Effects of aging on fluorescein iris and angle photography in normal subjects]

In the present study we took the fluorescein iris and angle photography of normal eyes and studied them according to different age groups. The range of age in 108 eyes of 92 subjects was from 20 to 93 years. They were free from any systemic diseases or ophthalmic diseases which would cause iris rubeosis. Fluorography was carried out using a Mizuno Trabeculens to determine the leakage points of fluorescence from the iris and the angle. In the angle there were gonio vessels which revealed no leakage of fluorescein. They were observed in 8 of 30 eyes (27%) for subjects in the fifth decade of life or less and in 24 of 78 eyes (31%) for subjects aged 50-90. No significant difference was seen between the two age groups. As to variations of gonio vessels, radial ciliary body vessel was found in 23 eyes, radial iris vessel or trabecular vessel in 10 eyes, and circular ciliary band vessel in 7 eyes. In the pupillary margin no leakage was seen in 30 eyes of 30 cases in the fifth decade of life or less, while leakage was found in 33 of 78 eyes, 42 of 62 cases over the fifth decade of life. In the angle leakage was seen in 4 of 30 eyes, 13 of 30 cases in the fifth decade of life or less, while leakage was observed in 43 of 78 eyes over the fifth decade of life. These results suggested that leakage of fluorescence from the pupillary margin, the angle or both increases with age.(ABSTRACT TRUNCATED AT 250 WORDS)     

虹膜荧光素血管造影对具有棕色虹膜的中国人前葡萄膜炎的诊断价值

背景 前葡萄膜炎的炎症性损伤与血-房水屏障的破坏有关,裂隙灯下对其病情的检查有一定的限制,而荧光素血管造影能客观显示病情的变化.但目前国内对虹膜荧光素血管造影(IFA)的应用研究较少.目的 观察中国人棕色虹膜葡萄膜炎患者IFA图像,探讨IFA在葡萄膜炎诊断和治疗中的临床应用价值.方法 对正常中国人40人40眼和前葡萄膜炎、全葡萄膜炎累及眼前段的患者13例21眼进行裂隙灯、虹膜彩色照相和IFA检查,探讨前葡萄膜炎患眼IFA表现并与正常人进行对照.结果 正常对照眼IFA不显影,呈色素遮蔽荧光,＞60岁正常老年人4例4眼瞳孔缘可见轻微荧光素渗漏.本组葡萄膜炎患眼IFA均有异常荧光素渗漏,按照前葡萄膜炎的严重程度表现为:(1)瞳孔缘和基质层放射状虹膜血管荧光素渗漏.(2)虹膜弥漫性或局限性萎缩,表现为放射状血管透见荧光.(3)虹膜新生血管(NVI),表现为细线状或花团状强荧光,随造影时间延长,有不同程度的荧光素渗漏.结论 IFA可显示裂隙灯检查不能够显示的虹膜炎症性损害病灶并间接反映血-房水屏障和虹膜血管的损害,IFA表现取决于炎症类型、部位以及炎症活动性的严重程度,有助于判断前葡萄膜炎的病情和监测治疗过程.     

Comprehensive study of the iris in transformed light in simple glaucoma]

Complex examination of the iris under light transformed by various methods - iridochromoscopy with iridochromophotography, transillumination in red light, and fluorescein angiography - was performed on 26 eyes of patients with simple glaucoma and 24 normal eyes of subjects aged between 42 and 76 years. All the methods employed revealed iris changes in 100% of the simple glaucoma cases. The differences found between the study group and the controls were significant (P = 0.01). A highly positive correlation was found between the results of iris fluorescein angiography and iridochromoscopy with iridochromophotography (r = 0.932; P = 0.0005), as well as between the results of iris fluorescein angiography and transillumination in red light (r = 0.921; P = 0.0005). Complex examination of the iris under transformed light showed the most typical changes in simple glaucoma to be exogenous pigmentation of the pupillary and ciliary regions, partial or complete destruction of the pupillary margin, and stromal atrophy affecting the pupil or the entire iris. Defects and thinning of the posterior iris pigment layer, iris vessel permeability disorders associated with hypoperfusion and microneovascularization in the lesser circle and the ciliary region were also found.     

Fuchs''s heterochromic cyclitis: a simultaneous bilateral fluorescein angiographic study of the iris.

Twelve patients with Fuchs's heterochromic cyclitis (FHC) were studied with simultaneous bilateral flucrescein angiography of the iris. The flow began a little earlier in the contralateral iris in 4 cases, and simultaneously in both irides in 8 cases. The radial iris vessels were narrow in 7 eyes with FHC and in the contralateral eyes of 2 elderly patients and 1 patient with pigmentary retinal dystrophy and FHC. An ischaemic sector of the iris was seen in 6 eyes with FHC, neovascularisation of the iris in 8 eyes, and fluorescein leakage of the iris vessels was seen in all eyes with FHC. No neovascularisation of the iris occurred in the contralateral eyes, and only minimal fluorescein leakage was seen at the pupillary border of 5 contralateral eyes. The results support the hypothesis of vascular pathomechanism in FHC.     

Iris fluorescein angiography and fluorescein gonioscopic photography after implantation of Choyce Mk IX anterior chamber lenses

Patients underwent intracapsular cataract extraction and implantation of a Choyce Mk IX anterior chamber intraocular lens. At fluorescein angiography (FAG) at a mean of 8 months post-operatively, 9 showed leaking from the iridal vessels, and 3 were normal: Three cases were excluded because of factors affecting the iris FAG. At a mean of 37 months 5 still had a slight degree of leakage. No primarily negative iris FAG changed to positive later. Fluorescein gonioscopic photography (FGP) revealed leakage in 29.5% of the tips of the foot plates at a mean of 37 months. No correlation was observable between FGP and gonioscopy. The pupillary deformation quotient DQ (greatest: smallest pupillary diameter) was significantly greater at a mean of 8 months in the eyes with leakage in iris FAG than in eyes without leakage (P = 0.0145). Individually a change both in direction against normalisation and in elongation was recorded during the observation time.     

A Study of the Vascular Network of the Iris Using Flat Preparation

Purpose

This study was performed to examine the vascular network of the human iris using flat preparation.

Methods

The ciliary body-iris structures were separated from human eyeballs, and a portion of the irises were treated with trypsin to remove the pigment granules. These iris tissues were unfolded and placed onto glass slides using flat preparation, and the vascular network of each iris was examined by fluorescein microscopy. The ciliary body-iris structures separated from the remaining eyes were stained with hematoxylin-eosin without trypsin treatment and were examined by light microscopy.

Results

The long posterior ciliary artery formed several branches before entering the iris root, and such branches formed the major arterial circle of the iris with diverse diameters in the vicinity of the iris root and the ciliary process. In the pupillary margin, the iris vasculature network formed a cone shape and then formed an arcade by connecting to adjacent vasculatures. In the vicinity of the collarette, the iris vasculature network formed the minor arterial circle of the iris with diverse diameters perpendicular to the arcade of the iris network located in the pupillary margin. In the pupillary margin, the capillaries were somewhat thick and connected to the irregular traveling iris vein.

Conclusions

The above findings explain the human iris vascular network and provide a theoretical basis for the sectoral filling of the iris vasculature seen in fluorescein iris angiography.     

Effect of lens implants on iris fluorescein angiography and the iris pigment layer

Fourteen eyes underwent cataract operation and implantation of an iris fixated (Medallion) pseudophakos. Eleven had an uncomplicated per- and post-operative course (group 1), 3 had a subluxation of the lens implant (group 2). The control group (group 3) consisted of the 14 contralateral eyes from group 1 and 2. Two cadaver eyes had a similar lens implanted (group 4). Groups 1-3 were investigated by bilateral simultaneous iris fluorescein angiography and retroiridal stereo transillumination photography. In group 1, one case with pupillary and diffuse semiperipheral leakage areas was observed, in a clinically healthy eye 15 months after the operation. An other one had some leakage at the pupillary border, but not in the area of contact with the loops. Rubbing between iris surface and some parts of the lens did not provoke local leakage. No new vessel formation was found. Pigment layer defects were observed in every operated eye, but no leakage was related to them except in the two pupillary areas mentioned. Mayor pigment defects did not progress in a quiet eye. The iris seems to be to some degree resistant to contact with the parts of the intraocular lens implant.     

Nonproliferative diabetic retinopathy with significant capillary nonperfusion

A clinical study was carried out in 80 eyes of 50 diabetic patients with significant capillary nonperfusion at least in one eye. Panoramic photography of the fundus and wide-angle composite fluorescein angiography was performed in all cases. Forty-nine patients had type II diabetes. The mean age of the patients was 60 years and the mean duration of diabetes was 12.1 years; 46% of the patients had hypertensive vascular disease. Small neovascular tufts were observed in the iris sphincter in 20% of eyes. In addition, abnormal leakage of dye was observed in these eyes. Abnormal leakage of dye from the iris vessels was also observed in 9 of 20 eyes without clinically visible neovascularization. Numerous soft exudates distributed in a semicircular arc pattern were observed in 49% of eyes. Soft exudates were isolated and scarce in 37% of cases and were completely absent in 14% of eyes. Thus, in a substantial proportion of cases, the severity of the retinopathy could not be assesed by ophthalmoscopic findings alone.Presented at the XVth Meeting of the Club Jules Gonin, Copenhagen, 10–15 August 1986     

A scanning electron-microscopic study of the posterior and anterior surfaces of the rat iris in pupillary dilation and constriction

Adult rat pupils were dilated with a mixture of 5% phenylephrine hydrochloride and 0·5% cyclopentolate, or constricted with 0·125% echothiophate iodide. The eyes were removed and fixed in glutaraldehyde. They were prepared for scanning electron microscopy by the camphene and critical point drying methods and coated with a thin layer of gold.In pupillary dilation the posterior surface of the iris is deeply circumferentially grooved. The ridges, separated by grooves, probably represent rows of posterior epithelial cells. The ridges divide and merge with neighbouring ridges. The height of the ridges, and the width and depth of the intervening grooves vary with the degree of dilation. An amorphous layer, most likely the basement membrane, covers all of the posterior surface obscuring the boundaries between the individual epithelial cells.In pupillary constriction the posterior surface of the iris is smooth and flat or there may be hints of bulging outwards of the posterior epithelial cells.In extreme pupillary constriction where the pupillary diameter is very small, the posterior surface of the iris is smooth except for a small zone around the pupillary margin. The posterior epithelial cells around the pupillary margin are arranged in radial ridges. These ridges are high around the pupillary margin but they become lower and eventually disappear peripherally. Large bulbous structures, formed probably as a result of eversions of the posterior epithelial cells, are often seen in amongst the radial epithelial ridges. A series of overlapping humps around the pupillary margin are probably due to the underlying sphincter muscle bundles.Two new features of the iris are revealed by scanning electron microscopy. Ciliary-iris processes are found all along the periphery of the iris anchoring the highly mobile iris to the ciliary body. Varying numbers of blood vessels lie superficial to the posterior surface of the iris. They appear to come from the iris stroma, turn around at the pupillary margin to traverse the whole extent of the posterior surface of the iris. These blood vessels may play a small role in the nutrition of the adult lens.In pupillary dilation the anterior surface of the iris is made up of a mass of circumferentially-oriented blood vessels bulging prominently into the anterior chamber. In pupillary constriction the blood vessels are stretched out. They zig-zag from the periphery of the iris towards the pupillary margin. Branches are often given off at the external bend of the parent blood vessel. These then go deep into the iris tissue. The larger blood vessels appear to be arranged much like the pleats of an accordion.The cells of the anterior border layer are variously polygonal in shape with a centrally located oval nucleus. Iris pores are formed as a result of gaps in between the individual epithelial cells spanned by cytoplasmic cell processes. Iridic crypts are generally large, irregularly round or oval in shape and possess well-defined borders. Cytoplasmic prolongations of the underlying cells and a fibrillar connective tissue network normally fills the openings of the iridic crypts.     

The complex study of the iris in transformed light

Complex investigations of the iris in a transformed light by methods of iridochromoscopy, iridochromophotography, examination in a polarized light, transillumination in red light and fluorescence angiography was conducted in 25 eyes of patients with open-angle glaucoma, 10 eyes of patients with anterior flaccid uveitis and in 23 healthy eyes (a control group). It was found that in patients with open-angle glaucoma and anterior flaccid uveitis trophic and vascular changes in the iris predominated, as compared with control. The most typical for open-angle glaucoma changes in the iris were atrophy of the stroma with predominant involvement of the pupillary zone, exogenic pigmentation of the pupillary and ciliary zones, destruction of the pigment margin of the pupil, thickening of the anterior border layer, pseudoexfoliation of the pupillary margin, defects in the posterior pigment layer, being more extensive in the pupillary zone, as well as disturbances in permeability of the iris in a combination with hypoperfusion and rare bundles of microneovascularization in the area of a lesser arterial circle and the ciliary zone. In case of flaccid uveitis, the most frequent changes were diffuse atrophy of the iris, efflorescence of the pupillary margin, destruction of the pigment rim of the pupil, multiple defects in the posterior pigment layer along its whole length, increased permeability of vessel, microneovascularization of the iris stroma in a form of a thin vascular network.     

Histologic localization of sodium fluorescein in human ocular tissues.

We studied the distribution pattern of sodium fluorescein in human eyes microscopically. The ciliary body showed early and diffuse leakage, with staining of the basement membrane of the nonpigmented ciliary epithelium, indicating movement of fluorescein from the ciliary body into the aqueous humor. After five minutes the iris stroma stained with fluorescein, probably from the aqueous humor. The retinal vessels and retinal pigment epithelium were impermeable to fluorescein. Corresponding to the background fluorescence seen in fluorescein angiography, fluorescence was present in Bruch's membrane and in the stroma of the inner one third of the choroid. Drusen stained most intensely in areas of greatest PAS positively. Early fluorescence of the optic disk was the result of intravascular perfusion of the dye. Minimal diffusion of fluorescein from the fenestrated choroidal vessels across the border tissue of Elschnig into the peripheral optic nerve bundles was observed. Late fluorescene of the optic disk was due mainly to fluorescein staining of the lamina scleralis and glial columns.     

Fluorescein iris angiography in nodular sarcoid iritis

The value of fluorescein iris angiography in the diagnosis and follow-up of nodular sarcoid iritis was studied in five patients with nodular iritis and histologically verified generalized sarcoidosis. On the angiograms the sarcoid nodules appeared as hyperfluorescent patches which always exceeded the number of nodules seen by biomicroscopy. Fresh iris nodules were characterized by mild diffuse fluorescence and dilatation and leakage of the adjacent vessels whereas old granulomas were covered by tortuous neovascular vessels which in the active stage of the disease leaked fluorescein profusely. After recovery or between recurrent attacks the amount of leakage decreased or stopped although the neovascular network did not disappear. At recurrences new areas of fluorescence due to fresh nodules were observed in addition to intense leakage from some of the previous lesions. Most of the small nodules were situated in the pupillary part of the iris resulting in dilatation and abnormal permeability of all the peripupillary vessels. The weakness of absence or diffuse leakage from the radial vessels of the iris agrees with the proliferative nature of sarcoid nodular iritis and explains the low-grade symptoms of the patients.     

中国人闭角型青光眼房角关闭机制的研究

目的 对中国人原发性闭角型眼光眼（闭青）房角关闭机制进行研究,为按发病机制分类提供依据。方法采用超声生物显微镜和诊断性的治疗方法对１２６例（１２６只眼）原发性闭青的房角及房角相关解剖结构进行活体、实时、定性及半定量观察分析。结果根据ＵＢＭ房角及房我有相关解剖结构的观察,可将原发性闭青房锄头 闭机制分为单纯性瞳孔阻滞型（４８例,４８只眼,占３８．１％）,单纯性非瞳孔阻滞（９例,９只眼,占７．１％）,     

虹膜荧光素血管造影在虹膜新生血管诊断中的应用

目的 探讨虹膜荧光素血管造影(IFA)在缺血性视网膜中央静脉阻塞(CRVO)虹膜新生血管(NVI)诊断中的价值.方法 经荧光素眼底血管造影(FFA)检查确诊的CRVO患者51例51只眼纳入研究.所有患者均行视力、裂隙灯显微镜检查、眼前节彩色照相、眼压及FFA+IFA检查.根据FFA检查结果分为非缺血性和缺血性CRVO,分别为20、31只眼.非缺血性CRVO20只眼中,男性11只眼,女性9只眼;年龄41～59岁.缺血性CRVO31只眼中,男性21只眼,女性10只眼;年龄28～62岁.采用德国海德堡眼底荧光血管造影仪进行FFA+IFA检查,将典型图像存入计算机图像处理系统进行分析.对比观察裂隙灯显微镜和IFA NVI的检出率.缺血性CRVO31只眼均行全视网膜激光光凝(PRP)治疗,其中,完成治疗27只眼,未坚持完成治疗4只眼.完成治疗后6个月,随访观察NVI消退情况.结果 非缺血性CRVO20只眼裂隙灯显微镜检查瞳孔缘及虹膜未见新生血管,占100.0%;IFA检查虹膜未见显影,呈色素遮蔽荧光,占100.0%.缺血性CRVO31只眼中,裂隙灯显微镜检查显示瞳孔缘及虹膜有细小新生血管13只眼,占41.9%;IFA检查显示NVI 23只眼,占74.2%.2种检查方法NVI检出率比较,差异有统计学意义(Z=-3.425,P=0.001).IFA检查NVI分别表现为小团状、细线状或不规则交叉网状强荧光染色及渗漏.完成PRP治疗的27只眼IFA检查结果显示,瞳孔缘及虹膜表面未见荧光染色及渗漏;未坚持完成PRP治疗4只眼,1～2个月后出现新生血管性青光眼(NVG).结论 IFA可以提示眼前节的缺血状态,具有较高的特异性,辅助CRVO缺血型早期诊断,预测是否发展NVG.

Abstract：

Objective To evaluate the application value of iris fluorescein angiography (IFA) in the diagnosis of ischemic center retinal vein occlusion (CRVO). Methods Fifty-one patients (51 eyes) with CRVO which had been diagnosed by fundus fluorescein angiography (FFA) were studied. All patients underwent the examination of visual acuity, slit lamp biomicroscope, anterior segment color photography,intraocular pressure, FFA and IFA. The patients were classified as non-ischemic CRVO (20 eyes) and ischemic CRVO (31 eyes). The 20 non-ischemic CRVO patients included 11 males and nine females, aged from 41 to 59 years. The 31 ischemic CRVO patients included 21 males and 10 females, aged from 28 to 62 years. FFA and IFA were performed for all the patients using Heidelberg retina angiograph, and the classic pictures were analyzed by the computer image processing system. The detection rate of iris neovascularization (NVI) by slit lamp biomicroscope and IFA was analyzed. All ischemic CRVO eyes underwent panretinal photocoagulation (PRP), and PRP was completed in 27 eyes and not completed in four eyes. Six months after PRP the regression of iris NVI was followed up. Results All non-ischemic CRVO eyes (100. 0% ) had no neovascularization on papillary margin and iris by slit lamp biomicroscopy, and had no fluorescence (pigment blocked fluorescence) on IFA. Thirteen eyes (41.9%) and 23 eyes (74.2%) of the 31 ischemic eyes had NVI by slit lamp biomicroscope and IFA, respectively. The NVI detection rate of those two methods was statistically different (Z= - 3. 425, P = 0. 001 ). NVI showed strong fluorescence and leakage with variable patterns (small blocks, thin lines and irregular cross-links) by IFA. There was no fluorescence staining and leakage on papillary margin and iris in 27 eyes who completed the PRP, but the neovascular glaucoma (NVG) occurred in one eyes who discontinued the PRP treatment after one to two months. Conclusions IFA has a high specificity in CRVO which hints the ischemic state of anterior segment. It is helpful to the early diagnosis of ischemic CRVO and the turnover of NVG.     

Iris angiographic changes in multifocal chorioretinitis with panuveitis

· Background:Multifocal chorioretinitis with panuveitis (MCP) is a chronic inflammatory disease of the peripheral retina and choroid with typical clinical appearance. Although obvious involvement of the anterior segment is often mild, severe chronic inflammatory reactions can occur after cataract surgery. Explantation of an intraocular lens (IOL) or primary aphakia may be necessary. In this pilot study we therefore examined the iris of patients with MCP by means of fluorescein angiography (IAG) to investigate iris vessel involvement.· Materials und methods:Twenty-one eyes of 13 patients with MCP (12 women, 1 man) were examined by IAG. The average age of the patients was 72.5±6.2 years, and the average duration of the disease prior to examination was 13 months. In 9 of 21 eyes a pars plana vitrectomy (PPV) was performed because of marked vitreous opacification. IAG was performed before and after surgery. · Results: Although clinically unremarkable the iris of 14/21 eyes showed avascular zones in IAG; 13/21 had irregular vessels such as vascular collaterals, and 10/21 exhibited neovascularization. All eyes showed leakage of dye at the pupillary margin, and in 15/21 there was leakage out of peripheral iris vessels. In 2 of 9 eyes angiographic changes such as avascular zones regressed after PPV. · Conclusion: Irides in patients with MCP that are unremarkable on slit-lamp examination may show marked angiographic changes. Thus IAG in those cases with planned cataract extraction and IOL, if necessary combined with PPV for vitreous opacification, may be warranted in order to better assess the prognosis after surgery. Received: 3 February 1999 Revised version received: 29 March 1999 Accepted: 13 April 1999     

Intracameral Avastin dramatically resolves iris neovascularization and reverses neovascular glaucoma

PURPOSE: To report the biologic effect of intracameral bevacizumab in patients with iris neovascularization secondary to proliferative retinal vasculopathies. METHODS: Sixteen eyes of 15 patients with iris neovascularization associated with or without neovascular glaucoma secondary to proliferative retinal vasculopathies received intracameral bevacizumab (1.25 mg). Ophthalmic evaluations included Snellen visual acuity (VA), complete ophthalmic iris angiography, and slit lamp photography. Main outcome measure was change in degree of iris neovascularization. Secondary outcomes included fluorescein iris angiographic leakage, control of intraocular pressure, and changes in VA. RESULTS: All patients with neovascularization demonstrated by slit lamp photography and fluorescein angiography (16/16 eyes) had complete (or at least partial) reduction in leakage of the neovascularization within 3 weeks after the injection. Leakage from iris neovascularization resolved in 12 of 16 (75%) eyes. In two cases recurrent leakage was seen as early as 4 weeks necessitating repeat injection. Intraocular pressure was controlled with maximum medical therapy in eight of nine eyes reducing the need for glaucoma surgery. Visual acuity improved from a median of hand motions to 20/200. CONCLUSIONS: In summary, intracameral bevacizumab was effective in reversing iris neovascularization in the majority of patients. It also facilitated intraocular pressure control in patients with associated glaucoma.     

Verteporfin photodynamic therapy for anterior segment neovascularization secondary to ischaemic central retinal vein occlusion

Purpose: To evaluate the efficacy of photodynamic therapy (PDT) with verteporfin for anterior segment neovascularizations (ASNVs) in patients affected by ischaemic form of central retinal vein occlusion (CRVO). Methods: Prospective non‐comparative case series including 10 consecutive patients (10 eyes) affected by ischaemic CRVO. Main outcome measure was the obliteration of ASNV. Results: One month after PDT, biomicroscopic examination showed partial obliteration of iris new vessels and complete closure of angle neovascularization. Iris fluorescein angiography performed 1 week after treatment showed partial closure of the iris new vessels with no evidence of leakage in the late phases. During the subsequent examinations, a partial reopening of the iris and angle new vessels in association with dye leakage on fluorescein angiography was evident. In any case, the fluorescein leakage turned out to be still reduced with respect to the baseline aspects. Conclusions: Our results show that PDT with verteporfin can partially obliterate ASNVs in eyes affected by ischaemic CRVO preventing from the evolution towards advanced stages of neovascular glaucoma, but is not effective in cases with complete angle synechial closure.     

地区性窄房角患者的房角关闭机制类型分析

目的 了解邯郸地区房角关闭病人的房角形态.方法 利用超声生物显微镜(URM)图像,对邯郸市眼科医院582例(582只眼)窄房角患者的房角及其相关结构进行定性及半定量观察分析,了解各种构型所占的比率.结果 单纯瞳孔阻滞型273例(46.9%),单纯非瞳孔阻滞型33例(5.7%),多种机制共存型276例(47.4%).单纯非瞳孔阻滞型中,单纯睫状体前位19例(3.3%),单纯虹膜周边肥厚14例(2.4%).而多种机制共存型中,瞳孔阻滞+虹膜周边肥厚型121例(20.8%),瞳孔阻滞+睫状体前位型66例(11.3%),瞳孔阻滞+虹膜周边肥厚型+睫状体前位型57例(9.8%),睫状体前位+虹膜周边肥厚型32例(5.5%).结论 多种机制共存是引起邯郸地区闭角型青光眼房角关闭的主要机制,邯郸地区房角关闭患者周边虹膜肥厚、睫状体和虹膜附着位置靠前型所占比率高于南方广州地区,房角关闭发生机制存在一定的地区差异.     

Digital infrared photography assists in the detection of iris and ciliary body cysts

PURPOSE: To report a case that illustrates the utility of digital infrared photography in the detection of iris and ciliary body cysts in an asymptomatic patient. MATERIALS AND METHODS: Digital infrared photography of the iris was performed in both eyes of a 50-year-old white woman who presented with bilateral endothelial pigment dusting and subtle iris transillumination defects. RESULTS: Infrared photography revealed a pronounced, rounded patch of transillumination in the periphery of the left iris. Also observed were focal, rounded regions of reduced transmittance in the peripheral iris of both eyes. These findings suggested the presence of bilateral iris and ciliary body cysts. High-resolution ultrasound biomicroscopic images were consistent with this suspicion. CONCLUSIONS: Digital infrared photography of the iris may be useful in the detection and evaluation of iris and ciliary body cysts.     

Sarcoid cyclitis

Fifty-two patients with ocular sarcoidosis were studied to determine how intraocular tissues are affected in this disease. Of 102 eyes, 36 (35.3%) had iris nodules, 50 (49.0%) demonstrated nodules in the anterior chamber angle, 42 (41.2%) showed ciliary nodules, 37 (36.3%) had snowball vitreous opacities, and 21 (20.6%) exhibited candlewax drippings on the retinal vessels. Special note was made of sarcoid changes in the ciliary processes using cycloscopy. Of the total 102 eyes, nodules in the ciliary processes were most predominant in 42 (41.2%), waxy exudates were observed in 25 (24.5%), cyclitic membrane-like exudates were seen in the posterior chamber, in 3 (2.9%), and swelling of the ciliary processes occurred in 12 (11.8%). There were no observable changes in 20 eyes (19.6%). It is remarkable that these changes occur in 80.4% of eyes with intraocular sarcoidosis.