ObjectiveTo observe clinical outcomes of laser photocoagulation on retinopathy of prematurity (ROP). MethodsClinical data of 64 cases of ROP infants (127 eyes) were studied retrospectively. Fifteen infants (30 eyes) were diagnosed of pre-threshold ROP (type Ⅰ, 23.6%) and 49 cases (97 eyes) of threshold ROP (76.4%). All the eyes underwent photocoagulation through binocular indirect ophthalmoscope (532 nm or 810 nm) within 72 hours after the confirmation ROP. In all the 15 cases (30 eyes) of pre-threshold ROP (type Ⅰ), 6 of them (12 eyes) were photocoagulated by laser of 532 nm, and the other 9 ones (18 eyes) were treated with 810 nm. In 49 threshold ROP infants (97 eyes), 37 cases (73 eyes) and 12 ones (24 eyes) were treated with laser of 532 nm or 810 nm respectively. All the infants were followed up 12-36 months (18.4 months) since photocoagulation to investigate regression of ROP. All the data of ROP infants photocoagulated, such as recovery rate of one-time photocoagulation, repeat rate, unfavorable outcomes, and complications, were analyzed statistically according to the severity of ROP and wave length of laser employed. ResultsIn all the 127 photocoagulation treated eyes, ROP regressed completely in 125 eyes (98.4%), temporal retinal traction remained in 2 eyes (1.6%), and no retinal detachment was found. ROP regressed completely in 118 eyes (92.9%) after one-time photocoagulation, recovered totally in 6 eyes (4.7%) after repeating photocoagulation 2-3 times, and resorted to cryotherapy in 3 eyes (2.4%). Subconjunctiva hemorrhage, found in 12 eyes (9.4%), was the most common complication. During photocoagulation, anesthetic accident occurred in 1 infant (1.6%), and 1 eye developed cataract (0.8%). It was suggested from statistical analysis that there was no significant difference on efficiency or safety between pre-threshold (type Ⅰ) and threshold ROP photocoagulated by laser of 532 nm or 810 nm. However, almost all of the ROP infants need repeat photocoagulation or additional cryotherapy, and patients with unfavorable outcomes or severe complications, occurred in threshold ROP treated with 532 nm laser. ConclusionPhotocoagulation with 532 nm or 810 nm laser is effective for type Ⅰ pre-threshold or threshold ROP.
ObjectiveTo investigate the characteristics of fundus image in patients with combined hamartoma of the retina and retinal pigment epithelium (CHRRPE). Methods Eight eyes of 8 cases with CHRRPE were included in this study.There were 5 males and 3 females, ranging from 6 to 21 years old (mean 14.13 years).In all cases, unilateral eye was affected. The best-corrected visual acuity (BCVA) was 0.02 to 0.2. The intraocular pressure in all eyes was normal. The ocular anterior segment in all cases was alright. For all cases, fundus photography, fundus autofluorescence (AF), fundus fluorescein angiography (FFA) and spectral-domain optical coherence tomography (SD-OCT) were taken. The characteristics of fundus image were analyzed. ResultsAll the CHRRPE lesions located at posterior pole, presenting as yellow-white elevations, surrounded by hyperpigmentation. Retinal vascular tortuosity and proliferation of epiretinal membrane were found in all CHRRPE lesions. In 8 affected eyes, lesions were involved in macula and optic disc in 3 eyes (37.5%), lesions were located in macula in 5 eyes (62.5%). AF images showed lesion bulges and the surrounding hyperpigmentation corresponding to the local hypo-AF in 7 eyes (87.5%), dense epiretinal membrane corresponding to the local hyper-AF in 1 eye (12.5%). FFA showed local hypofluorescence of choroidal background corresponding to lesions and the surrounding hyperpigmentation, tortuous retinal vascular due to traction of shrinkage membranes. Retinal capillary leakage and the fluorescence brightness gradually increased in all lesions.No retinal hemorrhage, exudation, area of capillary non-perfusion, retinal and choroidal neovascularization could be found in 8 CHRRPE eyes. SD-OCT showed disorganized and elevated lesion with uneven reflectivity in inner retina, mild attenuation of the retinal pigment epithelium (RPE) and photoreceptor inner segment/outer segment junction in all CHRRPE eyes. Of the 8 CHRRPE eyes, cavernous hypo-reflective shadowing due to the shielded optical signal acquisition below dense epiretinal membranes in 2 eyes (25.0%), membrane-like hyper-reflective signals connecting with RPE in 1 eyes (12.5%). ConclusionsDecreased AF appear in the location of CHRRPE lesion and the surrounding hyperpigmentation. Hypofluorescence of choroidal background can be found in the early phase of FFA, the fluorescence brightness of CHRRPE lesion gradually increases in FFA process. The retinal elevation, attenuated signal reflection of the RPE and photoreceptor inner segment/outer segment junction in CHRRPE lesion can be verified by OCT.
ObjectiveTo observe the imaging features of short-wave length fundus autofluorescence (SW-AF), near-infrared fundus autofluorescence (NIR-AF)and spectral-domain optical coherence tomograph (SD-OCT) in acute central serous chorioretinopathy (CSC). MethodsThis is a retrospective observational consecutive case series study. Eighty-two eyes with acute CSC from 76 patients were enrolled in this study.There were 50 males (56 eyes) and 26 females (26 eyes), average age was (41.32±7.37) years old, average course of the disease was (0.47±1.73) months. The routine clinical examinations included best corrected visual acuity, slit lamp microscope, indirect ophthalmoscope, fundus fluorescein angiography (FFA), SW-AF, NIR-AF and SD-OCT. The imaging features of NIR-AF, SW-AF, SD-OCT and FFA in same eye with acute CSC were analyzed comparatively. ResultsSD-OCT showed retinal pigment epithelium (RPE) detachment corresponding to RPE leakage point on FFA images in all CSC eyes. RPE leakage points in all eyes corresponding to local hypo-NIR-AF, whereas corresponding to normal SW-AF. NIR-AF demonstrated the area of decreased AF corresponding to serous retinal detachment in all eyes, of which, the area of hypo-SW-AF was consistent with that of sensory retinal detachment in 75 eyes. Except for RPE leaking fluorescein in 82 eyes, FFA showed window defects corresponding to clusters of hypo-NIR-AF in 45 eyes, of which, 27 eyes showed hypo-SW-AF appearing concurrently with the locations of window defects of FFA. In 18 eyes, the extent and amount of hypo-SW-AF were less than that of hypo-NIR-AF. ConclusionsThere was local RPE detachment in all eyes with acute CSC. The locations of sensory retinal detachment, local RPE detachment and RPE depigmentation showed hypo-NIR-AF. The locations of sensory retinal detachment and RPE depigmentation showed hypo-SW-AF in most of acute CSC eyes.