Objective To observe the characteristics of indocyanine green angiography and fundus fluorescein angiography (ICGA amp; FFA) in anterior ischemic optic neuropathy ( AION ) , and to investigate the etiology of AION and the value of ICGA and FFA in the diagnosis and study of AION. Methods Simultaneous ICGA and FFA were performed on 32 eyes of 31 AION patients and 38 eyes of 38 non-AION patients. Results The eyes that all or a part of the optic disclies in the watershed zon es of the choroidal blood supply were significantly more in the AION group tha n those in the non-AION group (Plt; 0.005 ) . All the watershed zones through the optic disc were vertical in shape. The fluorescence filling of the inferior and superior choroidal blood vessels near the optic disc were all slower than that of the temporal and nasal choroidal blood vessels. The types of watershed zones in the AION group were highly correspondent to the ischemic areas of the optic disc . In early ICGA , no fluorescence appeared at the optic disc, and in later stage, the ischemic area revealed no fluorescence, and the other area showed mostly asymmetric fluorescence. Conclusion The onset of AION is correlative to the choroidal blood supply around the optic disc. ICGA is more valuable in the diagnosis and study of AION than FFA . (Chin J Ocul Fundus Dis, 2001,17:111-114)
Optical coherence tomography (OCT) can depict mild papilledema and slight changes in the internal segment and external segment; measure thickness of the retinal nerve fiber layer, retinal thickness and macular volume; detect missing axons and damage to the macular ganglion cell complex. Thus, OCT has important application values and widespread prospects in diagnosis and differential diagnosis of glaucoma and nonglaucoma optic neuropathy, optic nerve diseases and macular diseases, outer and inner retinopathy as well as evaluation of curative effects, followup observation, prognosis and mechanisms in neuroophthalmological diseases. Neuro-ophthalmologists should pay more attention to the exploration and application of OCT in the field of neuro-ophthalmology.
ObjectiveTo observe the fundus fluorescein angiography (FFA) manifestations of pediatric morning glory syndrome (MGS) patients. MethodsFourteen eyes diagnosed as MGS of 14 patients were studied. Among the 14 cases, there were 7 male and 7 female patients. At the time of FFA, the mean age of the patients was (38.75±33.91) months old, ranging from 5.5 to 128.0 months. Among the 14 eyes, four (28.57%) were associated with persistent hyperplastic primary vitreous; four (28.57%) were associated with retinal detachment with no retinal breaks, and one (7.14%) was associated with peripapillary subretinal exudation. All patients underwent peripapillary laser photocoagulation under general anesthesia first and then FFA with the third generation of wide-angle digital retinal imaging system. The arm-retinal circulation time (A-RCT), numbers of blood vessels on the edges of optic disc of the MGS eyes and the contralateral healthy eyes, retinal vascular morphology, the peripheral avascular area, neovascularization, retinal detachment and other abnormalities were documented. The horizontal and vertical diameters of the optic disc of the affected eyes and the contralateral healthy eyes were measured. To compare the A-RCT, 16 children with normal FFA were selected as control group. ResultsThe diameters of the vertical and horizontal axis of the affected eyes were as (2.56±0.58) and (2.73±0.60) times of the contralateral healthy eyes respectively. The average A-RCT of the affected eyes and eyes of the control group were (13.25±4.10) and (9.34±2.20) s respectively. The affected eyes had significantly prolonged A-RCT. At early stage, the optic disc and peripapillary areas showed hypo-fluorescence, while the irregular retinochoroidal atrophy area outside of the optic disk manifested as hyper-fluorescence ring. At late stage, optic disc showed hyper-fluorescence. Numbers of blood vessels on the edge of the optic disc of the affected eyes and contralateral healthy eyes were 30.27±4.86 and 15.83±1.95 respectively, the affected eyes had much more vessels than the contralateral healthy eyes. All affected eyes had peripheral retinal non-perfusion areas. ConclusionFFA examination showed prolonged A-RCT and peripheral retinal non-perfusion areas in the affected MGS eyes.
Objective To observe the characteristics of changes of 24hour ambulatory blood pressure and heart rate of 50 patients with anterior ischemic optic neuropathy (AION). Methods Fifty patients with AION and the persons without in the control group, which had the same number, gender and age as the patients with AION, underwent 24-hour ambulatory blood pressure and heart rate measurement. Results Both groups had no difference in mean blood pressure and heart rate during the daytime (t=1.25,0.93; P＞0.05), higher than those in the nighttime (t=3.63,3.16; P＜0.05). Mean blood pressure and heart rate of AION group at night were lower than those of the control group (t=3.82,1.77; P＜0.01,0.05), especially diastolic pressure of AION group was lower than that of the control group from 2 am to 7 am (P＜0.01), as well as the heart rate from 2 am to 5 am (P＜0.05 or P＜0.01). The curves of blood pressure of AION group showed more gradual and fluctuant rising, while those of the control group showed sharper and less fluctuant rising. Conclusion According to the curves of blood pressure rising, the patients with AION may have some defects in auto-regulatory mechanism of blood pressure. The low spots of blood pressure and heart rate in early morning, which might be a critical point leading to AION. (Chin J Ocul Fundus Dis, 2002, 18: 259-261)
Objective To observe the characteristics of pupillary light reflex in the patients with retrobulbar neuritis, and to evaluate the effects of pupi llary light reflex on the diagnosis and treatment of retrobulbar neuritis. Methods Thirtyfive patients (thirtyfive eyes with the retrobulbar neuritis and thirtyfive fellow eyes) aged from 10 to 58 years and 50 healthy individuals (100 eyes) who didnlsquo;t differ from the patients in age and sex were examined by a automatic pupillometer. The pupillary area and response amplitude, latency and speed of papillary reflex were recorded. Results The latency of the pupillary light reflex delayed and the maximum amplitude decreased in patients with retrobulbar neuritis during the diseas eperiod, and the differences were highly significant compaired with the control group. After the treatment, as the symptoms were alleviated and the visual acuity improved, the latency of the pupillary light reflex and the maximum amplitude recovered. The statistic differences were both found between the results after treatment and those at the onset stage, and the results after treatment and those in the control group.Before the onset of the disease of the involued eyes and after the treatment, the papill ary light reflex and the maxium amplitude decreased, but didnamp;#146;t differe much from which in the control group. Conclusions The latency of the pupillary light reflex delayes and the maximum amplitude decreases in patients with retrobulbar neuritis. The examination of pupillary light reflex is helpful to diagnose retrobulbar neuritis early and inspect the condition of the disease. (Chin J Ocul Fundus Dis,2006,22:370-372)