Objective To observe the clinical effect of photodynamic therapy (PDT）based comprehensive treatment for choroidal neovascularization (CNV) in patients with multifocal choroiditis (MC). Methods Nine eyes of 8 MC patients (7 females and 1 male) with CNV who had undergone PDT based comprehensive treatment were enrolled in this study. The patients aged from 25 to 54 years with the mean of (41.8plusmn;10.6) years. The examinations of best-corrected visual acuity (BCVA), slit lamp microscope, indirect ophthalmoscopy, fundus fluorescein angiography and optical coherence tomography were performed. The BCVA ranged from 20/333 to 20/50 (mean logMAR 0.68plusmn;0.32). The mean CNV area was (0.767plusmn;0.445) mm2. The central retinal thickness (CRT) was (355.2plusmn;65.2) mu;m. Among the 8 patients,4 eyes received only PDT, 2 eyes received PDT and oral corticosteroid, 1 eye received PDT and intravitreal injection of 1.25 mg bevacizumab, 2 eyes received PDT and subtenon injection of 40 mg triamcinolone acetonide. The follow-up period ranged from 3 to 22 months, with the mean of (14.0plusmn;5.7) months. The BCVA, mean CNV area and CRT before and after treatment were analyzed. Results By the end of last visit, the BCVA improved to 20/250 to 20/25 (mean logMAR 0.58plusmn;0.37), but the difference was not statistically significant (t=1.890, P=0.095). Visual acuity improved 3 lines in 3 eyes (33.3%), improved 1.5 lines in 1 eye (11.1%), unchanged in 4 eyes (44.4%) and decreased 1.5 lines in 1 eye (11.1%). The mean CNV area decreased to (0.684plusmn;0.371) mm2, but the difference was not statistically significant (t=0.996, P=0.349). The CRT decreased to (295.3plusmn;79.4) mu;m, but the difference was not statistically significant (t=2.242, P=0.055). Conclusion PDT can stabilize visual acuity in patients with subretinal CNV secondary to MC, especially when combined with intravitreal injection of antivascular endothelial growth factor drugs or steroid.
Objective To characterize the clinical features of punctate inner choroidopathy (PIC) in Chinese patients.Methods The clinical data of 75 PIC patients (112 eyes) attending this center from June 1999 to October 2009 were reviewed retrospectively. All patients received routine examination and fluorescein fundus angiography (FFA). Twentyeight patients also received indocyanine green angiography (ICGA). VISUPAC 3.3 software was used to determine the size of lesions in early image of FFA at the artery stage. Results Of the 75 PIC patients (112 eyes), 54 patients (72%) were female, 37 patients (49%) were bilateral cases. Sixty patients (80%) were myopic, including eight patients (7%) with mild myopia, 22 patients (20%) with moderate myopia, and 57 patients (51%) with high myopia. The mean age at presentation was 32 years (range: 17-61). Multifocal PIC lesions (1-56 lesions) were mostly restricted to posterior pole of affected eyes (95%). Eightyfour eyes (75%) had 10 PIC lesions. The active lesions were yellowwhite and butterlike, 20-500mu;m in diameter. FFA showed that most acute lesions were early hyperfluorescence, and stained or slightly leaked on late period. The atrophic lesions were pouchedout, 502000 mu;m in diameter, with irregular pigmentation. Choroidal neovascularization developed in 70 eyes (63%). Papilledema (three eyes, 3%), staining of optic disc on latephase fluorescein angiography (three eyes, 3%), and segmental retinal phlebitis (two eyes, 2%) were rare.Conclusions PIC primarily affects young women with moderate or high myopia. It is featured by multifocal small yellow creamy lesions and/or atrophic punchedout lesions principally in the posterior pole. Choroidal neovascularization is the most common complication.
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. (Chin J Ocul Fundus Dis, 2005, 21: 367-370)
Objective To explore the clinical manifestations and the characteristics of images of indocyanine green angiography (ICGA) and fundus fluorescein a ngiography(FFA) of multifocal choroiditis. Methods Eight patie nts (10 eyes) with multifocal choroiditis were gathered. The clinical manifestations and the images of ICGA and FFA were analyzed. Results Foci of multifocal choroiditis were found in posterior pole and peripheral areas of ocular fundi of all of the 10 eyes. The images of ICGA revealed hypofluorescence in focal area. The images of FFA showed hypofluorescence at the early phase and fluorescein leakage at the late phase in the active focus, and fluorescein staining and window defect fluor escence in the inactive focus. Conclusions The clinical manife stations of multifocal choroiditis varied with disease course, location and numbers of the lesions. ICGA and FFA can show the development of the disease clearly, which may guide the treatment. (Chin J Ocul Fundus Dis，2004，20：87-89)
Objective To observe the clinical manifestations and feat ures of fundus fluorescein angiograms(FFA)of patients with multifocal choroiditis (MFC)MethodThe data of 8 patients who had been diagnosed by clinic and FFA as with MFC were collected, and their clinical manifestatio ns and results of FFA were analyzed and valued.ResultsThe age of the 7 female and 1 male patients ranged from 16 to 32, and all of the 8 patients had high myopia (from -6.00 D to -8.00 D) with binocular multiple small yellowish white lesions in posterior pole of the fundus and a few phlogistic ce lls in vitreous body. In addition, macular choroidal neovascularization membrane (CNV) was found in 6 patients, binocular in 2 and monocular in 4. The results of FFA in 7 patients showed hypofluorescence of the yellowish white lesions at t he early phase and pigmentation at the late phase; Corresponding manifestations of FFA could be found in the patients attended by CNV surrounded by leakage.ConclusionMFC are mostly diagnosed in young females with myopia. Most of the patients had binocular affection with multiple small yellowish white lesions at the posterior pole, whose FFA shows hypofluoresence of the active lesions at the early phase and pigmentation at the late phase. CNV may occur in patients with MFC.(Chin J Ocul Fundus Dis，2004，20：335－338)
Purpose To study choroidal vascular abnormal characteristics in choroidal vascular abnormal characteristics in choroiditis using indocyanine green angiography(ICGA). Methods Thirteen cases (16 eyes) of choroiditis were examined with fundus fluorescein angiography (FFA) and ICGA. Results ICGA findings in choroiditis were as follows:(1) dilatation of choroidal vessels with segmentary appearance and irregular margind;(2) hyperpermeability of choroidal vessels;(3) choroidal filling defects; (4) choroidal hypofluorescence with edema;(5) dilatation of vortex veins. (Chin J Ocul Fundus Dis,1998,14:92-84) Conclusion ICGA is useful in evaluating the lesions and circulation disturbance of choroiditis which cannot usually be demonstrable in FFA.