Objective To observe the clinical features of polypoidal choroidal vasculopathy (PCV) in Chinese patients.Methods Nine cases (9 eyes ) were examined with fundus examination, fundus fluorescein angiography (FFA) and indocyanine green angiography angiography (ICGA).Results FFA and ICGA showed the branching vascular networks (7 cases) and polyplike dilation at terminals of branches (9 cases), which mainly located in macular area (8 cases) and in peripapillary area (1 case), and which accompanied hemorrhagic or serous pigment epithelial detachment in 7 cases,and 4 of 7 cases had a significant horizontal black-white damarcation line. It definitely differed from fine choroidal neovascularization (CNV).Conclusion PCV in Chinese patients has the cardinal clinical features, i.e., polyplike lesions located mainly in macular area and most cases accompanied by hemorrhagic or serous pigment epithelium detachment. (Chin J Ocul Fundus Dis，2003，19：269-332)
ObjectiveTo observe confocal scanning laser ophthalmoscope (cSLO) based retinal imaging and color fundus camera in pigment epithelial detachment (PED) of polypoidal choroidal vasculopathy (PCV).MethodsPED of 30 patients (32 eyes) were recruited from June 2016 to June 2017 in the Beijing Tongren Hospital who were detected in high-definition OCT (HD-OCT) and diagnosed as PCV by FFA and ICGA. There were 16 males (17 eyes) and 14 females (15 eyes); aged from 50-83 years, with the mean age of 66.59 years. The photographs of ocular fundus including color fundus camera, cSLO imaging, HD-OCT, FFA and ICGA were analyzed. Multimodal imaging results were regarded as gold standard. Sensitivity and specificity were calculated in serous and hemorrhagic PED diagnosis using color fundus camera and cSLO imaging. The positive number of PED was used to compare between two modes fundus imaging by using χ2 test.ResultsTwenty serous PED eyes, 3 hemorrhagic PED eyes and 9 serous/hemorrhagic PED eyes were determined using multimodal imaging. The sensitivity and specificity of color fundus camera were 45% and 100% in detecting serous PED and 100% and 91% in detecting hemorrhagic PED. The sensitivity and specificity of cSLO imaging were 83% and 100% in detecting serous PED and 50% and 86% in detecting hemorrhagic PED. The positive number of serous PED in cSLO imaging was significantly higher than color fundus camera (χ2=7.752, P=0.011). The positive number of hemorrhagic PED in cSLO imaging shows no obvious difference compared with color fundus camera (χ2=1.164, P=0.419).ConclusionThe sensitivity and positive number of detecting serous PED with PCV in cSLO fundus imaging were higher than the color fundus camera technology.
Multicolor imaging (MCI) based on confocal scanning laser ophthalmoscopy can gather more diagnostic information than traditional fundus photographs through utilizing three wavelengths of laser to scan posterior retina, which gain different layer reflected signal since the depth of penetration into retina is different for each wavelength. Currently, it provides important information and reference value for diagnose of different layer diseases on retina or choroid combining MCI with OCT, FAF, FFA and so on. However, there are still misunderstandings in the diagnosis of retinal diseases with MCI. Careful observation of retinal details in MCI, CFP and other imaging methods is more conducive to the correct diagnosis of fundus ophthalmopathy.
The update of the cognition of fundus diseases is inseparable from the rapid development of fundus multimodal imaging. Especially in recent years, the application of wide and ultra-wide fundus photography, ultra-wide fundus fluorescein angiography, indocyanine green angiography, fundus autofluorescence and optical coherence tomography angiography contribute to observe the peripheral retinopathy more directly. The application of adaptive optics and fluorescence lifetime imaging ophthalmoscopy contribute to have a further understanding of fundus diseases at the cellular and metabolic level. Multimodal imageing reflect the pathological characteristics of the diseases from different angles and levels. At the same time, the digitization and intelligence of fundus images are also developing rapidly. However, there are some problems that the ophthalmologists needs to consider further, such as the correctly understanding the use of multimodal imaging, the application of artificial intelligence, and how to sum up from the images.
Objective To observe the changes of disease course and the prognosis of visual acuity of Chinese patients with polypoidal choroidal vasculopathy ( PCV).Methods Visual acuity and fundus photochromes of 20 eyes of 15 consec utive patients with PCV were followed up with a mean of 19.1 months (range from 2 to 64 months), in which the fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) of 14 eyes of 10 patients were followed up with a mean of 21.0 (range from 3 to 53) months.Results Among the 20 eyes, the visual acuity was more than 0.3 in 5 eyes (25.0%), between 0.1 and 0.2 in 6 (30%) and less than 0.1 in 9 (45.0%). During the follow-up, the visual acuity was improved in 2 (10.0%), stable in 10 (50.0%)), and regressed in 8 (40.0%). Only 1 eye (5.0 %) developed to macula scar. The result of ICGA revealed the polypoidal lesions that were unchanged in 4 eyes(28.6%), regressed in 2 (14.3%), grew in 6 (42.7%), repeatedly grew and spontaneously regressed in 6 (42.7%).Conclusions There is a large variation in the visual prognosis in Chinese patients with PCV. The polypoidal lesions can repeatedly grow and spontaneously regress in the natural course. (Chin J Ocul Fundus Dis，2004，20：8-11)
Ovjective To observe the surgically excised specimens from eyes with hemorrhagic age-related macular degeneration (AMD). Methods Thirty-six surgically excised specimens were captured from 36 patients with hemorrhagic AMD, 26 specimens were diagnosed as occult choroidal neovascular membrane (CNVM), 10 specimens were diagnosed as polypoidal choroidal vasculopathy (PCV). All specimens were routinely processed by hematoxylin and eosin, periodic acidSchiffprime;s stain and Masson stainings. At the maximum horizontal and vertical slice of the specimens, the category and amount of the cells in the specimen were recorded, as well as the relationship between the specimens and the surrounding tissue. Results The 36 specimens are categorized as neovascular membrane dominant (19/36), collagen fiber dominant (6/36), blood clot dominant (8/36) and degenerated thickened Bruch`s membrane dominant (3/36). Eighteen occult CNVM specimens and 1 PCV specimen are categorized as neovascular membrane dominant; all 6 collagen fiber dominant specimens are occult CNVM; 1 occult CNVM and 7 PCV specimens are categorized as blood clot dominant; and 1 occult CNVM and 2 PCV specimens are categorized as degenerated thickened Bruch`s membrane dominant. The occult CNVM categorized as neovascular membrane dominant present as small blood vessel with single endothelium cell attached; the PCV specimen categorized as neovascular dominant presents as big blood vessel with thick vessel wall under the Bruch`s membrane, retinal pigment epithelium and choroidal melanocyte are both observed in the PCV specimens. Conclusion The components of the specimens captured from eyes with hemorrhagic AMD are diversified.
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.
ObjectiveTo investigate the relationship of the age-related maculopathy susceptibility 2 (ARMS2) A69S polymorphism and polypoidal choroidal vasculopathy (PCV), and to explore the distribution of risk allele in PCV and exudative age-related macular degeneration (wAMD). MethodsThis is a systemic review and meta-analysis. A literature research was performed in Pubmed, Embase, Web of Knowledge, Chinese national Knowledge Infrastructure and Wanfang Medicine Database by the key words of "ARMS2, LOC387715, A69S, rs10490924, age related macular degeneration, polypoidal choroidal vasculopathy, single nucleotide polymorphism". Case-control studies were included, while review, case report, or systemic reviews were excluded. The latest one of multiple articles was included only which published by the same group. The results of individual studies were pooled using the software Review Manager 5.1.4, and the correlation between allele frequencies, genotype and phenotype were analyzed. ResultsA total of 14 articles, consisting 2007 PCV patients, 1308 wAMD patients and 3286 controls were recruited. The pooled odds ratio (OR) in random-effects models for genotype TT versus wild homozygous genotype GG is 5.20 (95% CI: 3.90-6.95). Heterozygous genotype GT mildly increased the risk in affecting PCV, and the OR of GT versus GG is 1.85 (95% CI: 1.42-2.40. The frequency of T allele in wAMD was higher than in PCV, pool OR=1.60 (95% CI: 1.31-1.96). ConclusionsThe ARMS2 A69S variant is associated with PCV. Genotypes of TT and GT had an effect in increasing the risk of PCV, and the effect is even greater in genotype of TT. T allele had an effect in increasing the risk of PCV and wAMD, and the risk for wAMD is slightly greater than for PCV.
Purpose To define the morphometric characteristic s and the implication of simultaneous fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) in traumatic choroidal rupture. Methods Simultaneous FFA and ICGA were carried out in 17 patient s (17 eyes) with traumatic choroidal rupture. Results Choroidal ruptures were shown as hyperfluorescence region in the early pha se of FFA,and as hyperfluorescence in the late phase of FFA but in ICGA were shown as hypofluorescence region in both early and late phases.The rupture regions in ICG A were longer than that in FFA in 5 patients (5 eyes).The rupture regions in 6 patients (6 eyes) with hemorrhage could be shown in ICGA,but couldn't be shown in FFA . Conclusion ICGA is helpful in diagnosing minor choroidal ruptures,in defining the extent of traumatic choroidal ruptures,and in further understanding the pathological changes of choroidal ruptures. (Chin J Ocul Fundus Dis, 2001,17:30-32)
OBJECUIVE: To observe the therapeutic efficacy of gamma;-knife/lymphokine activated killing cells (LAK)in chorold malignant melanoma (CMM). METHODS:Five cases of CMM had keen treated by retrobulbar injection of LAK cells and gamma;-knife irradiation at multiple sites.Ophthalmologic,imageologic, fundus fluorescein angiographic and T lymphocyte subset examinations were done before and after treatment. Tile follow-up period of this series of cases was 6-24 months. RESUILS:Thc CMM of 4 in 5 treated cases became atrophic and withered up clinically after gamma;-kinfe/LAK therapy. Among the 4 cases,2 of them had been followed up for more than 2 years,and the other 2 for 20 and 14 months respectively. The tumor of the 5th patient wko was followed up for 6 months after treatment,reduced to 3/5 of the original size,and no blood flow was found within thee tumor mass under the clinical examination. CONCLUSION :The gamma;-knife/LAK therapy was effective in treating CMM in saving the affected eye from being enucleated. Chin J Ocul Fundus Dis,1997,13: 96- 98）