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Objective:To investigate the features of multicolor imaging in the macular region of central serous chorioretinopathy (CSC) patients.Methods:A cross-sectional study was conducted.Thirty-four acute CSC patients (34 eyes) treated in Renmin Hospital of Wuhan University from August 2017 to January 2018 were enrolled.Among the 34 subjects, there were 21 males (21 eyes) and 13 females (13 eyes). The subjects were 26 to 61 years old, with an average age of (37.41±9.35) years.The course of the disease was 5 to 45 days, with an average course of (12.00±2.29) days.All the subjects were examined by color fundus photography, fluorescein angiography (FFA), indocyanine green angiography (ICGA), multicolor imaging, spectral-domain optical coherence tomography (SD-OCT). The image features of each patient were compared and analyzed.The diagnostic accordance rate for leakage point and serous retinal neuroepithelial detachment of multicolor imaging and color fundus photography was calculated according to FFA/ICGA and OCT.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Renmin Hospital of Wuhan University (No.WDRY2019-K037).Results:The serous retinal detachment region showed green light reflection area with clear boundary in 33 eyes (97.06%) in the standard as well as blue and green enhanced multicolor image, with not clear boundary in 1 eye (2.94%). The serous retinal detachment region showed weakly reflective area in 17 eyes (50%) in blue reflectance image, showed weak reflection with clear boundary in 32 eyes (94.11%) in green reflectance image, showed weakly reflection with clear boundary in 33 eyes (97.06%) in infrared reflectance image.The fluorescein leakage point in FFA image was found micro retinal pigment epithelium detachment (PED) in 19 eyes (55.88%), rough light band of retinal pigment epithelium (RPE) in 12 eyes (35.29%), and large PED in 3 eyes (8.82%) in SD-OCT image.The RPE leakage showed red mottled changes in the area of neuroepithelial detachment in 29 eyes (85.29%) in the standard as well as blue and green enhanced multicolor images, presented strong reflection spots in blue reflectance images in 2 eyes (5.88%), showed strong reflective spots in green reflectance in 5 eyes (14.70%), showed strong reflection spot in the weakly reflective area in 33 eyes (97.06%) in infrared reflectance images.Taking FFA/ICGA and OCT as the gold standard, the diagnostic accordance rate of standard multicolor, blue and green enhanced multicolor and infrared reflectance images for serous retinal neuroepithelial detachment and leakage points was higher than that of color fundus photography, and the differences were statistically significant (all at P<0.05). Conclusions:Standard multicolor, blue and green enhanced multicolor and infrared reflectance images can reflect the leakage point and retinal neuroepithelial detachment of acute CSC.Green reflectance image can show serous retinal neuroepithelial detachment of acute CSC.Multicolor imaging can be used as the auxiliary diagnosis method of acute CSC.
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Objective To observe the manifestation of fundus angiographs of polypoidal choroidal vasculopathy (PCV). Methods Twelve PCV patients involved 7 males and 5 females aging from 40 to 69 year old (average 56.4). Fundus examination, fundus fluorescein angiography (FFA), and indocyanine green angiography (ICGA) were performed on 12 patients (12 eyes) with PCV, out of whom 5 underwent optical coherenece tomography (OCT). Results In 12 eyes, deep and (or) superficial hemorrhage and yellow hard exudations were found, including orange-red lesions in 6 and pre-retinal hemorrhage in 2. The results of FFA discovered orange-red spotty fluorescence in 6 eyes and choroidal vascular network in 4 eyes. At the late phase, leakage of polypoidal hyperfluorescence spot in all of the eyes except 2 without leakage were found. The images of ICGA showed typical dotted or clustered polypoidal hyperfluorescence in 12 eyes at the late phase. OCT disclosed protrusion of the retinal pigment epitelium (RPE) with a bumpy surface at polypoidal structure in 4 eyes and no change in 1 eye. Conclusions PCV mainly affects the elderly persons and mostly on unilateral eyes. Macular hemorrhage, serous RPED, and (or) neuroepithelial detachment with yellow hard exudations are the main manifestations. Branching choroidal vascular net with ployplike terminal anourysmal dilations can be discovered in FFA and ICGA.
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Objective To investigate the characteristics of the ocular fundus of Chinese patients with polypoidal choroidal vasculopathy (PCV). Methods The photographs of ocular fundus of 42 Chinese patients (48 eyes) with PCV diagnosed by fundus photography, fundus fluorescein angiography (FFA), and indocyanine green angiography (ICGA) were analyzed. Results In 48 eyes with PCV, 35 (72.9%) had subretinal hemorrhage, 13 (27.1%) had yellow-white exudation, 7 (14.6%) had subretinal tuberculum-like focus in tangerine peel at the posterior pole, and 26 (54.2%) had hemorrhagic or serous pigment epithelium detachment (PED). Thirty-six eyes (75.0%) had polypoidal dilations with branching vascular network, and the other 12 (25.0%) had scattered polypoidal dilations without identifiable continuous branching vascular network. The location for these lesions were at the macular region in 30 eyes (62 5%), arcade region in 6 (12.5%), peripapillary region in 3 (6.3%), and combination region in 9 (18.8%). Conclusions Most of the lesions in Chinese patients with PCV locate at the macular region and temporal vascular arcade. Most eyes are characterized by branching choroidal vessels with polyplike terminal aneurysmal dilations in ICGA.
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Objective To investigate the clinical features of polypoidal choroidal vasculopathy (PCV) in Chinese patients. Methods The clinical data of 71 continuous patients (142 eyes) who were diagnosed with PCV by fundus photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT) were analyzed retrospectively. Results Eleven patients (11 eyes) of 71 patients (142 eyes) were diagnosed with PCV to make up 15.49% and 7 75% of the numbers of patients and affected eyes respectivery. The patients included 7 males (63 6%) and 4 females (36 4%). The predominant location for these lesions was the macular region in 10 eyes (90 9%). Fundus examination demonstrated the reddish-orange nodular elevations in 6 eyes. ICGA revealed umbrellalike or twiglike branching vascular networks and polypoidal dilations at the vascular terminals of the branches in all patients, and feeder vassels within choroidal vascular networks were found in 8 eyes. OCT images of retinochoroidal structures showed prominent anterior protrusion of the orange subretinal mass corresponding to the polypoidal structure in the indocyanine green angiogram. An apparent discontinuity was observed in the highly reflective layer which delineates the polypoidal structure. Conclusions PCV mainly affects the male over 50 years and the eyes involved were mostly unilateral. Most of polypoidal vascular lesions are present in the macular area.
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Objective To observe the clinical features of polypoidal choroidal vasculopathy (PCV) in Chinese patients. Methods Nine cases (9 eyes) were examined with fundus examination, fundus fluorescein angiography (FFA) and indocyanine green angiography angiography (ICGA). Results FFA and ICGA showed the branching vascular networks (7 cases) and polyplike dilation at terminals of branches (9 cases), which mainly located in macular area (8 cases) and in peripapillary area (1 case), and which accompanied hemorrhagic or serous pigment epithelial detachment in 7 cases,and 4 of 7 cases had a significant horizontal black-white damarcation line. It definitely differed from fine choroidal neo-vascularization (CNV). Conclusion PCV in Chinese patients has the cardinal clinical features, i.e., polyplike lesions located mainly in macular area and most cases accompanied by hemorrhagic or serous pigment epithelium detachment.
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Objective To investigate the clinical features of polypoidal choroidal vasculopathy. Methods The clinical manifestations and the findings of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) of 7 eyes in 6 patients with polypoidal choroidal vasculopathy were analyzed retrospectively. Results The ophthalmoscopic examination of PCV in this series of patients revealed orange-red lesions mainly in macular region in early stage, and then hemorrhage, exudation, edema, serous and (or) hemorrhagic detachment of retinal pigment epithelium in affected portions in advanced stage, and retinal and choroidal atrophy in late stage. FFA discovered the vascular dilation at the border of the choroidal vascular network in 1 eye, dotted hyperfluorescence in 6 eyes, and patches of hyperfluorescence in late phase. ICGA disclosed a vascular branching network in choroid with polypoid pattern of the terminal path of the vessels of network in early phase in 5 eyes, and the typical dotted or clustered polypoidal hyperfluorescence in 7 eyes in late phase. Conclusion The characteristic findings of FFA and ICGA are very diagnostic for PCV.
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Objective To analyze the problems in the diagnosis of Coats disease and its main causes of misdiagnosis. Methods The clinical data of a group of patients with Coats diseases who had undergone indirect ophthalmoscopy, ocular fundus photography, fundus fluorescein angiography (FFA) and follow-up examination were retrospectively analyzed. The main causes of misdiagnosis were analyzed via reviewing the images of FFA and revising or confirming the initial diagnosis of Coats diseases according to the main features of abnormal dilation of retinal capillary vessels. Result In 68 patients (75 eyes), there were 45 cases whose initial diagnosis was Coats disease while the final diagnosis was not, in whom the final diagnosis was old retinal vein occlusion in 21, retinal vasculitis in 9, diabetic retinopathy in 3, old posterior uveitis in 3, congenital retinoschisis in 3, and proliferative vitreoretinopathy, familial exudative vitreoretinopathy, racemose hemangioma, old rhegmatogenous retinal detachment, macular epiretinal membrane, and idiopathic juxtafoveal telangiectasis in 1, respectively. There were 23 patients who was diagnosed as Coats disease in the final diagnosis but not the initial one. The initial diagnosis was old posterior uveitis in 6 patients, retinal vasculitis in 5, exudative age-related macular degeneration in 4, retinal main arterial tumor in 2, retinal angioma in 3, intraocular tumor in 2, and central serous chorioretinopathy in 1. Conclusions There are many problems in the clinical diagnosis of Coats disease. The main reason of misdiagnosis is that the clinicians can not comprehensively master the core of the definition of Coats disease and its clinical characters.
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Objective To evaluate the clinical characters of retinal arterial macoraneurysms. Methods The routine eye examination and fundus fluorescein angiography in 15 cases with macroraneurysms were reviewed. Results The macroaneurysms in the first,second and third bifurcation were 6,7 and 2 cases respectively.The macroaneurysms in the superio temporal and inferio temporal artery were 4 and 10 cases respectively.There was on case in both superio and inferio temporal artery.The number of macroaneurysms was single in unitary form were 13 cases.The diameter of the macroaneurysms were between 250～500 ?m. Conclusions The FFA is helpful in diagnosis of macroaneurysms,and treatmnet of laser photocoagulation for the bleeding endangering the macular area.
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Objective To observe the characteristics of images of optic coherence tomography (OCT) for the macular region of congenital retinoschisis and investigate its significance. Methods The data of OCT of 11 patients (20 eyes) with congenital macular retinoschisis diagnosed by direct or preplaced-mirror ophthalmoscopy, fundus fluorescein angiography (FFA), and electroretinography (ERG) were retrospectively analyzed. Results The images of OCT showed split in the mid portion of sensory retina at the macula in all eyes. The retina of fovea centralis was divided by the split into two slightly thickening layers. In addition, in a few number of cases, the parafoveal sensory retina which became much thickening with 2 splits, was divided into 3 layers. Conclusion The characteristic of images of OCT in macular congenital retinoschisis is the split cavity at the middle layer of the retina, and OCT has a high sensitivity in the diagnosis of congenital retinoschisis.
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Objective To investigate the characteristic of OCT images of congenital macular coloboma and its utility in the diagnosis of the diseases. Methods Seven patients (9 eyes) with congenital macular coloboma who had been examined by visual acuity determination, slit lamp examination, ophthalmoscope and fluorescein angiography received OCT scan and fundus color photography. The results were retrospectively analyzed. Results The manifestation of congenital macular coloboma by OCT was the retinal and choroidal tissues focally pitted outwards along with sclera. The 3 dimensions of pit: horizontal diameter 668- 4 339 ?m ( 3 119 in average), vertical length 668- 4 531 ?m ( 2 591 in average), pits depth 230-2 146?m(1 084 in average).The retinal neurosensory layer became thin and defect. And the retinal neurosensory layer was thinner in the centre than that near the edge. Reflection of retinal pigment epithelium was uneven and discontinued. The dark area of choroid was enlarged. Conclusions It can be clearly shown by OCT that abnormal structure of retina and out layer of choroid in congenital macular coloboma. It is implied that the characteristic of OCT is helpful in the diagnosis of congenital macular coloboma.