The Synergistic Mechanisms of AIE, ESIPT and ICT in the α-cyanostilbene-based Derivative: A Red-fluorescence Probe With a Large Stokes' Shift for Copper (II) Ion Determination and Reversible Response to Amine/acid Vapor.

Herein, α-cyanostilbene-based luminogen with an electron donor-π-electron acceptor (D-π-A) architecture was formylated into the salicylaldehyde-analogue luminogen, followed by the Schiff base reaction with phenylamine, a red-emitting luminogen was elaborately designed and successfully synthesized in a high yield of 89%. Its well-defined structure was confirmed by FT-IR, MALDI-TOF-MS, HR-MS and 1H/13C NMR technologies. Based on the synergistic mechanisms of aggregation-induced emission (AIE), excited-state intramolecular proton transfer (ESIPT) and intramolecular charge transfer (ICT), it enjoyed a red-fluorescence emission at 627 nm in THF/water mixtures (fw = 95%) and was used as a probe. Moreover, the TLC-based test strips loaded with the probe not only exhibited the reversible fluorescence response to amine/acid vapor but also showed sensitive and selective fluorescence response towards Cu2+. Furthermore, the fluorescence titration experiment between the probe and Cu2+ in THF/water mixtures (fw = 95%, pH = 7.4) revealed that the detection limit was 1.18 × 10-7 M and the binding constant was 1.59 × 105. Job's plot experiment and HR-MS analysis revealed the 2:1 binding stoichiometry of the probe with Cu2+. The method enabled real-time assessment for Cu2+ in real water samples. This study could offer insightful opinions on the development of long-wavelength emissive luminogens based on α-cyanostilbene.

The Schiff Base Probe With J-aggregation Induced Emission for Selective Detection of Cu2.

Here, three Schiff bases 3a-c, differing by the substitutions (-H, -Cl, and -N(CH3)2) on the phenyl ring, have been designed and synthesized via the reaction of ortho-aminophenol with benzaldehyde, 2,4-dichlorobenzaldehyde and para-dimethylamine benzaldehyde in 1:1 molar ratio with favourable yields of 89-92%, respectively. Their structural characterizations were studied by FT-IR, NMR, MALDI-MS and elemental analysis. The fluorescence behaviours of compounds 3a and 3b exhibited a severe aggregation caused quenching (ACQ) effect in EtOH/water system. On the contrary, compound 3c had an obvious J-aggregation induced emission (AIE) feature in EtOH/water mixture (v/v = 1:1), and exhibited excellent sensitivity and anti-interference towards Cu2+ with the limit of detection (LOD) of 1.35 × 10-8 M. Job's plot analysis and MS spectroscopic study revealed the 2:1 complexation of probe 3c and Cu2+. In addition, probe 3c was successfully applied to the determination of Cu2+ in real aqueous samples.

Follow-up of a case of vitelliform macular dystrophy over an 8-year period.

PURPOSE: To show the follow-up of a case of vitelliform macular dystrophy with morphological and visual functional tests over an 8-year period. METHODS: Retrospective review of medical records. The morphological examination included color photography, fluorescein angiography, and ocular coherence tomography (OCT). The visual functional tests included visual acuity, electro-oculogram (EOG) and multifocal electroretinography (mfERG). The patient was observed for 8 years, from 2003 to 2011. RESULTS: During the follow-up, the improvement of sensory retinal detachment and reduction of yellow-white deposit were observed with color photography and fluorescein angiography. OCT revealed a decrease in sensory retinal detachment and subretinal hyper-reflective deposits; both of these morphological changes were correspondent. Visual acuity was maintained throughout the follow-up. The Arden ratio of EOG was decreased. The amplitudes of mfERG were decreased but slightly increased during the follow-up. CONCLUSION: The retinal morphological changes and visual function slightly improved in this case of vitelliform maculopathy. The prognosis is good.

Spectral-domain optical coherence tomographic findings at each stage of punctate inner choroidopathy.

PURPOSE: To describe the natural course of punctate inner choroidopathy (PIC) using spectral-domain optical coherence tomography (SD-OCT). DESIGN: Prospective observational case series. PARTICIPANTS: Forty-two consecutive patients (60 eyes) with PIC with at least 3 months of follow-up. METHODS: Serial SD-OCT images were obtained from both eyes of each participant at each visit. MAIN OUTCOME MEASURES: The morphologic characteristics of each stage of PIC lesions observed by SD-OCT. RESULTS: Continued stage progression of PIC lesions was observed in 27 eyes (45%), among which choroidal thickness changes were observed in 8 eyes (30%). Stage I lesion showed a normal appearance or slight irregularities in the outer nuclear layer. Stage II lesion appeared as a focal elevation of the retinal pigment epithelium (RPE) with corresponding disruption of the inner and outer segments of the photoreceptor interface. Stage III lesion broke through the RPE, forming a hump-shaped chorioretinal nodule with moderate reflectivity beneath the outer plexiform layer (OPL), generally with subsequent disruption of Bruch's membrane. Nodules occasionally invaded the inner retina, causing segmental retinal phlebitis in 2 eyes. Stage IV lesion regressed in a retrograde manner with tissue loss from the photoreceptor layer and inner choroid, finally leaving a V-shaped hernia of the OPL and inner retina into the choroid. Stage V lesion gradually eliminated the photoreceptors around the lesion; this process was accompanied by RPE proliferation at multiple levels, which reduced retinal herniation. Parafoveal stage V lesions caused late occult macular atrophy in 4 eyes. Choroidal thickness increased throughout the active phase and reached a peak at stage III; this parameter then significantly decreased at stage IV and gradually reached a minimum that was lower than the initial value at stage I. CONCLUSIONS: Punctate inner choroidopathy is a chorioretinitis rather than an inner choroidopathy. Spectral-domain OCT characterized a 5-stage evolution of PIC lesions: choroidal infiltration, formation of sub-RPE nodules, and then chorioretinal nodules, regression, and retinal herniation.

Development of clinical visual physiology in China during the past fifty years.

In the past 50 years, China has experienced a valuable development stage of clinical visual physiology and made substantial progresses in the aspects. It not only contributes to ophthalmology development, but also cultivates the precious visual physiology scientist and researcher groups in China and will advance Chinese ophthalmology toward a glorious future.

The types and severity of high myopic maculopathy in Chinese patients.

OBJECTIVE: To describe the severity and morphological features of high myopic maculopathy in Chinese patients and to evaluate their association with age, refractive error and visual acuity. METHODS: Six hundred and four eyes of 337 patients (ages 8-88 years) with high myopia (refractive error ≤ -6.0 D) presenting to the Zhongshan Ophthalmic Center were studied retrospectively. All patients underwent an ophthalmological examination including digital colour fundus photography. Fundus fluorescein angiography was performed in 251 patients (443 eyes) and indocyanine green angiography was performed in 35 patients (63 eyes). The type and severity of myopic degeneration were categorized in each eye. Risk factors associated with high myopic maculopathy were evaluated using General Estimating Equation models. RESULTS: Two hundred and fifty-one patients (443 eyes) presented with maculopathy in this study. The most common subtype of high myopic maculopathy was lacquer cracks (prevalence 29.1%). The most commonly observed degree was M(3) (choroidal pallor and tessellation, with posterior staphyloma and lacquer cracks). Older age was significantly associated with diffuse chorioretinal atrophy (p = 0.024), patchy chorioretinal atrophy (p < 0.001), choroidal neovascularisation (CNV, p < 0.001) and macular atrophy (p = 0.002). Younger age was associated with lacquer cracks (p < 0.001). A higher degree of myopia was a risk factor for almost all kinds of maculopathy: tessellated fundus (p = 0.001), lacquer cracks (p < 0.001), diffuse chorioretinal atrophy (p < 0.001), patchy chorioretinal atrophy (p = 0.025) and macular atrophy p < 0.001), whereas a lower degree of myopia was associated with CNV (p = 0.001). A worse visual acuity was associated with lacquer cracks (p = 0.001), macular atrophy (p < 0.001) and CNV p < 0.001), while better visual acuity was associated with tessellated fundus (p < 0.001) and diffuse atrophy (p = 0.002). Older age (p < 0.001), more myopic refractive error (p < 0.001) and worse visual acuity (p < 0.001) were significantly associated with a greater severity of maculopathy. There was no gender difference in the type and severity of myopic maculopathy. CONCLUSIONS: Age and refractive error are important risk factors playing different roles in the development of distinct subtypes and varying severities of high myopic maculopathy. Visual acuity is significantly associated with various subtypes and the severity of high myopic maculopathy.

Clinical features of punctate inner choroidopathy in Chinese patients.

PURPOSE: To characterize the clinical features of punctate inner choroidopathy (PIC) in Chinese patients. METHODS: A retrospective chart review of all patients admitted with PIC from June 1999 to October 2009. RESULTS: Of the 75 patients (112 eyes) diagnosed with PIC, 72% were women, 80% were myopic, and 49% exhibited bilateral involvement. The mean age at presentation was 32 years. Blurred central vision (64%) and scotoma (40%) were the most common symptoms. Multifocal PIC lesions were mostly restricted to the posterior pole (95%). The acute lesions were yellow and demonstrated hyperfluorescence (61%) or mild hyperfluorescence (36%) on fluorescein angiography, mostly (75%) <200 µm in diameter and <10 in number. Indocyanine angiography showed subclinical hypofluorescent spots in 32% of the affected eyes. Choroidal neovascularization developed in 63% of affected eyes. Papilledema (3%) and segmental retinal phlebitis (2%) were rare. Intact follow-up data of 27 patients (43 eyes) were available. Acute lesions turned into punched-out atrophic lesions within 3 months. New visible lesions developed in 5 eyes within 1 year after symptom onset. New choroidal neovascularization developed in five eyes. The mean best-corrected visual acuity significantly improved at last follow-up (P = 0.039). CONCLUSION: Punctate inner choroidopathy in Chinese is not rare and primarily affects young myopic women. It features multifocal, small, yellow lesions that develop within a short period, principally in the posterior pole, with subsequent atrophy. Complicated choroidal neovascularization is frequent. General visual prognosis is moderately good.

[Clinical observation of polypoidal choroidal vasculopathy].

OBJECTIVE: To observe the natural course and evaluate the prognostic factors influencing the follow-up visual acuity of polypoidal choroidal vasculopathy (PCV). METHODS: It was a retrospective case series. Forty-five consecutive patients (51 eyes) who were diagnosed with PCV by fundus photography, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were followed up with (11.1 ± 2.0) months (mean ± SD). Age, baseline visual acuity, the presence of pigment epithelium detachment (PED), lesion size, the polypoidal lesions involving the fovea and the regression of polypoidal lesions were recorded. Multi-factor regression analysis of visual acuity at follow up was applied with SPSS 16.0 statistics software. RESULTS: Among the 45 patients (51 eyes), the hemorrhage or exudation were increased in 15 eyes (29.4%), decreased in 25 eyes (49.0%), 5 eyes (9.8%) developed macula scar and 6 eyes (11.8%) macula atrophy. During the follow-up period, the visual acuity was improved in 11 eyes (21.6%), stable in 21 (41.2%) and regressed in 19 (37.2%). Twenty-five eyes (49.0%) demonstrated polypoidal lesions involving the fovea and 26 eyes (51.0%) did not. ICGA revealed that the polypoidal lesions were unchanged in 18 eyes (35.3%), regressed in 13 (25.5%), grew in 13 (25.5%), and mixed in 7 eyes (13.7%). The changes of visual acuity at follow up were related to the age, baseline visual acuity, and polypoidal lesions involving in the fovea (b = -0.005, 0.382 and -0.430; P = 0.034, 0.000 and 0.000). Improvement of visual acuity at follow up was related to the regression of polypoidal lesions (b = 2.259, P = 0.019, OR = 9.578). CONCLUSIONS: There is a large variation in the visual prognosis in Chinese patients with PCV. The presence of PED and the lesion size had no effect on the visual prognosis of PCV. Better visual acuity during follow-up period is correlated with younger age, better baseline visual acuity, polypoidal lesions not involving the fovea and a regression of polypoidal lesions.

[Retinal symmetry of multifocal visual evoked potential in both eyes of normal subjects].

PURPOSE: To analyze the retinal symmetry of multifocal visual evoked potential (mfVEP) in both eyes of normal subjects. METHODS: The monocular mfVEP in both eyes of 36 normal subjects (72 eyes) were tested with VERIS Science 4.0. The stimulus was the pattern reversal dart array consisted of 60 sectors, each included 16 black-white reverse patterns. The visual stimulation was controlled by a binary pseudo-random m-sequence and subtended 25 degrees of retinal region. RESULTS: The mfVEP patterns between left and right eyes of each subject were similar, and P1 latency and amplitude in correspondent visual field quadrants between left and right eyes had no significant difference(P>0.05). The latency of superotemporal visual field quadrant in right eyes was shorter than that of superonasal visual field quadrant in left eyes, and the amplitude of superonasal visual field quadrant in right eyes was longer than that of superotemporal visual field quadrant in left eyes(P<0.05). The P1 latency and amplitude among four visual field quadrants of each eye had significant difference(P<0.05). The P1 latency between the superonasal visual field quadrant and inferotemporal visual field quadrant or between the superonasal visual field quadrant and inferonasal quadrant visual field had significant differences in right or left eyes(P<0.05). CONCLUSION: The mfVEP of normal subjects exists retinal symmetry.

Angiographic leakage of polypoidal choroidal vasculopathy on indocyanine angiography.

BACKGROUND: There is no detailed report about the angiographic leakage of polypoidal choroidal vasculopathy (PCV) lesions on indocyanine green (ICG) angiography. This study aimed to investigate the angiographic leakage of polypoidal lesions in PCV on ICG angiography. METHODS: One hundred and forty-four eyes of 137 patients diagnosed as PCV were prospectively observed. Fundus examination, fluorescein angiography, and ICG angiography were performed. Leakage of polypoidal lesions and clinical features were recorded according to the angiograms. RESULTS: In all 144 eyes, 110 eyes showed angiographic leakage (leakage group) on ICG angiography and three subtypes of leakage group were noted, which were polypoidal dilations leakage (47 eyes, 42.7%), branching vascular networks leakage (14 eyes, 12.7%) and leakage of both (49 eyes, 44.5%). The other 34 eyes showed regression of polypoidal lesions (regression group). In leakage group, the rates of pigment epithelial detachment (PED), best corrected visual acuity (BCVA) < 0.1 and old subretinal hemorrhages were 56.4% (62 eyes), 19.1% (21 eyes), and 4.6% (5 eyes) respectively, compared with 8.8% (3 eyes), 50% (17 eyes) and 38.2% (13 eyes) of regression group (P < 0.001). The history of regression group was significantly longer (P < 0.001). CONCLUSIONS: Angiographic leakage and regression can be observed in PCV lesions. Leakage of both polypoidal dilations and branching vascular networks is the most common subtype in leakage group. PCV in leakage group is more likely to be related to PED, better BCVA and shorter history, while PCV regression group tends to relevant to old subretinal hemorrhage, worse BCVA and longer history. This may reflect that the former is active or in the early course while the later is resting or in the late phase of PCV.

SERPING1 polymorphisms in polypoidal choroidal vasculopathy.

PURPOSE: To investigate whether common genetic variants in the complement component 1 inhibitor gene (serpin peptidase inhibitor, clade G, member 1, SERPING1) are associated with polypoidal choroidal vasculopathy (PCV) in a Chinese Han population. METHODS: DNA samples were obtained from 118 PCV patients and 115 healthy subjects. Data derived from the HapMap project were used to select tag single nucleotide polymorphisms (SNPs) across the extended SERPING1 region. A previously reported age-related macular degeneration-related risk factor (rs2511989) was forcibly included. Genotyping of each tag SNP was performed by PCR restriction fragment length polymorphism and direct DNA sequencing techniques. RESULTS: Four SNPs for SERPING1, rs2509897, rs1005510, rs11603020, and rs2511989, were chosen as tag SNPs. None of these tag SNPs were associated with PCV, according to the single-SNP association test (p=0.41-0.83). Evaluation of common haplotypes across SERPING1 did not reveal any association with PCV (p=0.49-0.82). CONCLUSIONS: We found no evidence to support the role of any common SERPING1 variants, including the rs2511989 variant, in the susceptibility to PCV in a Chinese Han population.

Functional changes following combined intravitreal bevacizumab and photodynamic therapy for polypoidal choroidal vasculopathy.

PURPOSE: To assess the functional changes of retina in patients affected by polypoidal choroidal vasculopathy (PCV) after combined intravitreal bevacizumab and photodynamic therapy (PDT) by means of contrast sensitivity (CS) test and color vision test. METHODS: Twelve eyes of 12 patients were included in the study. The CS and color vision were measured and compared before the combined treatment and 1, 3 and 6 months after the treatment. RESULTS: The patients had an improvement in CS over pre-treatment values at the all of the five spatial frequencies. And the differences at 1.5 cycle per degree (cpd) at 1 and 3 months after treatment (p = 0.04 and 0.007 respectively) were statistically significant. The mean square root of total error score for color vision of the FM 100-hue test decreased after treatment and the change was significant at 3 and 6 months after treatment (p < 0.001 and 0.011 respectively). CONCLUSIONS: Combined intravitreal bevacizumab and PDT can improve the CS at low spatial frequency and color vision in patients affected by PCV, although the significant increases of CS were no longer found at 6-month follow-up.

[Fundus analysis of autofluorescence of stale fundus haemorrhage in indocyanine green angiography].

OBJECTIVE: To investigate the autofluorescence of stale fundus haemorrhage in age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV) with indocyanine green angiography (ICGA). METHODS: The color photographs and ICGA were performed in 36 eyes of 36 cases of exudative AMD or PCV with stale fundus haemorrhage. All of the cases were examined by funduscopy and fundus fluorescein angiography (FFA). RESULTS: Autofluorescence could be observed in all of the stale haemorrhage cases. Stale haemorrhage showed grayish color and the shapes and sizes of autofluorescence in ICGA were in accordance with those of the stale haemorrhage in the color photographs. The boundaries of autofluorescence were clear and the intensities were strong. The percentage of choroidal neovascularization (CNV) or PCV in or beside stale haemorrhage was significantly higher than that outside the stale haemorrhage (27 eyes, 75%). CONCLUSIONS: Autofluorescence of stale haemorrhage in ICGA can be mixed up with the high fluorescence of CNV and grapes-like polypoidal dilatation. It is helpful to compare the color photographs with ICGA and recognize the different ICGA characteristics in the assessment of ICGA results in these circumstances.

OCT and muti-focal ERG findings in spontaneous closure of bilateral traumatic macular holes.

PURPOSE: To report the spontaneous closure of bilateral traumatic macular holes in a young patient, followed up with optical coherence tomography (OCT), muti-focal electroretinogram (mfERG), and Humphrey visual field examination. METHODS: A 25-year-old male who suffered from bilateral blunt trauma to the eyes and developed traumatic macular holes was followed with ophthalmic examination, OCT, mfERG, and Humphrey visual field examination. RESULTS: The OCT results revealed spontaneous closure in both eyes 2 weeks after trauma, and the macular holes remained closed in the 7 months of follow-up. Visual acuity improved to 0.7 in right and 0.9 in left eye finally. Visual field examination and mfERG results improved slightly compared with the initial tests. However, there still were central scotomas in both eyes, especially in right eye at the end of follow-up, and the peaks of the retinal response density had not recovered in the macular area of the mfERG topography. CONCLUSIONS: Spontaneous closure of unilateral traumatic macular hole is not uncommon, but there is no report of spontaneous closure of bilateral traumatic macular holes as yet. Since the traumatic macular holes may close spontaneously, traumatic macular holes may be observed for a period of follow-up.

The photopic negative response of flash ERG in nonproliferative diabetic retinopathy.

PURPOSE: To test how the PhNR of the flash ERG is affected in human nonproliferative diabetic retinopathy (NPDR). METHODS: The PhNR was elicited with red stimuli (5 cd s/m(2) with 4-min duration) and blue background (10 cd/m(2)). Standard Ganzfeld flash ERGs were recorded according to the ISCEV standard for the clinical electroretinogram (2004). A total of 81 diabetic patients with different severity levels of NPDR were examined. Forty-three age-matched normal controls were also studied. RESULTS: The amplitude of PhNR decreased significantly as DR progressed, while the implicit time was prolonged. Amplitudes of the PhNR in the control group, no DR, mild NPDR, moderate NPDR, and severe NPDR were 78.1 +/- 15.1 microV, 69.0 +/- 17.8 microV, 64.5 +/- 13.2 microV, 45.9 +/- 9.0 microV, and 33.7 +/- 10.8 muV respectively, and the implicit times of PhNR were 71.5 +/- 5.0, 72.0 +/- 6.2, 73.6 +/- 5.0, 75.7 +/- 6.1, and 82.9 +/- 7.8 min respectively. Compared to the control group, the reduction of PhNR amplitude in all diabetic groups was statistically significant. However, except for the OPs, the percent reduction of the amplitude of standard ERG waves was far less than that of the PhNR. The percent decrease in amplitude of the PhNR and summation OPs was not significantly different in any diabetic group. However, the reduction of the amplitude of summation OPs (and other standard ERG waves) was statistically significant only in moderate and severe NPDR groups. CONCLUSIONS: PhNR is a sensitive indicator of the function of inner retina in diabetic patients. There is a potential role for the PhNR in assessing inner retinal damage and evaluating the effect of treatment in NPDR.

Functional and clinical findings in 3 female siblings with crystalline retinopathy.

PURPOSE: To present functional and clinical findings in three female siblings with crystalline retinopathy. METHODS: Functional and clinical examinations, including full-field and multi-focal electroretinograms (ERG), visual field, dark adaptation and fundus fluorescein angiography (FFA) were performed in three female siblings of a nonconsanguineous Chinese family, who exhibited characteristic retinal crystalline flecks of Bietti crystalline retinopathy. RESULTS: Ophthalmological examination revealed similar findings in the first and second daughter of the family. Best-corrected visual acuity was hand movement and finger counting respectively and funduscopic examination showed RPE clumping and relatively fewer yellow-white deposits in the posterior pole and mid-peripheral retina. FFA revealed massive RPE and choriocapillaris destruction. Ganzfeld ERG was undetectable or reduced markedly and multifocal ERG showed all responses were markedly depressed. Ophthalmological examination showed relative preservation of retinal function in the third daughter of the family (the proband). Best-corrected visual acuity was 0.5 in the right eye and 0.4 in the left eye. Funduscopic examination showed numerous crystal deposits scattered throughout the posterior pole. Dark adaptation revealed rod thresholds elevated dramatically and visual field examination demonstrated paracentral scotomas in both eyes. Full-field ERG was decreased slightly and multifocal ERG showed the central responses were markedly depressed. CONCLUSION: The present study describes typical crystalline retinopathy affecting three female siblings in a family.

[The electroretinogram of infants with nystagmus].

PURPOSE: To find the characteristics and clinical application of electroretinogram (ERG) in infants with nystagmus. METHOD: Forty-six cases (92 eyes) of infants with nystagmus (aged 2-72 months old) were tested with Neuropack MEB-2200K system according to the ERG standard of ISCEV. RESULTS: Five kinds of ERG responses of all subjects but one could be recorded. The abnormal rates of the rod ERG, standard mixture ERG, oscillatory potentials, single-flash cone ERG and 30 Hz flicker response were 65%, 86%, 61%, 77% and 62% respectively. The ERG abnormalities were evaluated from the 5 responses. The rod ERG decreased in 5 eyes. The rod-cone ERG decreased in 11 eyes. The cone ERG decreased in 14 eyes. The cone-rod ERG decreased in 23 eyes. The standard mixture ERG decreased in 8 eyes. The ERG was unrecordable in 8 eyes. The mild, middle, and severe decreases of rod and cone ERG appeared in 5 eyes respectively. The normal ERG was only recorded in 8 eyes. CONCLUSION: Abnormal rate of ERG is 91% in infants with nystagmus. The retina abnormality may pay an important role in the pathogenesis of nystagmus.

Choroidal folds in Vogt-Koyanagi-Harada disease.

PURPOSE: To analyze choroidal folds in Vogt-Koyanagi-Harada (VKH) disease by fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography (OCT). DESIGN: Retrospective, consecutive case series. METHODS: Records of 95 patients diagnosed with VKH disease from October 2001 to July 2006 were reviewed. All patients underwent FA, 17 patients underwent ICGA, and 20 underwent OCT. RESULTS: Of the 95 patients, 11 (12.0%) had choroidal folds and showed 10 to 15 hypofluorescent bands radiating from the optic disk that were similar to the large retinal vessels in shape and number on FA. On ICGA, the choroidal folds showed hyperfluorescence at the late stage. OCT showed clear folds but the number of folds was larger than on FA and ICGA. CONCLUSIONS: Choroidal folds are not uncommon in VKH disease. FA, ICGA, and OCT can help to identify their pathogenesis.

Subtype lesions of neovascular age-related macular degeneration in Chinese patients.

PURPOSE: To identify the subtype frequency and clinical features of neovascular age-related macular degeneration (AMD) in Chinese patients. METHODS: From January 2003 to August 2006, we investigated prospectively 155 newly diagnosed patients with presumed neovascular AMD. Fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed in both eyes of all patients. Subtype frequency and clinical features were recorded according to their angiograms. RESULTS: Three subtypes of lesion were noted, which were polypoidal choroidal vasculopathy (PCV), retinal angiomatous proliferation (RAP) and mixed lesions. Of the 155 patients, 105 (67.7%) had choroidal neovascularization (CNV) of the typical type seen in AMD, 38 (24.5%) had PCV and seven (4.5%) had RAP. In five (3.2%) additional cases, mixed lesions were noted. In 38 cases (47 eyes) with PCV, the rates of subfoveal, juxtafoveal and extrafoveal lesion were respectively 29.8% (14 eyes), 8.5% (four eyes), and 61.7% (29 eyes), compared with 75.6%, 14.6% and 9.8% for CNV lesion (P < 0.01). The percentage of subfoveal lesion in PCV group was significantly lower than that in the CNV group (P < 0.01). The location of the RAP lesion was subfoveal in two (28.6%) eyes, juxtafoveal in three (42.9%) eyes and extrafoveal in two (28.6%) eyes. The five eyes with mixed lesions were all PCV coexisting with CNV at the same eye, and in all of the five cases, CNV was subfoveal while PCV was extrafoveal. CONCLUSIONS: In this hospital-based study, PCV accounts for 24.5% of neovascular AMD and is the most common subtype, RAP is less frequent (4.5%), and mixed lesions are much less common in Chinese patients. PCV is least likely to involve the fovea in neovascular AMD.

Mutations in NYX of individuals with high myopia, but without night blindness.

PURPOSE: High myopia is a common genetic variant that severely affects vision. Genes responsible for myopia without linked additional functional defects have not been identified. Mutations in the nyctalopin gene (NYX) located at Xp11.4 are responsible for a complete form of congenital stationary night blindness (CSNB1). High myopia is usually observed in patients with CSNB1. This study was designed to test the possibility that mutations in the NYX gene might cause high myopia without congenital stationary night blindness (CSNB). METHODS: The genomic sequence of NYX in 52 male probands with high myopia but without CSNB was analyzed through direct DNA sequencing. Variations in the NYX were verified by analyzing available family members and 232 controls. RESULTS: Two unrelated male individuals with high myopia but without night blindness were found to have novel Cys48Trp and Arg191Gln mutations in NYX. The mutations were found to be located in distinct regions, different from the locations of mutations known to cause congenital stationary night blindness with myopia (CSNB1). CONCLUSIONS: Mutations in NYX may cause high myopia without CSNB. The observations suggest that NYX may have independent effects on myopia and night blindness.