Objective To cpmpare the assessment of retinal and choroidal disease using confocal scanning laser ophthalmoscope (cSLO) imaging and color fundus camera. Methods Sixty-seven patients (90 eyes) with fundus diseases were included in this study. There were 35 males (51 eyes) and 32 female (39 eyes), mean age was 51.32 years. All subjects underwent fundus imaging using cSLO technology and traditional color fundus camera, positive numbers of every retinal pathological change were calculated and compared. Spectral domain-optical coherence tomography (SD-OCT) was also done to compare the accordance rate between two modes of fundus imaging (cSLO technology and traditional color fundus camera) and SD-OCT in choroidal changes. Results The positive numbers of retinal microaneurysm (χ2=4.157, P < 0.05) and epiretinal membrane (χ2=5.428, P < 0.05) using cSLO fundus imaging were significantly higher than traditional color fundus camera, while the positive numbers of cotton wool spots (χ2=0.523), retinal hemorrhage (χ2=0.117), hard exudates (χ2=0.325) and macular hole (χ2=0.070) were no significant different (P > 0.05). The SD-OCT accordance rate of choroidal pathological changes using cSLO technology was higher than traditional color fundus camera (χ2=9.143, P=0.007). Conclusion In retinal and choroidal diseases, the imaging quality of cSLO fundus imaging technology is better than the traditional color fundus camera technology.
ObjectiveTo observe the full-field ERG (ff-ERG) characteristics of patients with acute regional occult outer retinopathy (AZOOR).MethodsA retrospective observational study. From June 2017 to June 2019, 62 eyes of 42 patients (AZOOR group) who were diagnosed with AZOOR in the Department of Ophthalmology of West China Hospital of Sichuan University were included in the study. All patients had no obvious localized disease on the fundus. Among 62 eyes, BCVA of 16 eyes were＜0.1, BCVA of 27 eyes were ≤0.5, and BCVA of 19 eyes were＞0.5. From June 2018 to January 2019, 40 normal volunteers (80 eyes) who attended the outpatient clinic of West China Hospital of Sichuan University and passed detailed ophthalmological examination to exclude all eye diseases including refractive errors were selected as the normal control group. All the examined eyes were tested with ff-ERG using the German Roland visual electrophysiological inspection system. The peak times and amplitudes of the waveforms induced by each response of dark adaptation 0.01 ERG, dark adaptation 3.0 ERG, dark adaptation 3.0 ERG, light adaptation 3.0 ERG, and light adaptation 30 Hz flicker ERG were recorded, respectively. The peak time and amplitude of each ff-ERG response between the two groups were compared by independent sample t test. The peak time and amplitude of each ff-ERG response between different BCVA eyes in the AZOOR group were compared by variance test.ResultsCompared with the normal control group, 0.01 ERG b wave of the dark adaptation of AZOOR group (t=3.601, －6.120), 3.0 ERG a wave and b wave of dark adaptation (t=2.627, －4.263, 3.719, －5.866), 3.0 Oscillation potential P2 wave of dark adaptation (t=－6.625), 3.0 ERG a wave and b wave of bright adaptation (t=3.762, －3.612, 3.648, －3.739) and 30 Hz flicker ERG P wave of bright adaptation (t=－3.832), all peak time of those were significantly delayed, the amplitude decreased, and the difference was statistically significant (P＜0.05). Comparison of different BCVA eyes in the AZOOR group showed that 0.01 ERG b wave amplitude of dark adaptation (F=3.950), 3.0 ERG a peak and b wave amplitude of dark adaptation (F=4.408, 4.876), oscillation potential P2 wave amplitude of dark adaptation (F=4.295), 3.0 ERG b wave amplitude of bright adaptation (F=4.344) and 30 Hz flicker ERG P wave amplitude of bright adaptation (F=4.483) of differences were statistically significant (P＜0.05). There was no statistically significant difference in waveform peak time and amplitude of the other reactions (P＞0.05). Pairwise comparison results showed that, compared with those with 0.1≤BCVA≤0.5 and BCVA＞0.5, those with BCVA＜0.1 dark adaptation to 0.01 ERG b wave, dark adaptation 3.0 ERG b wave, dark adaptation oscillation potential P2 wave, and light adaptation 3.0 ERG b wave and light adaptation 30 Hz scintillation ERG P wave amplitude were significantly reduced, and dark adaptation to 3.0 ERG a peak was significantly delayed, the difference was statistically significant (P＜0.05).ConclusionsThe ff-ERG of patients with AZOOR show delayed peak time and decreased amplitude of each response. The worse BCVA are accompanied by the more obvious decrease of each response amplitude of ff-ERG.
Objective To investigate the relationship of clinical indexes between retinopathy in systemic-lupus-erythematosus （SLE）nephritis and SLE，and to discuss its clinical significance. Method The clinical data of 43 cases of SLE nephritis with ocular fundus diseases were retrospectively analyzed.The relationships between retinopathy and kidney defect，general lesions，SLEDAI grade，antinuclear antibody （ANA），anti-double stranded DNA，complement 3 and antiphospholipid antibodies were analyzed with Logistic regression respectively. Results In 86 eyes of the43paitents，there were retinal cotton wool spots in51eyes（59.3%），edema of optic disk in 43 eyes（50.5%），retinal haemorrhage in 12 eyes（14.0%），retinal artery occlusion in 5 eyes（5.8%），central retinal vein occlusion in 2 eyes（2.3%），retinal detachment in 3 eyes（3.5%），optic atrophy in 2 eyes（2.3%），and neovascularization in 2 eyes（2.3%）.Logistic regression analysis revealed that SLEDAI grade had linear dependent relation with cotton wool spots and optic disk edema（chi;2=42.154，6.498;P＜0.001），and didnrsquo;t have any correlation with proteinuria，hematuria and kidney function.Linear relation between retinal vascular occlusion and antiphospholipid antibodies was found（chi;2=24.475，P＜0.001）.Retinal haemorrhages，retinal detachment，optic atrophy and neovascularization did not correlate with clinical features. Conclusion SLEDAI grade had linear dependent relation with cotton wool spots and optic disk edema in patients with SLE nephritis，and Linear relation between retinal vascular occlusion and antiphospholipid antibodies is ascertained. Ocular fundus diseases are clinically important for evaluating the therapeutic responses and prognosis in lupus nephritis. (Chin J Ocul Fundus Dis, 2006, 22: 239-241)
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)
Purpose To investigate the expression of the interleukin-6(IL-6)and tumor necrosis factor alpha(TNF-alpha;) in epiretinal membranes(ERM) of eyes with proliferative vitreoretinopathy(PVR). Methods Nineteen epiretinal membranes were obtained form eyes undergoing vitrectomy for retinal detachment complicated with PVR and observed by immunohistochemical methods. Results Expression of IL-6 and TNF-alpha; were observed in 12 and 15 membranes respectively with positive staining mostly in extracellular matrix of epiretinal membranes.Only one membrane showed positive to IL-6 intracellularly,and expression for IL-6 and TNF-alpha; simultaneously in membranes. Conclusion The findings indicate that IL-6、and TNF-alpha;might be involved in the development of PVR. (Chin J Ocul Fundus Dis,1998,14:219-221)
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.
Hypertensive retinopathy (HR) often coexist with carotid lesions in hypertensive patients. Carotid lesions are closely associated with cardiovascular and cerebrovascular diseases, as well as end events, offering early important evidence to screening high risk patients. HR has significant value to predict target organ damage (TOD) of hypertension including carotid lesion. In addition, hypertensive retinopathy and carotid lesions-related ischemic ocular diseases will cause serious vision function damage. This article is going to summarize the value and correlation between hypertensive retinopathy and carotid lesions in terms of clinical manifestations, pathological physiological mechanism and target organ damage.
Objctive To explore the relationship between the expression of Fas/FasL and the apoptosis occurs in retinal ischemia/reperfusion injury of rats , as well as the therapeutic effects of bFGF on the ischemic retina.Methods Th emodels of retinal ischemia/reperfusion injury was made by transient elevating introcular pressure. A total of 28 rats were divided into normal and operation group.The latter were subdivided into 1 hour, 6, 12, 24, 48 and 72 hours after reperfusion group, in which the left eyes of the rats were in the ischemia/reper fusion groups and the right ones were in the treatment groups (bFGF intracameral injection). Apoptosis was assessed by the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labelling (TUNEL) method, and the expression of Fas and Fas ligand was studied by strept avidin-biotin complex （SABC）immunohistochemistry. Results No positive cells were observed in the normal rats′retinae, but there was a significant number of TUNEL positive cells in 6-24 hours after transient ischemia followed by a decrease at the 48th hour. The number of TUNEL positive cells reached a maximum at the 24th hour after ischemia. The expression of Fas gradually increased as early as when it was at the 6th hour, reached a peak at the 24th hour, and then decreased at the 48th hour. Similarly, the expression of Fas ligand was at peak in 24-48 hours in GCL and INL of retina. Conclusions Retinal ischemia-reperfusion after transient elevated IOP induced apoptosis of cells in the retina. Fas/FasL may play an important role in the early events of the apoptotic pathways. bFGF can rescue RGCs from retinal ischemia/reperfusion injury through downregulation of the expression of Fas/FasL and may represent an important mechanism for therapeutic neuroprotection. (Chin J Ocul Fundus Dis，2003，19：160-163)
Inherited retinal diseases (IRDs) are a group of severe retinal degenerative diseases leading to permanent visual impairment. IRDs are the major cause of irreversible blindness in children and working age groups. Gene therapy is a new clinical treatment method and currently the only clear and effective treatment for IRDs, while, there are still risks in clinical research and application. How to standardize perioperative management and reduce the potential risks of treatment is one of the keys to ensure the safety and effectiveness of treatment. However, there is no systematic and standardized guidance on the perioperative management for IRDs gene therapy. Therefore, in order to standardize the perioperative management, the Fundus Disease Group of Ophthalmology Society of Chinese Medical Association and Chinese Medical Doctor Association organized domestic experts to put forward standardized opinions on the perioperative management of IRDs gene therapy in China after repeated discussion and combined with domestic and foreign research experience, so as to provide clinicians with reference and application in clinical research and practice.
Objective To evaluate the application value of intraocular biopsy in the diagnosis of atypical intraocular lesions. Methods The clinical data of 31 patients (31 eyes) with atypical intraocular lesions were retrospectively analyzed. All patients received intraocular biopsy including anterior chamber puncture, vitreous puncture and vitreous biopsy followed by pathological cell examination. Cytological examination was immediately performed for all biopsy fluids or tissues; biopsy times, the positive detecting rate and independent pathological diagnosis rate were analyzed. Intraoperative and postoperative complications were observed. Eyeballs with biopsy-suggested malignancy lesions were enucleated and underwent histopathological analysis. The biopsy results and histopathological results were compared and analyzed.Result Thirty-one eyes received 35 times of biopsy operation in total. The available samples harvested from 29 patients through 31 operations were valid for pathological cell examination，the positive detecting rate was 88.6%. Among the 31 eyes, 12 eyes had malignant lesions; 15 eyes had benign lesions; two eyes were diagnosed with benign lesions initially, but corrected to malignant through the second biopsy;the lesions in two eyes were not determined by biopsy. Among the 29 eyes with valid biopsy, 23 eyes were diagnosed independently by pathological examination; the diagnosis of the other six eyes was made based on pathological examination and clinical features. The independent pathological diagnosis rate was 71.4%. The complications included intraocular bleeding in five eyes, retinal detachment in three eyes and more serous inflammation in one eye. The sensitivity for diagnosis of malignant lesions was 85.7% and the specificity was 100.0%. The predictive value of positive test was 100.0% and the negative one was 86.7%.Conclusion Intraocular biopsy has important values in the diagnosis of atypical intraocular lesions.