Objective To observe the clinical manifestations and feat ures of fundus fluorescein angiograms(FFA)of patients with multifocal choroiditis (MFC)MethodThe data of 8 patients who had been diagnosed by clinic and FFA as with MFC were collected, and their clinical manifestatio ns and results of FFA were analyzed and valued.ResultsThe age of the 7 female and 1 male patients ranged from 16 to 32, and all of the 8 patients had high myopia (from -6.00 D to -8.00 D) with binocular multiple small yellowish white lesions in posterior pole of the fundus and a few phlogistic ce lls in vitreous body. In addition, macular choroidal neovascularization membrane (CNV) was found in 6 patients, binocular in 2 and monocular in 4. The results of FFA in 7 patients showed hypofluorescence of the yellowish white lesions at t he early phase and pigmentation at the late phase; Corresponding manifestations of FFA could be found in the patients attended by CNV surrounded by leakage.ConclusionMFC are mostly diagnosed in young females with myopia. Most of the patients had binocular affection with multiple small yellowish white lesions at the posterior pole, whose FFA shows hypofluoresence of the active lesions at the early phase and pigmentation at the late phase. CNV may occur in patients with MFC.(Chin J Ocul Fundus Dis，2004，20：335－338)
Objective To investigate the clinical features of multifocal choroiditis (MC) and guide the diagnosis and treatment. Methods Retrospective analysis of clinical data of 18 MC cases (28 eyes) who were diagnosed through fluorescein angiography (FFA) or indocyanine green angiography (ICGA) and fundus characteristics. Results Multiple round to oval lesions scattered throughout the posterior pole and peripheral areas of ocular fundi of all of the 28 eyes(binocular in 10 and monocular in 8) were found. Active focal lesions of ocular fundi were seen in 8 patients and inactive lesions in 10 patients. active and 10 cases were inactive. Choroidal neovascularization(CNV) in macular area was found in 7 patients. The images of FFA of the legions showed hypofluorescence in the early phase, with late leakage and gradual staining or window is defect in the late phase. Conclusions MC is a rare disease and often misdiagnosed to other disease and FFA helpful in diagnosis. (Chin J Ocul Fundus Dis, 2005, 21: 367-370)
ObjectiveTo analysis the fundus characteristics of fundus fluorescein angiography (FFA) of retinopathy of prematurity (ROP). MethodsEighty-four cases (168 eyes) who were diagnosed with ROP by a binocular indirect ophthalmoscope were included in the study. Among the 84 cases, there were 2 cases (4 eyes) of stage 1 ROP, 26 cases (52 eyes) of stage 2 ROP, 40 cases (80 eyes) of stage 3 ROP, 4 cases (8 eyes) of stage 4 ROP, and 4 cases (8 eyes) of stage 5 ROP, 9 cases (18 eyes) of plus disease, 8 cases (16 eyes) of aggressive posterior ROP (APROP). All infants received FFA with RetCam Ⅱ under general anesthesia and mydriasis. The retinal vein morphology, capillary filling state, neovascularization morphology and fluorescein leakage were observed. ResultsFFA revealed increased branching, expansion and tortuous peripheral retinal capillaries, increased capillary permeability with a small amount of fluorescein leakage in stage 1 ROP. There was a clear dividing line between the vascular area and the remote avascular area. In stage 2, the peripheral branches of temporal retinal blood vessels increased, and parallel distributed like a broom. The capillary end anastomosed with each other to form a loop. The fibrous tissues at the lesion edge proliferated as a ridge, with popcorn phenomenon. In stage 3, the ridge continued broadening, and the neovascular fibrous membrane formed breakthrough internal limiting membrane, stretched into the vitreous with a lot of fluorescein leakage. The ridge and remote avascular zone demarcated clearly. In stage 4 and 5, the vessel changes had similar phenomenon with the stage 2 and 3 in undetached retina, but the vessels in the detached retina expanded with fluorescein leakage. As for plus disease, the retinal arterioles in the posterior pole were tortuous, there were a large number of non-perfusion area in the peripheral retina with hemorrhage and obscured fluorescence. The retinal vessels in posterior pole in AP-ROP were also tortuous, and the capillaries were extreme expanded, while there were very few tortuous vessels and no capillary formation in the other part of retina.At the avascular zone boundaries, there were a large group of neovascularization with fluorescein leakage. ConclusionsThe demarcation line separating the avascular from the vascularized retinal regions is formed in stage 1, 2 and 3, and the amount of fluorescein leakage gradually increase from stage 1 to stage 3 ROP. The detached retina of stage 4 and stage 5 has an unclear focal length in the FFA. The plus disease mainly has arteriolar tortuosity in the posterior pole retina. In the AP-ROP cases, both of the arterioles and venules in posterior pole of retina are tortuous and expanding with neovascularization leakage of fluorescein.
Objective To investigate the clinical features, etiological classification and staging of epiretinal macular membrane(MEM)． Methods Clinical materials of 194 cases of MEM diagnosed by fundus fluorescein angiography in outpatient department of eye clinic in this hospital from 1983 to 2000 were retrospectively analyzed． Results There were typical clinical symptoms and signs of MEM in all of this 222 eyes of 194 patients． Etiological classification revealed that 4 cases were congenital(2．12%), 22 cases were secondary(11．34%), and 168 cases were idio pathic(86．60%)． Staging of course of disease indicated that 119 eyes were in early stage(53．60%), 72 eyes were in middle stage(32．43%), and 31 eyes were in late stage(13．96%)． Conclusion MEM may be classified as congenital, secondary and idiopathic type according to its pathogenesis , as early, middle and late stage according to the clinical course of disease．This can be helpful in treating the disease． (Chin J Ocul Fundus Dis, 2001,17:210-213)
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.
Objective To observe and analysis the features of images of fundus fluorescein angriography (FFA) in low-perfused retinopathy caused by cephalo-cervical peripheral vascular stenosis or occlusion. Methods The results of FFA of 27 patients diagnosed with carotid artery stenosis or occlusion by digital subtraction angiography (DSA) and examination of Doppler and vascular-pulsation were retrospectively analyzed. Result All of the patients had a delayed arm-retinal circulation duration from 20.0 to 81.08 seconds with the mean of 32.1 seconds; a delayed retinal arteriovenous filling duration from 6 to 64.0 seconds with the mean of 24.2 seconds. Delayed arm-retinal circulation duration and retinal a rteriovenous filling duration in 10 cases (37.0%); microangioma, vascular wall staining, nonperfused capillary area in 11 (40.7%); and anterior ischemic syndrome in 6 (22.2%) were found. In the 6 patients with anterior ischemic syndrome, 4 cases had narrow retinal artery, segmental changes of blood stream, vascular atresia, and abnormal arterio-venous anastomosis, and 2 cases had bold vascular loops. Conclusions The main manifestations of FFA in patients with low-perfused retinopathy are malperfusion and retinal ischemia, whose degrees relate to the extend of carotid artery stenosis or atresia, and the process of the disease.Serious retinal ischemia may combined with anterior ischemic syndrome. (Chin J Ocul Fundus Dis，2004，20：84-86)
Objective To observe the characteristics of multiple evanescent white dot syndrome (MEWDS) with modern multimodal imaging modalities. Methods This was a retrospective case study. Eleven patients (11 eyes) diagnosed with MEWDS were enrolled. There were 10 females and 1 male, mean age was 27.6 years (range 15-41 years). The period between disease onset and visiting to the hospital was between 2 to 13 days, the average time was 4.7 days. All the patients underwent examinations of best corrected visual acuity, slit-lamp biomicroscope, indirect ophthalmoscope, fundus color photography, fundus autofluorescence (FAF), fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and spectral domain optical coherence tomography (SD-OCT). The mean follow up duration was 3.2 months. The imaging characteristics were compared. Results Fundus color photography showed foveal orange-red granularity in all eyes. FAF showed strong autofluorescence with a vague boundary. FFA showed a variable number of highly fluorescent fine needle-like dots arranged in a ring in the early stage, and fluorescence remained in the late stage. ICGA showed advanced lesions of vague boundary merged into a large plaque of deep retinal hypofluorescence. SD-OCT showed the hyperreflectant material deposit over the retinal pigment epithelium and extending anteriorly through the interdigitation zone, ellipsoid layer, and toward the external limiting membrane. At the site of extrafoveal lesions, SD-OCT revealed the presence of discontinuities or disruptions centered on the ellipsoid zone to include the interdigitation. Conclusions In MEWDS patients, fundus photography showed foveal orange-red granularity; FFA showed early fluorescent dots distributed in a ring pattern; ICGA showed hypofluorescent lesions in the later stage; SD-OCT showed disruption of the interdigitation zone and ellipsoid zone and accumulations of hyperreflective material that was of variable size and shape; FAF showed strong autofluoresce areas that correlated to spots observed with FFA and ICGA.
ObjectiveTo observe and preliminarily discuss the distribution characteristics of the non-perfusion area (NP) of the retina in different stages of diabetic retinopathy (DR) and its changes with the progression of DR. MethodsA retrospective clinical study. From October 2018 to December 2020, 118 cases of 175 eyes of DR patients diagnosed in Eye Center of Renmin Hospital of Wuhan University were included in the study. Among them, there were 64 males with 93 eyes and 54 females with 82 eyes; the average age was 56.61±8.99 years old. There were 95 eyes of non-proliferative DR (NPDR), of which 25, 47, and 23 eyes were mild, moderate, and severe; 80 eyes were proliferative DR (PDR). Ultra-wide-angle fluorescein fundus angiography was performed with the British Optos 200Tx imaging system, and the fundus image was divided into posterior, middle, and distal parts with Image J software, and the ischemic index (ISI) was calculated. The difference of the retina in different DR staging groups and the difference of ISI were compared in the same area. The Kruskal-Wallis test was used to compare the ISI between the different DR staging groups and the Kruskal-Wallis one-way analysis of variance was used for the pairwise comparison between the groups. ResultsThe ISI of the posterior pole of the eyes in the moderate NPDR group, severe NPDR group, and PDR group were significantly greater than that in the distal periphery, and the difference was statistically significant (χ2=6.551, 3.540, 6.614; P=0.000, 0.002, 0.000). In severe NPDR group and PDR group, the ISI of the middle and peripheral parts of the eyes was significantly greater than that of the distal parts, and the difference was statistically significant (χ2=3.027, 3.429; P=0.015, 0.004). In the moderate NPDR group, there was no significant difference in ISI between the peripheral and distal parts of the eye (χ2=2.597, P=0.057). The ISI of the posterior pole of the eyes in the moderate NPDR group and the PDR group was significantly greater than that in the middle periphery, and the difference was statistically significant (χ2=3.955, 3.184; P=0.000, 0.009). In the severe NPDR group, there was no significant difference in ISI between the posterior pole and the middle periphery of the eye (χ2=0.514, P=1.000). Compared with the mild NPDR group and the moderate NPDR group, the ISI of the whole retina, posterior pole, middle and distal parts of the PDR group was larger, and the difference was statistically significant (χ2=－7.064, －6.349,－6.999, －5.869, －6.695, －6.723, －3.459, －4.098; P=0.000, 0.000, 0.000, 0.000, 0.000, 0.000, 0.003, 0.000). ConclusionThe NP of the eyes with different DR stages is mainly distributed in the posterior pole and the middle periphery. The higher the severity of DR, the greater the NP in the posterior and middle periphery.
Objective To icompare the effects of indocyanine green angiography(ICGA) on ganzfeld Electroretinogram(ERG). Methods ICGA was performed used the Topcon 50IA retina camera, Ganzfeld ERG was recorded by Neuropack Ⅱ evoked response recorder. The Ganzfeld ERG was recorded before and after ICGA in 20 cases (38 e yes) with different diseases , Ganzfeld ERG was recorded according to the ISCEV standard recommendations. Results ICGA did neither affect Ganzfeld ERG a-wave and b-wave latency nor amplitudes of dark adaptation, maximum response and light adaptation.(Pgt;0.05). Conclusion ICGA using the Topcon 50IA could be performed prior to the recording of the Ganzfeld ERG. (Chin J Ocul Fundus Dis, 2001,17:284-285)
ObjectiveTo observe the characteristics of images of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) in patients with acute retinal necrosis syndrome (ARNS), and investigate the applied value of FFA and ICGA in clinical diagnosis.MethodThe data of the ocular fundus, FFA and ICGA of 20 patients (28 eyes) with ARNS were retrospectively analyzed.ResultsThe images of FFA indicated hyperfluorescence of optic disc in 24 eyes (85.71%) at the late phase; widespread retinal vascular occlusion at the peripheral focus in 23 eyes (82.14%) with some occlusive vascular shadow and the fluorescein in some white-line-like blood vessels; fluorescent leakage at the junction of normal and abnormal retina in 22 eyes (78.57%); retinal detachment in 20 eyes (71.42%), including 9 with retinal hole (45% of the patients retinal detachment); and macular cystoid edema in 8 eyes (28.57%). The images of ICGA showed hyperfluorescence of optic disc in 8 eyes (28.57%) including 5 with dotted staining at the optic disc at the late phase; unclear choroidal vasculature in the peripheral focus in 20 eyes (71.42%); and choriodal scattered hypofluorescent patch at the focus area in 19 eyes (67.85%). At the late phase of ICGA, some intravascular emboli and segments of retinal vascular occlusion were clearly demonstrated. ConclusionThe main manifestations of patients with ARNS in the images of FFA were hyperfluorescence of optic disc and retinal vascular occlusion; and unclear choroidal vessels and scattered hypofluorescent patch at the focus area.Combination of FFA and ICGA is helpful to understand the extent of the lesions and the relations between choroids and retina, which has great significance in diagnosing ARNS.(Chin J Ocul Fundus Dis, 2005,21:100-102)