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)
Purpose To observe the features of the hyperfluorascent areas in the posterior ocular fundus detected by indocyanine green angiography(ICGA) in healthy volunteers, and to study circulatory properties of choroid. Methods Routine ICGA was performed on each of fifty consecutive normal eyes. Results ⑴Hyper fluorescence began at an average time of (30.80plusmn;5.42) seconds. ⑵The patterns of the hyperfluorescence revealed themselves in doubling areas divided symmetrically by the relatively hypoer fluorescence blelt running horizontally across the fovea in 29 eyes(58%), and single area in 21 eyes(42%).⑶The average area of the hyper fluorescence was (57.27plusmn;14.08)mm2.⑷ The sustaining time of the hyper fluorescence was (172.44plusmn;59.70) seconds at average. Conclusion During ICGA, a very patchy filling pattern of hyper fluorescence was visible in posterior fundus in normal eyes, and its filling time and shape presented choroidal blood supply and circulation. These parameters would offer consulted bases for clinical diagnosis of the choroidal diseases. (Chin J Ocul Fundus Dis,1999,15:1-3)
Purpose To investigate the blood dynamic feature of choroid in normal eyes. Methods Indocyanine green angiography (ICGA) was performed in each of fifty consecutive normal eyes. Results The earliest fundus fluorescence emerged at the mean timiest fundus fluorescence emerged at the mean time of (14.25plusmn;3.59) seconds,it represented the beginning of filling of choroidal arteries located at the posterior pole.The irrigation of choroidal veins appeared at the mean time of (15.03plusmn;3.44) seconds.At the time threre was the overlapping imaging appearance of choroisal arteries and veins.The most hyperfluorescent areas appered at the mean time of(16.75plusmn;3.78) seconds with definite shapes located at the posterior pole,and this stood for the fluorescence stage of choroidal arteries,veins and capillaries.The fluorescence of choroidal vein began to weaken at 11prime;58Prime;15plusmn;2prime;39Prime;86,and revealed the imaging of late stage of choroidal veins.The latest stage of ICGA was at 22prime;13Prime;22plusmn;3prime;30Prime;55,and presented obscure fluorescence. Conclusion The measurement results and fluorescent features of ICGA of normal eyes can offer consulted bases for the clinical diagnosis of the choroidal diseases. (Chin J Ocul Fundus Dis,1998,14:68-71)
Objective To evaluate ocular surface changes following minimal vitreoretinal surgery in postmenopausal women patients with proliferative diabetic retinopathy (PDR). Methods Sixty-one women PDR patients (61 eyes) underwent vitreous microsurgery were recruited in this prospective study, including 31 postmenopausal women (PMW group) and 30 non-postmenopausal women (non-PMW group). The contralateral eyes were considered as the control group. Corneal fluorescein (FL) staining, tear break-up time (TBUT), Schirmer I test (SIT), central corneal sensitivity and ocular surface disease index (OSDI) were estimated. All tests were carried out 1 day preoperatively and 1 day, 10 days, 1 month and 3 months postoperatively. The student’st test or Mann-WhitneyU and ANOVA for repeat measurements test were used. Results Preoperatively, TBUT of surgery and non-surgery eyes in PMW were shorter than non-PMW (t=−2.115, −2.035;P＜0.05), but higher OSDI scores were found in PMW (t=2.482, 2.208;P＜0.05). TBUT reduction rate (Z=−2.771, −1.993;P＜0.05) and OSDI rising rate (Z=2.539, 2.157;P＜0.05) of surgery eyes in PMW were higher than non-PMW 1 day and 10 days postoperatively. The lower SIT of surgery eyes in PMW were observed at 1 day and 10 days (t=−2.403, −2.029;P＜0.05) after surgery. At 10 days after surgery, FL and OSDI scores of surgery eyes in non-PMW returned to preoperative level (Z=−0.447, −0.513;P＞0.05), but in PMW, the recovery process experienced 1 month (Z=−1.500, −0.853;P＞0.05). TBUT and SIT of surgery eyes in two groups both reached preoperative level at 1 month following surgery (Z=−0.715, −1.266, −1.531, −0.522;P＞0.05). Conclusions PMW with PDR had ocular surface dysfunction, which resulted in aggravated dry eye after minimal vitreoretinal surgery.
ObjectiveTo investigate the risk factors of postoperative vitreous hemorrhage after minimal vitrectomy without endotamponade for proliferative diabetic retinopathy (PDR).MethodsFrom June 2015 to June 2017, 103 eyes of 103 patients with PDR diagnosed and underwent minimalvitrectomy in Henan Provincial People's Hospital were enrolled in the study. There were 58 males and 45 females, with the average age of 58.37±10.14 years and diabetes duration of 8.7±7.2 years. Baseline systemic parameters including sex, age, diabetes duration, hypertension, HbA1c, creatinine, whether received anticoagulants, ocular parameters including whether combined with vitreous hemorrhage, whether finished panretinal photocoagulation (PRP), whether received treatment of anti-VEGF, whether combined with iris neovascularization (NVI), lens status preoperatively, whether hypotony postoperatively and intraoperative parameters including whether disc neovascularization (NVD) bleeding, whether fibrovascular membrane (FVM) residual, laser points, whether combined with cataract phacoemulsification were identified by multivariate logistic regression analysis.ResultsTwenty-nine of 103 eyes (28.15%) developed PVH in 1 day to 6 months after surgery, with self absorption of 18 eyes and reoperation of 11 eyes. Univariate analysis showed there were significant differences in age (t=2.124, P=0.036), anti-VEGF(χ2=7.105, P=0.008), NVD bleeding (χ2=10.158, P=0.001) and FVM residual(χ2=8.445, P=0.004) between patients with and without postoperative vitreous hemorrhage. Sex (χ2=0.021, P=0.884), diabetes duration (t=0.87, P=0.386), hypertension (χ2=2.004, P=0.157), HbA1c (t=1.211, P=0.229), creatinine (t=0.851, P=0.397), preoperative oral anticoagulants (χ2=0.985, P=0.321), preoperative vitreous hemorrhage (χ2=0.369, P=0.544), PRP (χ2=1.122, P=0.727), NVI (χ2=2.635, P=0.105), lens status (χ2=0.172, P=0.679), hypotony postoperatively (χ2=1.503, P=0.220), laser points (χ2=1.391, P=0.238) and combined phacoemulsification surgery (χ2=0.458, P=0.499) were not associated with PVH. Multivariate logistic regression analysis revealed the more PVH appeared in younger (OR=1.065, P=0.009) and NVD bleeding (OR=6.048, P=0.001) patients.ConclusionYounger age and NVD bleeding are the important risk factors for PVH after minimal vitrectomy without endotamponade in PDR.
Objective To observe the clinical effect of minimally invasive vitreoretinal (MIV) surgery combined with a modified suprachoroidal drainage surgery for retinal detachment associated with choroidal detachment (RRDCD). Methods A prospective clinical study. A total of 27 patients (27eyes) diagnosed as RRDCD were recruited in this study. There were 16 males and 11 females, with an average of (53.67±14.82) years. The mean intraocular pressure (IOP) was (8.2±2.1) mmHg (1 mmHg=0.133 kPa) and best corrected visual acuity (BCVA) of minimum resolution angle logarithm (logMAR) was 1.87±0.58. All subjects underwent 23G MIV combined a modified suprachoroidal drainage surgery, which 23G stab knife and 1 ml syringe needle were used for surgery. The visual outcome, IOP, rate of retinal reattachment and complications were comparatively analyzed preoperatively and postoperatively. Results At 1 day, 10 days, 1 month and 3 months after surgery, the average of logMAR BCVA were 1.62±0.67, 1.51±0.63, 1.39±0.54, 1.32±0.56 and the mean of IOP were (13.47±5.06), (14.43±4.09), (14.89±4.30), (15.38±3.37) mmHg, respectively. There were significant differences of logMAR BCVA and IOP between before and after surgery (F=6.19, 15.21; P＜0.05). Retinal reattachments were achieved in 27 eyes (100%) at 1 day and 10 days after surgery. At 1 month and 3 months after surgery, the rate of retinal reattachment were 88.89% (24 eyes) and 85.19% (23 eyes), respectively. No severe complications such as endophthalmitis and choroidal hemorrhage were found at follow-up visits. Conclusion MIV combined with a modified suprachoroidal drainage surgery is an effective and safe treatment for RRDCD, which can promote retina tear closure, improve visual acuity.