Objective To observe the findings of indocyanine green angiography(ICGA) and fundus fluorescein angiography (FFA) of the patients with multifocal posterior pigment epitheliopathy(MPPE). Methods ICGA and FFA were performed in 6 cases(7 eyes)of MPPE and the findings were analysed and compared between these examinations. Results Five cases(5 eyes)were found to be in the active stage of the disease under FFA,and among them 4 eyes(80%)showed delayed choroidal perfusion at the early stage of ICGA.During the active stage of the disease,ICGA showed leakage relative to FFA leakage,and there were diffuse hyperfluorescence around the points of leakages as well as in the posterior pole of ocular fundus．In convulescence,although FFA revealed no obvious leakage,ICGA still denoted the presence of leakages. Conclusions MPPE was considered to be the more serious type of central serous chorioretinopathy showing the same but more extensive ICGA abnormality. (Chin J Ocul Fundus Dis,2000，16：6-8)
Objective To assess the effectiveness of transpupillary thermotherapy (TTT) for the treatment of central exudative chorioretinopathy. Methods Tweenty-nine eyes with central exudative chorioretinopathy were treated with Iris 810 nm diode laser TTT. The laser beam size was 1.0, 2.0 or 3.0 mm with power settings between 80-300 mW and treatment time 60 sec. The follow up periods were wihzin 4-40 weeks. The therapeutic effect was accessed by visual acuity examination,dinect ophthalmoscopy and fluorescein or indocyanine green angiography. Results The visual acuity improved in 8 eyes (28%), remained no change in 19 eyes (65%) and decreased in 2 eyes (7%). Choroidal neovascularization were closed in 12 eyes in fundus angiography. The symptoms alleviated in 10 patients. Conclusion Transpupillary thermotherapy is a potential treatment for the central exudative chorioretinopathy. (Chin J Ocul Fundus Dis, 2002, 18: 184-186)
Objective To evaluate the morphological changes of retinal neuroepithelium of central serous chorioretinopathy (CSC) by Fourierdomain optical coherence tomography(FD-OCT). Methods FD-OCT scan was performed on 92 eyes of 88 patients with CSC. The CSC diagnosis was established by international visual acuity chart, slit-lamp microscope, direct/indirect ophthalmoscope, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA). 6 mm horizontal line OCT scan was performed utilizing the infrared light emitted by diode, the scan depth was 2 mm with a 6 mmtimes;6 mm transverse area. The vertical and horizontal resolution was 5 mu;m and 18 mu;m respectively. The scan mode was 512times;128. Results The uplift of retinal neuroepithelium, separation or abnormal band of retinal pigment epithelial (RPE) were found in all eyes. There were 83 eyes (90.22%) of pigment epithelial detachment (PED), 68 eyes (73.91%) of nodular protruding of RPE, 5 eyes (5.43%) of localized RPE defects in the PED lesion, 36 eyes (39.14%) of dust-like reflects in the subretinal space and 59 eyes (64.14%) of granular deposits in the subretinal space. Conclusion Fourier-domain OCT scans can detect detailed morphologic changes in the retina of CSC patients.
Objective To investigate the clinical manifestation and histopathologic changes of the fungal necrotizing retinochoroiditis. Methods Collecting 7 cases of fungal retinochoroiditis with severe immunodepression and loss of visual acuity.Seven removed eyeballs were stained with HE,PAS and silver methenamine,and observed by light microscopy,and in addition,2 of them examined by electron microscopy.Also fungal cultures of blood and affected tissues were performed. Results The chief clinical macnifestation included ciliary injection of conjunctiva,opaque aqueous fluid and vitreous and diffuse hemorrhage and greyt white opacity with retinal detachment in severe cases.Pathologic changes included hemorrhage in the retina,chorioretinal tissue necrosis,hyphae in the blood vessels,affected tissue and vitreous.Fungal culture of blood was positive in three cases.Culture of affected tissues was positive in all cases. Conclusions Eedogenous fungal infection of choroid and retina may be due to the severe immunodepression of the sufferers and usually causes chorioretinal tissue destruction and blind. (Chin J Ocul Fundus Dis, 1999, 15: 235-237)
Objective To analyze the characteristics of images of fundus fluorescein angiography (FFA) in patients with central serous chorioretinopathy (CSC).Methods We observed the positions of leakage spots of retinal pigment epithelium (RPE) and analyzed their characteristics in 598 CSC patients. The ages, visual acuty, detachment areas of sensory retina, and leakage patterns of RPE were recorded and the correlation of them were analyzed. Results The leakage concentrated in the posterior pole, which occurred more frequently in the superior quadrant, nosal quadrant, and near fovea regions than in the inferior quadrant,temporal quadrant, and far regions from fovea, respectively (chi;2=67.13,20.93, 212.715; Plt;0.01).We found that there were relations between the ages of patients and the patterns of the leakage. A total of 35 patients (54.7% out of 64) at the age of ge;50 had small leakage; 82 patients (53.2% out of 154) at the age of 35-39 had diffusing leakage. Smaller retinal detachment in patients with multiple serous leakage and bigger retinal detachment area in patients with single serous leakage were found; no statistical significance was found (F=1.925,Pgt;0.05). There was negative correlation between the visual acuity and the detachment area in CSC patients (t=-0.335,Plt;0.01), and there was no correlation between the visual acuity and the distances from the leakage spots to the fovea (t=-0.029, -0.145;Pgt;0.05).Conclusion The leakages occurs in various regions whose difference is significant; the patterns of leakage are related to the ages; there is no relation between the serous retinal detachment area and the number of the leakage.
Objective To evaluate the clinical features and treatment outcomes of ocular posterior segment syphilis. Methods The clinical data of 24 patients with active ocular syphilis were retrospectively reviewed. The diagnosis was made first in eye clinic，and verified by treponema pallidum particle agglutination (TPPA) and rapid plasma reagin (RPR). The patients, 17 males and 7 females, aged from 30 to 63 years with an average of 47.6 years. The duration of symptoms ranged from 3 days to 2 years with an average of 5.8 months (le;1 month, 7 cases; 1-3 month, 5 cases; 3-6 months, 5 cases; ＞6 months, 7 cases). There were 18 bilateral cases and 6 unilateral cases. The result of human immunodeficiency virus (HIV) test was negative for all cases. Twenty-three patients received systemic penicillin therapy and 1 patient was treated with oral erythromycin due to penicillin allergy. Before treatment, the mean visual acuity was 0.17plusmn;0.19，the mean titer of RPR was 1:84。The follow-up period was half a year. Results The major ocular manifestations included bilateral (16 cases) or unilateral (1 case) chorioretinitis, unilateral retinal vasculitis (2 cases), unilateral neuroretinitis (2 cases), and bilateral (2 cases) or unilateral (1 case) optic neuritis. The mean follow-up visual acuity was 0.60plusmn;0.29，the mean follow-up titer of RPR was1:18.8. Some patients had got the diagnosis and prompt treatment at the early stage of the disease and their visual acuity recoveried very well. Conclusions The major manifestion of ocular posterior segment syphilis is chorioretinitis. It is important to consider the possibility of syphilis when patients have inflammation of posterior segment. Prompt serology examination and penicillin treatment are the keys to cure ocular syphilis.
Objective To analyze the etiology of central exudative chorioretinopathy（CEC）. Methods A total of 32 CEC patients were asked the medical history, and underwent examination of purified protein derivative（PPD）test, chest Xray, blood routine test, Creactive protein, erythrocyte sedimentation rate, TORCH test and rapid plasma regain cirde card test, to determine the possible causes of CEC. Results Thirty-two patients didnprime;t have the history of tuberculosis, and no evidence of systemic active tuberculosis was found in the chest X-ray examination. the results of PPD test showed the positive rate was 37.5％. The disease condition of paitents with positive result of PPD test was stable or was alleviated after anti-tuberculosis therapy. All the results in IgM of TORCH test and rapid plasma regain cirde card test were negative. Conclusion No infectious factors related to CEC was found, thus choroidal neovascularization of CEC might be idiopathic.
Purpose To investigate the pattern of subretinal neovascular membrane(SRNVM)in central exudative chorioretinitis(CEC). Methods With the help of a PC microcomputer,we performed a quantitative measurement of SRNVM in 32 eyes of 32 patients with Rieger is CEC. Results SRNVM-optic disc area ratio were 0.1151plusmn;0.0842．The foveola was on the top of SRNVM in 7 cases．The other 25 of SRNVMs were scattered in macular area around foveola,and 2 of them were nasal to it．The distance between the edge of SRNVM and foveola was less than 175mu;m in 13 cases,175～300mu;m in 4 cases and more than 300mu;m in 15 cases． Conclusion To be compared with the previous data,the present results suggested that laser photocoagulation might be one of the most important therapies for SRNVM in Rieger is CEC． (Chin J Ocul Fundus Dis,1998,14:114-115)
Objective To evaluate the therapeutic effect of vitrectomy on bullous retinal detachment. Methods The clinical data of 7 patients (9 eyes) with bullous retinal detachment who had undergone vitrectomy due to useless photocoagulation were retrospectively analyzed. Bullous retinal detachment of the patients had been diagnosed by examination of slit-lamp microscope, three-mirror gonioscope, indirect ophthalmoscope, B-mode ultrasound, and fundus fluorescein angiography. All of the affected eyes underwent vitrectomy with closed triple incisions through the pars plana after release of subretinal liquid under the local anaesthesia. The cortex of vitreous body was taken out, and exsuction of subretinal liquid was carried out via retinal incision. Photocoagulation closed the incision and the effusion area of the retina, and intraocular filling matter was injected after exchange of air and liquid. The follow-up period lasted 3 months to 8 years with the average period of 47 months. Results Reattached retina was found in all of the affected eyes during the follow-up period. One eye underwent a second vitrectomy due to local retinal redetachment caused by a new retinal hole formed by the pull of pre-retinal proliferative membrane and a silicon vesicle entered the subretinal space, but the retina reattached after 1-year follow-up examination. The visual acuity impr oved in different degree after the operation in 8 eyes, but remained unchanged in 1 eye. Conclusion Vitrectomy for terminal bullous retinal detachment may promote the reattachment of retina safely and effectively, and save partial visual acuity of the affected eyes. (Chin J Ocul Fundus Dis, 2006, 22:299-301)