Objective To investigate the characteristics of the ocular fundus of Chinese patients with polypoidal choroidal vasculopathy (PCV).Methods The photographs of ocular fundus of 42 Chinese patients (48 eyes) with PCV diagnosed by fundus photography, fundus fluorescein angiography (FFA), and indocyanine green angiography (ICGA) were analyzed.Results In 48 eyes with PCV, 35 (72.9%) had subretinal hemorrhage, 13 (27.1%) had yellow-white exudation, 7 (14.6%) had subretinal tuberculum-like focus in tangerine peel at the posterior pole, and 26 (54.2%) had hemorrhagic or serous pigment epithelium detachment (PED). Thirty-six eyes（75.0%）had polypoidal dilations with branching vascular network, and the other 12 (25.0%) had scattered polypoidal dilations without identifiable continuous branching vascular network. The location for these lesions were at the macular region in 30 eyes (62.5%), arcade region in 6 (12.5%), peripapillary region in 3 (6.3%), and combination region in 9 (18.8%).Conclusions Most of the lesions in Chinese patients with PCV locate at the macular region and temporal vascular arcade. Most eyes are characterized by branching choroidal vessels with polyplike terminal aneurysmal dilations in ICGA. (Chin J Ocul Fundus Dis，2003，19：269-332)
Objective To analyze the etiology of central exudative chorioretinopathy（CEC）. Methods A total of 32 CEC patients were asked the medical history, and underwent examination of purified protein derivative（PPD）test, chest Xray, blood routine test, Creactive protein, erythrocyte sedimentation rate, TORCH test and rapid plasma regain cirde card test, to determine the possible causes of CEC. Results Thirty-two patients didnprime;t have the history of tuberculosis, and no evidence of systemic active tuberculosis was found in the chest X-ray examination. the results of PPD test showed the positive rate was 37.5％. The disease condition of paitents with positive result of PPD test was stable or was alleviated after anti-tuberculosis therapy. All the results in IgM of TORCH test and rapid plasma regain cirde card test were negative. Conclusion No infectious factors related to CEC was found, thus choroidal neovascularization of CEC might be idiopathic.
We have studied retrospectively 13 eyes with postoperative choroidal detachment of retinal detachment surgery in 126 cases(129 eyes).The frequency of choroidal detachment in this series is 10.1%(13/129).And we found that the middle-aged patients were more common sufferers,and drainaging the subretinal fluid,the extent of retinal degeneration and the buckling procedure might be the related factors to the occurence of postoperative choroidal detachment of retinal detachment surgery. （Chin J Ocul Fundus Dis,1993,9:210-213）
Interleukin-18 is an inactive precursor which lacks a signal peptide, it has a role in regulating retinal pathological angiogenesis. It also inhibits experimental choroidal neovascularization (CNV) via interferon-γand thrombospondin-1. Currently little is known about its mechanisms of inhibition for CNV, may be speculated to be due to effects of anti-angiogenesis, down-regulates vascular permeability and lower vascular endothelial growth factor (VEGF) levels via directly acting on the vascular endothelial cell and epithelial cells. Exogenous administration of mature recombinant interleukin-18 has no adverse effect on retinal pigment epithelial cell viability. In addition, the anti-VEGF role of interleukin-18 is tested to be safe and effective for humans. Interleukin-18 alone or in combination with anti-VEGF shows to be a good prospect for improving the prognosis of experimental CNV. However, more large clinical studies are required to confirm the exact efficacy of interleukin-18 for CNV.
Myopic macularpathy is the main cause of the decline of visual function in high myopia, which including tigroid fundus, lacquer cracks, diffuse retinal choroid atrophy, plaque retinal choroid atrophy, choroidal neovascularization (CNV), Fuchs spot and posterior staphyloma. The tigroid fundus is the initial myopic retinopathy. The lacquer cracks is a special lesion in the posterior pole of high myopia. When the lacquer cracksen enlarge or lacquer cracks progress to plaque retinal choroid atrophy should be paid to monitoring the occurrence of CNV. Myopic macularpathy progression include two mode. One is from tigroid fundus——lacquer cracks——plaque retinal choroid atrophy——CNV to macular atrophy. And the other is from tigroid fundus——diffuse retinal choroid atrophy——atrophy enlarge to diffuse retinal choroid atrophy with plaque retinal choroid atrophy or plaque retinal choroid atrophy occurence on the border of posterior staphyloma. Understanding the progression patterns and natural course of these lesions will help the clinic to further understand the course of high myoipa.
Objective To investigate the clinical features of polypoidal choroidal vasculopathy. Methods The clinical manifestations and the findings of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) of 7 eyes in 6 patients with polypoidal choroidal vasculopathy were analyzed retrospec tively.Results The ophthalmoscopic examination of PCV in this series of patients revealed orange-red lesions mainly in macular region in early stage, and then hemorrhage, exudation, edema, serous and (or) hemorrhagic detachment of retinal pigment epithelium in affected portions in advanced stage, and retinal and choroidal atrophy in late stage. FFA discovered the vascular dilation at the border of the choroidal vascular network in 1 eye, dotted hyperfluorescence in 6 eyes, and patches of hyperfluorescence in late phase. ICGA disclosed a vascular branching network in choroid with polypoid pattern of the terminal path of the vessels of network in early phase in 5 eyes, and the typical dotted or clustered polypoidal hyperfluorescence in 7 eyes in late phase.Conclusion The characteristic findings of FFA and ICGA are very diagnostic for PCV. (Chin J Ocul Fundus Dis，2003，19：269-332)
ObjectiveTo investigate the changes of choroid thickness in adolescents with different types of non-pathological high myopia (HM). MethodsA retrospective observational study. From January 2021 to April 2022, 179 eyes of 101 adolescents with myopia in Liaocheng Aier Eye Hospital were collected and analyzed. According to the spherical equivalent (SE) and corneal curvature, subjects were divided into mild myopia or emmetical eye group (control group), HM group, occult HM group (OHM group) and super HM group (SHM group). There were 52 eyes in 30 cases, 47 eyes in 26 cases, 42 eyes in 24 cases and 38 eyes in 21 cases, respectively. Medical optometry, intraocular pressure, optical coherence tomography (OCT), axial length (AL) and corneal curvature were measured. The macular foveal choroidal thickness was analyzed by using spectral-domain OCT. The diopter was expressed in SE. The thickness of choroid in the fovea of macular region was measured by enhanced deep imaging with frequency domain OCT. The thickness of choroid was measured in 9 regions within 1 mm, 3 mm from the fovea, including the upper, lower, nasal and temporal regions. Generalized estimating equation was used to compare the data among groups, and the least significant difference t-test was used to compare the data among groups. The correlation between AL, corneal curvature, intraocular pressure and choroidal thickness was analyzed by Pearson correlation. ResultsThe choroidal thickness in the foveal macula and the areas 1 mm and 3 mm away from the fovea were compared among the control group, HM group, OHM group and SHM group, the difference were significant (χ2=76.646, 36.715, 27.660, 35.301, 24.346, 38.093, 36.275, 33.584, 36.050; P＜0.05). Compared with the control group, the choroidal thickness of the fovea and the choroidal thickness in each area within 1 and 3 mm from the fovea in the HM group, the OHM group and the SHM group were significantly thinner than those in the control group, and the difference was statistically significant (P＜0.05). There were statistically significant differences in choroidal thickness in each region between the group and the SHM group, and between the OHM group and the SHM group (P＜0.05). The results of correlation analysis showed that AL was negatively correlated with choroidal thickness in various regions (P＜0.05); SE was positively correlated with choroidal thickness in various regions (P＜0.05); corneal curvature and intraocular pressure had no significant correlation with choroidal thickness in various regions (P＞0.05). ConclusionsThe choroidal thickness of SHM is significantly lower than that of OHM and HM; OHM patients have lower SE. However, the choroidal thickness is significantly thinner. AL and SE are the influencing factors of choroidal thickness.
Objective To compare changes in retinal and choroidal blood flow in the macular area of eyes with idiopathic macular hole (IMH), fellow eyes, and normal eyes. Additionally, the correlation between these blood flow changes and the occurrence and development of IMH. Methods A cross-sectional study. From January 2023 to January 2024, 47 patients (47 eyes) diagnosed with IMH (IMH group) in Department of Ophthalmology of The Second Hospital of Hebei Medical University were included in the study. The contralateral eye of IMH eyes was assigned to the contralateral eye group. Healthy volunteers with matched gender and age were selected as the normal control group. Swept-source optical coherence tomography angiography was used to acquire the vessel density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) in the areas within 0-1 mm and 1-6 mm around the fovea, including the superior, temporal, inferior, and nasal regions. Additionally, the choroidal blood flow area (CBFA) and three-dimensional choroidal vascular index (3D-CVI) were measured. The minimum linear diameter (MLD) and base diameter (BD) of the IMH were manually measured. Spearman correlation analysis was performed to evaluate the correlation between the size of the IMH and the various vascular parameters. ResultsCompared with the normal control group, the SCP-VD in the 3rd stage (t=1.298, P=0.009) and 4th stage (t=1.264, P＜0.000) eyes in the IMH group was significantly decreased, with statistical significance; the DCP-VD (t=1.958, 2.150, 1.712, 1.667; P=0.027, ＜0.000, ＜0.000, ＜0.000) and 3D-CVI (t=0.027, 0.030, 0.024, 0.023; P=0.005, 0.003, ＜0.000, ＜0.000) in eyes of all stages were significantly decreased, with statistical significance; the CBFA in eyes of stages 2-4 was significantly decreased, with statistical significance (t=0.027, 0.022, 0.021; P=0.028, 0.002, 0.002). Compared with the contralateral eye group, the DCP-VD and 3D-CVI in the IMH group were significantly reduced, with statistical significance (Z=−3.289, −2.704; P=0.001, 0.007). Pairwise comparisons between eyes of different stages in the IMH group showed that SCP-VD was significantly different between stage 2 and stage 4 (t=1.776, P=0.008); DCP-VD was significantly different between stage 1 and stage 3, and stage 1 and stage 4 (t=1.685, 1.661; P=0.002, 0.000). Correlation analysis showed that SCP-VD was negatively correlated with MLD and BD (r=−0.508, −0.408; P=0.002, 0.014); DCP-VD was negatively correlated with BD (r=−0.410, P=0.013). Compared with the normal control group, the nasal CBFA in stage 3 and 4 IMH eyes (t=0.149, 0.145; P=0.005, 0.002), and the nasal 3D-CVI in stage 1 and 3 IMH eyes (t=0.030, 0.027; P=0.002, ＜0.000) were significantly decreased, with statistical significance. ConclusionsThe SCP-VD, DCP-VD, CBFA, and 3D-CVI in IMH eyes were significantly reduced. SCP-VD showed a negative correlation with MLD and BD, while DCP-VD was only negatively correlated with BD.
Objective To summarize the therapeutic effect and clinical characteristics of repetitive photodynamic therapy (PDT) for patients with exudative age-related macular degeneration (AMD). Methods The clinical data from 78 patients (94 eyes) with exudative AMD who had undergone PDT from July, 2002 to March, 2005 were retrospectively analyzed. The average age of the patients was 68.4, and the treated times was 132 (mean 1.4). Thirty eyes underwent PDT 68 times, including twice in 22 eyes (73.3%), 3 times in 7 eyes (23.3%), and 6 times in 1 eye (3.3%). The follow-up period lasted 3-32 months with the average of 16.7 months. Results In the final follow-up examination, the results of fundus fluorescein angiography or combined with indocyanine green angiography showed that the leakage of choroidal neovascularization (CNV) stopped in 14 eyes (46.7%), reduced in 12 (40%), and remained in 4 (13.3%). Compared with the condition before first PDT, the correct visual acuity increased ge;2 lines in 7 eyes (23.3%), changed plusmn;1 line in 14 eyes (43.3%), and decreased ge;2 lines in 9 eyes (30%) in the final examination. After first PDT, the best corrected visual acuity increased ge;2 lines in 13 eyes (43.3%), changed plusmn;1 line in 12 eyes (40%), and decreased ge;2 lines in 5 eyes (16.7%). During the follow-up period, the best corrected visual acuity occurred after first PDT in 24 eyes (80%), after second PDT in 5 eyes (16.7%), and after third PDT in 1 eye (3.3%). Conclusions In patients undergone repetitive PDT, CNV in most of the affected eyes completely or partly closed and the visual acuity improved or remained still in 67.8% of the patients in the final follow-up examination. The best correct visual acuity mainly happened after the first PDT, and as the times of PDT increased, the probability of the best correct visual acuity decreased. (Chin J Ocul Fundus Dis, 2006, 22: 220-223)