Segmentation of retinal microaneurysms in fluorescein fundus angiography images by a novel three-step model.

Introduction: Microaneurysms serve as early signs of diabetic retinopathy, and their accurate detection is critical for effective treatment. Due to their low contrast and similarity to retinal vessels, distinguishing microaneurysms from background noise and retinal vessels in fluorescein fundus angiography (FFA) images poses a significant challenge. Methods: We present a model for automatic detection of microaneurysms. FFA images were pre-processed using Top-hat transformation, Gray-stretching, and Gaussian filter techniques to eliminate noise. The candidate microaneurysms were coarsely segmented using an improved matched filter algorithm. Real microaneurysms were segmented by a morphological strategy. To evaluate the segmentation performance, our proposed model was compared against other models, including Otsu's method, Region Growing, Global Threshold, Matched Filter, Fuzzy c-means, and K-means, using both self-constructed and publicly available datasets. Performance metrics such as accuracy, sensitivity, specificity, positive predictive value, and intersection-over-union were calculated. Results: The proposed model outperforms other models in terms of accuracy, sensitivity, specificity, positive predictive value, and intersection-over-union. The segmentation results obtained with our model closely align with benchmark standard. Our model demonstrates significant advantages for microaneurysm segmentation in FFA images and holds promise for clinical application in the diagnosis of diabetic retinopathy. Conclusion: The proposed model offers a robust and accurate approach to microaneurysm detection, outperforming existing methods and demonstrating potential for clinical application in the effective treatment of diabetic retinopathy.

Effect of propylene glycol mannate sulfate on non-proliferative diabetic retinopathy.

PURPOSE: To evaluate the effect of propylene glycol mannate sulfate (PGMS) on retinopathy in non-proliferative diabetic patients. METHODS: Eighty patients (111 eyes) with non-proliferative diabetic retinopathy were selected and retrospectively analyzed. Patients were divided into a control group (40 cases, 56 eyes) and an experimental group (40 cases, 55 eyes) using a random number table method. The control group continued had routine blood glucose management, while the experimental group received PGMS 100 mg additionally TID for 60 days. Changes in visual acuity, fundus conditions including hemorrhage points and exudation in each quadrant, and non-perfusion area were revealed through fundus angiography before and after the treatment period. RESULTS: After PGMS treatment, the experimental group demonstrated significant improvements compared to the control group in terms of eyesight improvement (P=0.002), the macular edema and macular retinal thickness (P=0.008). The total clinical efficacy rate of the experimental group was 67.86%, which was higher than 38.18% of the control group (P=0.032). Notably, there was a significant reduction in macular hemorrhage and hard extrusion. CONCLUSION: Oral administration of PGMS is an effective treatment for non-proliferative diabetic retinopathy.

Application progress of swept-source optical coherence tomography angiography in ophthalmology / 国际眼科杂志(Guoji Yanke Zazhi)

Swept-source optical coherence tomography angiography(SS-OCTA)is a new vascular imaging technique that was recently proposed. It has the advantages of being non-invasive, quick, high-resolution, and automated vascular stratification imaging. It is extremely helpful in the early diagnosis of ophthalmology-related diseases, as well as in the evaluation of treatment effectiveness and the tracking of disease progression. Based on the foundation of OCTA, SS-OCTA utilizes a fast-tuning laser with a wavelength of 1 050 nm for deeper penetration and non-invasive depth-resolved imaging of the retinal and choroidal microvascular systems, deepening the understanding of the characteristics of a wide range of ophthalmic diseases(fundus lesions, glaucoma, neurodegenerative diseases, etc.). The structures of the anterior segment of the eye can also be studied using SS-OCTA, including changes in the depth and density of corneal neovascularization as well as changes in iris neovascularization before and after therapy. This approach provides a novel tool for ophthalmic clinical practice. The development of the clinical use of SS-OCTA technology in ophthalmology is reviewed in this article.

Comparison of widefield swept-source optical coherence tomographic angiography and fluorescein fundus angiography for detection of retinal neovascularization with diabetic retinopathy.

BACKGROUND: To compare vitreous angiomosaic images (VAMIs), obtained by widefield swept-source optical coherence tomographic angiography (wfSS-OCTA) and the image of fluorescein fundus angiography (FFA) in the identification of retinal neovascularization (NV) in patients with diabetic retinopathy (DR). METHODS: In this prospective observational study, severe non-proliferative diabetic retinopathy (NPDR) or proliferative DR (PDR) patients were included. All patients underwent FFA and wfSS-OCTA. The number of NVs identified by wfSS-OCTA VAMIs using five fixations 12 × 12 mm montage scans and the resembling FFA images were compared. RESULTS: Fifty-three eyes of 29 patients were enrolled. NVs were detected in 25 eyes by using FFA, including 9 NVs of the disc (NVDs) and 72 NVs elsewhere (NVEs), and in 29 eyes by OCTA, including 11 NVDs and 90 NVEs. The detection rate of NV and NVD of OCTA was comparable to that of FFA (p > 0.05), and the level of agreement was excellent (κ = 0.850, κ = 0.754). Using FFA as the gold standard, the sensitivity for detection of NV by OCTA was 100.0%, specificity was 85.7%, the positive-predictive value was 86.2%, and the negative-predictive value was 100.0%. Compared with FFA, OCTA was superior in terms of the number of NVEs identified (p = 0.024). When we excluded images of patients treated with anti-vascular endothelial growth factor (VEGF) intravitreal therapy for < 3 months, OCTA was comparable to FFA in terms of the number of NVEs discovered (p = 0.203), with excellent agreement (intraclass correlation coefficient = 0.941). CONCLUSIONS: WfSS-OCTA is an independent non-invasive alternative to FFA for NV discovery, NVD detection, and individual NVE identification, particularly in patients with PDR who have a history of prior treatment with anti-VEGF.

Fluorescent and Biocompatible Nitrogen and Sulfur Co-Doped Carbon Nanodot as an Ocular Fundus Angiography Imaging Agent.

The florescence characteristics and the toxicities of carbon nanodots (CDs) are directly related to their elemental compositions. Fluorescent and non-toxic agent for imaging of biological systems was aimed. Sulfur and nitrogen co-doped CDs (S/N-CDs) was hydrothermally produced in an average size of 8 nm. S/N-CDs showed blue fluorescence under UV-light with an excitation wavelength of 365 nm. After 24 h, S/N-CDs was non-cytotoxic in HUVEC and L929 cells. S/N-CDs have a great potential to act as an alternative material for commercial fluorescent materials with its 85.5% of quantum yield. S/N-CDs was approved in vitro as an imaging agent for an ocular fundus angiography of rats.

IRVAN syndrome: A case report and a literature review.

Introduction and Importance: Idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome is a rare retinal defect. It has a female predominance. The staging of IRVAN was defined depending on ocular criteria. Case presentations: A 30-year-old female patient presented with floaters in the left eye. One year later, it was diagnosed with Fluorescein fundus angiography (FFA) at stage Ⅲ of IRVAN syndrome. After one year, the right eye was affected, diagnosed at stage Ⅱ, and successfully treated with heavy Pan-Retinal Photocoagulation (PRP). Clinical discussion: IRVAN Syndrome is an extremely rare retinal defect which has female predominance. The etiology of this syndrome still idiopathic. The most encountered symptoms are blurred vision and vision loss. FFA is the best diagnostic investigation to reveal the retinal abnormalities. Many suggested protocols were mentioned to treat IRVAN Syndrome. Our experience suggests IRVAN Syndrome a differential diagnosis for patients with floaters, and assures that PRP is an affective curement for late stages of IRVAN Syndrome. Conclusions: Heavy PRP was used successfully for stage II and III. The case emphasizes the importance of early diagnosis to assert the complications. Furthermore, IRVAN syndrome should be considered as a differential diagnosis in patients with floaters. Therefore, heavy PRP is highly recommended as a suitable treatment for IRVAN syndrome.

Retinal evaluation by fundus angiography before and after vitrectomy and foreign body removal in a patient with ocular siderosis: a case report.

Background: Ocular siderosis (OS) is a rare severe complication arising from retained iron-containing intraocular foreign bodies. In the young male patient reported in this paper, the intraretinal diffusion and distribution of siderotic particles before and after the removal of the foreign body were observed via fundus angiography (FA). Case Description: A 33-year-old decoration worker was diagnosed as the absolute stage of right eye glaucoma in the local hospital and was treated with cataprolol and brinzolamide eye liquid to reduce intraocular pressure. The symptoms did not improve. He came to our hospital for treatment. He was finally diagnosed with "foreign body, siderosis, and secondary glaucoma in the right eye" based on eye examinations. According to the observation via fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), grade 2-3 vascular occlusion extended in a gradient along the foreign body, there was no retinal perfusion in the temporal retina, the siderotic particles were distributed along the artery, and inflammatory changes occurred in the optic nerve and retinal vein. He underwent pars plana vitrectomy, foreign body removal, retinal laser photocoagulation, silicone oil filling and pressure reducing valve implantation. Silicone oil was removed three months later. The postoperative visual acuity was not improved, the intraocular pressure was well controlled, and there was concurrent cataract, but it did not affect the fundus examination. At 3 and 10 months after operation, the fundus angiography showed that the particles distributed along the artery decreased, the inflammation of optic nerve and retinal vein subsided, and the laser spots in the non perfusion area were clear. Conclusions: The influence of iron ion on retinal vein and the distribution of iron ion along retinal artery can be seen macroscopically by FA before and after foreign body removal.

The Efficacy and Safety of Adalimumab in Treating Pediatric Noninfectious Chronic Anterior Uveitis With Peripheral Retinal Vascular Leakage: A Pilot Study.

Purpose: This study is aimed to assess the efficacy of adalimumab in alleviating peripheral vascular leakage in pediatric chronic anterior uveitis patients, along with its ability to improve best-corrected visual acuity (BCVA) and inflammation parameters, its efficacy in reducing topical glucocorticosteroids (GCs) and systemic immunomodulatory therapy (IMT), and its safety profile. Methods: A self-controlled study of pediatric chronic anterior uveitis patients who presented with peripheral retinal vascular leakage on ultra-widefield fluorescein fundus angiography and underwent adalimumab treatment was conducted. The primary outcome was the extent of retinal vascular leakage at the 3- and 6-month follow-up visits. Secondary outcomes included BCVA, inflammation parameters (fresh keratic precipitates, anterior chamber cell, and vitreous cell grades), frequency of topical glucocorticosteroid eye drops, IMT load, and adverse effects at the 3- and 6-month follow-up visits. Results: Twenty patients with a mean age of 9.30 ± 3.26 years old were included. The mean follow-up period was 9.0 ± 3.0 months, with all patients followed up for at least 6 months. At the 3- and 6-month follow-ups, the peripheral vascular leakage score decreased significantly (2.87, 95% CI (2.14, 3.60), p < 0.001 for 3 months, 2.75, 95% CI (1.76, 3.73), p < 0.001 for 6 months). Alongside BCVA (p = 0.013 for 3 months, p = 0.005 for 6 months) was improved significantly, inflammatory parameters represented by fresh keratic precipitates, anterior chamber cell, and vitreous cell grades were improved significantly (p < 0.001, p < 0.001, for all parameters) and topical GC usage was significantly reduced (p < 0.001, p < 0.001) at 3 and 6 months. There was also a statistically significant reduction in systemic IMT load at 6 months (p < 0.001). Adverse events in the observation period included local redness around the injection site and mild upper respiratory symptoms. Conclusion: Adalimumab could effectively alleviate peripheral vascular leakage in pediatric patients with chronic anterior uveitis. It could also be helpful in improving BCVA and inflammation parameters and decreasing topical glucocorticosteroid eye drops and systemic IMT. Adalimumab is generally safe for pediatric uveitis.

Characteristic changes of macular microvascular structure in central retinal vein occlusion / 中华实验眼科杂志

Objective:To explore the microvasculature changes in macular area of central retinal vein occlusion (CRVO) patients with macular edema (ME).Methods:A cross-sectional study was conducted.Fifteen patients with monocular ME secondary to CRVO (30 eyes) and 15 age- and gender-matched normal subjects (15 eyes) were enrolled in The Second Affiliated Hospital of Chongqing Medical University from November 2017 to March 2019.Best corrected visual acuity (BCVA), intraocular pressure, slit lamp microscope with pre-set lens, color fundus photography and optical coherence tomography (OCT) were performed in all subjects.The central macular thickness (CMT), foveal avascular zone (FAZ) area, FAZ perimeter, acircularity index (AI), vessel density of superficial retinal capillary plexus (SCP) and deep retinal capillary plexus (DCP) in 3 mm×3 mm macular area were measured by optical coherence tomography angiography instrument and compared between different groups.The correlation between BCVA, CMT and microvascular structural parrameters in ME eyes of CRVO patients was analyzed by Pearson linear correlation test.This study protocol adhered to the Declaration of Helsinki and was approved by the Ethics Committee of The Second Affiliated Hospital of Chongqing Medical University (No.2018-211).Written informed consent was obtained from each subject before any medical examination.Results:Compared with contralateral eyes, the FAZ area and FAZ perimeter of ME eyes were significantly increased, and AI, the vessel density of SCP and DCP were significantly decreased (all at P<0.01).Compared with normal control eyes, the FAZ area and FAZ perimeter of contralateral eyes of CRVO patients were significantly increased, and AI, the vessel density of DCP were significantly decreased (all at P<0.05).In ME eyes, the BCVA LogMAR was positively correlated with FAZ area and FAZ perimeter ( r=0.614, 0.609; both at P<0.05), and was negatively correlated with AI and vessel density of SCP ( r=-0.517, -0.593; both at P<0.058).In ME eyes, CMT was positively correlated with FAZ area and FAZ perimeter ( r=0.523, 0.610; both at P<0.05), and was negatively correlated with AI and the vessel density of SCP ( r=-0.537, -0.608; both at P<0.05). Conclusions:The characteristic microvascular change in ME secondary to CRVO eyes is the decrease of blood flow caused by the decrease of capillaries in fovea, and the same change in blood flow also exists in their contralateral eyes.The degree of ME and visual function damage are correlated with the degree of foveal damage and the blood flow in fovea.

Diagnostic value of OCTA and FFA in central serous chorioretinopathy complicated with choroidal neovascularization: a meta-analysis / 中华实验眼科杂志

Objective:To systematically evaluate the diagnostic value of optical coherence tomography angiography (OCTA) and fluorescein fundus angiography (FFA) for choroidal neovascularization (CNV) in central serous chorioretinopathy (CSC).Methods:PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Internet (CNKI), VIP database and Wanfang Database were searched for literature published from January 1991 to March 2020 with CSC patients as subjects and OCTA and FFA as diagnostic methods of CNV.The quality of the included literature was evaluated with Australian JBI tool.A meta-analysis was performed using Review Manager 5.3 software.The source of heterogeneity was identified by age and total number of samples subgroup analysis.Results:Nine studies with a total sample size of 374 eyes were enrolled.The quality score of 8 studies was greater than 14.The detection rate of CNV in CSC by OCTA was higher than that by FFA [odds ratio( OR)=3.99, 95% confidence interval( CI): 1.44-11.07, P<0.001].Studies with sample size >40 showed no heterogeneity ( I2=49%, P=0.14), suggesting that sample size might be a source of heterogeneity.Publication bias was found by funnel plot. Conclusions:OCTA has a higher detection rate of CNV secondary to CSC than FFA, and it can be used as a routine inspection method.

Repurposing bortezomib for choroidal neovascularization treatment via antagonizing VEGF-A and PDGF-D mediated signaling.

Neovascular age-related macular degeneration (neoAMD) is the leading cause of blindness in AMD and manifests as choroidal neovascularization (CNV). Anti-vascular endothelial growth factor (VEGF) therapies are the mainstay treatments but with limited efficacy and cause detrimental effects on the retina after long-term application. These disadvantages warrant alternative strategy. Herein, we examined the effect on CNV by intravitreal injection of bortezomib, a reversible proteasome inhibitor, and further dissected the mechanism. Krypton red Laser was used to create CNV model in mice. The angiogenesis volume was assessed in choroidal flat-mount with isolectin GS-IB4 labeling and the leakage was examined with fluorescein fundus angiography. Injection of Borsub inhibited angiogenesis in the CNV model which was dose-dependent; the injection significantly inhibited leakage as well. Furthermore, Borsub injection reduced the contents of VEGF-A, macrophage chemotactic factor 1 (MCP-1), and platelet-derived growth factor (PDGF)-D but not PDGF-B, examined by enzyme-linked immunosorbent assay, in choroid/retinal pigment epithelium (RPE) tissue. These injections also reduced phospho-VEGFR-2 and phospho-PDGFRß in choroid/RPE tissue examined by immunoblotting. Moreover, Borsub inhibited the recruitment of mural cells or macrophages to laser-injured spots. Injection of Borsub indicated negative effect on scotopic and photopic responses recorded by electroretinogram. Altogether, intravitreal injection of Borsub significantly reduced CNV by antagonizing VEGF-A/Flk-1 and PDGF-D/PDGFRß pathways without impacting electroretinography parameters. Thus, Borsub may offer an invaluable therapy for the prevention and treatment of neoAMD.

Time-lapse angiography of the ocular fundus: a new video-angiography.

BACKGROUND: Ocular fundus angiography is an indispensable component of the tests utilized for fundus diseases. Dynamic angiography results can provide additional information; however, many difficulties remain. In this study, we introduce a modified method, time-lapse angiography (TLA), to dynamically present imaging results. METHODS: TLA, combining time-lapse photography and fundus angiography (using Heidelberg retina angiography II, Germany), includes pre-photographing and post- photosynthesis and ultimately produces a video that is approximately 15 s in length. RESULTS: Four typical videos in the article showed the characteristics of TLA, including a short and rapid but continuous and integral presentation, highly valid information, high definition, etc. CONCLUSIONS: TLA is beneficial for the diagnosis of diseases and the assessment of progression and is convenient for peer communication, patient interpretation, and student education. The application of time-lapse photography in ocular fundus angiography is a monumental and innovative attempt.

Bilateral giant retinal pigment epithelial tears in hypertensive choroidopathy.

PURPOSE: To report a case of hypertensive choroidopathy with bilateral bullous serous retinal detachments (SRDs), retinal pigment epithelial detachments (PEDs), and giant retinal pigment epithelial (RPE) tears. OBSERVATIONS: A 68-year-old man with a history of hypertension and diabetes mellitus presented with bilateral visual loss of about 10 day's duration. He discontinued his oral medications for 2 months without the advice of a physician. At his first visit, the best-corrected visual acuities (BCVAs) were 0.02 in the right eye and 0.3 in the left eye (decimal notation), and the respective intraocular pressures were 15 and 13 mmHg. Bullous SRDs, large PEDs, and giant RPE tears were present bilaterally. Blot retinal hemorrhages and hard exudates were seen in the left eye. The systemic blood pressure was 231/77 mmHg, and bilateral lower leg edema was observed. Biochemical blood tests showed deteriorated renal function, hypoalbuminemia, and hyperglycemia. Ultra-wide-field fundus fluorescein angiography showed leakage at the areas of the SRDs and hyperfluorescent areas corresponding to the RPE tears bilaterally. Indocyanine green angiography showed hypofluorescent areas corresponding to the PEDs. Systemic computed tomography and magnetic resonance imaging were performed, and no malignancy was found. Based on these findings, hypertensive choroidopathy was diagnosed. A week after antihypertensive treatment, the SRDs and PEDs resolved bilaterally, and the BCVAs improved to 0.4 and 0.5 in the right and left eyes, respectively. The RPE tears remained in both eyes, although the SRDs and PEDs did not recur. CONCLUSIONS AND IMPORTANCE: Hypertensive choroidopathy must be considered in the differential diagnosis of SRDs and/or PEDs.

High-Resolution In Vivo Fundus Angiography using a Nonadaptive Optics Imaging System.

PURPOSE: We provide a proof of concept for the detailed characterization of retinal capillary features and surrounding photoreceptor mosaic using a customized nonadaptive optics angiography imaging system. METHODS: High-resolution fluorescein angiography (FFA) and/or indocyanine green angiography (ICGA) images were obtained using a modified Heidelberg retina angiograph (HRA2) device with a reduced scan angle enabling 3° field of view. Colocalized images of the photoreceptor mosaic also were captured in vivo using the same instrument. Visibility of vascular subbranches were compared between high-resolution images and conventional fundus angiography (FA) with a 30° field of view. RESULTS: High-resolution angiographic and infrared images (3° × 3° field of view, a 10-fold magnification) were obtained in 10 participants. These included seven patients with various retinal diseases, including myopic degeneration, diabetic retinopathy, macular telangiectasia, and central serous chorioretinopathy, as well as three healthy controls. Images of the retinal vasculature down to the capillary level were obtained on angiography with the ability to visualize a mean 1.2 levels more subbranches compared to conventional FA. In addition, imaging of the photoreceptor cone mosaic, to a sufficient resolution to calculate cone density, was possible. Movement of blood cells within the vasculature also was discernible on infrared videography. CONCLUSIONS: This exploratory study demonstrates that fast high-resolution angiography and cone visualization is feasible using a commercially available imaging system. TRANSLATIONAL RELEVANCE: This offers potential to better understand the relationship between the retinal neurovascular system in health and disease and the timing of therapeutic interventions in disease states.

A case study of ciliary detachment with primary pulmonary hypertension.

PURPOSE: To introduce a case of ciliary detachment with primary pulmonary hypertension (PPH). METHODS: The clinical manifestations of a case of ciliary detachment with PPH were addressed by comprehensive examination including ultrasound biological microscope (UBM), intraocular pressure, color fundus photographs, fluorescence fundus angiography (FFA). In addition, echocardiography is used to measure primary pulmonary pressure. RESULTS: When the echocardiography displayed a systolic pulmonary arterial pressure of 106 mmHg, UBM exhibited ciliochoroidal detachment, as well as peripheral retinal effusion and non-perfusion areas in FFA. After well controlled of PPH, UBM showed normal ciliary body. FFA confirmed that retinal effusion disappeared. CONCLUSIONS: The elevated venous pressure in PPH is responsible for decreased choroidal backflow and reduced venous blood outflow from the eye. PPH would contribute to the clinical manifestations of severe choroidal detachment and peripheral retina effusion in this patient.

Application of ophthalmic methods in age-related macular degeneration / 国际眼科杂志(Guoji Yanke Zazhi)

As the increasing population aging,the incidence of age-related macular degeneration is increasing,blinding rate also increasing,so it is very important for the early diagnosis and treatment of age-related macular degeneration.There are many methods to check the aging macular degeneration,such as fundus angiography,optical coherence tomography (OCT),visual field and multifocal electroretinogram (mfERG).In recent years,many emerging ophthalmic methods have emerged and are gradually applied to clinical diagnosis,including optic coherence tomography angiography (OCTA).The function of these methods has its unique advantages,but there are also limitations.This paper will review these existing methods.

Efficacy and safety of ranibizumab for wet age-related macular degeneration in Chinese patients.

AIM: To evaluate the clinical efficacy and safety of ranibizumab for wet age-related macular degeneration (wAMD) in Chinese patients and to determine the mean number of injections administered over one year of follow-up. METHODS: This single centre, retrospective observational case series study included data from 121 patients with wAMD (121 eyes) who were diagnosed by indirect ophthalmoscopy, fluorescence fundus angiography (FFA), indocyanine green angiography, and optical coherence tomography. Ranibizumab was injected into the vitreous cavities once per month for 3mo and as needed afterwards. Changes in visual acuity and central foveal thickness (CFT) during the follow-up period were compared, and the mean number of injections over the year was calculated. Patients with one or more adverse events related to the drugs and injections were recorded for further adverse events analysis. RESULTS: The study population included 70 males and 51 females aged between 50 and 87y (mean: 71.32±9.41y). The mean number of injections over the first year was 5±1 (range: 3-9). The mean best-corrected visual acuity by Early Treatment Diabetic Retinopathy Study increased from 43.2±19.3 (95%CI: 39.8-46.7) at baseline to 51.7±20.1 (95%CI: 48.1-55.3), and central foveal thickness (CFT) decreased from 526.5±277.0 µm (95%CI: 476.6-576.4) to 258.2±161.6 µm (95%CI: 229.2-287.3) at 12mo. The differences were statistically significant (P<0.001). Visual acuity significantly improved in 34.1% of the patients (38 eyes), stabilized in 66.1% of the patients (80 eyes), and significantly decreased in 2.5% of the patients (3 eyes). CFT at baseline was an independent risk factor of decreased CFT and increased visual acuity. None of the patients had severe adverse events during the follow-up period. CONCLUSION: Ranibizumab can effectively control disease progression and improve visual acuity in patients with wAMD. The disease conditions of most patients stabilized after a one-year treatment with an average of 5 injections.

Evaluation and types of fundus characters in systemic lupus erythematosus / 眼科新进展

Objective To analyze the clinical characteristics of fundus changes in systemic lupus erythematosus (SLE) patients.Methods Color fundus and FFA were performed in 27 SLE patients (54 eyes) with fundus abnormalities.Clinical characteristics were analyzed.SLE disease activity index (SLEDAI) was evaluated in the patients.SLEDAI was analyzed by SPSS 19.0 Student-t test.Results Four clinical types were found in 27 patients.Capillary obstruction was found in 28 eyes of 14 patients,retinal artery occlusion in 11 eyes of 6 patients,retinal vein occlusion in 7 eyes of 6 patients,choroidal vessel obstruction in 2 eyes of 1 patient.SLEDAI was evaluated in 24 patients.SLEDAI in 5 patients with retinal artery occlusion was (25.6 ± 2.2) scores,which was significantly higher than other patients(18.2 ± 2.9)scores (P ＜0.05).Conclusion This clinical typing scheme may help to know fundus abnormalities in SLE patient,and it may be related to SLE activity.SLEDAI in patients with retinal artery occlusion is higher than other patients.

Application of OCT angiography in ophthalmology / 国际眼科杂志(Guoji Yanke Zazhi)

Optical coherence tomography angiography (OCTA) is a new technology of angiography in recent years.In addition to the advantages of traditional OCT,it can observe blood flow in different retinal and choroidal segmentation slab.By using the pseudo-color,abnormal vascular structure can be distinguished from normal vascular structure of the retina.Dye injection is not needed with OCTA,which is different from fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA).OCTA provides more and more accurate blood flow information.However,like other biometric technology,OCTA has its limitations and shortcomings.This review will analyze and summarize the operating principle of OCTA,its application in ophthalmology,as well as its advantages and limitations.

Spectral-domain optical coherence tomography characteristics of acute central serous chorioretinopathy / 中华眼底病杂志

Objective To observe the characteristics of spectral-domain optical coherence tomography (SD-OCT) for leakage point in acute central serous chorioretinopathy (CSC).Methods A total of 21 acute CSC patients (21 eyes) were enrolled in this retrospective study,including 17 men (17 eyes) and 4 women (5 eyes).The mean age was (47.3±8.8) years (range 35-66 years).The mean duration was (1.6±0.8) months (range 0.5-3.0 months).All patients were underwent mydriatic fundus photography,SD-OCT examination and fluorescein fundus angiography (FFA).SD-OCT and FFA images were carefully compared to observe the SD-OCT examination characteristics of fluorescence leakage point.Results 21/21 eyes had one fluorescein leakage point.In addition to serous retinal detachment,leakage point in the SD-OCT examination showed retinal pigment epithelium (RPE) protrusion in 10 eyes (47.6 ％),RPE detachment in 7 eyes (33.3 ％),highly reflective areas suggesting fibrinous exudate in the subretinal space in 3 eyes (14.3 ％),and RPE defect in 1 eye (4.8 ％).Conclusion The SD-OCT characteristics of acute CSC include RPE protrusion,RPE detachment,highly reflective areas suggesting fibrinous exudate in the subretinal space and RPE defect.