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)
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 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)
Objective To investigate the cilinical value of indocyanine green angiography(ICGA) in patients with Vogt-Koyanagi-Harada syndrome(VKH). Methods Fundus fluorescein angiography(FFA) and indocyanine green angiography(ICGA) were used for comparative analyses in 26 cases(52 eyes)of VKH. Results In the acute stage of VKH,FFA revealed the multifocal leakage in the pigment epithelium and the multifocal serous retinal detachment,and the typical FFA manifestations disappeard following treatment．In the acute stage of the disease the ICGA showed:(1)numerous patchy areas of hypofluorescence and decreased flurescence in large and middle choroidal vessels(66.7%);(2)dilatation of the choroidal vessels(70.8%)and(3)in latephase of ICGA,the patchy areas of hyperfluorescence(79.2%).During the recovery stage of the disease,the abnormal undings in ICGA were resolved slower than those found in FFA. Conclusions ICGA may assist in providing valuable informations on choroidal circulation of VKH and be useful in evaluating the curative effects． (Chin J Ocul Fundus Dis,20000,16:9-11)
Objective To compare the consistency and difference of optical coherence tomography angiography (OCTA) and traditional multimodal fundus imaging in the diagnosis and activity evaluation of choroidal neovascularization (CNV) in exudative age-related macular degeneration (AMD). Methods A total of 112 exudative AMD patients (130 eyes) were included in this retrospective study, 62 were men (71 eyes) and 50 were women (59 eyes). The mean age was (68.250±9.789) years (range 50 – 91 years). All patients were underwent traditional multimodal fundus imaging including fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and spectral domain optical coherence tomography (OCT); OCTA was performed at the same time. The CNV type was divided into active and non-active according to the results of traditional multimodal fundus imaging. The vascular pattern was divided into active and non-active according to the results of OCTA. Using traditional multimodal fundus imaging as the standard, the sensitivity and specialty of OCTA was evaluated. Results In 130 eyes, CNV was visualized on traditional multimodal fundus imaging in 109 eyes (83.8%); CNV was visualized on OCTA in 103 eyes (79.2%), which including 7 eyes of false negative and 1 eye of false positive. The sensitivity of OCTA for CNV diagnosis was 93.6%, with specificity of 95.2%. The CNV detection rate between two methods had no significant difference (Youden index=0.89,Kappa value=0.796,P=0.07). In 109 eyes diagnosed with CNV by traditional multimodal fundus imaging, 73 eyes (67.0%) were active CNV and 36 eyes (33.0%) were non-active CNV; the vascular pattern was active in 60 eyes (55.0%) and non-active in 49 eyes (45.0%). The sensitivity of OCTA for the detection of active CNV was 82.2%, with specificity of 100.0%. The active CNV detection rate between two methods had no significant difference (Youden index=0.82,Kappa value=0.753,P=0.00). Conclusion In the diagnosis and activity evaluation of CNV in exudative AMD, there is remarkable consistency between OCTA and traditional multimodal fundus imaging.
Optical imaging technology of ocular fundus, including fundus fluorescein angiography (FFA), optical coherence tomography (OCT) and fundus autofluorescence (FAF), is growing at an unprecedented speed and scale and is integrating into the routine clinical management of ocular fundus diseases, such as diagnosis, treatment, and mechanism study. While FFA allow us to observe the retinal and choroidal blood circulation, OCT and FAF are non-invasive, fast and quantifiable measurement; such techniques show even more unique advantages and are favored tools. All these retinal imaging technologies, together with a variety of retinal function assessments, bring us into the era of big data of ocular fundus diseases. All of these developments are the challenges and opportunities for the operator and user of these fundus optics imaging technologies. In order to improve its clinical applications and allocate resources rationally, we need to understand the optical properties of these retinal imaging technologies, and standardize diagnosis behavior. This is a continuous learning process needs to continue to explore.
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)
Objective To investigate the characteristics of indocyanine green angiography(ICGA) in central serous chorioretinopathy(CSC) Methods The simultanous fundus fluorescein angiography(FFA) and ICGA were performed on 79 eyes of 70 consecutive patients with Heidelberg Retina Angiography. Results Seventy-nine eyes in FFA revealed RPE leakages.The changes of ICGA showed a small localized delay of filling of choroid vessels during the early phase of angiography in 23 eyes,choroidal capillary congestion in 79 eyes,the choriodal capillary hyperpermeability in the area of RPE leakage in 78 eyes,pigment epithelial detachment in 25 eyes and RPE atrophy in 21 eyes． Conclusion The findings in this research indicate that the choroidal abnormalities are the basic characteristics of ICGA in CSC. (Chin J Ocul Fundus Dis,20000,16:14-16)
ObjectiveTo compare the effects of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) on classifications and locations of choroidal neovascularization (CNV) located under subretinal hemorrhage in age-related macular degeneration, and on the areameasuring of subretinal hemorrhage.MethodsThe medical record of 177 patients with subretinal hemorrhage associated with AMD confirmed by photochrome of ocular fundus, FFA and ICGA examinations were retrospectively reviewed. The locations and classifications of CNV on the images of FFA and ICGA in the 177 patients and the area of subretinal hemorrhage of 30 patients randomly selected from the 177 patients were analyzed and measured. ResultsOn the images of FFA, the locations and classifications of CNV could be defined in 160 patients (90.4%), and CNV was considered eligible for laser therapy in 24 patients (13.6%). On the images of ICGA, the locations and classifications of CNV could be defined in 175 patients （98.9%），and CNV was considered eligible for laser therapy in 51 patients (28.8%). There was no statistical difference of the locations（Z=-0.383，P=0.701） and classifications （ χ2=2.993，P=0.810） of CNV on the images of FFA and ICGA. The areas of blocked fluorescence measured on the images of FFA (x-=26.610 mm2 and M=13.548 mm2) were larger than those of ICGA (x-=24.714 mm2，M=12.875 mm2) with statistical differences （Z=-3.000，P=0.003） between FFA and ICGA. ConclusionsICGA is beneficial for imaging CNV located under subretinal hemorrhage, and may increase the number of the patients who are considered eligible for laser treatment. The effect of measurement of the area of subretinal hemorrhage in AMD evaluated by FFA is better. (Chin J Ocul Fundus Dis,2003,19:149-151)
Using optical imaging equipment with different wavelength and computer technology, fundus optical imaging diagnostic techniques can record fundus reflected light, auto fluorescence and emitted light after excitation by external light source in order to observe and analyze the structure and pathological process of retina and choroid. Advances in fundus optical image capture technology (including laser, confocal laser, spontaneous auto-fluorescence, multispectral imaging) and storage and analysis technology, promote this field into a high-definition digital imaging era, with features of rapid, non-invasive, wide-angle three-dimensional multi-level integration, dynamic automatic navigation location tracking and combined application of a variety of optical imaging diagnostic techniques. In order to promote clinical and scientific research of ocular fundus diseases, we need to understand the development trend of optical imaging diagnostic technique, interpret the fundus imaging features appropriately, reasonably chose different inspection techniques, establish standardized diagnosis criteria and continue to expand clinical applications.