Objective To observe the location of the watershed zones of the choroidal blood supply relative to the optic disc in glaucoma by indocyan ine green angiography, and to investigate the mechanisms in the development of glaucomatous neuropathy. Method Simultaneous ICGA and FFA were performed on 31 eyes of 31 patients with glaucoma (17 of POAG, 14 of NTG) and 37 eyes of 37 control subjects. The watershed zones were classified into three types according to their location relative to the optic disc: by type I, no water shedzone around the optic disc; type II, the optic disc surrounded partially by watershed zone; type III, the optic disc surrounded completely by watershed zone. Each of the watershed zone types was scored (i.e., type I=1, type II=2, type III=3). Results In 87.1% of the glaucomatous eyes , the watershed zones included or partially included the optic disc. However, the figure in the control group was 56.8%. The glaucoma group had a higher score of watershed zone type than the control group. Conclusions The mechanisms in the development of glaucomatous neuropathy are correlative to the choroidal blood supply around the optic disc. (Chin J Ocul Fundus Dis,2004,20:218-220)
Objective To icompare the effects of indocyanine green angiography(ICGA) on ganzfeld Electroretinogram(ERG). Methods ICGA was performed used the Topcon 50IA retina camera, Ganzfeld ERG was recorded by Neuropack Ⅱ evoked response recorder. The Ganzfeld ERG was recorded before and after ICGA in 20 cases (38 e yes) with different diseases , Ganzfeld ERG was recorded according to the ISCEV standard recommendations. Results ICGA did neither affect Ganzfeld ERG a-wave and b-wave latency nor amplitudes of dark adaptation, maximum response and light adaptation.(Pgt;0.05). Conclusion ICGA using the Topcon 50IA could be performed prior to the recording of the Ganzfeld ERG. (Chin J Ocul Fundus Dis, 2001,17:284-285)
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 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)
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 observe the characteristics of indocyanine green angiography in exudative age-related macular degeneration. Methods Thirty one cases(36 eyes)were diagnosed as exudative age-related macular degeneration by ocular examination,fundus color photography,fundus fluorescein angiography(FFA)and indocyanine green angiography(ICGA).Their ages ranged from 50 to 82 years.The visual acuities were FC/30cm before eye to 0.7.We analyzed and compared the characteristics of ICGA and FFA in these patients. Results Of 26 eyes with occult choroidal neovascularization(CNV)by FFA,15(57.7%)had classic CNV.Of 4 eyes with serous retinal pigment epithelial detachment(PED)without CNV by FFA,l had serous PED with classic CNV.The hyperfluorescence of the scar stain was defected by ICGA. Conclusion ICGA adds clinically useful information and is important in laser treatment of patients with occult CNV in AMD. (Chin J Ocul Fundus Dis,1998,14:76-80)
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)
Purpose To investigate the clinical features and pathogenesis of acute posterior multifocal placoid pigment epitheliopathy(APMPPE). Methods To observe the features in 8 eyes of 6 cases of APMPPE with fundus fluorescein angiography(FFA) and indocyanine green angiography(ICGA).One of the cases had been observed continuously for 160 days. Results 1.FFA: at the acute stage of APMPPE,the affected foci showed low fluorescence in the early phase and stained gradually in 3 eyes;the fluorescence of recessive foci were still lower in 4 eyes,and the stale one showed window defect fluorescence due to some RPE fading and fluorescence sheltering due to pigment deposit.2.ICGA:at acuted stage,the fluorescence of choroid lobules was ofen defected untill in late period of pathogenical changes. Conclusion The findings demonstrate the obstruction of choriocapillaries may be the primary pathogenesis of APMPPE. (Chin J Ocul Fundus Dis,1998,14:84-87)
Objective To observe the imaging features of ultra-wide field short wave fundus autofluorescence (SW-FAF) in eyes with multiple evanescent white dot syndrome (MEWDS), and analysis the correspondence to conventional images. Methods It was a retrospective case series study. Thirteen patients (14 eyes) diagnosed with MEWDS were enrolled. There were 12 females and 1 male, aged from 22 to 57 years, mean age was 34.5 years. All the eyes underwent fundus color photography, optical coherence tomography (OCT) and ultra-wide field autofluorescence (FAF). Simultaneous fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed in 6 eyes. The characteristic changes of SW-FAF in studied eyes were observed and compared with the images of FFA and ICGA. All the eyes were followed up every 1 to 2 weeks, with an average of 16.7 weeks. The characteristic images of SW-FAF and corresponding OCT were studied during follow up. Results MEWDS presented with numerous multiple hyper-autofluorescent spots, sized from 50-500 μm, with a vague boundary in ultra-wide field SW-FAF. These spots located mainly at the peripapillary area and the posterior pole with a confluent pattern. The lesions extended to the mid-peripheral retina as well and became more scattered. The distribution of the hyper-autofluorescent lesions in SW-FAF corresponded roughly to that of the greyish-white spots seen in color photograph and the hyper-fluorescent spots detected by FFA. It was consistent with the distribution of hypo-fluorescent spots in late-phase ICGA as well. But the number of the spot showed in FAF is much more than that in FFA, and slightly less than that in ICGA. The OCT scans through the hyper-autofluorescent lesions in SW-FAF showed impairment of outer retina. After the recovery, the hyper-autofluorescent spots disappeared with the outer retina structure repaired completely. Conclusions MEWDS presented with numerous multiple hyper-autofluorescent spots which located mainly at the peripapillary area in ultra-wide field SW-FAF. The distribution of the hyper-autofluorescent lesions in SW-FAF corresponded roughly to color photograph, FFA and ICGA in late-phase. The OCT scans through the hyper-autofluorescent lesions in SW-FAF showed impairment of outer retina.