The origin of blood supply and the features of vascular distribution of the fascia lata was obeervedby the method of microsurgical anatomy.It was found that there were 4 sources of the blood supplyfor the fascia lata. The blood vessels in the anterior supperior femoral area were from the original partof the decp femoral artery,while in the inferior part,the arteriess were from the tributary of theperforating artery. The blood vessels in the poterior superior femoral area were from both t...
Objective To observe the location of peripapillary choroidal watershed zones relative to the optic disc in the different types of glaucoma. Methods A total of 98 patients (98 eyes) with glaucoma (glaucoma group) were enrolled in this study. The eyes included 34 eyes with primary open-angle glaucoma (POAG group), 33 eyes with normal tension glaucoma (NTG group) and 31 eyes with chronic angle closure glaucoma (CACG group). Thirty-seven fellow eyes of 37 patients with monocular blunt trauma were selected in this study as control group. The differences of age (t=1.197), sex (chi;2=3.548), average diopter (t=-1.644) between glaucoma group and control group were not statistically significant (P＞0.05). The differences of age (F=2.645), sex (F=1.984), average diopter (F=2.621), and visual fields mean defect (MD) (F=0.899) between different types of glaucoma were also not statistically significan(P＞0.05).Simultaneous indocyanine green angiography (ICGA) and fundus fluorescein angiography (FFA) were performed on all subjects. The watershed zones were classified into three types according to its location relative to the optic disc: in type Ⅰ, the watershed zone did not include the optic disc or could not be observed; in type Ⅱ, the watershed zone partially included the optic disc; in type Ⅲ, the watershed zone completely included the optic disc. The location of watershed zones relative to the optic disc in the different types of glaucoma was comparatively analyzed. The relationship between watershed zones, type and age, and MD were also analyzed by Pearson analysis method. Results The constituent ratio of type Ⅱ and Ⅲ watershed zones were 81.6% and 56.8% in glaucoma group and control group, respectively; with a statistically significant difference (chi;2=8.756,P＜0.003). The constituent ratios of type Ⅱ and Ⅲ watershed zones were 82.4%, 90.9%, 71.1% in POAG, NTG and CACG group, respectively. No significant differences were found between POAG and NTG group (chi;2=1.039), POAG and CACG group (chi;2=1.039, 1.166;P＞0.05). But there was significant difference between NTG and CACG group (chi;2=4.107,P＜0.05). Significant differences were found between POAG and control group, NTG and control group (chi;2=5.352, 10.141;P＜0.05). No significant difference was found between CACG and control group (chi;2=1.444,P＞0.05). There was no correlation between age and watershed zone type (r=0.114,P＞0.05). The watershed zones type of glaucoma group positively correlated with MD (r=0.354,P=0.000). Conclusion The peripapillary choroidal watershed zones in glaucoma patients include the optic disc more than in healthy eyes.
Objective To observe the histopathological changes in human eyes with ischemic central retinal vein occlusion (CRVO), and to provide objective basis for effective methods of prevention and treatment for (CRVO). Methods Histopathological analysis was performed on the samples of 11 eyes in 11 patients with ischemic CRVO. The changes of central retinal veins (CRV) and central retinal arteries (CRA) wereobserved. Results The lumen of CRV became narrow when passed through the lamina cribrosa in 11 eyes, in which organized thrombus was found in the lamina cribrosa region and post lamina cribrosa region in 5 eyes, and organized thrombus re-unobstructed channels, endothelial proliferation and narrow lumen were found in 6 eyes. Arteriosclerosis of the CRA was observed in all of the 11 eyes with thick wall of the artery and narrow lumen. Proliferation of endothelium of wall of CRA and narrow lumen in the lamina cribrosa region was found in 2 eyes and no thrombus was found at the lamina cribrosa level. Conclusion During the course of ischemic CRVO, thrombus occurs in CRV at the level of lamina cribrosa. The prognosis of CRVO may lie on the time and degree the thrombosis re-opens. The mechanism of CRVO is that CRV is pressed in the narrow interspace of scleral channels of lamina cribrosa. (Chin J Ocul Fundus Dis, 2007, 23: 163-165)
Objective To evaluate the influence of the location of retinal vessel trunk on neuroretinal rim width of inferior and superior sectors of optic disc, and explore its role in the diagnosis of glaucomatous optic nerve lesion. Methods The photographs of ocular fundus from 459 patients with clear location of retinal vessel trunk, including large disc in 131, medium disc in 145, horizontally oval disc in 75, and small disc in 108 were evaluated. Independent-sample t test was used to compare the difference of the superior and inferior rim widths between the higher-vessel group and the lower-vessel group, and to compare the difference of superior and inferior vessel distances between the narrow-superior-rim-width group and the narrow inferior-rim-width group. Results In most of the patients, or the ones with large and small disc, the ratio of superior rim width to summation of superior and inferior rim widths in the higher-vessel group（0.467plusmn;0.051，0.445plusmn;0.040，0.508plusmn;0.056）were less than which in the lowervessel group（0.500plusmn;0.066，0.474plusmn;0.062，0.546plusmn;0.048）, and the differences were significant（P=0.000, 0.045, 0.018）; the ratio of superior vessel distance to summation of superior and inferior vessel distance in the narrow-superior-rim-width group（0.510plusmn;0.051，0.508plusmn;0.055，0.512plusmn;0.036）were less than which in the narrow-inferior-rim-width group（0.528plusmn;0.045，0.533plusmn;0.048，0.534plusmn;0.045）, and the differences were significant（P=0.000, 0.046, 0.022）. Conclusions The position of optic disc vessel trunk influences its superior and inferior rim width. The rim closer to vessel trunk position has narrower width than which comparatively far away from the position. In patients with large, medium, horizontally oval optic disc, glaucoma optic nerve lesion would be considered if the optic disc has the shape of narrower inferior rim, broader superior rim, and vessel location in the superior half of the disc. In the ones with small disc, the optic disc with the shape of narrower superior rim, broader inferior rim, and vessel location in the inferior half of the disc may suggest glaucoma optic nerve lesion. (Chin J Ocul Fundus Dis, 2007, 23: 118-121)
Objective To investigate the clinical characteristics and mechanisms of ocular manifestations related to carotid artery stenosis. Methods The general clinic data and related ocular manifestations in 124 patients with carotid artery stenosis were retrospectively. Results In the 124 patients, 36 (29%) had ocular manifestations, and 28 (22. 6 %) complained the ocular discomfort as the first symptom. Among the 36 patients, 31 patients (86.1%) had been disclosed unilateral or double stenosis of internal carotid artery by carotid Doppler ultrasound examination, and the result of digital subtract angiography revealed middle and severe degree of internal carotid artery stenosis in 8 and 23 patients respectively. There was no statistic difference of incidence of ocular manifestations between 67 patients of severe internal carotid artery stenosis and 34 patients with middle one（chi;２test,P =0.266 2，P＞0.05). The ocular manifestations included amaurosis fugax (52.8%),acute decline or loss of the visual ability and defect of visual fields (36.1%), binocular diplopia (13.9%), ptosis (13.9%), and persistent high intraocular pressure(2.8%) one patient might had several ocular manifestations simultaneously. In 36 patients, central retinal artery occlusion had been diagnosed in 4, venous stasis retinopathy in 1,central or branch retinal vein occlusion in 6, neovascular glaucoma in 1, and anterior ischemic opticneuropathy in 2. One patient with double occlusion of internal carotid artery didnrsquo;t have any ocular manifestation. Conclusion Carotid artery stenosis, especially internal carotid artery may lead to acute or chronic ocular ischemic lesions, and the occurrence of ocular manifestations in chronic ocular ischemic lesions relates to compensa tion of collateral circulation；patients with ocular ischemic lesions are recomm end to undergo a routine carotid artery examination. (Chin J Ocul Fundus Dis, 2006,22:376-378)
Purpose To discuss changes of macular choriocapillaris hemodynamics in AMD. Methods Eighty-six eyes of 86 patients underwent ICGA,including macular drusen in 15 eyes of 15 patients,exudative AMD in 52 eyes of 52 patients,atrophic AMD in 19 eyes of 19 patients,for the observation of macular choriocapillaris perfusion. Results Choriocapillaris filling phase (CFP) of exudative AMD was obviously longer than that of eyes with normal, atrophic AMD and drusen groups (P＜0.05). Forty eyes had local or extensive choroidal filling deficiency and prolongation, including 24 eyes of exudative AMD, 12 eyes of atrophic AMD,and 4 eyes of drusen group. Conclusion CFP of macula is prolonged and choriocapillaris perfusion is abnormal in AMD and macular drusen eyes. (Chin J Ocul Fundus Dis, 2002, 18: 116-118)
Purpose To observe the changes of choroidal circulati on and the retinal lesions caused by ocular contusion with indocyanine green ang iography (ICGA). Methods ICGA examination was performed on 30 cases (30 eyes) of various traumatic condition in conjunction with fundus fluorescein angiography (FFA). Results FFA of 19 cases (63.3%) showed the hypofluorence in quadrant or whole disc in accordance with the area of delayed filling of choroid. Twentysix cases (86.2%) showed d efected choroidel perfusion in ICGA,among them 16 cases showed localized delayed perfusion, in which the shortest perfusion time was 1 min 50 s and the l ongest time was 5 min.43 s,and 10 patients showed localized perfusion defect,and reversed filling time of retinochoroid vessels in 6 patients. Five cases (16.6%) had delayed filling time in both choroidal and central retinal vessels . Damage of retinal pigment epithelium was found in the areas of choroidal abnor mal perfusion. Conclusion ICGA combined with simultane ously FFA, is valuable in evaluating blunt injury of the ocular fundus and ben eficial to its diagnosis and treatment. (Chin J Ocul Fundus Dis, 2001,17:122-124)
Objective To observe the characteristics of indocyanine green angiography and fundus fluorescein angiography (ICGA amp; FFA) in anterior ischemic optic neuropathy ( AION ) , and to investigate the etiology of AION and the value of ICGA and FFA in the diagnosis and study of AION. Methods Simultaneous ICGA and FFA were performed on 32 eyes of 31 AION patients and 38 eyes of 38 non-AION patients. Results The eyes that all or a part of the optic disclies in the watershed zon es of the choroidal blood supply were significantly more in the AION group tha n those in the non-AION group (Plt; 0.005 ) . All the watershed zones through the optic disc were vertical in shape. The fluorescence filling of the inferior and superior choroidal blood vessels near the optic disc were all slower than that of the temporal and nasal choroidal blood vessels. The types of watershed zones in the AION group were highly correspondent to the ischemic areas of the optic disc . In early ICGA , no fluorescence appeared at the optic disc, and in later stage, the ischemic area revealed no fluorescence, and the other area showed mostly asymmetric fluorescence. Conclusion The onset of AION is correlative to the choroidal blood supply around the optic disc. ICGA is more valuable in the diagnosis and study of AION than FFA . (Chin J Ocul Fundus Dis, 2001,17:111-114)
Objective To evaluate the effects of cold provoca tion on optic dise blood flow and retinal light sensitivity of primary open-angle glaucoma (POAG) patients,and explore the relationship between the changes of optic disc blood flow and retin al light sensitivity. Methods A total 33 POAG patients (33 eyes)and 13 normal controls (13 eyes) were tested by usin g th e Heidelberg retinal flowmetry (HRF) and Topcon automatic perimeter,and the optic disc blood flow and retinal light sensitivity of POAG patients and normal cont rols were measured at normal conditions and after cold provocation. Results The mean optic disc blood flow,volume and the mean retinal light sensitivity of POAG patients decreased significantly (Plt;0.05) after cold provocation.There was a linear and significant relationsh ip between the decrease of mean optic disc blood flow and mean retinal light sen sitivity of POAG patients (r=0.615,P＜0.001). The optic disc blood flow of POAG patients with a history of migraine were more likely to r educe in response to cold provocation and reduced much more than those without such history (Plt;0.05). Conclusion Cold provocation can significantly reduce both the optic disc blood flow and retinal light sensitivity in POAG patients.A close correlation was fo und between the amount of mean optic disc blood flow decrease and the volume of mean retinal light sensitivity decline. (Chin J Ocul Fundus Dis, 2001,17:37-40)
Objective To study the characteristics of choroidal circulation in RP. Methods Using ICGA to obse rve 37 cases of RP and compare with healthy volunteers. Results ① The earliest fluorescein filling time of the choroidal arteries in RP group was (14.38plusmn;3.95) seconds,the choroidal veinous in RP group was (17.27plusmn;5.94) seconds,and there was no obvious difference between RP and control group.②The fluorescein failing time of choroidal vein in RP group was (475.75 plusmn;153.70)seconds.③The area of the bright fluorenscence in posterior fundus in RP group was (41.20plusmn;19.99) mm2,and compared with the control group,there was significant difference (P＜0.0001). ④In the mid to late phase during ICGA，in RP group the veillike hypofluorescence was found in 61 e yes (84.7%),plaque hyperfluorescence in posterior fundus in 21 eyes (29.2%),and leakage of heperfluorescence in 4 eyes(5.6%). Conclusion ①The perfusion pressure of choroidal vessels in RP reveals no c hange.②The blood volume of choroidal vessels becomes decreased in RP.③The choroidal capillaries become atrophic in RP.④Choroidal neovascularization may occur in patients with RP. (Chin J Ocul Fundus Dis, 2001,17:26-29)