Optical coherence tomography angiography characteristics of choroidal neovascularizaiton in eyes with fiat irregular pigment epithelial detachments / 中华眼底病杂志

Objective To assess the occurrence of CNV in patients presenting with flat irregular pigment epithelial detachments (FIPED).Methods Forty-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.Results Of 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.Conclusion OCTA 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.

Optical coherence tomography angiography and traditional multimodal fundus imaging in the diagnosis and activity evaluation of choroidal neovascularization in exudative age-related macular degeneration / 中华眼底病杂志

Objective To compare the consistency and difference of optical coherence tomography angiography (OCTA) and traditional multimodal fundus imaging in the diagnosis and activity evaluation of choroidal neovascularization (CNV) in exudative age-related macular degeneration (AMD). Methods A total of 112 exudative AMD patients (130 eyes) were included in this retrospective study, 62 were men (71 eyes) and 50 were women (59 eyes). The mean age was (68.250±9.789) years (range 50–91 years). All patients were underwent traditional multimodal fundus imaging including fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and spectral domain optical coherence tomography (OCT);OCTA was performed at the same time. The CNV type was divided into active and non-active according to the results of traditional multimodal fundus imaging. The vascular pattern was divided into active and non-active according to the results of OCTA. Using traditional multimodal fundus imaging as the standard, the sensitivity and specialty of OCTA was evaluated. Results In 130 eyes, CNV was visualized on traditional multimodal fundus imaging in 109 eyes (83.8%);CNV was visualized on OCTA in 103 eyes (79.2%), which including 7 eyes of false negative and 1 eye of false positive. The sensitivity of OCTA for CNV diagnosis was 93.6%, with specificity of 95.2%. The CNV detection rate between two methods had no significant difference (Youden index=0.89, Kappa value=0.796, P=0.07). In 109 eyes diagnosed with CNV by traditional multimodal fundus imaging, 73 eyes (67.0%) were active CNV and 36 eyes (33.0%) were non-active CNV;the vascular pattern was active in 60 eyes (55.0%) and non-active in 49 eyes (45.0%). The sensitivity of OCTA for the detection of active CNV was 82.2%, with specificity of 100.0%. The active CNV detection rate between two methods had no significant difference (Youden index=0.82, Kappa value=0.753, P=0.00). Conclusion In the diagnosis and activity evaluation of CNV in exudative AMD, there is remarkable consistency between OCTA and traditional multimodal fundus imaging.

Idiopathic polypoidal choroidal vasculopathy masquerading as choroidal tumors: one year follow-up of a peripheral lesion / Vasculopatia polipoidal idiopática da coroide simulando tumores da coroide: um ano de seguimento de uma lesão periférica

ABSTRACT This case report describes peripheral idiopathic polypoidal choroidal vasculopathy (IPCV) with a collection of small aneurysmal dilations that masqueraded as choroidal tumors in an elderly patient. A 68-year-old African American woman was referred to us with a suspected diagnosis of asymptomatic vascular choroidal tumor and choroidal capillary hemangioma, affecting the temporal peripheral fundus. Upon examination, optical coherence tomography (OCT) revealed two large hemorrhagic pigment epithelium detachments (PED), and indocyanine green angiography (ICG) confirmed the diagnosis of IPCV. One year later, there was reduction in the hemorrhagic pigment epithelium detachments and the lesion took on a different appearance, resembling a choroidal osteoma. No treatment was necessary despite the presence of multiple polyps. IPCV is a rare condition that can resemble other choroidal diseases depending on the stage of presentation. OCT is the best tool to determine the characteristics of the lesions, and indocyanine green angiography should be used to confirm the diagnosis. Not all cases require treatment.

RESUMO Relato de um caso de vasculopatia polipoidal idiopática da coroide (IPCV) com múltiplas dilatações aneurismáticas em região temporal periférica da retina, em uma paciente idosa que assemelhou-se com alguns tumores de coroide no seguimento de um ano. Paciente de 68 anos da raça negra, assintomática, foi encaminhada com a hipótese diagnóstica de um tumor vascular de coroide e hemangioma capilar da coroide, em região temporal inferior periférica da retina. Ao exame de tomografia de coerência óptica (OCT) era observado dois grande descolamentos de epitélio pigmentado (DEP), sendo confirmado o diagnóstico de vasculopatia polipoidal idiopática da coroide pela angiografia com indocianina verde (ICG). Após um ano, houve absorção do descolamento do epitélio pigmentado hemorrágico assemelhando-se assim ao osteoma de coroide. Nenhum tratamento foi necessário apesar da quantidade dos pólipos. A vasculopatia polipoidal idiopática da coroide é uma doença rara que, dependendo do estágio da apresentação, pode se assemelhar com algumas doenças da coroide. A tomografia de coerência óptica pode ilustrar melhor as características das lesões e a ICG confirma o diagnóstico. Nem todos os casos necessitam ser tratados.

Development trend and clinical applications of ocular fundus optical imaging diagnostic technology / 中华眼底病杂志

Using optical imaging equipment with different wavelength and computer technology,fundus optical imaging diagnostic techniques can record fundus reflected light,auto fluorescence and emitted light after excitation by external light source in order to observe and analyze the structure and pathological process of retina and choroid.Advances in fundus optical image capture technology (including laser,confocal laser,spontaneous auto-fluorescence,multispectral imaging) and storage and analysis technology,promote this field into a high-definition digital imaging era,with features of rapid,non-invasive,wide-angle three-dimensional multi-level integration,dynamic automatic navigation location tracking and combined application of a variety of optical imaging diagnostic techniques.In order to promote clinical and scientific research of ocular fundus diseases,we need to understand the development trend of optical imaging diagnostic technique,interpret the fundus imaging features appropriately,reasonably chose different inspection techniques,establish standardized diagnosis criteria and continue to expand clinical applications.

Clinical applications of optical fundus imaging technology / 中华眼底病杂志

Optical imaging technology of ocular fundus,including fundus fluorescein angiography (FFA),optical coherence tomography (OCT) and fundus autofluorescence (FAF),is growing at an unprecedented speed and scale and is integrating into the routine clinical management of ocular fundus diseases,such as diagnosis,treatment,and mechanism study.While FFA allow us to observe the retinal and choroidal blood circulation,OCT and FAF are non-invasive,fast and quantifiable measurement; such techniques show even more unique advantages and are favored tools.All these retinal imaging technologies,together with a variety of retinal function assessments,bring us into the era of big data of ocular fundus diseases.All of these developments are the challenges and opportunities for the operator and user of these fundus optics imaging technologies.In order to improve its clinical applications and allocate resources rationally,we need to understand the optical properties of these retinal imaging technologies,and standardize diagnosis behavior.This is a continuous learning process needs to continue to explore.

Comparative observation of fundus ophthalmoscopic image characteristics of central serous chorioretinopathy / 中华眼底病杂志

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 (39.1±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),autofluorescence (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 hyperfluorescent 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 hyperfluorescence.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.

Clinical findings and characteristics of FFA and ICGA in polypoidal choroidal vasculopathy / 中华眼底病杂志

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.

Polypoidal choroidal vasculopathy / 中华眼底病杂志

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.

The clinical features of polypoidal choroidal vasculopathy / 中华眼底病杂志

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.

Characteristics of the ocular fundus of Chinese patients with polypoidal choroidal vasculopathy / 中华眼底病杂志

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.

Clinical observation of multifocal choroiditis / 中华眼底病杂志

Objective To investigate the clinical features of multifocal choroiditis (MC) and guide the diagnosis and treatment. Methods Retrospective analysis of clinical data of 18 MC cases (28 eyes) who were diagnosed through fluorescein angiography (FFA) or indocyanine green angiography (ICGA) and fundus characteristics. Results Multiple round to oval lesions scattered throughout the posterior pole and peripheral areas of ocular fundi of all of the 28 eyes(binocular in 10 and monocular in 8) were found. Active focal lesions of ocular fundi were seen in 8 patients and inactive lesions in 10 patients. active and 10 cases were inactive. Choroidal neovascularization(CNV) in macular area was found in 7 patients. The images of FFA of the legions showed hypofluorescence in the early phase, with late leakage and gradual staining or window is defect in the late phase. Conclusions MC is a rare disease and often misdiagnosed to other disease and FFA helpful in diagnosis.

Comparison of fundus fluorescein angiography and indocyanine green angiography for imaging of subretinal hemorrhage in age-related macular degeneration / 中华眼底病杂志

Objective To compare the effects of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) on classifications and locations of choroidal neovascularization (CNV) located under subretinal hemorrhage in age-related macular degeneration, and on the area-measuring of subretinal hemorrhage. Methods The medical record of 177 patients with subretinal hemorrhage associated with AMD confirmed by photochrome of ocular fundus, FFA and ICGA examinations were retrospectively reviewed. The locations and classifications of CNV on the images of FFA and ICGA in the 177 patients and the area of subretinal hemorrhage of 30 patients randomly selected from the 177 patients were analyzed and measured. Results On the images of FFA, the locations and classifications of CNV could be defined in 160 patients (90.4%), and CNV was considered eligible for laser therapy in 24 patients (13.6%). On the images of ICGA, the locations and classifications of CNV could be defined in 175 patients (98.9%),and CNV was considered eligible for laser therapy in 51 patients (28.8%). There was no statistical difference of the locations (Z=-0.383,P=0.701) and classifications (?2=2.993,P=0.810) of CNV on the images of FFA and ICGA. The areas of blocked fluorescence measured on the images of FFA (=26.610 mm2 and M= 13.548 mm2) were larger than those of ICGA (=24.714 mm2, M=12.875 mm2) with statistical differences (Z=-3.000,P=0.003) between FFA and ICGA. Conclusions ICGA is beneficial for imaging CNV located under subretinal hemorrhage, and may increase the number of the patients who are considered eligible for laser treatment. The effect of measurement of the area of subretinal hemorrhage in AMD evaluated by FFA is better.

Indocyanine green angiography in high myopia / 中华眼底病杂志

Objective To discuss the image of indocyanine green angiography (ICGA) about high myopia. Methods Tweenty seven patients (54 eyes) with high myopia underwent ocular examination, fundus color photography, simultaneous ICGA and fluorescein angiography (FFA) with the confocal scanning laser ophthalmoscope.The findings for the two modes of amgiographies were compared. Results Lacquer crack was evident on ICGA in 19 eyes among which the focal, plaque choroidal neovascularization (CNV) were apparent in the middle part of lacquer cracks in 10 eyes (52.6%) .In comparison the lacquer cracks were seen in only 7 eyes on FFA. Choroidal capillary atrophy was seen on ICGA and FFA in 14 eyes and ICGA shew thick choroidal vessels in 3 eyes. Conclusion ICGA is superior to FFA for showing choroidoretinal degeneration and atrophy,lacquer crack and CNV in high myopic eyes, and conduce to evaluating prognosis.

Curative effect of peeling of the internal limiting membrane on diabetic macular edema / 中华眼底病杂志

Objectives To evaluate the effect of peeling of internal limiting membrane (ILM) on the post-operative visual acuity in patients with diabetic macular edema, and to detect the role indocyanine green (ICG) plays in the surgery of peeling of ILM. Methods Thirty patients (31 eyes) with diabetic retinopathy at proliferative stage with macular edema underwent vitrectomy. The patients were randomly divided into two groups: 16 eyes in group A underwent single vitrectomy with panretinal photocoagulation and ocular filling with 20% SF6; 15 eyes in group B underwent vitrectomy and peeling of ILM after the posterior pole was stained with ICG. All of the patients were asked to keep the posture of facing down for 10-14 days. The follow-up lasted 3-12 months. Results In 16 eyes in group A, the visual acuity increase of 2 or more lines in 10 (62.5%) and alleviation of macular edema in 9 (56.2%) were found; the postoperative average macular retinal thickness examined by optic coherence tomography (OCT) was 393 ?m. In 15 eyes in group B, the visual acuity increase of 2 or more lines in 14 (93.3%) and alleviation of macular edema in 14 (93.3%) were found; the postoperative average macular retinal thickness was 319 ?m. The postoperative improvement of visual acuity in group B was much better than that in group A ( ? 2=4.210, P =0.05), while the postoperative macular retinal thickness in group B was obviously lower than that in group A ( P

Observation of the peripapillary watershed zones in glaucoma by indocyanine green angiography / 中华眼底病杂志

Objective To observe the location of the watershed zones of the choroidal blood supply relative to the optic disc in glaucoma by indocyanine green angiography, and to investigate the mechanisms in the development of glaucomatous neuropathy. Method Simultaneous ICGA and FFA were performed on 31 eyes of 31 patients with glaucoma (17 of POAG, 14 of NTG) and 37 eyes of 37 control subjects. The watershed zones were classified into three types according to their location relative to the optic disc: by type Ⅰ, no watershed zone around the optic disc; type Ⅱ, the optic disc surrounded partially by watershed zone; type Ⅲ, the optic disc surrounded completely by watershed zone. Each of the watershed zone types was scored (i.e., type Ⅰ=1, type Ⅱ=2, type Ⅲ=3). Results In 87.1% of the glaucomatous eyes, the watershed zones included or partially included the optic disc. However, the figure in the control group was 56.8%. The glaucoma group had a higher score of watershed zone type than the control group. Conclusions The mechanisms in the development of glaucomatous neuropathy are correlative to the choroidal blood supply around the optic disc.

Choriocapillaris circulatory study of macula in aging macular degeneration / 中华眼底病杂志

Purpose To discuss changes of macular choriocapillaris hemodynamics in AMD. Methods Eighty six eyes of 86 patients underwent ICGA,including macular drusen in 15 eyes of 15 patients,exudative AMD in 52 eyes of 52 patients,atrophic AMD in 19 eyes of 19 patients,for the observation of macular choriocapillaris perfusion. Results Choriocapillaris filling phase (CFP) of exudative AMD was obviously longer than that of eyes with normal, atrophic AMD and drusen groups ( P

Relationship between choroidal neovascularization and macular choroidal watershed zones in patients with age-related macular degeneration / 中华眼底病杂志

ObjectiveTo investigate the possible relationship between choroidal neovascularization (CNV) and macular choroidal watershed zones (CWZ) in patients with age-related macular degeneration (AMD). MethodsFifty-seven selected indocyanine green video angiograms (ICGA) of 57 patients (57 eyes) with AMD were evaluated, and 35 ones of the healthy fellow eyes of 35 patients with unilateral non-AMD fundus diseases were selected as age-matched control. The video angiograms were evaluated for investigating the relationship between CNV and macular CWZ. ResultsIn 57 eyes with AMD, 35 (61.4%) had macular CWZ, while in 35 control patients only 3 (8.57% ) had. The difference was significant (P

Characteristics of histopathology of choroidal neovascular membrane in age-related macular degeneration / 中华眼底病杂志

Objective To investigate the manifestations of indocyanine green angiography (ICGA) of the choroidal neovascular membrane (CNV) and the relationship with histopathological changes in patients with age-related macular degeneration (AMD). Methods Twenty-one eyes of 21 patients with AMD diagnosed by ICGA were classified into three types based on ICGA findings: developing type in 9 eyes, degenerating type in 9, and stabilizing type in 3. CNV was extracted by vitrectomy and the histopathological characteristics of CNV was observed under the light and electron microscope. Results The histopathological characteristics of the specimens of developing type revealed abundant CNV partly enwrapped with non-pigmental cells and fibrous tissue or a few pigmental cells; degenerating type revealed reduced activation duration of CNV, many pigmental cells and a little fibrous tissue; stabilizing type revealed a mass of fibrous tissue,few CNV and nonexistence of pigmental cells. Conclusion The histopathological characteristics of exudative AMD may be related to the manifestations of ICGA.

Indocyanine green angiography in ocular contusion / 中华眼底病杂志

Purpose To observe the changes of choroidal circulation and the retinal lesions caused by ocular contusion with indocyanine green angiography (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. Twenty six cases (86.2%) showed defected 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 longest 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 abnormal perfusion. Conclusion ICGA combined with simultaneously FFA, is valuable in evaluating blunt injury of the ocular fundus and beneficial to its diagnosis and treatment.

Characteristics of fundus angiography in acute retinal necrosis syndrome / 中华眼底病杂志

Objective To observe the characteristics of images of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) in patients with acute retinal necrosis syndrome (ARNS), and investigate the applied value of FFA and ICGA in clinical diagnosis. Method The data of the ocular fundus, FFA and ICGA of 20 patients (28 eyes) with ARNS were retrospectively analyzed. Results The images of FFA indicated hyperfluorescence of optic disc in 24 eyes (85.71%) at the late phase; widespread retinal vascular occlusion at the peripheral focus in 23 eyes (82.14%) with some occlusive vascular shadow and the fluorescein in some white-line-like blood vessels; fluorescent leakage at the junction of normal and abnormal retina in 22 eyes (78.57%); retinal detachment in 20 eyes (71 42%), including 9 with retinal hole (45% of the patients retinal detachment); and macular cystoid edema in 8 eyes (28 57%). The images of ICGA showed hyperfluorescence of optic disc in 8 eyes (28 57%) including 5 with dotted staining at the optic disc at the late phase; unclear choroidal vasculature in the peripheral focus in 20 eyes (71.42%); and choriodal scattered hypofluorescent patch at the focus area in 19 eyes (67.85%). At the late phase of ICGA, some intravascular emboli and segments of retinal vascular occlusion were clearly demonstrated. Conclusion The main manifestations of patients with ARNS in the images of FFA were hyperfluorescence of optic disc and retinal vascular occlusion; and unclear choroidal vessels and scattered hypofluorescent patch at the focus area.Combination of FFA and ICGA is helpful to understand the extent of the lesions and the relations between choroids and retina, which has great significance in diagnosing ARNS.