Intravitreal injection of antiangiogenic agents is widely used to treat retinal vascular disease. This therapy can induce regression of neovascular vessels; reduce intraocular inflammation and retinal vascular permeability, and control macular edema. However the action period of these agents is short, and thus this therapy need repeated injections which cause higher operation risk and cost. Retinal laser photocoagulation therapy can close retinal capillary non-perfusion area and neovascular vessels, reduce macular edema caused by vascular leakage. However, as its therapeutic effect is based on the destruction of the retinal tissues in the lesion area, this therapy need longer time to show its effects. When the disease is controlled by this method, it may already induce some structural irreversible damages to the retina, especially the macular. This is why the visual acuity is not satisfactory in some patients, even though the disease get controlled, macular edema gets disappeared and anatomical structure of retina get improved. Properly evaluating all the pros and cons of retinal photocoagulation and intravitreal injection of antiangiogenic agents, will allow us to explore a better way to combine these two therapies to treat retinal vascular diseases.
The ocular fundus changes and the damage of visual function were various at different stages of diabetic retinopathy (DR). To get hold of timing and different therapic method correctly of early diagnosis, whole body treatment, laser photocoagulation and vitreous-retina surgery and adopting targeted interventions could help patients receiving the most reasonable and effective treatment at different stages, both of them are keys to reduce the damage of visual function. （Chin J Ocul Fundus Dis，2008，24：240-243）
Objective To observe the of macular serous neuroepithelial detachment and the necessary auxiliary examination methods for the diagnosis.Methods The clinical data of 46 patients (49 eyes) aged above 45 years with macular serous neuroepithelial detachment who have been diagnosed by binocular indirect ophthalmoscope and optical coherence tomography (OCT) were retrospectively analyzed. All the patients had undergone fundus fluorescein angiography (FFA) and indocyanine angiography (ICGA), and the diagnosis was established based on the results of FFA, ICGA and OCT. Results In these 46 patients (49 eyes), central serous chorioretinopathy (CSC) was found in 31 (34 eyes, 69.4%), agerelated macular degeneration (AMD) was found in 12 (12 eyes, 24.5%), and polypoidal choroidal vasculopathy (PCV) was found in 3 (3 eyes, 6.9%). In the 34 eyes with CSC, 12 eyes (35.3%) had typical CSC and 22 eyes (64.7%) had chronic CSC. If the 12 eyes with AMD, 9 eyes (75%) had occult CNV, 2 eyes (16.7%) had minimally classic CNV, and 1 eye had classic CNV. Conclusions The causes of serous macular neuroepithelial detachment in patients aged above 45 years are complex; ICGA may help to establish the definitive diagnosis of chronic CSC, occult CNV,and PCV should be considered.
Objective To observe the clinical features of polypoidal choroidal vasculopathy (PCV) in Chinese patients.Methods Nine cases (9 eyes ) were examined with fundus examination, fundus fluorescein angiography (FFA) and indocyanine green angiography angiography (ICGA).Results FFA and ICGA showed the branching vascular networks (7 cases) and polyplike dilation at terminals of branches (9 cases), which mainly located in macular area (8 cases) and in peripapillary area (1 case), and which accompanied hemorrhagic or serous pigment epithelial detachment in 7 cases,and 4 of 7 cases had a significant horizontal black-white damarcation line. It definitely differed from fine choroidal neovascularization (CNV).Conclusion PCV in Chinese patients has the cardinal clinical features, i.e., polyplike lesions located mainly in macular area and most cases accompanied by hemorrhagic or serous pigment epithelium detachment. (Chin J Ocul Fundus Dis，2003，19：269-332)
Objective To verify the pattern characteristics of optical coherance tomography (OCT) images in diabetic maculopathy (DM). Methods OCT were performed in sixty cases of DM and 30 cases of normal control group,and in 54 cases of DM,fundus fluorescein angiography (FFA) was performed simutaneously.The results from 2 kinds of examinations were compared each other. Results The average retinal thickness at the central fovea was (314.54plusmn;154.13) mu;m in DM group.The macular edema in the cases of DM accounted to 57.1% on OCT examination. The rate of retinal swelling associated with cystoid macular edema (CME) was 38.5%,with retinal detachment (RD) 9.2%,and with both CME and RD was 16.9%Those with mormal macular thickness and mild macular edema primarily showed focal leakage in FFA exam,while those with moderate and severe macular edema showed diffuse leakage in FFA exam.The rate of CME was 28.6% presented in FFA and 58.9% in OCT examination (t= 3.39,Plt;0.05). Conclusion OCT images of DM reveal 3 kinds of morphological features：retinal welling,CME,and sensory retinals de tachment.OCT is superior to FFA in detecting CME. (Chin J Ocul Fundus Dis, 2001,17:184-186)