Objective To investigate the ingestion, metabolism and subcellular localization of indocyanine green (ICG) in human retinal epithelial (R PE) cells.Methods RPE cells were incubated with 0.25 mg/ml ICG under the condition of 37oC in the camera. The ICG granule and ultrastructure of RPE cells were observed under the electron microscopy after 1, 4, and 24hour incubation, and the ICG autofluorescence was detected by fluorescence microscopy after the incubation for 1, 2, 4, 8, 12, 24, and 48 hours, respectively. The ab sorbency (A value) of ICG solution was measured at 805 nm with ultraviol et/v isible specrtrometer. The standard curve of concentration of ICG was drawn and the related equation of concentration of ICG and the A value was calculated. After being incubated for 1, 2, 4, 8, 12, 24, 48, and 72 hours, respectively, the A value of supernatant fluid was calculated according to the equation. Aft er incubated with ICG for 24 hours, one sample was observed under electron microscope and fluorescence microscope per week to evaluate the metabolizable period of ICG .Results ICG granules were distributed evenly after entering the RPE cells. After incubated with 0.25 mg/ml ICG for 24 hours, no significant change of the ultrastructure of the RPE cells was found. ICG granules accu mulated in the cells as the time goes by and reached the peak after 24 hours, and then they decreased because of the slowdown of the metabolism. Few ICG was still remained in the cells 1 week later Conclusions RPE cells may take in ICG actively. ICG metabolizable period in RPE cells is long, which may be one of the mechanisms of the toxicity of ICG to the retina in the vitreous operation.(Chin J Ocul Fundus Dis，2004，20：179-181)
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 investigate the clinical features of multifocal choroiditis (MC) and guide the diagnosis and treatment. Methods Retrospective analysis of clinical data of 18 MC cases (28 eyes) who were diagnosed through fluorescein angiography (FFA) or indocyanine green angiography (ICGA) and fundus characteristics. Results Multiple round to oval lesions scattered throughout the posterior pole and peripheral areas of ocular fundi of all of the 28 eyes(binocular in 10 and monocular in 8) were found. Active focal lesions of ocular fundi were seen in 8 patients and inactive lesions in 10 patients. active and 10 cases were inactive. Choroidal neovascularization(CNV) in macular area was found in 7 patients. The images of FFA of the legions showed hypofluorescence in the early phase, with late leakage and gradual staining or window is defect in the late phase. Conclusions MC is a rare disease and often misdiagnosed to other disease and FFA helpful in diagnosis. (Chin J Ocul Fundus Dis, 2005, 21: 367-370)
Objective To investigate the features of ocular fundus of retinal pigment epithelial detachment (PED) in Chinese patients more than 50. Methods The clinical data of 31 continuous patients (34 eyes) with PED diagnosed by ocular fundus photochromy, fundus fluorescein angiography (FFA) and indocyanine green angiography ( ICGA ) from Oct, 2001 to Aug, 2004 were analyzed retrospectively. Results In 34 eyes with PED, the results of FFA showed serous PED in 18 (52.9%), hemorrhagic PED in 8 (23.5%), and serosanguineous PED in 8 (23.5%); the results of ICGA revealed PED associated with choroidal neovascularization (CNV) in 12 (35.3%), PED associated with ploypoidal choroidal vasculopathy (PCV) in 17 (50.0%), PED associated with both CNV and PCV in 1 (2.9%), and avascular PED in 4 (11.8%). Conclusions PED in Chinese patients more than 50 can be associated with CNV, PCV or other avascular diseases, and PCV is the most common intercurrent choroidal vascular disease. (Chin J Ocul Fundus Dis, 2006, 22: 224-227)
Objective To compare the characteristics of the ocular fundus of exudative age-related macular degeneration (AMD) with polypoidal choroidal vasculopathy (PCV). Methods The photographs of ocular fundus of 123 patients (137 eyes) with exudative AMD and 42 patients (48 eyes) with PCV diagnosed by fundus photography, fundus fluorescein angiography (FFA), and indocyanine green angiography (ICGA) were retrospectively analyzed. Results In 137 eyes with exudative AMD, 16 eyes (11.7%) had classic neovascularization (CNV), 121 (88.3%) had occult CNV. In the eyes with occult CNV, 42 eyes (34.7%) had hot spots, 74 eyes (61.2%) showed plaque hyperfluorescences and 2 eyes (1.7%) had hot spots with PCV in ICGA. In 48 eyes with PCV, 7 eyes (14.6%) had subretinal reddish-orange lesions, 2 eyes (4.2%) of the polypoidal dilations with branching vascular network were detected with FFA, 36 eyes (75.0%) demonstrated polypoidal dilations with branching vascular network, and 12 eyes (25.0%) showed scattered polypoidal dilations without identifiable continuous branching vascular network, 16 eyes (33.3%) had the polypoidal dilations resembling a cluster of grapes, and 32 eyes (66.3%) showed the polypoidal dilations as several solitary round aneurismal dilations. The polypoidal dilations showed either a washout of the dye from the polyp with staining of its walls or staining of the dye in the late phase of ICGA. Conclusions The different features of exudative AMD and PCV in the ICGA, and the PCV with subretinal reddish-orange lesions are useful in the differentiate diagnosis of the both diseases. (Chin J Ocul Fundus Dis，2004，20：307-309)
Objective Observation on the characteristics of choroidal melanomas with indocyanine green angiography (ICGA) and fundus fluorescsin angiography(FFA). Methods Both ICGA and FFA were used in 16 cases of choroidal melanoma for comparison and analysis. Results 81.2% of tumors showed hypofluorescence all the way or faint fluorescence in later stage．62.6% of tumors had characteristic intrinsic tumor vassels with ICGA,while 12.5% of tumors had intrinsic vessels with FFA．Those tumors that can't be diagnosed owing to whole hyperfluorescence in later stage with FFA may be diagnosed by visibility of intrinsic tumor vessels with ICGA. Conclusion ICGA is helpful in the diagnosis of choroidal melanoma. (Chin J Ocul Fundus Dis, 2000，16：3-5)
Objective To evaluate the characteristics of two angiographic manifestation of ocular fundus in choroidal metastatic carcinomas. Methods Fundus fluoresein angiography (FFA) and indocyanine green angiography (ICGA) were performed on 17 patients (24 eyes) with choroidal metastatic carcinomas, and the characteristics of these two kinds of angiograms were analyzed and compared each other. Results According to various clinical features, e.g., locations of metastatic tumor in ocular fundus, disease course, and different kinds of original malignancy, the findings of ocular fundus were divided into (1) Isolation type: FFA showed pinpoint and mottled leaks against hypofluorescence background, increased and confluent fluoresecence in later stage. ICGA showed the similar images as in FFA, except later appearance of leaks and the choroidal vesseles could be seen beneath the thin metastatic tumor mass.(2) Diffusion type: Tumors showed hypofluorescence in early stage and uneven ill-defined hyperfluorescence both in FFA and in ICGA. (3) Small metastatic carcinomas: Hypofluorescence in early stage and mild mottled hyperfluorescence were found in FFA as well as in ICGA. Conclusion Both FFA and ICGA are helpful in the diagnosis of choroidal metastatic tumors and ICGA may be conducive if there are some troubles in diagnosing the tumors with FFA. (Chin J Ocul Fundus Dis, 2002, 18: 92-95)
Objective lt;brgt;To investigate the morphological features of choroidal neovascularization (CNV) in central exudative chorioretinopathy (CEC) using optical coherence tomography（OCT）. lt;brgt; lt;brgt;Methods lt;brgt;OCT and fundus fluorescein angiography (FFA) were performed in 41 cases (43 eyes) of CEC,and the course of CEC disease was from 1 week to 10 months. Twenty-seven of 43 eyes were also examined by indocyanine green angiography (ICGA). lt;brgt; lt;brgt;Results lt;brgt;OCT images revealed 5 kinds of morphological features of CEC: well-defined CNV（41.86 %）,poorly-defined CNV(30.23 %),hemorrhagic pigment epithelium detachment （PED）(16.28 %), CNV companied with serous (6.98 %) or hemorrhagic neurosensory retina detachment (4.65 %). CNV mainly showed well-defined and poorly-defined CNV (72.09 %).In those eyes that could clear define the CNV boundary,there were 12 eyes on FFA examination and 20 eyes on ICGA examination which defined the boundary from retinal horizontal plane, while there were 23 eyes on OCT examination which defined the boundary from retinal vertical section. Classic CNV on FFA consistently presented with well-defined boundaries on OCT, whereas non-classic CNV had a variable cross-sectional appearance. lt;brgt; lt;brgt;Conclusions lt;brgt;The OCT morphological features of CNV in CEC is mainly well-defined CNV and poorly-defined CNV; OCT examination can precisely observe the retinal and choriocapillaries pathological anatomy of CEC from retinal vertical section, in making the CEC diagnosis as an important complementary examination of FFA and ICGA which observe the focus from retinal horizontal plane. lt;brgt; lt;brgt;(Chin J Ocul Fundus Dis, 2002, 18: 121-124)
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)