Atrophic Tracts of Retinal Pigment Epithelium in Central serous Chorioretinopathy and Its Angiographic Findings

Atrophic tracts of the retinal pigment epithelium are angiographic images of the posteior pole, esp, inferior hemispheric retina. It is likely that serous detachment of the neuroepithelium constituting the central serous chorioretinopathy (CSC) of the posterior pole prolongs itself downwards, leaving a localized atrophy as a mark on the pigmented epithelium. In this study, they are presented in 8 cases (10 eyes) afected jointly by the CSC. All of the patients were male. The average age at the time of follow-up examination was 44.5 years. One of 10 eyes was noted to have clinically discernible, dependent peripheral retinal detachment. Retinal pigment epithelial atrophic tracts in this study were classified by 3 patterns in the FAG. One pattern presents as an irregular atrophic tract, which almost is located at the watershed zone near the temporal margin of the optic disc. Another pattern presents as the atrophic tract with a vertical line, which coursed vertically from the posterior pole into the inferior fundus. The other pattern composes of the two previous patterns. The atrophic tract of the RPE in the FAG showed hyperfluorescence. The lesions within the atrophic tracts of the RPE showed several depigmented spots and a pronounced window defect in the FAG. In the ICG angiography, the atrophic tracts of the tetinal pigment epithelium showed hypofluorescence distinctly during late phase of the ICG angiography.

The Extent of Patient's Content for Epiphora and Skin Scar in external Dacryocystorhinostomy Operation

External dacryocystorhinostomy(DCR) has been a main surgery for epiphora since its introduction, offering the advantages of the complete formation of the ostium, the formation of flap, and potential application in all cases suffering from chronic epiphora although the disadvantages of postoperative morbidity and a cutaneous scar. In this study, the authors report the extent of patient's content for epiphora and skin scar in 131 cases treated with external DCR perfomed on 112 patients between december 1994 and January 1996. DCR incision followed the periorbital relaxed skin gension lines in order to minimize cutaneous scar. External DCR were combined with silicone intubation of the lacrimal drainage system. The medical records of all patients undergoing external DCR procedures were reviewed retrospectively in detail. the authors asked about postoperative epiphora and skin sacr through the questionnaire or the telephone. Phtients with follow-up periods less than 6 months or conjunctivo-dacryocystorhinostomy were not included in the study. Of 131 cases, 126 were improved for epiphora in comparision with preoperative state after a single attempt, yielding a success rate of 96.2%. Of 131 cases, 129(98.2%) did not express discontent for skin scar. Although endonasal DCR is considered as an increasingly attractive alternative to external DCR, external DCR is still a good procedure to treat epiphora in unexperienced surgeon for endonasal DCR.