Objective To investigate the ingestion, metabolism and subcellular localization of indocyanine green (ICG) in human retinal epithelial (R PE) cells.Methods RPE cells were incubated with 0.25 mg/ml ICG under the condition of 37oC in the camera. The ICG granule and ultrastructure of RPE cells were observed under the electron microscopy after 1, 4, and 24hour incubation, and the ICG autofluorescence was detected by fluorescence microscopy after the incubation for 1, 2, 4, 8, 12, 24, and 48 hours, respectively. The ab sorbency (A value) of ICG solution was measured at 805 nm with ultraviol et/v isible specrtrometer. The standard curve of concentration of ICG was drawn and the related equation of concentration of ICG and the A value was calculated. After being incubated for 1, 2, 4, 8, 12, 24, 48, and 72 hours, respectively, the A value of supernatant fluid was calculated according to the equation. Aft er incubated with ICG for 24 hours, one sample was observed under electron microscope and fluorescence microscope per week to evaluate the metabolizable period of ICG .Results ICG granules were distributed evenly after entering the RPE cells. After incubated with 0.25 mg/ml ICG for 24 hours, no significant change of the ultrastructure of the RPE cells was found. ICG granules accu mulated in the cells as the time goes by and reached the peak after 24 hours, and then they decreased because of the slowdown of the metabolism. Few ICG was still remained in the cells 1 week later Conclusions RPE cells may take in ICG actively. ICG metabolizable period in RPE cells is long, which may be one of the mechanisms of the toxicity of ICG to the retina in the vitreous operation.(Chin J Ocul Fundus Dis，2004，20：179-181)
Objective To investigate the cilinical value of indocyanine green angiography(ICGA) in patients with Vogt-Koyanagi-Harada syndrome(VKH). Methods Fundus fluorescein angiography(FFA) and indocyanine green angiography(ICGA) were used for comparative analyses in 26 cases(52 eyes)of VKH. Results In the acute stage of VKH,FFA revealed the multifocal leakage in the pigment epithelium and the multifocal serous retinal detachment,and the typical FFA manifestations disappeard following treatment．In the acute stage of the disease the ICGA showed:(1)numerous patchy areas of hypofluorescence and decreased flurescence in large and middle choroidal vessels(66.7%);(2)dilatation of the choroidal vessels(70.8%)and(3)in latephase of ICGA,the patchy areas of hyperfluorescence(79.2%).During the recovery stage of the disease,the abnormal undings in ICGA were resolved slower than those found in FFA. Conclusions ICGA may assist in providing valuable informations on choroidal circulation of VKH and be useful in evaluating the curative effects． (Chin J Ocul Fundus Dis,20000,16:9-11)
Objective To evaluate the effect of pulse dye-densitometry by indocyanine green test (PDD-ICG)on the assessment of hepatic function reserve. MethodsSeventy-five hepatic carcinoma patients aimed to accept hepatectomy from March 2007 to February 2008 at West China Hospital were prospectively included in this study.Patients were grouped by dysfunction grade of hepatic function and the indexes before operation were compared.Furthermore, patients were grouped by K and R15 value to compare the moderate and severe liver dysfunction ratio, respectively. ResultsSixty cases manifested slight liver dysfunction,12 cases manifested moderate liver dysfunction,and 3 cases manifested severe liver dysfunction(the latter was took into moderate group due to the cases were too few).The difference of Child-Pugh score and common liver function examination indexes such as PT and INR before operation was not significant betweentwo groups(P＞0.05).ButPDD-ICG experiment indexes(K and R15)were remarkable different betweentwo groups(P＜0.05).The patients were divided into two groups according to K and R15 value,respectively.The rate of moderate and severe liver dysfunction was significant different between K＜0.158/min groupand K≥0.158/min group(47.1% vs. 12.1%,P＜0.05),and likewise moderate and severe liver dysfunction was significant different between R15≤10% group and R15＞10% group(15.9% vs.41.7%,P＜0.05）. ConclusionPDD-ICG is an effective and easyto evaluate hepatic function reserve of patient undergone hepatectomy.Therefore,it may give clinical instruction to predict and avoid the liver dysfunction after operation.
ObjectiveTo assess the occurrence of CNV in patients presenting with flat irregular pigment epithelial detachments (FIPED). MethodsForty-five patients (49 eyes) with FIPED on OCT were enrolled in this retrospective study. There were 25 males (28 eyes) and 20 females (21 eyes). The mean age was 61.022±9.292 years. FFA, ICGA, spectral domain OCT and OCT angiography (OCTA) were performed in all patients during the same period. The FIPED was defined as an irregular elevation of the RPE allowing distinct visualization of Bruch’s membrane on OCT B-scan. The abnormal vascular signals from the deep retinal layer to the choroid layer on OCTA was defined as CNV. The CNV was classified into a type 1 CNV and a type 2 CNV according to the OCT characteristics. The CNV was classified into a typical and occult CNV according to the characteristics of the FFA image. Of all 49 eyes, fundus angiography revealed 18 eyes (36.7%) with CNV, and 31 eyes (63.3%) with no characteristic signs of CNV. FFA examination found that CNV in 8 eyes (classic CNV in 1 eyes, occult CNV in 7 eyes), which confirmed by OCT were type 1 CNV; transmitted fluorescence in 41 eyes. ICGA examination showed that CNV-like hyperfluorescence spots in 18 eyes, suspicious hyperfluorescence spots in late stage in 20 eyes, and choroidal high permeability in 11 eyes, respectively; and 18 CNV eyes were confirmed to be type 1 CNV by OCT. To compare the detection of CNV by OCTA and fundus angiography. ResultsOf the 49 eyes with FIPED, OCTA detected 36 eyes (73.5%) of type 1 CNV, and full or partial strong reflex signals were seen in FIPED; 13 eyes (26.5%) were not associated with CNV, and some strong reflection signals were found in FIPED in 9 eyes, 4 eyes with weak reflection signal. The FFA was examined for 1, 7 eyes of the classic and occult CNV, which confirmed to be type 1 CNV by OCTA. Among the 18 eyes with CNV which detected by ICGA, OCTA also found type 1 CNV. Among the 20 eyes with ICGA’s late suspicious strong fluorescent spots, OCTA showed 17 eyes of type 1 CNV; in 11 eyes with high choroidal permeability, OCTA showed type 1 CNV in 1 eye. Among the 36 eyes with CNV which detected by OCT, there were SRD in 32 eyes, no SRD in 2 eyes and retinal interlamellar cavities in 2 eyes. ConclusionOCTA can detect 73.5% of FIPED eyes with CNV. Compared with traditional fundus angiography, OCTA has a higher detection rate of CNV under FIPED. The FIPED of the internal strong reflection signal has a certain diagnostic value for the type 1 CNV.
Objective To observe and estimate the image characters of indocyanine green angiography (ICGA) and fundus fluorescein angiography (FFA) in atrophic age-related macular degeneration(AMD) and macular drusen. Methods FFA, ICGA and fundus photography were performed on 95 eyes of 73 atrophic AMD patients, in cluding 19 patients (26 eyes) with depigmentation and atrophy of retinal pigment epithelium (RPE), 15 (30 eyes) with macular drusen, and 39 (39 fellow eye) with unilateral exudative AMD.Results In 26 eyes with depigmentation and atrophy of RPE, the result of FFA of 24 eyes with depigmentaion showed patch hyperfluore scence, and of ICGA showed patch hyperfluorescence and hypofluorescence on the late photographs; in 2 eyes with maplike atrophy of RPE, the result of FFA showed patch hyperfluorescence, and of ICGA showed choriocapillaris defect with sharply demarcated boundaries and hypofluorescence of large choroidal vessels. In 30 eyes with macular drusen, the result of FFA of 8 eyes with hard drusen showed hyperfluorescence, and of ICGA showed patch and spot hyperfluorescence; the result of FFA of 16 eyes with soft drusen showed hyperfluorescence, and of ICGA showed persistent patch hypofluorescence intermixed with cluster hyperfluorescence; and the result of FFA of 6 eyes with both soft and hard drusen showed hyperfluorescence, and of ICGA showed patch hyperfluorescence intermixed with hypofluorescence. When it was hypofluorescence in ICGA in patients with macular drusen, larger quantity and range of fluorescence were found in FFA than in ICGA; when it was hyperfl uorescence in ICGA, smaller quantity and range of fluorescence were found in FFA than in ICGA. In 39 fellow eyes of unilateral exudative AMD, 32 or 31 eyes, examined by ICGA or FFA, had abnormal fluorescence of drusen and depigmentation and atrophy of RPE damage.Conclusions Simultaneous examination of IC GA and FFA can be useful for accurate evaluation of fundus image characters of types of angiography in atrophic AMD.(Chin J Ocul Fundus Dis，2003，19：79-82)
ObjectiveTo explore the feasibility of using indocyanine green angiography in mapping the superficial temporal vessels and assisting design and harvesting of the superficial temporal artery based forehead flap. Methods A clinical data of 14 patients with facial soft tissue defects repaired with superficial temporal artery based forehead flaps between October 2015 and November 2022 was retrospectively analyzed. There were 9 males and 5 females with a median age of 9.5 years (range, 3-38 years). The forehead flaps were used to reconstruct facial soft tissue defects following excision of facial scar (8 cases) or congenital melanocyte nevus (6 cases). The size of defects ranged from 3 cm×2 cm to 24 cm×9 cm. Before operation, the indocyanine green angiography was used to map the superficial temporal artery and vein, and to analyze the relationship of the arteries and veins. The forehead flaps with unilateral superficial temporal fascia as the pedicle was transferred to repair the small facial defect in 2 cases. The facial pedicle contained the frontal branch of the superficial temporal artery and 2 cm of the superficial temporal fascia around the vessel, and the tiny accompanying vein of the frontal branch of the superficial temporal artery was used as the outflow of the flap. The forehead flaps with the skin pedicle including bilateral or unilateral superficial temporal fascia and the overlying skin was pre-expanded and transferred to repair the large facial defect in 12 cases. The skin pedicle contained the frontal branch of superficial temporal artery and one of main branches of superficial temporal vein. Among the 12 cases, the frontal branch of superficial temporal vein was used as the outflow in 4 cases, and the parietal branch was used as the outflow in 8 cases. The size of the flaps ranged from 3 cm×2 cm to 30 cm×13 cm. The skin pedicles were divided at 3 weeks after the flap transfer. ResultsIndocyanine green angiography could clearly showed the course and branching of the superficial temporal artery and vein. Individual differences existed in the location where the frontal branch of the superficial temporal artery entered the forehead. The superficial temporal vein had great variability and did not follow the artery. One patient had expander-related complication, which resulted in 3-cm flap necrosis. The necrotic tissue was debrided and repaired with skin grafting. The other flaps totally survived and the incisions healed by first intention. All patients were followed up 2-24 months, with a median of 11.5 months. The color, texture, and thickness of the flaps matched well with those of recipient sites. Hypertrophic scar was not observed in recipient or donor site. All patients were satisfied with the reconstructive outcomes. ConclusionIndocyanine green angiography can clearly visualize the course and the branches of the superficial temporal arteries and veins, which can help surgeons understand the position, distribution, and concomitant relationship of the superficial temporal vessels, and make a rational surgical plan of the forehead flap.
Objective To observe and analyze the configuration and distribution of vortex veins by indocyanine green angiography (ICGA) combining with widefield contact lens system. Methods A total of 28 patients (32 eyes), including 16 females (19 eyes) and 12 males (13 eyes) with the age of 28-84 (average 71), were examined by ICGA combing with widefield contact lens. The patients were divided into high myopia group (15 eyes with diopter ge;-6.0 D) and non high myopia group (17 eyes with diopter lt;-6.0 D or normal sight). Results A total of 166 vortex veins were detected, including 118 circinate veins (71.1%), 34 thick-stripe-like veins (20.5%), and 14 irregular vein (8.4%). There are 71 vortex veins in the right eyes with average 5.07 vortex veins in each eye; and 95 veins in the left eyes with average 5.28 vortex veins in each eye. The number of vortex veins at in the inferior temporal, inferior-nasal, over-temporal and over-nasal retina was 47, 42, 39, and 38, respectively, with average 1.34 vortex veins in each quadrant (the inferiortemporal was the most: average 1.53). A total of 160 vortex veins came out from the scleral around the equator area 46 disc diameter (DD) away from the optic disc (964%); the other 6 vortex veins came out at the point 3-4 DD away from the optic disc (3.6%). A total of 123 (74.1%) vortex veins had ampullae with different directions. Horizontal and vertical ampullae were most common. There was no difference in numbers and configuration of vortex veins beween the two groups. Conclusion The vortex veins has circinate, thick-stripe-like, and irregular configurations; the distribution of vortex veins in eyes with high myopia or non high myopia is almost accordant. ICGA combining with the wide-field contact lens examination can observe all of the vortex veins within a single visual field.
Purpose To observe the changes of choroidal circulati on and the retinal lesions caused by ocular contusion with indocyanine green ang iography (ICGA). Methods ICGA examination was performed on 30 cases (30 eyes) of various traumatic condition in conjunction with fundus fluorescein angiography (FFA). Results FFA of 19 cases (63.3%) showed the hypofluorence in quadrant or whole disc in accordance with the area of delayed filling of choroid. Twentysix cases (86.2%) showed d efected choroidel perfusion in ICGA,among them 16 cases showed localized delayed perfusion, in which the shortest perfusion time was 1 min 50 s and the l ongest time was 5 min.43 s,and 10 patients showed localized perfusion defect,and reversed filling time of retinochoroid vessels in 6 patients. Five cases (16.6%) had delayed filling time in both choroidal and central retinal vessels . Damage of retinal pigment epithelium was found in the areas of choroidal abnor mal perfusion. Conclusion ICGA combined with simultane ously FFA, is valuable in evaluating blunt injury of the ocular fundus and ben eficial to its diagnosis and treatment. (Chin J Ocul Fundus Dis, 2001,17:122-124)
Objective To explore the clinical manifestations and the characteristics of images of indocyanine green angiography (ICGA) and fundus fluorescein a ngiography(FFA) of multifocal choroiditis. Methods Eight patie nts (10 eyes) with multifocal choroiditis were gathered. The clinical manifestations and the images of ICGA and FFA were analyzed. Results Foci of multifocal choroiditis were found in posterior pole and peripheral areas of ocular fundi of all of the 10 eyes. The images of ICGA revealed hypofluorescence in focal area. The images of FFA showed hypofluorescence at the early phase and fluorescein leakage at the late phase in the active focus, and fluorescein staining and window defect fluor escence in the inactive focus. Conclusions The clinical manife stations of multifocal choroiditis varied with disease course, location and numbers of the lesions. ICGA and FFA can show the development of the disease clearly, which may guide the treatment. (Chin J Ocul Fundus Dis，2004，20：87-89)
Objective To observe ophthalmoscopic image characteristics of central serous chorioretinopathy (CSC). Methods Twenty-one eyes of the 18 patients diagnosed with CSC were enrolled in this study．The patients included 12 males (14 eyes) and six females (seven eyes)．The patients ages ranged from 26 to 47 years，with a mean age of (39.1plusmn;5.4) years. There were nine patients (11 eyes) with acute CSC, seven patients (seven eyes) with chronic CSC, and two patients (three eyes) with recurrent CSC. All the patients were examined using color fundus photography including infrared (IR), auto-fluorescence (AF), near infrared ray-auto-fluorescence (NIR-AF), fluorescein angiography (FA) and indocyanine green angiography (ICGA) photography. The ophthalmoscopic image characteristics of CSC were comparared. Results The circular serous retinal detachments of 21 eyes were depicted in color images of the ocular fundus, which in the IR showed the hypo-fluorescence. Ten eyes displayed mottled hyper-fluorescent spots associated with serous retinal detachments corresponding to the leakage points. The serous retinal detachments of 15 eyes in the AF images showed hypo-fluorescence, six eyes showed hyper-fluorescence. Fourteen eyes presented with hypo-or hyper-fluorescent spots corresponding to the leakage points, seven eyes presented without abnormal fluorescence corresponding to the leakage points. In addition, three eyes with acute CSC showed many scattered hyper-fluorescent spots, which showed hypo-fluorescence in the ICGA. The serous retinal detachment of 15 eyes exhibited hypo-fluorescence in the NIR-AF images, six eyes showed hyper-fluorescence. Fourteen eyes presented with hypo- or hyper-fluorescent spots corresponding to the leakage points, seven eyes presented without abnormal fluorescence corresponding to the leakage points. Twenty-one eyes in FA identified the leakage. Eight eyes showed regional choroidal delayed filling, 13 eyes exhibited regional choriocapillary dilatation during 1-5 minutes after injection of ICGA. During 1-5 minutes after injection of ICGA, six eyes showed more lesions than FA, three eyes showed obvious patchy hypo-fluorescence whereas the FA were normal. Conclusions CSC has its own characteristic fundus images in the IR, FA and NIR-A. FA is still the photographic method of choice, but ICGA can reveal lesions of the choroid in CSC. IR, FA and NIR-AF are not as good as FA and ICGA for detecting of leakage points.