases(7 eyes)of MPPE and the findings were analysed and compared between these examinations. Results Five cases(5 eyes)were found to be in the active stage of the disease under FFA,and among them 4 eyes(80%)showed delayed choroidal perfusion at the early stage of ICGA.During the active stage of the disease,ICGA showed leakage relative to FFA leakage,and there were diffuse hyperfluorescence around the points of leakages as well as in the posterior pole of ocular fundus．In convulescence,although FFA revealed no obvious leakage,ICGA still denoted the presence of leakages. Conclusions MPPE was considered to be the more serious type of central serous chorioretinopathy showing the same but more extensive ICGA abnormality. (Chin J Ocul Fundus Dis,2000，16：6-8)
Objective To analyze the etiology of central exudative chorioretinopathy（CEC）. Methods A total of 32 CEC patients were asked the medical history, and underwent examination of purified protein derivative（PPD）test, chest Xray, blood routine test, Creactive protein, erythrocyte sedimentation rate, TORCH test and rapid plasma regain cirde card test, to determine the possible causes of CEC. Results Thirty-two patients didnprime;t have the history of tuberculosis, and no evidence of systemic active tuberculosis was found in the chest X-ray examination. the results of PPD test showed the positive rate was 37.5％. The disease condition of paitents with positive result of PPD test was stable or was alleviated after anti-tuberculosis therapy. All the results in IgM of TORCH test and rapid plasma regain cirde card test were negative. Conclusion No infectious factors related to CEC was found, thus choroidal neovascularization of CEC might be idiopathic.
Objective To investigate the effects and the safety of compound anisodine injection on treatment of primary and secondary ischemic optic neuropathy and choroidoretinopathy. Methods A multicentered,random,controlled study was applied on 403 patients,including 217 patients of primary ischemic optic neuropathy and choroidoretinopathy,and 186 patients of secondary ischemic optic neuropathy and choroidoretinopathy.All the patients were assigned into 3 groups randomly:112 patients in control group and treatment group respectively,179 patients in open group.Compound anisodine 2 ml was injected subcutaneously around superficial temporal artery to the patient in treatment and open group once every day,while tolazoline 25 mg was given in the same way to the patient in control group for 21 days.Visual acuity,visual field and fundus condition are examined to evaluate the effects of treatment,and intraocular pressure,blood pressure,electrocardiography,blood and urine routine examination,blood test for renal and liver function are taken to study the safety of the treatment.The main subjects of the control and treatment group before treatment were comparable (Pgt;0.05) Results The difference of effective rate between treatment group (82.14%) and control group (36.61%) was significant (chi;2=48.14,P=0.0000).The effective rate of open group is 80.45%.The effects on both primary and secondary patients in treatment group (87.04% and 77.59%) were better than those in control group (35.19% and 37.93%),and the difference was significant (P=0.0000) .The difference of the results in different centers was not significant according to Ridit analysis.There was few side effect except temporary dry mouth in some patients and the parameters of safety had no significant change before and after treatment. Conclusion Compound anisodine is a safe and effective drug to treat primary and secondary ischemic optic neuropathy and choroidoretinopathy. (Chin J Ocul Fundus Dis,2000,16:71-74)
Objective To evaluate the clinical features and treatment outcomes of ocular posterior segment syphilis. Methods The clinical data of 24 patients with active ocular syphilis were retrospectively reviewed. The diagnosis was made first in eye clinic，and verified by treponema pallidum particle agglutination (TPPA) and rapid plasma reagin (RPR). The patients, 17 males and 7 females, aged from 30 to 63 years with an average of 47.6 years. The duration of symptoms ranged from 3 days to 2 years with an average of 5.8 months (le;1 month, 7 cases; 1-3 month, 5 cases; 3-6 months, 5 cases; ＞6 months, 7 cases). There were 18 bilateral cases and 6 unilateral cases. The result of human immunodeficiency virus (HIV) test was negative for all cases. Twenty-three patients received systemic penicillin therapy and 1 patient was treated with oral erythromycin due to penicillin allergy. Before treatment, the mean visual acuity was 0.17plusmn;0.19，the mean titer of RPR was 1:84。The follow-up period was half a year. Results The major ocular manifestations included bilateral (16 cases) or unilateral (1 case) chorioretinitis, unilateral retinal vasculitis (2 cases), unilateral neuroretinitis (2 cases), and bilateral (2 cases) or unilateral (1 case) optic neuritis. The mean follow-up visual acuity was 0.60plusmn;0.29，the mean follow-up titer of RPR was1:18.8. Some patients had got the diagnosis and prompt treatment at the early stage of the disease and their visual acuity recoveried very well. Conclusions The major manifestion of ocular posterior segment syphilis is chorioretinitis. It is important to consider the possibility of syphilis when patients have inflammation of posterior segment. Prompt serology examination and penicillin treatment are the keys to cure ocular syphilis.