ObjectiveTo systematically analyze the clinical features, multimodal imaging characteristics, and subtype distribution of pigmented paravenous chorioretinal atrophy (PPCRA). MethodsA retrospective case series. From January 2015 to June 2025, 19 patients (34 eyes) diagnosed with PPCRA at Department of Ophthalmology of Daping Hospital, Army Medical Center of PLA of Army Medical University were included in the study. Among them, there were 9 males and 10 females; the age was 52.0 (18, 59) years old. All affected eyes underwent fundus color photography examination; the numbers of eyes that underwent fundus autofluorescence (FAF), optical coherence tomography (OCT), fluorescein fundus angiography (FFA), and indocyanine green angiography (ICGA) were 17, 23, 15, and 10 respectively. Based on the results of fundus color photography and/or FAF examination, PPCRA was classified into perivenous subtype, focal subtype, and confluent subtype. All images were classified by two experienced ophthalmologists in a blinded and independent manner. The Fisher exact test was used to compare the differences in macular involvement rates among different types. ResultsAmong the 34 eyes, 16 eyes (47.1%, 16/34) were perivenous subtype, 13 eyes (38.2%, 13/34) had the confluent subtype, and 5 eyes (14.7%, 5/34) had the focal subtype. The consistency rate of the independent judgments by the two readers was 79.4% (27/34) (κ= 0.653, 95% confidence interval 0.427-0.878, P＜0.001), indicating a substantial consistency. Among the 23 eyes that underwent OCT examination, 12 eyes (52.2%, 12/23) had macular involvement, including 9 eyes (90.0%, 9/10) of the fusion type and 3 eyes (30.0%, 3/10) of the venous side type; no macular involvement was observed in the focal subtype. There was a statistically significant difference in the rate of macular involvement among different types (P=0.003). FAF typically showed paravenous band-like hypoautofluorescence with irregular rim hyperautofluorescence. FFA predominantly demonstrated transmission hyperfluorescence without leakage; venous leakage was noted in both eyes of one patient. ICGA commonly showed persistent paravenous hypofluorescence. OCT revealed attenuation or loss of the ellipsoid zone and interdigitation zone, with outer retinal thinning. In severely atrophic areas, OCT also showed reduced or absent reflectivity of the retinal pigment epithelium, together with choroidal thinning. ConclusionsThe perivenous subtype was the most common subtype of PPCRA. Macular involvement was associated with the confluent subtype, suggesting a potentially higher risk of macular structural involvement in this phenotype. Multimodal imaging can clearly present lesion features and is valuable for lesion assessment and follow-up.
ObjectiveTo investigate the clinical features and prognosis of patients with choroidal tuberculoma. MethodsA retrospective and observational study. From 2011 to 2022, 15 patients (16 eyes) with choroidal tuberculoma diagnosed and treated in Department of Ophthalmology, Shanghai Eye & ENT Hospital of Fudan University were included. The patients underwent examinations including best corrected visual acuity (BCVA), fundus color photography, optical coherence tomography (OCT), fluorescein fundus angiography (FFA), and indocyanine green angiography (ICGA). Chest CT examination, purified protein derivative test and interferon-γ release test were also performed. BCVA was performed using the Snellen visual acuity chart, which was converted to Logarithm of the minimum angle of resolution (logMAR) visual acuity when recorded. All the patients received antitubercular therapy and the duration was 12-15 months. Thirteen patients were combined with oral corticosteroids. The average follow-up time was 36 months. Rank sum test was used to compare logMAR BCVA before and after treatment. ResultsAmong the 15 patients, 5 were male and 10 were female; 1 case was bilateral involvement; 7 patients had a strong positive tuberculin skin test; 8 patients had a positive interferon-γ release assay. Six patients had pulmonary tuberculosis. One patient had peritoneal tuberculosis. Lesions were located in the posterior pole in 12 eyes, 1 eye with papillary tuberculoma. Peripheral lesions were found in 4 eyes. There were 9 eyes each with anterior segment inflammation or vitreous inflammation; 7 eyes were with exudative retinal detachment. OCT examination revealed a hyporeflective thickening of the choroidal stroma, the corresponding elevation of the retina, and often accompanied by subretinal fluid. FFA revealed hyperfluorescence of the mass and fluorescence accumulation with subretinal fluid at the late stage. ICGA revealed hypofuorescence of the lesion. The lesions subsided after treatment, and there was no recurrence during follow-up period. Cataract surgery was performed in 4 eyes due to complicated cataract. One eye undergone vitrectomy due to secondary rhegmatogenous retinal detachment. Anti-vascular endothelial growth factor therapy was performed in 1 eye due to secondary choroidal neovascularization. Ocular wall perforation occurred in 1 eye, and the condition was stable after treatment. Before treatment, the average logMAR BCVA was 1.02±0.57, which improved to 0.31±0.35 after treatment. The difference between the mean logMAR BCVA before and after treatment was statistically significant (P＜0.05). ConclusionsCombination of medical history, clinical manifestations, laboratory tests, and imaging can assist in the diagnosis of choroidal tuberculoma. The main manifestations are subretinal yellowish-white lesions in posterior pole. Standardized anti-tuberculosis therapy can effectively improve the prognosis of vision.
ObjectiveTo investigate short-term changes in retinal and choroidal microcirculation in healthy adults after voluntary blood donation. MethodsA prospective observational clinical study. Nine healthy volunteers (18 eyes) who donated blood voluntarily at Tianjin Medical University Eye Hospital in August 2025 were included. Among them, 5 were male (10 eyes) and 4 were female (8 eyes); their age was (38.00±12.33) years old. Optical coherence tomography angiography was used to scan the macular area within a 6 mm×6 mm range. The software of the instrument automatically divided the scanning area into three concentric circular regions centered on the fovea centralis: the central fovea region with a diameter of 1 mm, the perifoveal central fovea region ranging from 1 to 3 mm, and the perifoveal area surrounding the fovea with a diameter of 3 to 6 mm. Measurements of blood flow density in the fovea centralis region, perifoveal central fovea region, and perifoveal area surrounding the fovea at different retinal layers (the entire retinal layer, the choroidal capillary layer, and the medium choroidal blood vessel layer) were conducted 30 minutes before blood donation and 30, 120 minutes after blood donation. Diastolic blood pressure (DBP), systolic blood pressure (SBP), and intraocular pressure were recorded, and ocular perfusion pressure (OPP) was calculated. Repeated measurement data were analyzed using one-way analysis of variance. ResultsThere was no statistically significant difference in SBP, DBP, OPP and intraocular pressure among different blood donors at different measurement time points (P＞0.05). There was also no statistically significant difference in SBP, DBP and intraocular pressure among overall blood donors at different time points (P＞0.05); however, OPP significantly decreased at 120 minutes after blood donation, and the difference was statistically significant (F=5.380, P=0.02). Compared with 30 minutes before blood donation, the temporal blood flow density in the periphery of the paracentral fovea, the superior part and the surrounding area of the fovea in the peripheral area decreased significantly at 30 minutes after blood donation (F=3.920, 3.45,0 4.200; P=0.03, 0.04, 0.02), and recovered by 120 minutes. There was no statistically significant difference in the blood flow density of the entire retinal layer in the macular area and the large blood vessel layer in the choroid at different measurement time points among overall blood donors (P＞0.05). The correlation analysis results showed that there was no significant correlation between OPP at 30 minutes and 120 minutes after blood donation and the temporal blood flow density of the choroidal capillary layer in the temporal part of the periphery of the paracentral fovea, the superior part and the surrounding area of the fovea (r=0.037, 0.047, 0.187, ?0.027, 0.056, 0.156; P＞0.05). ConclusionsThere is no significant correlation between the blood flow density in the macular area of the retina and choroid and OPP. The mild and reversible changes in the choroidal microcirculation could occur.