ObjectiveTo observe the imaging features of cystoid macular edema (CME) in multicolor imaging (MC), and to evaluate the value of MC in the diagnosis of CME.MethodsDescriptive case series study. From August 2017 to June 2018, 42 eyes of 37 patients with CME diagnosed in the people's Hospital of Wuhan University were included in the study. Among them, there were 24 males and 13 females, with an average age of 48.51±10.29 years. There were 14 eyes with diabetic retinopathy, 14 eyes with central retinal vein occlusion, 8 eyes with branch retinal vein occlusion, 4 eyes with uveitis, and 2 eyes with Eales disease. The macular color fundus photography (CFP) was performed with Visucam 200 non-mydriatic fundus camera of Zeiss company in Germany. MC, frequnce domainoptical OCT (SD-OCT) and FFA were examined by Spectralis HRA2 + OCT of Heidelberg company in Germany. According to the MC standard method, five images, including 488 nm blue reflection (BR), 515 nm green reflection (GR), 820 nm infrared reflection (IR) imaging and standard MC and blue-green enhancement (BG), were obtained at the same time. Compared with SD-OCT, CFP and MC images were scored. Friedman M test and Wilcoxon signed rank test were used for statistical analysis.ResultsThe standard MC and BG images showed blue-green uplift area or petal-shaped appearance, surrounded by green reflection areas with clear boundaries. BR image can be seen in the low reflexes area. On the GR image, there were patches or cystic low reflection areas, surrounded by a slightly high reflection. On the IR image, patches or cystoid high reflexes can be seen, surrounded by low reflection dark areas with clear boundaries. The average scores of CFP, standard MC, GB, IR, GR and BR were 1.20±0.94, 3.05±0.99, 2.90±1.04, 2.55±1.27, 2.00±0.94, 0.51±0.85 respectively, and the differences were statistically significant (χ2= 151.61, P=0.000). The score of CFP were significantly lower than that of standard MC (Z=－5.421), BG (Z=－5.354), IR (Z=－4.714), GR (Z=－4.438) and higher than that of BR (Z=－3.435). The differences were statistically significant (P=0.000, 0.000, 0.000, 0.000, 0.001).ConclusionsThe quality of MC imaging is better than that of CFP. Combined with SD-OCT, it can be used as an assistant method to diagnose CME.
ObjectiveTo observe the effect of interventional thrombolytic therapy for central retinal artery occlusion (CRAO) with ipsilateral internal carotid artery occlusion via supratrochlear artery retrogradely or external carotid artery anterogradely.MethodsNine CRAO patients (9 eyes) were enrolled in this study, including 5 males and 4 females. The mean age was (45.2±18.1) years. The mean onset duration was 24 hours. There were 4 eyes with vision of no light perception, 3 eyes with light perception and 2 eyes with hand movement. Fundus fluorescein angiography (FFA) examination showed that the retinal artery was filled with delayed fluorescence. The peak of fluorescence was seen in the anterior part of the artery, and some of the eyes showed retrograde filling. The arm-retinal circulation time (A-Rct) was ≥35 s in 4 eyes, ≥35 s - ＜25 s in 5 eyes. The filling time of retinal artery and its branches (FT) was ≥15 s in 2 eyes, ≥12 s - ＜15 s in 3 eyes, ≥9 s - ＜12 s in 4 eyes. All the patients received the treatment of interventional thrombolytic therapy via supratrochlear artery retrogradely (8 eyes) or external carotid artery anterogradely (1 eye) according to the indications and contraindications of thrombolytic therapy in acute cerebral infraction patients. Urokinase (0.4 million U in total) was intermittently injected into the arteries. After artery thrombolysis, the changes of digital subtraction angiography (DSA), filling time of retinal artery and its branches on FFA within 24 hours and the visual acuity were observed. According to the A-Rct and FT on FFA, the therapeutic effects on retinal circulation were defined as effective markedly (A-Rct≤15 s, FT≤2 s) , effective (A-Rct was improved but in the range of 16 - 20 s, FT was in 3 - 8 s) and no effect (A-Rct was improved but ≥21 s, FT≥9 s). The related local or systemic complications were recorded.ResultsAfter the injection of urokinase into the catheter, the ophthalmic artery and its branches were increased in 6 eyes (66.7%), and the development of the eye ring was significantly more than that of the eyes before thrombolysis. The circulation time in ophthalmic artery was speeded up for 2 s before thrombolysis in 3 eyes, 3 s in 3 eyes, and 4 s in 2 eyes. Within 24 hours after thrombolysis treatment, the A-Rct was significantly decreased than that of before interventional therapy. The retinal circulation was effective markedly in 4 eyes (44.4%), effective in 4 eyes (44.4%) and no effect in 1 eyes (11.2%) . The vision was improved 3 lines in 4 eyes (44.4%), 2 lines in 3 eyes (33.3%), 1 line in 1 eye (11.2%) and no change in 1 eye (11.2%). There were no abnormal eye movements, vitreous hemorrhage and incision hematoma, intracranial hemorrhage, cerebral embolism, and other local and systemic adverse effectives during the follow-up.ConclusionsThe interventional thrombolytic therapy via supratrochlear artery retrogradely or external carotid artery anterogradely for CRAO with the ipsilateral internal carotid artery occlusion can improve retinal circulation and vision. There are no related local or systemic complications.
OBJECTlVE:To investigate Ihe changes of macuiar lesions in dry type of age re[amd maeuJar clegcneration(AMD)and search for a sensitive melhod for detecting tile development of the disease. METHODS:The fundus fluoreseein angiography(FFA) ,visual acuity,FM 100-hue test and photopie electroretinogram(ERG)were used to examine a series of 60 patients(111 eyes)with dry AMD aged 50~80 years with the visual acuity of le;1.0.The patients were felhwed tip in 3~74 months(average 30.2 months). RESULTS:In 68 eyes undergone FFA examination and followed llp for Ihe average period of 25.6 months ,the macular lesions were found worsened in 25%, The visual acuity in follow-up periods was found decreasing more than 2 lines in 18% of the fotal 111 affectd eyes.There were not any statistically significat difference in photopic ERG between the initial and final cxaminations in 63 eyes tested. The tolal error score of FM 100-hue test had a statistically significant difference between the initial test and the test taken two years afterwards(Plt; 0.01 )in 81 eyes examlnccl. CONCLUSIONS:Most of the macular lesions and visual acuity in dry type of AMD revealed a [avorahle prognosis,but occasionally complicated with ehoroidal neovaseularization. The total error score of FM 100-hue test might be a sensitive method for monitoring the development of dry type of AMD. （Chin J Ocul Fundus Dis,1997,13: 150-152）