ObjectivesTo evaluate the effect of peeling of internal limiting membrane (ILM) on the postoperative visual acuity in patients with diabetic macular edema, and to detect the role indocyanine green (ICG) plays in the surgery of peeling of ILM. MethodsThirty patients (31 eyes) with diabetic retinopathy at proliferative stage with macular edema underwent vitrectomy. The patients were randomly divided into two groups: 16 eyes in group A underwent single vitrectomy with panretinal photocoagulation and ocular filling with 20% SF6; 15 eyes in group B underwent vitrectomy and peeling of ILM after the posterior pole was stained with ICG. All of the patients were asked to keep the posture of facing down for 10-14 days. The follow-up lasted 3-12 months.ResultsIn 16 eyes in group A, the visual acuity increase of 2 or more lines in 10 (62.5%) and alleviation of macular edema in 9 (56.2%) were found; the postoperative average macular retinal thickness examined by optic coherence tomography (OCT) was 393 μm. In 15 eyes in group B, the visual acuity increase of 2 or more lines in 14 (93.3%) and alleviation of macular edema in 14 (93.3%) were found; the postoperative average macular retinal thickness was 319 μm. The postoperative improvement of visual acuity in group B was much better than that in group A (X2=4.210, P=0.05), while the postoperative macular retinal thickness in group B was obviously lower than that in group A (P＜0.01). The operative sample was proved to be the ILM. ConclusionsVitrectomy is effective for diabetic macular edema and the curative effect may be improved by peeling of ILM; ICG can dye ILM well, which ensures the safe and accurate peeling of ILM.(Chin J Ocul Fundus Dis, 2005,21:138-141)
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 lt;brgt;To investigate the morphological features of choroidal neovascularization (CNV) in central exudative chorioretinopathy (CEC) using optical coherence tomography（OCT）. lt;brgt; lt;brgt;Methods lt;brgt;OCT and fundus fluorescein angiography (FFA) were performed in 41 cases (43 eyes) of CEC,and the course of CEC disease was from 1 week to 10 months. Twenty-seven of 43 eyes were also examined by indocyanine green angiography (ICGA). lt;brgt; lt;brgt;Results lt;brgt;OCT images revealed 5 kinds of morphological features of CEC: well-defined CNV（41.86 %）,poorly-defined CNV(30.23 %),hemorrhagic pigment epithelium detachment （PED）(16.28 %), CNV companied with serous (6.98 %) or hemorrhagic neurosensory retina detachment (4.65 %). CNV mainly showed well-defined and poorly-defined CNV (72.09 %).In those eyes that could clear define the CNV boundary,there were 12 eyes on FFA examination and 20 eyes on ICGA examination which defined the boundary from retinal horizontal plane, while there were 23 eyes on OCT examination which defined the boundary from retinal vertical section. Classic CNV on FFA consistently presented with well-defined boundaries on OCT, whereas non-classic CNV had a variable cross-sectional appearance. lt;brgt; lt;brgt;Conclusions lt;brgt;The OCT morphological features of CNV in CEC is mainly well-defined CNV and poorly-defined CNV; OCT examination can precisely observe the retinal and choriocapillaries pathological anatomy of CEC from retinal vertical section, in making the CEC diagnosis as an important complementary examination of FFA and ICGA which observe the focus from retinal horizontal plane. lt;brgt; lt;brgt;(Chin J Ocul Fundus Dis, 2002, 18: 121-124)
Purpose To discuss changes of macular choriocapillaris hemodynamics in AMD. Methods Eighty-six eyes of 86 patients underwent ICGA,including macular drusen in 15 eyes of 15 patients,exudative AMD in 52 eyes of 52 patients,atrophic AMD in 19 eyes of 19 patients,for the observation of macular choriocapillaris perfusion. Results Choriocapillaris filling phase (CFP) of exudative AMD was obviously longer than that of eyes with normal, atrophic AMD and drusen groups (P＜0.05). Forty eyes had local or extensive choroidal filling deficiency and prolongation, including 24 eyes of exudative AMD, 12 eyes of atrophic AMD,and 4 eyes of drusen group. Conclusion CFP of macula is prolonged and choriocapillaris perfusion is abnormal in AMD and macular drusen eyes. (Chin J Ocul Fundus Dis, 2002, 18: 116-118)
Purpose To define the morphometric characteristic s and the implication of simultaneous fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) in traumatic choroidal rupture. Methods Simultaneous FFA and ICGA were carried out in 17 patient s (17 eyes) with traumatic choroidal rupture. Results Choroidal ruptures were shown as hyperfluorescence region in the early pha se of FFA,and as hyperfluorescence in the late phase of FFA but in ICGA were shown as hypofluorescence region in both early and late phases.The rupture regions in ICG A were longer than that in FFA in 5 patients (5 eyes).The rupture regions in 6 patients (6 eyes) with hemorrhage could be shown in ICGA,but couldn't be shown in FFA . Conclusion ICGA is helpful in diagnosing minor choroidal ruptures,in defining the extent of traumatic choroidal ruptures,and in further understanding the pathological changes of choroidal ruptures. (Chin J Ocul Fundus Dis, 2001,17:30-32)