Objective To detect the clinical characters and the classification of the congenital retinal vascular anomalies. Methods Nine cases (12 eyes) of congenital retinal vascular anomalies were examined by ocular examination and fundus fluorescein angiography (FFA), in which 3 cases (4 eyes) were examined by indocyanine green angiography (ICGA) simultaneously. Results The congenital retinal vascular anomalies were located at the posterior pole in 8 cases (10 eyes), and extended to peripheral retina in 1 case (2 eyes). Congenital retinal vascular anomalies were classified as follows: congenital retinal macrovessel (1 case, 1 eye); congenital retinal arteriolar tortuosity (2 cases, 3 eyes); inherited retinal venous beading (1 case, 2 eyes); and congenital prepapillary vascular loops (5 cases, 6 eyes). Four cases (5 eyes) were associated with spontaneous hemor rhage induced by physical exertion (Valsalva maneuver). Conclusion Most of the congenital retinal anomalies are located at the posterior pole, involving arteries and veins, and can be associated with spontaneous hemorrhage induced by Valsalva maneuver. (Chin J Ocul Fundus Dis，2003，19：269-332)
Objective To observe the characteristics of fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)in juvenile retinoschisis． Methods The photochromes of the ocular fudus of 7 cases(14 eyes)who were diagnosed as juvenile retinoschisis were taken，among whom，5(10 eyes)were examined bv FFA，and 6(12 eyes)bv OCT． Results In 8 eyes with cystiform stellate maculopathy under ophtalmoscope，the result of FFA showed granular fluorescence in different density and shape without exact connection of the configuration between these granules and the cystlike maculopathy．In 2 eyes with pigment disorder in the macula under ophthalmoscope，blocky fluorescence was found in FFA．In 3 eyes with peripheral schisis，FFA discovered distorted and dilated retinal capillaries with different extent,and flecks of non-perfusion area．OCT images revealed thickening of the macular neuroepithelium with laminal separation,and cystic low-reflect areas in the inner layer． Conclusions In juvenile retinoschisis, pigment proliferation and degeneration in the macular area could be found．Granular fluorescence and cystic low—reflect areas could be seen in FFA and OCT，respectively. (Chin J Ocul Fundus Dis，2004，20：5-7)
ObjectiveTo observe the surgical effects of scleral buckling and vitrectomy for familial exudative vitreoretinopathy (FEVR). Methods34 eyes of 27 patients with FEVR who underwent either scleral buckling or vitrectomy were enrolled in this study. There are stage 2B in 2 eyes (5.88%), stage 3B in 7 eyes (20.59%), stage 4A in 1 eye (2.94%), stage 4B in 16 eyes (47.06%), stage 5 in 8 eyes (23.53%). 5 eyes associated with rhegmatogenous retinal detachment. The surgical approaches had been chosen according to the disease stage, severity, extent and morphology of the proliferative membrane. 13 eyes (stage 2B in 2 eyes, 3B in 4 eyes, and 4 in 7 eyes) underwent scleral buckling and 21 eyes (stage 3B in 3 eyes, 4 in 10eyes, and 5 in 8 eyes) underwent vitreoretinal surgery. The main outcome measurement was the anatomic status of the macula, which was recorded as attached, partially attached or remain detached. The mean follow up was (18.00±14.61) months (range 4 to 60 months). ResultsAmong 13 eyes received scleral buckling, the macula was attached in 2 eyes with stage 2B (15.38%), partially attached in 11 eyes (84.62%) including 4 eyes with stage 3B, 1 eye with stage 4A and 6 eyes with stage 4B. Among 21 eyes received vitrectomy, the macula was attached in 8 eyes (38.10%) including 2 eyes with stage 3B, 4 eyes with stage 4 and 2 eyes with stage 5; the macula was partially attached in 9 eyes (42.86%) inducing 4 eyes with stage 4 and 5 eyes with stage 5; the macula remained detached in 4 eyes (19.05%) including 1 eye with stage 3B, 2 eyes with stage 4 and 1 eye with stage 5. ConclusionIf the surgical approaches were chosen based on the stage of FEVR and the severity, extent and morphology of the proliferative membrane, the surgery is effective and beneficial to FEVR patients.
ObjectiveTo observe the application value and therapeutic efficacy of wide-field digital pediatric retinal imaging system (RetcamⅢ) fundus fluorescein angiograms (FFA) assisted photocoagulation on familial exudative vitreoretinopathy (FEVR). MethodsThe study included 46 eyes of 34 patients with staging 2 FEVR. All patients received color fundus photography and FFA under general anesthesia. The blood vessel reliability of color fundus photography and FFA was comparatively determined. Binocular indirect ophthalmoscope laser photocoagulation was applied to peripheral retina with abnormal leakage as indicated by FFA, the wavelength was 532nm, the duration was 0.25 s and the energy was 200-280 mW. After laser photocoagulation, fundus imaging and FFA was repeated. Further laser photocoagulation was immediately added to areas with vessel leakage but missing the photocoagulation. After treatment, the mean follow-up duration was 14.4 months. The follow up focused on neovascularization, exudative lesions, vitreous traction and merging of photocoagulation spots within 3 months, and on fibrosis membrane resulting in macular traction, tractional retinal detachment, vitreous hemorrhage or Coats disease-like retinal exudates after 3 months. ResultsIt was hard to identify the blood vessels based on the color fundus images and some avascular zone maybe missed. Neovascularization can't be determined by shape of the blood vessels. On the other hand, those new blood vessels can be easily recognized by FFA as leakage sites at the boundary of avascular zone. The surgeon could quickly and accurately locate the FEVR area guided by the color fundus images and FFA from same angle under binocular indirect ophthalmoscope. During the treatment, there was no retinal FEVR area missed laser photocoagulation for all patients. There was no neovascularization, exudative lesions, vitreous traction within 3 months, and no fibrosis membrane, tractional retinal detachment, vitreous hemorrhage or Coats disease-like retinal exudates after 3 months. There were no ocular and systemic complications during and after the FFA and laser photocoagulation. ConclusionWide-field RetcamⅢFFA can help retinal specialists to identify abnormal neovascularization, locate the lesion area, and thus increase the success rate of laser photocoagulation, reduce the ocular and systemic complications for FEVR.