OBJCTIVE :To investigate the fundus ocu]i changes in hypnxie isehemic encepbalnpa ally(HIE)of new[x,rns. METHODS:One hundred and two newblt;~rns suffered from HIE were investi- gated to observe lhe pathological neular fundus changes by di~et ophthabnoseopy after mydria~s. RE- SULTS:Seventy seven ca.~s(154 eyes)were found to have ophthalmoscopic changes in the ~ular fundi including papilledema .white retina vaseolar abnormality and hemorrhage. CONCLUSIONS:In clinical view .the severity of HIE depends on the pathological ebanges of the brain .and ftmdus ahnormalby will be very often in middle and .~vere sufforers of HIE.
Purpose Observation on changes of choroidal circulation in 21 cases (42 eyes) of retinal dystrophies. Methods Fundus fluorescein angiography (ICGA) were used for comparartive analyses of the retinal and choroidal blood circulation of 21 cases (42 eyes) of retinal dystrophic diseases. Results The changes of choroidal circulation,i.e.slow perfusion or filling defects were observed in four kinds of retinal dystrophies. Conclusion ICGA may assist in providing valuable informations on choroidal circulation of retinal dystrophic diseases. (Chin J Ocul Fundus Dis,1998,14:88-91)
ObjectiveTo explore the necessity, construction plans, and implementation methods for the establishment of a fundus disease-specific biobank are discussed. MethodsAn evidence-based medicine study. “Biobank”, “Disease-specific biobank”, “Eye diseases”, “Fundus disease” were hereby used as search terms. Literatures were retrieved related to biobank construction from PubMed, Embase, China National Knowledge Infrastructure, and Wanfang databases since their establishment until October 2023. Two researchers independently selected and analyzed literature, extracting data for further analysis. ResultsAfter screening, 23 articles were included, comprising 11 articles in Chinese and 12 articles in English, involving 23 institutions. The disease-specific biobank has been built earlier abroad than domestically. Both domestic and foreign biobank have a scale of less than 1, 1 to 10, and more than 10 thousand samples, with the eye disease-specific biobank having less than 10 thousand samples. The majority of these disease-specific biobank focued on tumor-related diseases and consist of both physical and information components. Ethical committees were required to declare and record the construction of biobank, and dedicated personnel and information management systems are established. Quality control systems have been developed with standard operating procedures from sample collection to storage. These disease-specific biobank effectively supported research projects, but there was a lack of resource sharing domestically compared to abroad. Based on practical experience, the construction of fundus disease-specific biobank at West China Hospital of Sichuan University has been improved. Separate sample collection processes have been formulated for outpatient clinics and operating rooms. Standard operating procedures have been established for unique eye samples, including vitreous fluid, proliferative membranes of the retina, aqueous humor, tears, etc., to ensure sample quality. ConclusionEstablishing a fundus disease-specific biobank can promote basic and clinical research, advance the development of translational medicine, achieve resource sharing, and foster discipline development.
Objective To investigate the features of ocular fundus of retinal pigment epithelial detachment (PED) in Chinese patients more than 50. Methods The clinical data of 31 continuous patients (34 eyes) with PED diagnosed by ocular fundus photochromy, fundus fluorescein angiography (FFA) and indocyanine green angiography ( ICGA ) from Oct, 2001 to Aug, 2004 were analyzed retrospectively. Results In 34 eyes with PED, the results of FFA showed serous PED in 18 (52.9%), hemorrhagic PED in 8 (23.5%), and serosanguineous PED in 8 (23.5%); the results of ICGA revealed PED associated with choroidal neovascularization (CNV) in 12 (35.3%), PED associated with ploypoidal choroidal vasculopathy (PCV) in 17 (50.0%), PED associated with both CNV and PCV in 1 (2.9%), and avascular PED in 4 (11.8%). Conclusions PED in Chinese patients more than 50 can be associated with CNV, PCV or other avascular diseases, and PCV is the most common intercurrent choroidal vascular disease. (Chin J Ocul Fundus Dis, 2006, 22: 224-227)
ObjectiveTo deeply explore the clinical features and gene mutations of Waardenburg syndrome (WS) by tested of the eyes and genes of three patients. MethodsA Case series study. From 2019 to 2021, 3 children with WS who were diagnosed at Department of Ophthalmology, West China Hospital of Sichuan University were included in the study. Among them, there were 2 males and 1 female; the ages were 3, 4, and 12 months, respectively. All children underwent external eye, anterior segment, fundus and fluorescein fundus angiography, the clinical features of the eyes were observed. The peripheral venous blood of 3 children was collected, and the whole genome DNA was extracted for whole exome sequencing to analyze the gene mutation sites. ResultsAll children had different degrees of iris heterochromia and fundus pigment abnormalities, and were accompanied by sensorineural hearing impairment. Case 1 had dystopia canthorum; case 2 had macular fovea hypoplasia. The sequencing results of case 1 showed that there were large fragments of heterozygous deletion in exons 2-8 of the Paired box 3 (PAX3) gene, who was diagnosed as WS Ⅰ type. The sequencing results of of case 2 showed heterozygous mutation in exon 9 of Microphthalmia-associated transcription factor (MITF) gene (c.1066 C＞T), combined with heterozygous mutation in exon 1 of HPS6 gene (c.1417 G＞T), who was diagnosed as WS Ⅱ type. The sequencing result of case 3 showed that the exon 3 of SOX10 gene had loss of heterozygosity (c.497_500 delAAGA), who was diagnosed as WS Ⅳ type. Both PAX3 and SOX10 gene mutations were newly discovered mutations. ConclusionsThe ocular clinical features of Waardenburg syndrome include hypopigmentation of the iris and choroid, and dystopia canthorum, etc. Early screening of the eye and hearing will help to better diagnose the disease. The large fragments of heterozygous deletion in exons 2-8 of the PAX3 gene, the heterozygous mutation in exon 9 of MITF gene (c.1066 C＞T), and the loss of heterozygosity in exon 3 of SOX10 gene are pathogenic genetic variations of 3 children.
Based on the current situation of patients with retinal diseases in China and the clear requirements of the "14th Five-Year Plan for Eye Health (2021-2025)" to strengthen the construction of the prevention and control system for retinal diseases, experts in the field of retinal diseases in China have conducted in-depth and comprehensive thematic discussions, and used the modified Delphi method for collective decision-making and opinion solicitation, ultimately forming consensus and consistent guidance suggestions for the management of chronic diseases of retinal diseases that are in line with China's national conditions. This consensus includes key content such as definitions, treatment plans, and follow-up frequency for the management of chronic diseases of the fundus. It clearly proposes relevant measures to improve the management process of chronic diseases of the fundus, and elaborates on the advantages and feasibility of establishing an online remote platform for the management of chronic diseases of the fundus, in order to assist doctors in formulating personalized treatment plans and ensure that patients receive standardized treatment and follow-up. This consensus will provide guidance and reference for the management of chronic diseases and long-term standardized diagnosis and treatment of major fundus diseases in China.
Microaneurysm is the initial symptom of diabetic retinopathy. Eliminating this lesion can effectively prevent diabetic retinopathy in the early stage. However, due to the complex retinal structure and the different brightness and contrast of fundus image because of different factors such as patients, environment and acquisition equipment, the existing detection algorithms are difficult to achieve the accurate detection and location of the lesion. Therefore, an improved detection algorithm of you only look once (YOLO) v4 with Squeeze-and-Excitation networks (SENet) embedded was proposed. Firstly, an improved and fast fuzzy c-means clustering algorithm was used to optimize the anchor parameters of the target samples to improve the matching degree between the anchors and the feature graphs; Then, the SENet attention module was embedded in the backbone network to enhance the key information of the image and suppress the background information of the image, so as to improve the confidence of microaneurysms; In addition, an spatial pyramid pooling was added to the network neck to enhance the acceptance domain of the output characteristics of the backbone network, so as to help separate important context information; Finally, the model was verified on the Kaggle diabetic retinopathy dataset and compared with other methods. The experimental results showed that compared with other YOLOv4 network models with various structures, the improved YOLOv4 network model could significantly improve the automatic detection results such as F-score which increased by 12.68%; Compared with other network models and methods, the automatic detection accuracy of the improved YOLOv4 network model with SENet embedded was obviously better, and accurate positioning could be realized. Therefore, the proposed YOLOv4 algorithm with SENet embedded has better performance, and can accurately and effectively detect and locate microaneurysms in fundus images.
Objective To investigate the iconographic characteristics and clinical significances of synchronic examination of indocyanine green angiography (ICGA) and fundus fluorescein angiography (FFA) for high myopia.Methods Thirty patients (57 eyes) with high myopia（gt;-6.00D）, selected randomly and consecutively, were examined by ICGA and FFA synchronically.Results The result of early phase of FFA showed hypofluorescence of the background in 25 eyes，while of late phase showed subretinal neovascularization (SRNV) in 10 eyes and streak formation in 40 eyes. The result of ICGA showed choroidal retrobulbar arteries in 8 eyes, hypofluorescence of the background in 35 eyes, SRNV in 8 eyes, and streak formation in 52 eyes.Conclusion The iconographic characteristics of ICGA and FFA of high myopia include hypofluorescence of the background, SRNV and streak formation. ICGA can givemore exact information on the lesions of choroid in high myopia. The synchronic examination of ICGA and FFA may act as a guide to the therapy for high myopia.(Chin J Ocul Fundus Dis，2003，19：87-89)
Chronic disease is a major threat to human health. Fundus disease has become a major ophthalmic disease affecting daily life. Although great breakthroughs have been made in the treatment, compared with other chronic disease management, the management of patients with fundus disease is still in its infancy. To strengthen the management exploration of patients with fundus diseases, establish a management model of fundus diseases and strive to improve patients' awareness of fundus diseases and adherence to treatment and follow-up are the great challenges at present. All ophthalmic centers should strengthen patient education, establish a regional cooperation network, support the construction of grassroots medical capacity, cultivate talents, enhance training, promote the standardized treatment of fundus diseases, standardize fundus imaging inspection and diagnosis, and promote the homogeneous construction of diagnosis and treatment of chronic fundus diseases. We will accelerate the construction of a hierarchical diagnosis and treatment system and the ability to link consultation and referral. Through systematic management and intervention of fundus diseases, a large number of patients with fundus diseases will receive early screening, diagnosis, standardized continuous treatment and systematic management, and improve the quality of life of patients with fundus diseases.
Objective To detect the value of three-dimensional (3D) ultrasound diagnosis in common ocular fundus diseases. Methods Two-dimensional (2D) images of 38 patients with common ocular fundus diseases were three-dimensionally reconstructed via 3D ultrasound workstation. The 3D images reflecting the ocular diseases were analyzed. Result In 38 patients with common ocular fundus diseases, there was vitreous hemorrhage in 16 patients, retinal detachment in 12, choroidal detachment in 5, and intraocular space occupying lesion in 5. Compared with the 2D images, 3D reconstructed images reflect the lesions more intuitionistically, displayed the relationship between the lesions and the peripheral tissues more clearly, and revealed the blood flow more specifically. During a scanning examination, 3D reconstructed technology provided the diagnostic information of section of X, Y and Z axises simultaneously which shortened the time of examination; the condition of any point of lesions and the relation between the lesion and the peripheral tissues could be gotten by the tools like cut and chop provided by 3D imaging software itself, which avoided detecting the same lesion with different angles and lays and proved the diagnostic efficacy. Conclusions 3D ultrasound diagnosis is better than 2D in diagnosis of vitreous, retina, choroid, and intraocular space occupying lesion. 3D ultrasound diagnosis is a complementarity for the 2D one, and the Z axis changes the former observational angles which may provide the new way of precise diagnosis. (Chin J Ocul Fundus Dis, 2005, 21: 381-383)