The improvement of diagnostic levels for fundus diseases depend on the advancements of fundus imaging technology. Different fundus imaging technologies allow doctors to inspect ocular fundus from different aspects such as morphological or functional changes of retina. As a basic fundus examination method, optical coherence tomography provides highresolution and crosssectional retinal images coupled with noninvasive advantages. Fully understanding of the advantages and disadvantages of each fundus imaging technique, appropriate choosing one or combining several imaging techniques, and optimizing diagnostic procedures for each fundus disease are crucial steps to improve our diagnostic levels of ocular fundus diseases.
In recent years, more and more new diagnostic and examining techniques are popularized, which improves the level of ocular fundus disease diagnosis and treatment. Because of the uneven distribution of diagnostic and therapeutic instruments resources, low level of application techniques, and different professional level of the doctors, the improvement and development of the application of the equipments and level of the diagnosis and treatment were inhibited. Appropriate understanding and applying basic diagnostic techniques of ocular fundus disease and comprehensive promoting the professionalsprime; levels are an urgent problem needs to be solved.
Objective To investigate the features of ocular fundus of retinal pigment epithelial detachment (PED) in Chinese patients more than 50. Methods The clinical data of 31 continuous patients (34 eyes) with PED diagnosed by ocular fundus photochromy, fundus fluorescein angiography (FFA) and indocyanine green angiography ( ICGA ) from Oct, 2001 to Aug, 2004 were analyzed retrospectively. Results In 34 eyes with PED, the results of FFA showed serous PED in 18 (52.9%), hemorrhagic PED in 8 (23.5%), and serosanguineous PED in 8 (23.5%); the results of ICGA revealed PED associated with choroidal neovascularization (CNV) in 12 (35.3%), PED associated with ploypoidal choroidal vasculopathy (PCV) in 17 (50.0%), PED associated with both CNV and PCV in 1 (2.9%), and avascular PED in 4 (11.8%). Conclusions PED in Chinese patients more than 50 can be associated with CNV, PCV or other avascular diseases, and PCV is the most common intercurrent choroidal vascular disease. (Chin J Ocul Fundus Dis, 2006, 22: 224-227)
Objective To compare the characteristics of the results of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) in patients with classic choroidal neovasculazation (CNV). Methods The data of FFA and ICGA of 34 patients (36 eyes) with classic CNV were analyzed retrospectively and the results of the two examinations were analyzed contrastively. Results The results of FFA revealed the clew or cartheel-tike configuration of classic CNV at the early phase in 3 out of 15 eyes (20%) with age-related macular degeneration (AMD); in 5 out of 7 eyes with pathological myopia(71.4%); and in 9 out of 14 eyes with central exudative chorioretinopathy (CEC),(64.3%),In 36 eyes with classic CNV, the images of ICGA indicated CNV distinctly in 20 (55.6%) and indistinctly in 15 (41.6%); CNV was not detected by ICGA in 1 eye (2.8%); feeding blood vessels in 6 eyes (16.7%) were detected by ICGA but none by FFA. Conclusions At the early phase of FFA, the configuration of classic CNV is clew-like in eyes with pathological myopia and CEC, and erose in eyes with AMD. The image of ICGA which indicated the outline of classic CNV is not as clear as the one of FFA, but it can reveal the feeding vessels which FFA can not. (Chin J Ocul Fundus Dis, 2006, 22: 217-209)
Objective To explore the frequency, clinical features, and characteristics of results of fundus fluorescein angiography (FFA) of uveitis related cystoid macular edema (CME). Methods The clinical data and FFA results of 67 patients (106 eyes) with posterior uveitis examined in our hospital from July 2002 to June 2005 were collected. The clinical features and characteristics of FFA images of CME were observed and analyzed. Results Among the106 eyes of 67 patients with uveitis,the CME was observed in 28 eyes (26.4%) of 18 patients, including 7 males and 11 females with the average age of (42.5plusmn;10.8) years. The dark area due to the choroidal fluorescence blocked by the macular edema was found at the early FFA phase, and th en followed by the punctate and sheetlike leakage of fluorescein; the capillar y was dilated at the venous phase, and the typical petaloid appearance was seen at the late phase because the fluorescein cumulated in several small vesicles in the macular area. After treated by corticosteroids and topical non-steroidal anti-inflammatory medicine and carbonic anhydrase inhibitors, the extent of CME diminished, and the visual acuity improved in varying degrees. Conclusi ons Uveitis may seriously harm the visual function, in which CME induces the damage of visual acuity. Early detection and timely treatment may prevent thepermanent visual damage. (Chin J Ocul Fundus Dis, 2006, 22: 394-396)
ObjectiveTo observe the features of the manifestations of fundus fluorescein angiography （FFA） in multiple sclerosis （MS） and their value in clinical diagnosis.MethodsThe clinical data of 42 patients (84 eyes) with MS diagnosed by magnetic resonance imaging (MRI) and examination of cerebrospinal fluid (CSF) were retrospectively analyzed. The clinical data included visual acuity, ocular fundus examined by direct ophthalmoscope after mydriasis, FFA, visual field, CSF，visual evoked potential (VEP) and MRI examination.ResultsIn 42 patients (84 eyes),the positive detectable rate of examination of direct ophthalmoscope, CSF, visual field, VEP, and MRI was 36.9%, 21.4%, 71.4%, and 83.3% respectively. Abnormal results of FFA were found in 44 eyes (52.38%), including papillitis in 4 eyes（4.76%）at the early stage with extended physiological scotoma and central scotoma; neuroretinitis in 7 eyes （8.33%）at the medium stage with central or para-central scotoma; optic atrophy in 33 eyes（39.29%） at the late stage with centripetal constriction and even tubular visual field. ConclusionThe main angiographic features of MS are papillitis, neuroretinitis and optic atrophy. The manifestations of FFA combined with the results of examination of CSF，visual field, VEP and MRI is helpful for comprehensive and exact diagnosis of MS.(Chin J Ocul Fundus Dis, 2005,21:300-302)
Objective To detect the value of three-dimensional (3D) ultrasound diagnosis in common ocular fundus diseases. Methods Two-dimensional (2D) images of 38 patients with common ocular fundus diseases were three-dimensionally reconstructed via 3D ultrasound workstation. The 3D images reflecting the ocular diseases were analyzed. Result In 38 patients with common ocular fundus diseases, there was vitreous hemorrhage in 16 patients, retinal detachment in 12, choroidal detachment in 5, and intraocular space occupying lesion in 5. Compared with the 2D images, 3D reconstructed images reflect the lesions more intuitionistically, displayed the relationship between the lesions and the peripheral tissues more clearly, and revealed the blood flow more specifically. During a scanning examination, 3D reconstructed technology provided the diagnostic information of section of X, Y and Z axises simultaneously which shortened the time of examination; the condition of any point of lesions and the relation between the lesion and the peripheral tissues could be gotten by the tools like cut and chop provided by 3D imaging software itself, which avoided detecting the same lesion with different angles and lays and proved the diagnostic efficacy. Conclusions 3D ultrasound diagnosis is better than 2D in diagnosis of vitreous, retina, choroid, and intraocular space occupying lesion. 3D ultrasound diagnosis is a complementarity for the 2D one, and the Z axis changes the former observational angles which may provide the new way of precise diagnosis. (Chin J Ocul Fundus Dis, 2005, 21: 381-383)
Objective To investigate the iconographic characteristics and clinical significances of synchronic examination of indocyanine green angiography (ICGA) and fundus fluorescein angiography (FFA) for high myopia.Methods Thirty patients (57 eyes) with high myopia（gt;-6.00D）, selected randomly and consecutively, were examined by ICGA and FFA synchronically.Results The result of early phase of FFA showed hypofluorescence of the background in 25 eyes，while of late phase showed subretinal neovascularization (SRNV) in 10 eyes and streak formation in 40 eyes. The result of ICGA showed choroidal retrobulbar arteries in 8 eyes, hypofluorescence of the background in 35 eyes, SRNV in 8 eyes, and streak formation in 52 eyes.Conclusion The iconographic characteristics of ICGA and FFA of high myopia include hypofluorescence of the background, SRNV and streak formation. ICGA can givemore exact information on the lesions of choroid in high myopia. The synchronic examination of ICGA and FFA may act as a guide to the therapy for high myopia.(Chin J Ocul Fundus Dis，2003，19：87-89)
ObjectiveTo probe the classification of diabetic retinopathy (DR) and the different grade of diabetic and type of macular edema according to fundus fluorescein angiography (FFA). MethodsFFA was performed on 1 058 patients (2 097 eyes) to classify DR and macular edema with the analysis of duration of DM, visual acuity, manifestation of FFA images and results of ophthalmoscopic examination.ResultsIn 2 097 eyes, there were 124 (5.9%) without DR, 396 (18.9%) with DR I, 430 (20.5%) with DR II, 563 (26.8%) with DR III, 262 (125%) with preproliferative diabetic retinopathy (PPDR), 254 (12.%) with DR IV, 60 (2.9%) with DR V, and 8 (0.4%) with DR VI. In 2 097 eyes there were 819 (39.1%) with macular edema, including 311 (38%) with focal macular edema, 322 (39.3%) with diffused macular edema, 112 (13.7%) with cystoid macular edema, 25 (3.1%) with ischemia macular edema, and 49 (6.0%) with proliferative macular edema.ConclusionWith the analysis of the results of FFA of 2 097 eyes, we classify DR in stage Ⅰ (primary stage Ⅰ and Ⅱ), Ⅱ (primary stage Ⅲ), Ⅲ (preproliferative diabetic retinopathy), Ⅳ,Ⅴ, and Ⅵ; classify macular edema of DR in focal, diffused, cystoid, ischemic, and proliferating ones.(Chin J Ocul Fundus Dis, 2003,19:333-337)
Objective Observation on the characteristics of choroidal melanomas with indocyanine green angiography (ICGA) and fundus fluorescsin angiography(FFA). Methods Both ICGA and FFA were used in 16 cases of choroidal melanoma for comparison and analysis. Results 81.2% of tumors showed hypofluorescence all the way or faint fluorescence in later stage．62.6% of tumors had characteristic intrinsic tumor vassels with ICGA,while 12.5% of tumors had intrinsic vessels with FFA．Those tumors that can't be diagnosed owing to whole hyperfluorescence in later stage with FFA may be diagnosed by visibility of intrinsic tumor vessels with ICGA. Conclusion ICGA is helpful in the diagnosis of choroidal melanoma. (Chin J Ocul Fundus Dis, 2000，16：3-5)