The experimental models of chronic hepatic lesion of 40 rabbits were made by intra-abdominal injection of thioacetamide.The chronic hepatic lesion was confirmed by pathological examination and hepatectomies were performed in accordance with different measurements on each rabbit.The observations included indocyanine green retention rate,hepatic resection volume,and the outcomes of operations.The results showed that the mortality was correlative with the change of hepatic functions in the background of chronic hepatic lesion.The indocyanine green retention and the level of serum albumin are important parameters to indicate hepatic impairment.When the former was over 40% or the latter below 2.8g% the operative danger was high and the mortality was over 50%.In accordance with the classification of hepatic function,the preoperative functional state of liver were classified:grade A,B and C.the mortality of posthepatectomy were respectively 16.7%,3O%,and 72%.The multiple progressive regression equation is employed for calculating the postoperative outcome.The equation predicted the postoperative outcome with 88.9% accuracy.
Objective To observe ophthalmoscopic image characteristics of central serous chorioretinopathy (CSC). Methods Twenty-one eyes of the 18 patients diagnosed with CSC were enrolled in this study．The patients included 12 males (14 eyes) and six females (seven eyes)．The patients ages ranged from 26 to 47 years，with a mean age of (39.1plusmn;5.4) years. There were nine patients (11 eyes) with acute CSC, seven patients (seven eyes) with chronic CSC, and two patients (three eyes) with recurrent CSC. All the patients were examined using color fundus photography including infrared (IR), auto-fluorescence (AF), near infrared ray-auto-fluorescence (NIR-AF), fluorescein angiography (FA) and indocyanine green angiography (ICGA) photography. The ophthalmoscopic image characteristics of CSC were comparared. Results The circular serous retinal detachments of 21 eyes were depicted in color images of the ocular fundus, which in the IR showed the hypo-fluorescence. Ten eyes displayed mottled hyper-fluorescent spots associated with serous retinal detachments corresponding to the leakage points. The serous retinal detachments of 15 eyes in the AF images showed hypo-fluorescence, six eyes showed hyper-fluorescence. Fourteen eyes presented with hypo-or hyper-fluorescent spots corresponding to the leakage points, seven eyes presented without abnormal fluorescence corresponding to the leakage points. In addition, three eyes with acute CSC showed many scattered hyper-fluorescent spots, which showed hypo-fluorescence in the ICGA. The serous retinal detachment of 15 eyes exhibited hypo-fluorescence in the NIR-AF images, six eyes showed hyper-fluorescence. Fourteen eyes presented with hypo- or hyper-fluorescent spots corresponding to the leakage points, seven eyes presented without abnormal fluorescence corresponding to the leakage points. Twenty-one eyes in FA identified the leakage. Eight eyes showed regional choroidal delayed filling, 13 eyes exhibited regional choriocapillary dilatation during 1-5 minutes after injection of ICGA. During 1-5 minutes after injection of ICGA, six eyes showed more lesions than FA, three eyes showed obvious patchy hypo-fluorescence whereas the FA were normal. Conclusions CSC has its own characteristic fundus images in the IR, FA and NIR-A. FA is still the photographic method of choice, but ICGA can reveal lesions of the choroid in CSC. IR, FA and NIR-AF are not as good as FA and ICGA for detecting of leakage points.
Objective To investigate the clinical characteristics of patients with polypoidal choroidal vasculopathy (PCV) from Central China . Methods This was a retrospective study, and 403 eyes of 362 patients diagnosed as PCV by ocular fundus photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT) were enrolled. The general clinical data, fundus manifestation and ocular fundus examinations were statistically analyzed. Results Three hundred and sixty-two cases included 249 males (68.8%) and 113 females (31.2%). Age ranged from 45 to 91 years old, and mean age was (64.81plusmn;9.31) years old. Bilateral lesions were observed in 41 patients (11.3%) and unilateral lesions were observed in 321 patients (88.7%)． In these 403 eyes, typical orangered lesions were observed in 162 eyes (40.2%); yellowishwhite exudate could be found in 185 eyes (45.9%); 268 eyes (66.5%) showed variable degrees of subretinal hemorrhage. Drusen was found in 23 eyes (5.7%), pigment proliferation in 20 eyes (5.0%) and fiber vascular scar in 96 eyes (23.8%). The lesions of 386 eyes (95.8%) located in macular region, 53 eyes (13.2%) in peripapillary area. Lesions presented multifoci in 67 eyes (16.6%). Three hundred and four eyes (75.4%) presented typical polypoidal lesions and 152 eyes (37.7%) with abnormal branching choroidal networks. Hemorrhagic retinal pigment epithelial detachments (PED) were found in 200 eyes (49.6%) and serous PED in 96 eyes (23.8%), both existed in 25 eyes（6.2%）. OCT showed 56 eyes (13.9%) presented cystoid dark chamber between the neurosensory retina and 109 eyes (27.0%) with double-layer sign formed by the separation of retinal pigment epithelium and Bruchprime;s membrane (27.0%). Two hundred and seventy-four eyes (68.0%) were found with conelike elevation beneath the RPE layer and 151 eyes (37.6%) with neurosensory detachment. Conclusions In Central China, the majority of PCV patients were male, unilateral. Most PCV lesions were located in the macula. Subretinal hemorrhage, polypoidal lesions and abnormal choroidal vascular networks were common in the PCV patients. Hemorrhagic PED presented a higher ratio than serous PED.
Objective To observe the of macular serous neuroepithelial detachment and the necessary auxiliary examination methods for the diagnosis.Methods The clinical data of 46 patients (49 eyes) aged above 45 years with macular serous neuroepithelial detachment who have been diagnosed by binocular indirect ophthalmoscope and optical coherence tomography (OCT) were retrospectively analyzed. All the patients had undergone fundus fluorescein angiography (FFA) and indocyanine angiography (ICGA), and the diagnosis was established based on the results of FFA, ICGA and OCT. Results In these 46 patients (49 eyes), central serous chorioretinopathy (CSC) was found in 31 (34 eyes, 69.4%), agerelated macular degeneration (AMD) was found in 12 (12 eyes, 24.5%), and polypoidal choroidal vasculopathy (PCV) was found in 3 (3 eyes, 6.9%). In the 34 eyes with CSC, 12 eyes (35.3%) had typical CSC and 22 eyes (64.7%) had chronic CSC. If the 12 eyes with AMD, 9 eyes (75%) had occult CNV, 2 eyes (16.7%) had minimally classic CNV, and 1 eye had classic CNV. Conclusions The causes of serous macular neuroepithelial detachment in patients aged above 45 years are complex; ICGA may help to establish the definitive diagnosis of chronic CSC, occult CNV,and PCV should be considered.
Objective To investigate the imaging characteristics of patients with choroidal folds, which including ocular fundus, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT). Methods The clinical data of 62 eyes of 34 patients with choroidal folds were analyzed retrospectively. The patients include 10 patients(20 eyes) of VogtKoyanagiHarada syndrome, 1 patients(2 eyes) of Behcet diseases, 11 patients(21 eyes) of other uveitis, 5 patients (9 eyes) of papolloedema, 2 patients(2 eyes) of choroidal tumor, 2 patients(4 eyes) of, hypotony with macular degeneration, 1 patient(2 eyes) of,Graves diseases, 1 patient (1 eye) of,blunt trauma and 1 patient(1 eye) of uveal effusion syndrome. All patients underwent the examination of direct ophthalmoscope, fundus color photography and FFA, meanwhile, 9 patients (17 eyes) with ICGA examination, 9 patients(18 eyes) with OCT examination. Results Choroidal folds were bright and dark stripes on the fundus, their numbers were variable. They can be arranged radially, horizontally, oblique or concentrically around the macular area, or radiating from optic disk but rarely over equator region. On FFA there were more folds which were subjected to coarse folds and wrinkles. They were obvious at early stage and no leakage at late stage. On ICGA choroidal folds showed normal or hypofluorescence at early stage, and hyperfluorescence or hypofluorescence at late stage. The hyperfluorescence or hypofluorescence bands were corresponding to the hypofluorescence of FFA but not obvious as FFA. On OCT choroidal folds involved choriod and retinal pigment epithelial layer (RPEL). Conclusion Choroidal fold is a bright and dark stripes that involved choriod and RPEL. The angiography showed hypofluorescence bands without leakage. Be familiar with the imaging features of choroidal folds can help to found the choroidal folds and the original diseases.
Objective To observe the clinical features of choroidal folds in Vogt-Koyanagi-Harada disease. Methods The clinical data of 112 patients with choroidal folds in Vogt-Koyanagi-Harada disease were retrospectively analyzed. All patients were examined by fundus color photography and fundus fluorescein angiography (FFA). 8 patients underwent indocyanine green angiography (ICGA) and 7 patients received optical coherence tomography (OCT) meanwhile. Results Of the 112 patients, 16 patients (14.3%) had choroidal folds. on FFA, there are 10 to 15 hypofluorescenct bands radiating from the optic disk which were similar to the large retinal vessels in shape and number(choroidal fine folds). On ICGA the choroidal folds showed obvious hyperfluorescence at the late stage. On OCT the reflective bands of Bruch membrane and retinal pigment epithelium (RPE) showed the wavy folds. Conclusions Choroidal folds in Vogt-Koyanagi-Harada disease are characterized by fine folds radiating from the optic disk which is not uncommon in Vogt-Koyanagi-Harada disease.
Objective To investigate the characteristics of images of angiography in uveal effusion syndrome (UES). Methods The clinical data of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) in 11 patients (17 eyes) with UES were retrospectively analyzed, and 4 patients (7 eyes) underwent angiography again 1 month to 28 months after segmental sclerectomy. Result The results of FFA and ICGA showed papilledema and venous tortuosity and dilation in 12 eyes, leakage spots at the post pole of ocular fundus in 2 eyes, leopard spots in 14 eyes, linear or meshy pigment stripes in 8 eyes. The results of ICGA showed uneven flecked hyperfluorescence lasted to later stage in 4 patients (5 eyes), a triangle hypofluorescence area at the inferior fundus in 1 eye, and a geographic pattern hypofluorescence at the posterior pole in 1 eye. Segmental sclerectomy was performed on 5 patients (8 eyes), and after surgery, cilia-choroidal detachment was gradually alleviated and even disappeared, the status of choroidal hyperpermeability was alleviated, and the leakage spots disappeared. The subretinal fluid increased in only 1 eye 2 years after the surgery. Conclusion The characteristics of aniography for UES are venous tortuosity and dilation, papilledema, leopard spots, and linear or meshy pigmentary stripes, which may deepen our understanding about the disease and help to diagnose it. (Chin J Ocul Fundus Dis, 2007, 23: 189-192)
Objective To observe and analyze the configuration and distribution of vortex veins by indocyanine green angiography (ICGA) combining with widefield contact lens system. Methods A total of 28 patients (32 eyes), including 16 females (19 eyes) and 12 males (13 eyes) with the age of 28-84 (average 71), were examined by ICGA combing with widefield contact lens. The patients were divided into high myopia group (15 eyes with diopter ge;-6.0 D) and non high myopia group (17 eyes with diopter lt;-6.0 D or normal sight). Results A total of 166 vortex veins were detected, including 118 circinate veins (71.1%), 34 thick-stripe-like veins (20.5%), and 14 irregular vein (8.4%). There are 71 vortex veins in the right eyes with average 5.07 vortex veins in each eye; and 95 veins in the left eyes with average 5.28 vortex veins in each eye. The number of vortex veins at in the inferior temporal, inferior-nasal, over-temporal and over-nasal retina was 47, 42, 39, and 38, respectively, with average 1.34 vortex veins in each quadrant (the inferiortemporal was the most: average 1.53). A total of 160 vortex veins came out from the scleral around the equator area 46 disc diameter (DD) away from the optic disc (964%); the other 6 vortex veins came out at the point 3-4 DD away from the optic disc (3.6%). A total of 123 (74.1%) vortex veins had ampullae with different directions. Horizontal and vertical ampullae were most common. There was no difference in numbers and configuration of vortex veins beween the two groups. Conclusion The vortex veins has circinate, thick-stripe-like, and irregular configurations; the distribution of vortex veins in eyes with high myopia or non high myopia is almost accordant. ICGA combining with the wide-field contact lens examination can observe all of the vortex veins within a single visual field.
Objective To compare the characteristics of fundus angiograms of central serous chorioretinopathy (CSC) with exudative agerelated macular degeneration (AMD) in patients more than 45. Methods The colorized photographs of ocular fundus, and results of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) of 32 patients (39 eyes) with CSC and 20 patients (22 eyes) with exudative AMD more than 45 were collected and analyzed retrospectively. Results In 39 eyes with CSC, the results of FFA revealed classic CSC in 11 (28.2％) and diffuse retinal pigment epitheliopathy (DRPE) in 28 (71.8％); the results of ICGA showed localized choroidal delayed filling associated with dilated vessels in 39 (100％) in the early phase, choroidal hyperpermeability in 39 (100％), identifiable hyperfluorescence of leakage from RPE in 16 (41.0％) was observed in the middle phase, and a distinctive silhouetting of the larger choroidal vessels in 5 (12.8％) was detected in the late phase. In 22 eyes with exudative AMD without evident hemorrage, the results of ICGA exhibited focal CNV in 13 (59.1％), plaque CNV in 8 (36.4%), and combination CNV in 1 (4.5%)；choroidal delayed filling around macular region vicariously was found in 5 (22.7％) in the early phase, choroidal hyperpermeability was not observed in the middle phase and silhouetting of the larger choroidal vessels was not showed in the late phase. Conclusions The differences of the ICGA features between CSC and exudative AMD in patients more than 45 include focal or multifocal hyperfluorescence of leakage from RPE, multifocal choroidal hyperpermeability in the middle phase, silhouetting of the larger choroidal vessels in the late phase, and no focal or plaque CNV.
Objective To investigate the features of ocular fundus of retinal pigment epithelial detachment (PED) in Chinese patients more than 50. Methods The clinical data of 31 continuous patients (34 eyes) with PED diagnosed by ocular fundus photochromy, fundus fluorescein angiography (FFA) and indocyanine green angiography ( ICGA ) from Oct, 2001 to Aug, 2004 were analyzed retrospectively. Results In 34 eyes with PED, the results of FFA showed serous PED in 18 (52.9%), hemorrhagic PED in 8 (23.5%), and serosanguineous PED in 8 (23.5%); the results of ICGA revealed PED associated with choroidal neovascularization (CNV) in 12 (35.3%), PED associated with ploypoidal choroidal vasculopathy (PCV) in 17 (50.0%), PED associated with both CNV and PCV in 1 (2.9%), and avascular PED in 4 (11.8%). Conclusions PED in Chinese patients more than 50 can be associated with CNV, PCV or other avascular diseases, and PCV is the most common intercurrent choroidal vascular disease. (Chin J Ocul Fundus Dis, 2006, 22: 224-227)