Objective lt;brgt;To evaluated the effect of transpupillary thermotherapy (TTT) on age-related macular degeneration (AMD). lt;brgt; lt;brgt;Methods lt;brgt;Sixty-two cases (62 eyes) of exudative AMD were managed with TTT. Before treatment, 58 cases underwent fundus fluorescein angiography(FFA),42 cases underwent simultaneous indocyanine green angiography (ICGA), and 56 cases underwent optic coherence tomography (OCT).TTT was delivered using a 810 nm diode laser with variable spot sizes 0.5-3.0 mm and power range 60-40 mW,60 seconds duration. Sixty-two cases were followed up for 1-10 months with 4.8 months average. lt;brgt; lt;brgt;Results lt;brgt;The visual acuities of last visit were compared with those before the treatment. The visual acuity was unchanged in 43 cases (69.3%), improved in 15 cases (24.2%), and declined in 4 cases (6.5%). OCT was re-done in 51 cases and compared with OCT images before TTT treatment. The height of macular edema was unchanged in 29 cases (56.9%), decreased in 18 cases (35.3%), and increased in 4 cases (7.8%). The amelioration of visual acuity was compatible with that of macular configuration in the majority of cases (74.5%). Only in 13 cases (25.5%) the amelioration of visual acuity lagged behind that of macular configuration. The re-treatment was performed in 18 cases (29.1%), probably due to insufficiency of laser power. No side-effect was found. lt;brgt; lt;brgt;Conclusion lt;brgt;TTT makes most of the cases of exudative AMD retaining or improving their visual acuity. The employment is secured. Further exploration is needed in order to obtain the parameters of the laser treatment. (Chin J Ocul Fundus Dis, 2002, 18: 180-183)
Objective To explore the relationship between the classification of diabetic macular edema（DME）and the stages of the diabetic retinopathy (DR) , the diabetic duration and the visual loss.Methods Retrospectively analyzed the clinical data of fundus fluorescein angiography (FFA) and other related information of 1521 patients who were diagnosed as DR. Classified DR according to national standard of the diagnosis and classification of DR, and classified DME according to the standard made by the early treatment diabetic retinopathy study research group of United States. The occurrence of DME in DR in each stage and the relationships between DME and the disease course and the vision were analyzed.Results In 1521 patients, 791 eyes in 468 patients had DME ( 30.77%), including 361 eyes (45.64%) with focal DME and 430 eyes (54.36%) with diffuse DME. The occurrence of DME was 1.13% in I-stage DR, 7.84%in II-stage DR, 41.98% in III-stage DR, and 48.93% in IV-stage DR. Focal and diffuse DME usually occurred at the III and IV stage of DR respectively, with 178 eyes (22.51%) with focal macular edema at the III stage of DR, and 249 eyes (31.48%) with diffuse DME at the IV-stage of DR. Patients with DME were hardly found at the V and VI stage of DR because of retinal proliferation and vitreous hemorrhage or other complications which made the condition of macula region blurred. The visual acuity of diffuse DME was worse than focal DME. DME often occurred within 10 years in the diabetic duration, and its severity and incidence increased year by year.Conclusions DME is the main cause of visual impairment of DR. The incidence of DME increased as the course of the DR prolonged. Along with the development of retinopathy, the incidence of DME increased, and the severity of DME aggravated, but the development of DME and its classification can not be brought into definite correspondence or unification with the classification of DR, hence the typing of DME in another individual classification in DR is of course necessary. (Chin J Ocul Fundus Dis，2003，19：83-86)
PURPOSE:To approach the changes of visual function by using the dense matrix mapping in macula(DMMM)in patients with age-related macular degenerationl(AMD). METHODS:The DMMM was designed using Humphrey-640,thee study included 51 patients(71 eyes)in dry type,AMD,23 patients(27 eyes)in wet type and 16 normal elderly(21 eyes). RESULTS:In 2.5 degree of macula:the mean light sensitivity(MLS)was 35.61plusmn;1.37 in normal elderly.33.30plusmn;2. 49 in dry type group and 20.67plusmn;8.30 in wet type group,and differences were highly significant statistically among them. In S degree the MLS is 34.93plusmn;1.46 in normal elderly.32.95plusmn;1.82 in dry type group, 22.11plusmn;7.74 in wet type group ,and the differences were highly significant statistically among them. CONCLUSIONS:The MLS of DMMM declined at early stage of dry type AMD and there was relatively high sensitivity of MLS of DMMM in evaluating the visual function in early AMD. （Chin J Ocul Fundus Dis,1996,12: 217-219 ）
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)
Objective To evaluate the visual function before and after photodynamic therapy(PDT) in patients with subfoveal choroidal neovascularization ( CNV) caused by age-related macular degeneration (AMD). Methods Twenty-five consecutive patients (34 eyes) treated with PDT (verteporfin) for subfoveal CNV in age-related macular degeneration diagnosed by fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT). Visual function including best corrected visual acuity, contrast sensitivity frequency, binocular function, confusion, stereo-vision, color vision, metamorphopsis and central scotoma were examed before photodynamic therapy and 1 week, 1 month, 3 month after photodynamic therapy. The follow-up time varied from 3 months to 2 years (mean 7.6 months). Results The changes of visual function at the 3rd month after photodynamic therapy revealed improving in 13 eyes (38.24%), without any change in 17 eyes (50.00%), and decreasing in 6 eyes (17.65%). Visual acuity with logMRA improved after photodynamic therapy, but without statistic difference. All spatial contrast sensitivity improved. Contrast sensitivity for spatial frequencies 5 cycles per degree (cpd) was better after photodynamic therapy with significant difference (P=0.045).Binocular function, fusion function, stereo function and color vision were slightly improved without statistic difference. Conclusion Damage of visual function in macular degeneration is many-sided. The treatment of PDT for exudative AMD can improve part visual function. (Chin J Ocul Fundus Dis，2004，20：289-291)
Dysregulation and activation of immune processes are important in age-related macular degeneration (AMD) pathogenesis. The single nucleotide polymorphism of complement factor H is widely recognized as a risk factor to AMD. Over-activation of nod-like receptor3 and polymorphism of Toll-Like Receptor 3 also associated with AMD. Except for innate immune processes, adaptive immunity also play a critical role in AMD, a growing body of evidence supports that auto-antibodies and T cells are related with AMD. Additionally A2E and lipid oxidation byproducts might also have a role in AMD pathogenesis.
OBJECTIVE:To evaluate the therapeutic effect of acetazolamide treatment on chronic cystoid macular edema (CME). METHODS:Thirty-seven patients (40 eyes)with documented chronic CME of various causes were prospectively treated for 4-week periods with acetazolamide or a placebo in a randomised,crossover study that compared their effects on the reduction of macular edema and improvement of visual functions. Central retinal artery(CRA) blood flow was determined using Doppler velocimetry and vessel diameter measurement using computerised digital image analysis of monochromatic fundus photographs on 10 patients (12 eyes)with CME pre-and post-administration of acetazolamide. RESULTS:More than half the patients showed a response to acetazolamide with partial or complete resolution of. edema. Thirty eyes had improved in visual acuity in the treated patients. Statistically significant improvement were seen in 10deg; thresholds of visual field and ERG b wave amplitude. No improvement was seen when the patients received placebo. There were significant increase of blood flow velocity in CRA and retinal vessels diameter after acetazolamide were administered 3 hours later in CME patients (Plt;0.05). CONCLUSION: Acetazolamide could be of value in reducing the degree of edema and improving visual function to chronic CME. The improvement on retinal circulation might be a major cause to limit the CME. （Chin J Ocul Fundus Dis,1997,13: 89-92）
Objective To investigate the effects of Hep-A and Hep-B on vascular endothelial growth factor (VEGF)-induced breakdown of blood-retinal barrier. Methods The mice were subcutaneously injected vehicle, Hep-A or Hep-B 10 mg/kg twice a day for 5 days. Then, 1 μl of 10-6mol/L VEGF were intravitreous injected. After 6 hours, 13.7×104Bq/g3H-mannital were injected intraperitoneally. The mice were sacrificed and the retinas, lungs, kidneys were removed and examined for radioactivity. The result were analyzed using SPSS software to calculate and compare retina/lung and etina/kidney leakage ratio among groups of different treatment. Result The retina/lung and retina/kidney leakage ratio were 0.38±0.04 and 0.21±0.03 respectively in normal mice; increased significantly to 1.05±0.11 and 0.46±0.04 respectively in model mice, both Plt;0.01 compared to those in normal mice; decreased to 0.59±0.06 and 0.32±0.03 respectively in mice treated with Hep-A, both Plt;0.01 compared to those in model mice; decreased 0.54±0.04 and 0.35±0.03 in mice treated with Hep-B,both Plt;0.01 compared to those in model mice. Conclusion Hep-A and Hep-B can significantly reduce VEGF-induced breakdown of blood-retinal barrier in mice. Chin J Ocul Fundus Dis，2004，20：352-354)