ObjectiveTo observe the efficacy of intravitreal injection of ranibizumab (IVR) and combined treatment for severe Coats disease. MethodsNineteen Coats disease patients (24 eyes) were enrolled in this retrospective non-comparative interventional clinical study. The patients included 17 males and 2 females. The age was ranged from 1 to 42 years old, with an average of (13.05±6.78) years. The patients included 15 children (age ≤14 years old) and 4 adults (age ≥18 years old). There were 13 patients with 3a stage and 6 patients with 3b stage. The treatment methods including IVR only, IVR combined with cryotherapy, IVR combined with cryotherapy and sclerotomy to drain subretinal fluid, IVR combined with vitrectomy. Treatments were repeated if it was necessary at the first day, the first week and the first month after injection. The interval between treatments was ≥1 month. Eleven patients (57.9%) underwent one treatment, 3 patients (15.8%) underwent 2 treatments, 3 patients (15.8%) underwent 3 treatments, 2 patients (10.5%) underwent 4 treatments. The treatment frequency including 22 times of IVR only, 6 times of IVR combined with cryotherapy, 5 times of IVR combined with cryotherapy and sclerotomy to drain subretinal fluid, 1 time of IVR combined with vitrectomy. The follow-up period was ranged from 6 to 36 months, with an average of (19.11±7.05) months. Visual acuity, retinal reattachment and ocular adverse events were observed. ResultsThree children (15.8%) were failing to test the visual acuity. Visual acuity was improved in 2 patients (10.5%), stable in 13 patients (68.4%) and decreased in 1 patient (5.3%). Three patients (15.8%) achieved totally retinal reattachment after treatment, while 16 patients (84.2%) achieved partially retinal reattachment. One patient had vitreous hemorrhage. One patient had neovascular glaucoma. ConclusionIVR and combined treatment were effective for severe Coats disease.
Objective To cpmpare the assessment of retinal and choroidal disease using confocal scanning laser ophthalmoscope (cSLO) imaging and color fundus camera. Methods Sixty-seven patients (90 eyes) with fundus diseases were included in this study. There were 35 males (51 eyes) and 32 female (39 eyes), mean age was 51.32 years. All subjects underwent fundus imaging using cSLO technology and traditional color fundus camera, positive numbers of every retinal pathological change were calculated and compared. Spectral domain-optical coherence tomography (SD-OCT) was also done to compare the accordance rate between two modes of fundus imaging (cSLO technology and traditional color fundus camera) and SD-OCT in choroidal changes. Results The positive numbers of retinal microaneurysm (χ2=4.157, P < 0.05) and epiretinal membrane (χ2=5.428, P < 0.05) using cSLO fundus imaging were significantly higher than traditional color fundus camera, while the positive numbers of cotton wool spots (χ2=0.523), retinal hemorrhage (χ2=0.117), hard exudates (χ2=0.325) and macular hole (χ2=0.070) were no significant different (P > 0.05). The SD-OCT accordance rate of choroidal pathological changes using cSLO technology was higher than traditional color fundus camera (χ2=9.143, P=0.007). Conclusion In retinal and choroidal diseases, the imaging quality of cSLO fundus imaging technology is better than the traditional color fundus camera technology.
ObjectiveTo determine the positive results of confocal scanning laser ophthalmoscope (cSLO) based retinal imaging and traditional color fundus camera in screening epiretinal membrane (ERM) in elderly people. MethodsA total of 184 retired staffs from certain company (363 eyes) were included in this study, 153 were men (304 eyes) and 31 were women (59 eyes). The mean age was 74.35 years (range 47-92 years). All subjects were underwent fundus imaging using cSLO technology and traditional color fundus camera and Cirrus high definition optical coherence tomography (HD-OCT). The imaging quality of two technologies were analyzed and compared according to the evaluation standards. The positive accordance rate was used to compare between two modes fundus imaging (cSLO technology and traditional color fundus camera) and HD-OCT. ResultsIn 363 eyes, the positive number of screening ERM using HD-OCT was 122 eyes (33.6%); the positive number of traditional color fundus camera was 33 eyes (9.1%); the positive number of cSLO imaging was 76 eyes (20.9%). The HD-OCT positive accordance rate of screening ERM using traditional color fundus camera and cSLO technology were 27.0% vs. 62.3%. The HD-OCT positive accordance rate of screening ERM using cSLO technology was significant higher than traditional color fundus camera (χ2=30.81, P < 0.001). ConclusionThe HD-OCT positive accordance rate of screening ERM in elderly people was higher using cSLO technology than using traditional color fundus camera.
ObjectiveTo observe confocal scanning laser ophthalmoscope (cSLO) based retinal imaging and color fundus camera in pigment epithelial detachment (PED) of polypoidal choroidal vasculopathy (PCV).MethodsPED of 30 patients (32 eyes) were recruited from June 2016 to June 2017 in the Beijing Tongren Hospital who were detected in high-definition OCT (HD-OCT) and diagnosed as PCV by FFA and ICGA. There were 16 males (17 eyes) and 14 females (15 eyes); aged from 50-83 years, with the mean age of 66.59 years. The photographs of ocular fundus including color fundus camera, cSLO imaging, HD-OCT, FFA and ICGA were analyzed. Multimodal imaging results were regarded as gold standard. Sensitivity and specificity were calculated in serous and hemorrhagic PED diagnosis using color fundus camera and cSLO imaging. The positive number of PED was used to compare between two modes fundus imaging by using χ2 test.ResultsTwenty serous PED eyes, 3 hemorrhagic PED eyes and 9 serous/hemorrhagic PED eyes were determined using multimodal imaging. The sensitivity and specificity of color fundus camera were 45% and 100% in detecting serous PED and 100% and 91% in detecting hemorrhagic PED. The sensitivity and specificity of cSLO imaging were 83% and 100% in detecting serous PED and 50% and 86% in detecting hemorrhagic PED. The positive number of serous PED in cSLO imaging was significantly higher than color fundus camera (χ2=7.752, P=0.011). The positive number of hemorrhagic PED in cSLO imaging shows no obvious difference compared with color fundus camera (χ2=1.164, P=0.419).ConclusionThe sensitivity and positive number of detecting serous PED with PCV in cSLO fundus imaging were higher than the color fundus camera technology.
Objective To evaluate the diagnostic value of Heidelberg retinal angiography(HRA) combined with optical coherence tomography (OCT) to detect neovascularization (CNV) in exudative agerelated macular degeneration (AMD) patients. Methods This is a cross-sectional study of a series of clinical cases. AMD diagnosis was established by international standard vision chart, Slit lamp microscope, direct or indirect ophthalmoscope examination. A total of 50 eyes (42 cases) of exudative AMD received HRA and frequency domain OCT scan. All 50 eyes received fundus fluorescein angiography (FFA) and frequency domain OCT simultaneously, and among them 15 eyes also received indocyanine green angiography (ICGA) at the same time. FFA and ICGA were carried out by conventional methods, CNV was localized by real-time localization technology of frequency domain OCT. In the radial and grid-like section from the areas with b fluorescence, image acquisition settings are 7 mu;m fault for each frame, 30 deg; intervals for radial section, 10 vertical and 10 horizontal scan lines for gridlike section. CNV can be divided into 4 types (typical CNV, partial typical CNV, occult CNV, CNV scarring) according to their boundaries demonstrated in FFA. Based on the features of the OCT images, there were 3 types of integrated image (sub-RPE type, sub-retinal type and mixed type). Results CNV was detected in all 50 eyes. There were 4 eyes (8%) of typical CNV, 11 eyes (22%) of partial typical CNV, 32 eyes (64%, including 27 eyes of RPE detachment and 5 eyes of passive late leakage) of occult CNV and 3 eyes (6%) of CNV scarring. There were 4 eyes (8%) of subRPE type (CNV under the RPE light band) , 16 eyes (32%) of subretinal type(interrupted light band of RPE and choroid capillary layer) and 30 eyes (60%) of mixed type of integrated image. Conclusion The image integration technology of the HRA and frequency domain OCT system provide a valuable tool to classify and measure CNV, which will benefit the clinical treatment of AMD patients.