【Abstract】Objective To look for a feasible way to evaluate hepatic reserve function completely by retention rate of indocyanine green at 15 minutes （ICGR15）and Child-Pugh classification supplemented by hepatic clearance of D-sorbitol (CLh-s). Methods The ICGR15, Child-Pugh classification and CLh-s were examined in 186 patients with liver cirrhosis. Relations between CLh-s and operative complications were further studied when ICGR15 and Child-Pugh classification was superposed. ResultsThe superpositions of ICGR15 (40% being boundary) and Child-Pugh classification was centralized between Child-Pugh B and C. ICGR15 of 17 examples were higher than 40% in 63 examples of Child-Pugh B. Eight examples of them had some complications, CLh-s=(584.52±98.27) ml/min (CLh-s＜700 ml/min), while 9 examples of them had no complications, CLh-s=(801.25±75.04) ml/min (CLh-s＞700 ml/min). Conclusion The CLh-s could be interrelated with operative complication, and it is considered as an effective supplement to ICGR15 and Child-Pugh classification for the evaluation of hepatic reserve function, CLh-s (700 ml/min being boundary) could be used to predict operative complication, to evaluate hepatic reserve function effectively, and to provide the basis for choosing the right time for operation.
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)
Objective To investigate the ingestion, metabolism and subcellular localization of indocyanine green (ICG) in human retinal epithelial (R PE) cells.Methods RPE cells were incubated with 0.25 mg/ml ICG under the condition of 37oC in the camera. The ICG granule and ultrastructure of RPE cells were observed under the electron microscopy after 1, 4, and 24hour incubation, and the ICG autofluorescence was detected by fluorescence microscopy after the incubation for 1, 2, 4, 8, 12, 24, and 48 hours, respectively. The ab sorbency (A value) of ICG solution was measured at 805 nm with ultraviol et/v isible specrtrometer. The standard curve of concentration of ICG was drawn and the related equation of concentration of ICG and the A value was calculated. After being incubated for 1, 2, 4, 8, 12, 24, 48, and 72 hours, respectively, the A value of supernatant fluid was calculated according to the equation. Aft er incubated with ICG for 24 hours, one sample was observed under electron microscope and fluorescence microscope per week to evaluate the metabolizable period of ICG .Results ICG granules were distributed evenly after entering the RPE cells. After incubated with 0.25 mg/ml ICG for 24 hours, no significant change of the ultrastructure of the RPE cells was found. ICG granules accu mulated in the cells as the time goes by and reached the peak after 24 hours, and then they decreased because of the slowdown of the metabolism. Few ICG was still remained in the cells 1 week later Conclusions RPE cells may take in ICG actively. ICG metabolizable period in RPE cells is long, which may be one of the mechanisms of the toxicity of ICG to the retina in the vitreous operation.(Chin J Ocul Fundus Dis，2004，20：179-181)
Objective To evaluate the characteristics of two angiographic manifestation of ocular fundus in choroidal metastatic carcinomas. Methods Fundus fluoresein angiography (FFA) and indocyanine green angiography (ICGA) were performed on 17 patients (24 eyes) with choroidal metastatic carcinomas, and the characteristics of these two kinds of angiograms were analyzed and compared each other. Results According to various clinical features, e.g., locations of metastatic tumor in ocular fundus, disease course, and different kinds of original malignancy, the findings of ocular fundus were divided into (1) Isolation type: FFA showed pinpoint and mottled leaks against hypofluorescence background, increased and confluent fluoresecence in later stage. ICGA showed the similar images as in FFA, except later appearance of leaks and the choroidal vesseles could be seen beneath the thin metastatic tumor mass.(2) Diffusion type: Tumors showed hypofluorescence in early stage and uneven ill-defined hyperfluorescence both in FFA and in ICGA. (3) Small metastatic carcinomas: Hypofluorescence in early stage and mild mottled hyperfluorescence were found in FFA as well as in ICGA. Conclusion Both FFA and ICGA are helpful in the diagnosis of choroidal metastatic tumors and ICGA may be conducive if there are some troubles in diagnosing the tumors with FFA. (Chin J Ocul Fundus Dis, 2002, 18: 92-95)
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)
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.
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)
Objective To analyse the indocyanine green angiographic findings in contralateral eyes of patients with unilateral exudative age-related macular degeneration(AMD). Methods Fundus photograph,fundus fluorescein angiography(FFA) and indocyanine green angiography(ICGA) were performed in a series of 70 patients with unilateral AMD and drusens and pigmentary changes in the macular region in contralateral eyes.The findings of fluoroangiograms were observed and analysed. Results ICGA revealed the characteristics of the contralateral eyes as follows:(1)Drusen could be hypofluorescent,hyperfluorescent or normal fluorescent;(2)14 eyes revealed plaque-like late hyperfluorescent;(3)13 eyes revealed choroidal filling defect;(4)18 eyes revealed pindot-like clusters of late hyperfluorescence. Conclusion ICGA is useful in evaluating the lesions and circulation disturbance of the contralateral eye,and may help to find the risk factors of developing future exudative changes. (Chin J Ocul Fundus Dis, 1999, 15: 216-218)
Objective To study the characteristics of choroidal circulation in RP. Methods Using ICGA to obse rve 37 cases of RP and compare with healthy volunteers. Results ① The earliest fluorescein filling time of the choroidal arteries in RP group was (14.38plusmn;3.95) seconds,the choroidal veinous in RP group was (17.27plusmn;5.94) seconds,and there was no obvious difference between RP and control group.②The fluorescein failing time of choroidal vein in RP group was (475.75 plusmn;153.70)seconds.③The area of the bright fluorenscence in posterior fundus in RP group was (41.20plusmn;19.99) mm2,and compared with the control group,there was significant difference (P＜0.0001). ④In the mid to late phase during ICGA，in RP group the veillike hypofluorescence was found in 61 e yes (84.7%),plaque hyperfluorescence in posterior fundus in 21 eyes (29.2%),and leakage of heperfluorescence in 4 eyes(5.6%). Conclusion ①The perfusion pressure of choroidal vessels in RP reveals no c hange.②The blood volume of choroidal vessels becomes decreased in RP.③The choroidal capillaries become atrophic in RP.④Choroidal neovascularization may occur in patients with RP. (Chin J Ocul Fundus Dis, 2001,17:26-29)