Image characteristics and quantitative analysis of multicolor imaging in eyes with cystoid macular edema_Chinese Journal of Ocular Fundus Diseases

Authors：

He Lu ,  Chen Changzheng , Yi Zuohuizi , Wang Xiaoling , Xu Amin , Liu Juejun

Eye Center, People's Hospital of Wuhan University, Wuhan 430060, China;

Corresponding author：

Chen Changzheng, Email: whuchenchzh@163.com

Keywords：

Macular edema/diagnosis; Tomography, optical coherence; Fluorescein angiography; Multicolor imaging

DOI：

10.3760/cma.j.issn.1005-1015.2020.01.006

Video：

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Objective To observe the imaging features of cystoid macular edema (CME) in multicolor imaging (MC), and to evaluate the value of MC in the diagnosis of CME.Methods Descriptive case series study. From August 2017 to June 2018, 42 eyes of 37 patients with CME diagnosed in the people's Hospital of Wuhan University were included in the study. Among them, there were 24 males and 13 females, with an average age of 48.51±10.29 years. There were 14 eyes with diabetic retinopathy, 14 eyes with central retinal vein occlusion, 8 eyes with branch retinal vein occlusion, 4 eyes with uveitis, and 2 eyes with Eales disease. The macular color fundus photography (CFP) was performed with Visucam 200 non-mydriatic fundus camera of Zeiss company in Germany. MC, frequnce domainoptical OCT (SD-OCT) and FFA were examined by Spectralis HRA2 + OCT of Heidelberg company in Germany. According to the MC standard method, five images, including 488 nm blue reflection (BR), 515 nm green reflection (GR), 820 nm infrared reflection (IR) imaging and standard MC and blue-green enhancement (BG), were obtained at the same time. Compared with SD-OCT, CFP and MC images were scored. Friedman M test and Wilcoxon signed rank test were used for statistical analysis.Results The standard MC and BG images showed blue-green uplift area or petal-shaped appearance, surrounded by green reflection areas with clear boundaries. BR image can be seen in the low reflexes area. On the GR image, there were patches or cystic low reflection areas, surrounded by a slightly high reflection. On the IR image, patches or cystoid high reflexes can be seen, surrounded by low reflection dark areas with clear boundaries. The average scores of CFP, standard MC, GB, IR, GR and BR were 1.20±0.94, 3.05±0.99, 2.90±1.04, 2.55±1.27, 2.00±0.94, 0.51±0.85 respectively, and the differences were statistically significant (χ²= 151.61, P=0.000). The score of CFP were significantly lower than that of standard MC (Z=－5.421), BG (Z=－5.354), IR (Z=－4.714), GR (Z=－4.438) and higher than that of BR (Z=－3.435). The differences were statistically significant (P=0.000, 0.000, 0.000, 0.000, 0.001).Conclusions The quality of MC imaging is better than that of CFP. Combined with SD-OCT, it can be used as an assistant method to diagnose CME.

Citation： He Lu, Chen Changzheng, Yi Zuohuizi, Wang Xiaoling, Xu Amin, Liu Juejun. Image characteristics and quantitative analysis of multicolor imaging in eyes with cystoid macular edema. Chinese Journal of Ocular Fundus Diseases, 2020, 36(1): 25-28. doi: 10.3760/cma.j.issn.1005-1015.2020.01.006 Copy

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17.	李淑婷, 王相宁, 杜新华, 等. 共焦激光扫描炫彩眼底成像与彩色眼底照相对糖尿病视网膜病变的检出比较[J]. 中华眼底病杂志, 2018, 34(4): 338-342. DOI: 10.3760/cma.j.issn.1005-1015.2018.04.006.Li ST, Wang XN, Du XH, et al. Comparison of confocal laser scanning colorful fundus imaging and color fundus photography for detection of diabetic retinopathy[J]. Chin J Ophthalmol, 2018, 34(4): 338-342. DOI: 10.3760/cma.j.issn.1005-1015.2018.04.006.
18.	Li ST, Wang XN, Du XH, et al. Clinical application of multicolour scanning laser imaging in diabetic retinopathy[J]. Lasers Med Sci, 2018, 33(6): 1371-1379. DOI: 10.1007/s10103-018-2498-5.
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1. 董方田, 孙心铨, 王燕琪. 黄斑囊样水肿[M]//张承芬. 眼底病学. 北京: 人民卫生出版社, 2010: 348-354.Dong FT, Sun XQ, Wang YQ. Cystoid macular edema[M]//Zhang CF. Diseases of ocular fundus. Beijing: People's Medical Publishing House, 2010: 348-354.
2. 吴琨芳, 文峰.黄斑水肿[M]//文峰. 眼底病临床诊治精要. 北京: 人民军医出版社, 2011: 78-83.Wu KF, Wen F. Macular edema[M]//Wen F. Essentials of clinical diagnosis and treatment of fundus diseases, Beijing: People's Military Medical Publishing House, 2011: 78-83.
3. Tan AC, Fleckenstein M, Schmitz-Valckenberg S, et al. Clinical application of multicolor imaging technology[J]. Ophthalmologica, 2016, 236(1): 8-18. DOI: 10.1159/000446857.
4. 霍妍佼, 魏文斌. 眼底成像技术新进展——共聚焦激光扫描检眼镜[J]. 国际眼科纵览, 2015, 39(4): 224-228. DOI: 10.3760/cma.j.issn.1673-5803.2015.04.002.Huo YJ, Wei WB. Progress in fundus imaging: confocal scanning laser opthalmoscope[J]. Int Rev Ophthalmol, 2015, 39(4): 224-228. DOI: 10.3760/cma.j.issn.1673-5803.2015.04.002.
5. 霍妍佼, 杨丽红, 魏文斌. 激光扫描共焦检眼镜对黄斑囊样水肿成像的定量分析[J]. 中华实验眼科杂志, 2017, 35(1): 53-57. DOI: 10.3760/cma.j.issn.2095-0160.2017.01.011.Huo YJ, Yang LH, Wei WB. Imaging performance and quantitative analysis of confocal scanning laser ophthalmoscope for cystoid macular edema[J]. Chin J Exp Ophthalmol, 2017, 35(1): 53-57. DOI: 10.3760/cma.j.issn.2095-0160.2017.01.011.
6. 中华医学会眼科学会眼底病学组. 我国糖尿病视网膜病变临床诊疗指南(2014年)[J]. 中华眼科杂志, 2014, 50(11): 851-865. DOI: 10.3760/cma.j.issn.0412-4081.2014.11.014.Chinese Ocular Fundus Diseases Society, Chinese Ophthalmological Society, Chinese Medical Association. Guidelines for clinical diagnosis and treatment of diabetic retinopathy in China[J]. Chin J Ophthalmol, 2014, 50(11): 851-865. DOI: 10.3760/cma.j.issn.0412-4081.2014.11.014.
7. 吴景学. 视网膜病[M]//赵堪兴. 眼科学. 8版. 北京: 人民卫生出版社, 2013: 312-217.Wu JX. Retinopathy[M]//Zhao KX. Ophthalmology. 8 ed. Beijing: People's Medical Publishing House, 2013: 312-217.
8. 杨培增. 葡萄膜炎各论[M]//杨培增. 葡萄膜炎诊断与治疗. 北京: 人民卫生出版社, 2009: 423-498.Yang PZ. Uveitis[M]// Yang PZ. Diagnosis and treatment of uveitis. Beijing: People's Medical Publishing House, 2009: 423-498.
9. Vieira P, Manivannan A, Sharp PF, et al. True colour imaging of the fundus using a scanning laser ophthalmoscope[J]. Physiol Meas, 2002, 23(1): 1-10. DOI: 10.1088/0967-3334/23/1/301.
10. Sharp PF, Manivannan A. The scanning laser ophthalmoscope[J]. Phys Med Biol, 1997, 42(5): 951-966. DOI: 10.1088/0031-9155/42/5/014.
11. Reznicek L, Dabov S, Kayat B, et al. Scanning laser 'en face' retinal imaging of epiretinal membranes[J]. Saudi J Ophthalmol, 2014, 28(2): 134-138. DOI: 10.1016/j.sjopt.2014.03.009.
12. 霍妍佼, 杨丽红, 魏文斌. 黄斑前膜患者激光视网膜成像特点分析[J]. 中华眼科杂志, 2016, 52(11): 836-839. DOI: 10.3760/cma.j.issn.0412-4081.2016.11.007.Huo YJ, Yang LH, Wei WB. Diagnostic performance of laser retinal imaging in the epiretinal membrane[J]. Chin J Ophthalmol, 2016, 52(11): 836-839. DOI: 10.3760/cma.j.issn.0412-4081.2016.11.007.
13. Alten F, Clemens CR, Heiduschka P, et al. Characterisation of reticular pseudodrusen and their central target aspect in multi-spectral, confocal scanning laser ophthalmoscopy[J]. Graefe's Arch Clin Exp Ophthalmol, 2014, 252(5): 715-721. DOI: 10.1007/s00417-013-2525-y.
14. Ben Moussa N, Georges A, Capuano V, et al. Multicolor imaging in the evaluation of geographic atrophy due to age-related macular degeneration[J]. Br J Ophthalmol, 2015, 99(6): 842-847. DOI: 10.1136/bjophthalmol-2014-305643.
15. Graham KW, Chakravarthy U, Hogg RE, et al. Identifying features of early and late age-related macular degeneration: a comparison of multicolor versus traditional color fundus photography[J]. Retina, 2018, 38(9): 1751-1758. DOI: 10.1097/IAE.0000000000001777.
16. Ahmad MSZ, Carrim ZI. Multicolor scanning laser imaging in diabetic retinopathy[J]. Optom Vis Sci, 2017, 94(11): 1058-1061. DOI: 10.1097/OPX.0000000000001128.
17. 李淑婷, 王相宁, 杜新华, 等. 共焦激光扫描炫彩眼底成像与彩色眼底照相对糖尿病视网膜病变的检出比较[J]. 中华眼底病杂志, 2018, 34(4): 338-342. DOI: 10.3760/cma.j.issn.1005-1015.2018.04.006.Li ST, Wang XN, Du XH, et al. Comparison of confocal laser scanning colorful fundus imaging and color fundus photography for detection of diabetic retinopathy[J]. Chin J Ophthalmol, 2018, 34(4): 338-342. DOI: 10.3760/cma.j.issn.1005-1015.2018.04.006.
18. Li ST, Wang XN, Du XH, et al. Clinical application of multicolour scanning laser imaging in diabetic retinopathy[J]. Lasers Med Sci, 2018, 33(6): 1371-1379. DOI: 10.1007/s10103-018-2498-5.
19. Chen FK, Viljoen RD, Bukowska DM. Classification of image artefacts in optical coherence tomography angiography of the choroid in macular diseases[J]. Clin Exp Ophthalmol, 2016, 44(5): 388-399. DOI: 10.1111/ceo.12683.
20. Pang CE, Freund KB. Ghost maculopathy: an artifact on near-infrared reflectance and multicolor imaging masquerading aschorioretinal pathology[J]. Am J Ophthalmol, 2014, 158(1): 171-178. DOI: 10.1016/j.ajo.2014.03.003.

Chinese Journal of Ocular Fundus Diseases

Image characteristics and quantitative analysis of multicolor imaging in eyes with cystoid macular edema

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