Objective To investigate the clinical manifestation and histopathologic changes of the fungal necrotizing retinochoroiditis. Methods Collecting 7 cases of fungal retinochoroiditis with severe immunodepression and loss of visual acuity.Seven removed eyeballs were stained with HE,PAS and silver methenamine,and observed by light microscopy,and in addition,2 of them examined by electron microscopy.Also fungal cultures of blood and affected tissues were performed. Results The chief clinical macnifestation included ciliary injection of conjunctiva,opaque aqueous fluid and vitreous and diffuse hemorrhage and greyt white opacity with retinal detachment in severe cases.Pathologic changes included hemorrhage in the retina,chorioretinal tissue necrosis,hyphae in the blood vessels,affected tissue and vitreous.Fungal culture of blood was positive in three cases.Culture of affected tissues was positive in all cases. Conclusions Eedogenous fungal infection of choroid and retina may be due to the severe immunodepression of the sufferers and usually causes chorioretinal tissue destruction and blind. (Chin J Ocul Fundus Dis, 1999, 15: 235-237)
Objective To analyze the etiology of central exudative chorioretinopathy（CEC）. Methods A total of 32 CEC patients were asked the medical history, and underwent examination of purified protein derivative（PPD）test, chest Xray, blood routine test, Creactive protein, erythrocyte sedimentation rate, TORCH test and rapid plasma regain cirde card test, to determine the possible causes of CEC. Results Thirty-two patients didnprime;t have the history of tuberculosis, and no evidence of systemic active tuberculosis was found in the chest X-ray examination. the results of PPD test showed the positive rate was 37.5％. The disease condition of paitents with positive result of PPD test was stable or was alleviated after anti-tuberculosis therapy. All the results in IgM of TORCH test and rapid plasma regain cirde card test were negative. Conclusion No infectious factors related to CEC was found, thus choroidal neovascularization of CEC might be idiopathic.
Objective To investigate the relationship between the level of testosterone and estradiol in serum and central serous chorioretinopathy (CSC).Methods The clinical data of 200 patients with active phase CSC who diagnosed by clinical manifestation, examination of fundus and fluorescence fundus angiography (FFA), were retrospectively analyzed. Two hundreds healthy people were collected as a control group. The blood of ulnar vein was collected and the method of magnetic homogeneous enzyme immunoassay was used to detect the level of testosterone and estradiol in serum of two groups. The results were analyzed statistically by t test.Results The values of testosterone and estradiol of male were all higher in CSC group than that in control group，the differences were statistical significance（t=2.804，2.913；P=0.010，0.008）；it was also higher in female（t=2.078，2.807；P=0.049，0.010）. The value of testosterone/estradiol of male was higher than that of female in CSC group，the difference was statistical significance(t=2.231，P=0.046).Conclusions The level of testosterone and estradiol in serum of CSC group increased obviously, especially the value of testosterone/estradiol. The increase of estradiol and testosterone/estradiol may be an etiological factor of CSC.
Objective To analyze the characteristics of images of fundus fluorescein angiography (FFA) in patients with central serous chorioretinopathy (CSC).Methods We observed the positions of leakage spots of retinal pigment epithelium (RPE) and analyzed their characteristics in 598 CSC patients. The ages, visual acuty, detachment areas of sensory retina, and leakage patterns of RPE were recorded and the correlation of them were analyzed. Results The leakage concentrated in the posterior pole, which occurred more frequently in the superior quadrant, nosal quadrant, and near fovea regions than in the inferior quadrant,temporal quadrant, and far regions from fovea, respectively (chi;2=67.13,20.93, 212.715; Plt;0.01).We found that there were relations between the ages of patients and the patterns of the leakage. A total of 35 patients (54.7% out of 64) at the age of ge;50 had small leakage; 82 patients (53.2% out of 154) at the age of 35-39 had diffusing leakage. Smaller retinal detachment in patients with multiple serous leakage and bigger retinal detachment area in patients with single serous leakage were found; no statistical significance was found (F=1.925,Pgt;0.05). There was negative correlation between the visual acuity and the detachment area in CSC patients (t=-0.335,Plt;0.01), and there was no correlation between the visual acuity and the distances from the leakage spots to the fovea (t=-0.029, -0.145;Pgt;0.05).Conclusion The leakages occurs in various regions whose difference is significant; the patterns of leakage are related to the ages; there is no relation between the serous retinal detachment area and the number of the leakage.
Purpose To investigate the pattern of subretinal neovascular membrane(SRNVM)in central exudative chorioretinitis(CEC). Methods With the help of a PC microcomputer,we performed a quantitative measurement of SRNVM in 32 eyes of 32 patients with Rieger is CEC. Results SRNVM-optic disc area ratio were 0.1151plusmn;0.0842．The foveola was on the top of SRNVM in 7 cases．The other 25 of SRNVMs were scattered in macular area around foveola,and 2 of them were nasal to it．The distance between the edge of SRNVM and foveola was less than 175mu;m in 13 cases,175～300mu;m in 4 cases and more than 300mu;m in 15 cases． Conclusion To be compared with the previous data,the present results suggested that laser photocoagulation might be one of the most important therapies for SRNVM in Rieger is CEC． (Chin J Ocul Fundus Dis,1998,14:114-115)
Objective To asses the potential of a new imaging technique,opticl coherence tomography(OCT),for diagnosis and monitoring of central serous choroidoretinopathy(CSC). Methods Thirty cases (32eyes) with CSC were examined by ophthalmoscopy, fundus fluorescein angiography and OCT. Some patients were monitored by OCT. Results Among images of OCT in 32 eyes with CSC, 27 eyes showed serous neurosensory detachement,2 eyes appeared retinal pigment epithelial detachement and 3 eyes combined neurosensory detachement with pigment epithelial detachement.Monitoring images of OCT in ll eyes revealed absorption of serous fluid and decrease of neurosensory detachment． Conclusions OCT is potentially useful as a new and noninvasive diagnostic technique for quantitative examination of patients with CSC and objectively monitoring the clinical course of the serous retinal detachement in this disease. (Chin J Ocul Fundus Dis, 1999, 15: 131-134)
Objective To compare difference of the cross-sectional pathological imaging and quantitative measurement of central serous chorioretinopathy (CSC) between time- and fourier-domain optical coherence tomography (OCT). Methods Consecutive 26 patients (26 eyes) with unilaterial CSC were subsumed. Bilateral eyes of all the patients underwent time- and fourier-domain OCT. Horizontal and vertical line scanning and radial six-line scanning protocols were used for timedomain OCT examination; horizontal and vertical high resolution five-line scanning and macular cube scanning protocols were used for fourier-domain OCT examination. The characteristics of OCT images, retinal segmentation and the quantitative measurement were compared between these two methods. Results Fourier-domain OCT could yield the three-dimensional images of surface of inner limiting membrane (ILM) and RPE. The band of external limiting membrane (ELM) of normal subjects and CSC patients, and the inner segment and outer segment (IS/OS) of normal subjects could be clearly shown by fourier-domain OCT. However, the band of IS/OS disappeared in 65.4% of the CSC patients. The outer boundary of retina was defined in front of the retinal pigmental epithelia (RPE) by fourier-domain OCT. The foveal thickness of normal subjects and CSC patients was (180.50plusmn;12.69) and (158.41plusmn;34.20) mu;m, respevtively. The height of detachment of neural epithelial layer was (245.84plusmn;154.61) mu;m measured by fourier-domain OCT. The band of IS/OS of normal subjects could be clearly shown by time-domain OCT. However, the band of IS/OS disappeared in 73.4% of the CSC patients, which showed no difference with fourier-domain OCT (Z=-0.108, P=0.914). The outer boundary of retina was defined in front of the IS/OS band by OCT. The foveal thickness of normal subjects was (141.16plusmn;12.75) mu;m, which was thinner than that measured by fourier-domain OCT (t=20.671，P=0.000). The foveal thickness and the height of detachment of neural epithelial layer was (146.40plusmn;36.28) mu;m and (240.32plusmn;156.82) mu;m measured by time-domain OCT, respectively, which showed no significant difference with which measured by fourier-domain OCT (t value was from 0.026 to 1.517, P value was from 0.144 to 0.980). Conclusions Fourier-domain OCT yields better visualization of intraretinal layers and more accurate definition of outer boundary of retina than time-domain OCT. Thus the measurements by fourier-domain OCT were more accurate. Moreover, three-dimensional images of CSC shown by fourier-domain OCT enable the comprehensive observation of pathological morphology and location.
Objective To assess the effectiveness of transpupillary thermotherapy (TTT) for the treatment of central exudative chorioretinopathy. Methods Tweenty-nine eyes with central exudative chorioretinopathy were treated with Iris 810 nm diode laser TTT. The laser beam size was 1.0, 2.0 or 3.0 mm with power settings between 80-300 mW and treatment time 60 sec. The follow up periods were wihzin 4-40 weeks. The therapeutic effect was accessed by visual acuity examination,dinect ophthalmoscopy and fluorescein or indocyanine green angiography. Results The visual acuity improved in 8 eyes (28%), remained no change in 19 eyes (65%) and decreased in 2 eyes (7%). Choroidal neovascularization were closed in 12 eyes in fundus angiography. The symptoms alleviated in 10 patients. Conclusion Transpupillary thermotherapy is a potential treatment for the central exudative chorioretinopathy. (Chin J Ocul Fundus Dis, 2002, 18: 184-186)
Objective To evaluate the therapeutic effect of vitrectomy on bullous retinal detachment. Methods The clinical data of 7 patients (9 eyes) with bullous retinal detachment who had undergone vitrectomy due to useless photocoagulation were retrospectively analyzed. Bullous retinal detachment of the patients had been diagnosed by examination of slit-lamp microscope, three-mirror gonioscope, indirect ophthalmoscope, B-mode ultrasound, and fundus fluorescein angiography. All of the affected eyes underwent vitrectomy with closed triple incisions through the pars plana after release of subretinal liquid under the local anaesthesia. The cortex of vitreous body was taken out, and exsuction of subretinal liquid was carried out via retinal incision. Photocoagulation closed the incision and the effusion area of the retina, and intraocular filling matter was injected after exchange of air and liquid. The follow-up period lasted 3 months to 8 years with the average period of 47 months. Results Reattached retina was found in all of the affected eyes during the follow-up period. One eye underwent a second vitrectomy due to local retinal redetachment caused by a new retinal hole formed by the pull of pre-retinal proliferative membrane and a silicon vesicle entered the subretinal space, but the retina reattached after 1-year follow-up examination. The visual acuity impr oved in different degree after the operation in 8 eyes, but remained unchanged in 1 eye. Conclusion Vitrectomy for terminal bullous retinal detachment may promote the reattachment of retina safely and effectively, and save partial visual acuity of the affected eyes. (Chin J Ocul Fundus Dis, 2006, 22:299-301)