Persistent and bilateral choroidal vascular abnormalities in central serous chorioretinopathy

BACKGROUND: To clarify the role of choroidal vascular abnormalities in central serous chorioretinopathy (CSC) in active stage, remission, and recurrence. METHODS: Indocyanine green angiography and fluorescein angiography were performed in 105 eyes (104 patients) with active CSC. Forty-six patients were followed up for 6 to 48 months (mean +/- standard deviation, 22.5 +/- 8.9 months) with repeated angiography (mean +/- standard deviation, 3.5 +/- 1.5 times). Indocyanine green angiography and fluorescein angiography also were performed during remission in all 46 eyes with CSC and during recurrent CSC in 6 eyes. Unaffected fellow eyes underwent angiographic examinations in all patients. RESULTS: In active CSC, indocyanine green angiography showed a choroidal filling delay (71%), venous dilation (61%), and focal choroidal hyperfluorescence (96%) surrounding leakage from the retinal pigment epithelium. Focal choroidal hyperfluorescence was present in unaffected areas of affected eyes (55%). The choroidal venous dilation (36%) and choroidal hyperfluorescence (62%) were noted even in unaffected fellow eyes. These choroidal abnormalities persisted during remission after leakage ceased throughout the follow-up period. In the six patients with recurrent CSC, new leakage developed in the areas of persistent choroidal hyperfluorescence. Central serous chorioretinopathy developed in the unaffected fellow eye in one of these six patients. CONCLUSION: Choroidal vascular abnormalities persist in both eyes even after leakage from the retinal pigment epithelium ceases. Central serous chorioretinopathy may recur in areas of choroidal vascular abnormalities.     

脉络膜破裂荧光血管造影分析

目的　为了研究眼底荧光血管造影在脉络膜破裂诊断中的应用价值。方法　用Ｎｉｋｏｎ 眼底照相机对１２ 例脉络膜破裂患者进行荧光血管造影检查,并进行详细分析。结果　１２ 例患者中９ 例板层脉络膜破裂,２ 例全层破裂,１ 例单纯色素上皮层破裂。结论　荧光血管造影能显示脉络膜破裂的大小、形状、数目、受损层次,并能以此判断预后。     

全层黄斑裂孔的鉴别诊断

目的：探讨全层黄斑裂孔与板层黄斑裂孔以及囊样黄斑变性的诊断和鉴别诊断方法。 方法：用Amsler方格表、Watzke征检查和激光瞄准光检查对30例全层黄斑裂孔、12例板层黄斑裂孔和8例囊样黄斑变性患者进行检查,其结果用四格表确切概率法进行统计分析。 结果：Amsler方格表检查,Watzke征检查及50μm激光瞄准光试验在全层黄斑裂孔组中阳性率均为100%;板层黄斑裂孔和囊样黄斑变性组中分别为85%、65%及0。 结论：对全层黄斑裂孔的诊断,Amsler表检查具有敏感性,但不具特异性;Watzke征敏感而且较特异;激光瞄准光检查非常敏感而且特异．这些检查有助于对全层黄斑裂孔的准确诊断。 （中华眼底病杂志,1996,12：211-213）     

Features of abnormal choroidal circulation in central serous chorioretinopathy

AIMS: To evaluate abnormalities in the choroidal circulation in cases of central serous chorioretinopathy (CSC). METHODS: A complete clinical ophthalmological examination was performed using simultaneous fluorescein and indocyanine green (ICG) angiography with a confocal scanning laser ophthalmoscopy and the digital images analysed in 36 consecutive patients with acute CSC. To quantify the choroidal circulation, the foveal choroidal blood flow was measured in 11 patients using laser Doppler flowmetry. RESULTS: Fluorescein angiography showed focal leakage from the retinal pigment epithelium in all patients. ICG angiography revealed delays in arterial filling in 27 eyes (75%), and fluorescein angiography showed small hypofluorescent points around the leakage in 27 eyes (75%). Abnormal choroidal hyperfluorescence was observed in 30 eyes (83%). The choroidal blood flow in eyes with CSC was 45% lower than in fellow eyes (p<0.01). CONCLUSION: Decreased choroidal blood flow in CSC was demonstrated for the first time. The decreased choroidal blood flow might be correlated with the small, localised hypofluorescent areas, which may indicate non-perfused areas of the choriocapillaris that are frequently seen during ICG angiography.     

息肉状脉络膜血管病变的临床表现及眼底血管造影

目的 观察息肉状脉络膜血管病变(pol ypiodal choroidal vasculopathy, PCV)的临床表现及眼底血管造影特征。 方法 回顾分析6例PCV患者7只眼的临床资料及荧光素眼底血管造影(fundus fluorescein angiography, FFA)与吲哚青绿血管造影(indocyanine green angiography, ICGA) 检查资料。 结果 PCV患者早期眼底仅可见橘红色病变，随病情进展出现出血 、渗出、水肿、浆液性和(或)出血性视网膜色素上皮(retinal pigment epithelium, RPE) 脱离，病程长者可出现视网膜、脉络膜萎缩。FFA检查1只眼病变处脉络膜血管网扩张，6只眼见密度不均的斑点状强荧光，造影过程中荧光渗漏，晚期呈强度不均的强荧光片；ICGA检查5只眼早期显示分支状脉络膜血管网，末端扩张呈息肉状，晚期脉络膜血管结构不清，息肉状扩张仍然可辨，7只眼均有形态独特的孤立或簇状分布的息肉状强荧光点，晚期仍有染料存留。 结论 PCV患者眼底可见橘红色病变及出血、渗出和RPE脱离，FFA及ICG检查可见分支状脉络膜血管网及末端息肉状扩张。 （中华眼底病杂志，2003，19：269-332）     

慢性中心性浆液性脉络膜视网膜病变与息肉样脉络膜血管病变多模式影像学特征的比较

目的　比较慢性中心性浆液性脉络膜视网膜病变（chronic central serous chorioretinopathy,CCSC）与息肉样脉络膜血管病变（polypoidal choroidal vasculopathy,PCV）的多模式影像学差异。方法　回顾性分析CCSC组11例11眼患者及PCV组21例21眼患者的临床资料。所有患者均行最佳矫正视力、黄斑中心凹下脉络膜厚度测量及荧光素眼底血管造影、吲哚菁绿血管造影、光学相干断层扫描血管成像（optical coherence tomography angiography,OCTA）和频域光学相干断层扫描多模式影像学检查,并对检查结果进行统计学分析。结果　CCSC组患者最佳矫正视力为0.33±0.11,显著高于PCV组（0.21±0.13）,差异有统计学意义（P<0.05）。CCSC组患者黄斑中心凹下脉络膜厚度为（368.20±51.65）μm,PCV组为（342.28±37.18）μm,两组相比差异无统计学意义（P>0.05）。荧光素眼底血管造影检查结果显示,CCSC组和PCV组均为斑点状高荧光表现,CCSC组患眼可伴有色素上皮萎缩带或慢性神经上皮脱离通道表现。吲哚菁绿血管造影检查结果显示,CCSC组11眼病灶区出现周围脉络膜血管扩张及高通透性改变;而PCV组21眼均出现脉络膜息肉样病变,其中12眼为脉络膜分支血管网。OCTA检查结果显示,CCSC组4眼病灶部位表现为脉络膜毛细血管层高血流信号,其外环绕低血流信号,7眼表现为粗颗粒形态的斑驳状血流信号;PCV组15眼可检出息肉样病变,表现为高反射信号,呈结节状、环状或点状,12眼检出脉络膜分支血管网病变,表现为血管样结构的高血流信号。频域光学相干断层扫描检查发现,CCSC组7眼为浆液性视网膜色素上皮脱离（pigment epithelium detachment,PED）;PCV组12眼为波浪形隆起的视网膜色素上皮层与Bruch膜组成的双层征,10眼为陡峭的视网膜色素上皮指状突起（或称PED峰）,18眼为浆液性或出血性PED。CCSC组患者治疗随访时,OCTA检查发现2眼继发I型脉络膜新生血管。结论　CCSC与PCV之间存在不同的影像学表现,多模式影像检查有助于两者的鉴别。另外,OCTA能够较好地显示脉络膜新生血管结构,可用于该类疾病的治疗随访。     

Early findings in central areolar choroidal dystrophy

We examined 69 members of two caucasian families with an autosomal dominant form of central areolar choroidal dystrophy using ophthalmoscopy and fundus photography. In five members who had a good visual acuity macular lesions were found. In three of them retinal function tests were performed, which turned out to be normal. These 5 patients underwent fluorescein angiography. Early symptoms of central areolar choroidal dystrophy are small parafoveal hyperfluorescent areas due to retinal pigmentepithelium loss and areas of pigment mottling in the macula. Until now the early lesions of central areolar choroidal dystrophy in patients with a good visual acuity in both eyes have not been described clearly.     

多模式影像技术在Stargardt病不同病变阶段的临床运用

目的： 观察多模式影像技术在Stargardt病不同病变阶段的影像特征。 方法： 回顾性系列病例研究。 对云南大学附属医院2016 年5 月至2019 年8 月确诊的28 例（ 56 眼） Stargardt患者进行眼底彩色照相、 自发荧光、 眼底荧光血管造影、 光学相干断层扫描（ OCT）、 炫彩眼底成像、 血流成像OCT（ OCTA） 等多模式检查, 总结各类影像检查在疾病不同阶段的特征。 结果： 眼底彩色照相可显示, 随病变进 展黄斑区的萎缩病变逐渐扩大, 伴后极部眼底色泽改变。炫彩成像通过多波长的组合, 可用更好的 对比度和层次感显示出萎缩的细胞和范围。眼底自发荧光通过自发荧光的高低变化提示视网膜色 素上皮（ RPE） 的受损情况, 同时能清楚直观地显示黄斑区萎缩病灶的大小。眼底荧光血管造影在 Stargardt病中的观察可直接反映视网膜色素上皮层、 脉络膜血管的损伤程度。 随着Stargardt病的发展, 黄斑区RPE层萎缩范围扩大, 视网膜及脉络膜毛细血管继发进行性萎缩。 OCT提供了断层眼底的影 像信息, 随病变进展, 中心凹周围神经上皮层变薄, 光感受器不同程度萎缩、 消失, RPE层不同程 度萎缩, 反光减弱, 脉络膜层毛细血管萎缩, 从层次深度和范围的广度都体现了病变的发展。 OCTA 中本研究观察到随着病变的进展, 各层次血管密度呈减少趋势。扫描视网膜深层血管时, 透见了 下方的脉络膜血管, 随着萎缩加重, 透见的脉络膜血管的范围扩大。 结论： 不同的眼科影像技术在 Stargardt病的不同阶段表现有各自特点和优势, 为临床医师提供了更多角度的追踪随访、 病情评估 的手段。     

Rieger anomaly with bilateral choroidal osteoma: coincidence or association?

PURPOSE: To report a case of Rieger anomaly associated with bilateral choroidal osteoma. CASE: An 18-year-old woman presented with corectopia, iridocorneal adhesions, and stromal hypoplasia of the iris, and was diagnosed with Rieger anomaly. RESULTS: Fundus examination revealed bilateral yellowish-orange, placoid degenerative fundus lesions with pseudopod-like edges associated with the areas of retinal pigment epithelium atrophy, indicating choroidal osteoma. Fundus fluorescein angiography showed bilateral early patchy and late diffuse hyperfluorescence. B-scan echography revealed placoid lesion at the posterior ocular coats characterized by localized areas of high ultrasound reflectivity with a corresponding retrobulbar orbital shadowing. This indicated a dense calcium foreign body. In addition, computed tomography of the orbit demonstrated bilateral plate-like thickening with calcification of the choroid that was isodense with the normal skeletal bone. CONCLUSIONS: Although Rieger anomaly is classically known as a disease of the anterior segment of the eye, choroidal osteoma may be a posterior segment finding of the disease that has not previously been reported.     

视网膜脱离复位术后吲哚青绿与荧光素眼底血管造影

目的 探讨裂孔性视网膜脱离复位术后荧光素眼底血管造影(fundus fluorescein angiography,FFA)与吲哚青绿血管造影(indocyanine green angiography,ICGA)的特征。 方法 对21例单纯裂孔性视网膜脱离复位术后的21只患眼行FFA与ICGA同步检查。 结果 ①21只眼人工嵴上FFA有透见荧光,ICGA可见脉络膜血管扩张,14只眼有脉络膜充盈缺损;②6只眼裂孔部位巩膜表面冷凝者FFA见局部斑片状荧光素渗漏,ICGA造影晚期局部脉络膜斑片状强荧光;③6只眼裂孔部位光凝者FFA见光凝斑周伴少许荧光素渗漏,ICGA无明显强荧光;④ICGA视盘周围及下方扇形充盈迟缓2只眼,颞下人工嵴后片状充盈迟缓2只眼。 结论 人工嵴上FFA的透见荧光和ICGA的脉络膜血管扩张影像为视网膜脱离复位术后主要的FFA和ICGA特征。(中华眼底病杂志,2000,16:17-19)     

Fundus fluorescein and indocyanine green angiographic study of Behcet's disease and Vogt-Koyanagi-Harada syndrome

OBJECTIVE: To study the choroidal and retinal changes in Behcet's disease and Vogt-Koyanagi-Harada syndrome (VKHS) using indocyanine green angiography (ICGA) and fundus fluorescein angiography (FFA). METHODS: Seventeen cases (27 eyes) of Behcet's disease and 18 cases (36 eyes) of VKHS were examined with FFA and ICGA. All of the patients showed an active intraocular inflammation when examined. RESULTS: FFA showed leakage from retinal vessels in patients with Behcet's disease. ICGA revealed choroidal abnormalities including dilatation and hyperpermeability of choroidal vessels in 11 eyes (40.7%). In VKHS, FFA revealed the hyperfluorescence and serous pigment epithelium detachments. Dilatation and hyperpermeability of choroidal vessels revealed by ICGA were found in 36 eyes (100%), multihypofluorescent dark dots in 32 eyes (88.9%), and choroidal filling defects in 28 eyes (77.8%). CONCLUSIONS: Although retinal vascular lesions are predominant in Behcet's disease, choroidal abnormalities evidenced by dilatation of choroidal vessels are also present in some patients. Hyperfluorescence and hypofluorescence revealed are the main findings in the patients with VKHS. A combination of FFA and ICGA is recommended for the examination of Behcet's disease and VKHS.     

Choroidal vascular lesions identified by ICG angiography in a case of familial amyloidotic polyneuropathy

BACKGROUND: To describe a patient with familial amyloidotic polyneuropathy (FAP) whose choroidal vascular lesions were demonstrated dynamically with the use of indocyanine green (ICG) angiography. CASE: A 59-year-old man complained of blurred vision due to vitreal amyloidosis in both eyes. Fundus examination after pars plana vitrectomy showed multiple retinal hemorrhages. OBSERVATIONS: ICG angiography performed after vitrectomy clearly delineated multiple sites of hyperfluorescence indicating tissue staining alongside the major choroidal veins in the lower fundus of his left eye. ICG hyperfluorescence was more evident in the late angiographic phase. Fundus examination and fluorescein angiography revealed no abnormal findings at the corresponding sites of ICG dye leakage. CONCLUSIONS: Choroidal vascular lesions in eyes with FAP were demonstrated in vivo using ICG angiography for the first time. ICG angiography may be very beneficial to evaluate occult choroidal involvement in patients with FAP.     

Confocal scanning laser microscopic findings of excised choroidal neovascular membranes of age-related macular degeneration and their comparison with the clinical features

PURPOSE: To evaluate the histopathological characteristics of choroidal neovascular membranes excised from eyes of patients with age-related macular degeneration (AMD) and to correlate their characteristics with the clinical features of AMD. METHODS: Choroidal neovascular tissues were excised from 3 patients with AMD and examined by light and confocal scanning laser microscopy. The clinical features were obtained by fundus photography, fluorescein angiography (FA), and indocyanine green angiography (IA) and compared with the histopathological findings. RESULTS: Light microscopy showed the presence around the vascular structures of cells containing pigment. Confocal scanning laser microscopy revealed lipofuscin signals of the retinal pigment epithelium cells around the vascular tissue that was also confirmed by three-dimensional reconstructed views from serial optical sections. Clinical observations of the fundus by IA showed that all 3 cases had areas with hyperfluorescence in early phase on IA. A dark rim was observed around the area of hyperfluorescence in 2 cases, and the dark rim was located within the neovascular membrane. The patterns of fluorescence were heterogeneous in some phases on IA, which reflected the histological heterogeneity of the neovascular membrane. CONCLUSIONS: The retinal pigment epithelium cells appear to play a special role in the induction and regression of the choroidal neovascular membrane associated with age-related macular degeneration.     

蝶形视网膜色素上皮营养不良患者的多模式眼底影像学特征

目的:探讨蝶形视网膜色素上皮营养不良(BPD)患者的多模式眼底影像特征。方法:回顾分析2016-01/2019-07经多模式影像检查确诊BPD的患者18例36眼的眼底彩照、红外照相、自发荧光、荧光造影、脉络膜造影、光学相干断层扫描(OCT)及眼底血流成像OCT(OCTA)等多模式眼底影像检查。结果:典型的眼底彩色照相可显示色素异常沉着而呈现的蝶翅样病变外观,病变进展后蝶形外观不明显,而相应区域萎缩;红外照相显示BPD患者的眼底黄色病灶,表现为白色高亮影像;自发荧光可有斑片状、点状所勾勒的蝶翅表现,也可有以上特征重叠的表现,当病变进展萎缩明显时,自发荧光不能显示典型的蝶形改变,但可以反映出色素上皮细胞的破坏程度范围;眼底荧光血管造影和脉络膜造影除了显示蝶形病变外,能更为精准地显示血管病变情况,尤其是脉络膜新生血管(CNV)的检查;OCT显示病变位于视网膜色素上皮(RPE)之上与光感受器之间。随病变进展,色素上皮表现相应扩大的损伤,继发CNV者可见突破RPE的高反射信号;OCTA显示病变对视网膜深层和浅层损伤不明显,但脉络膜血流信号不同程度丢失,可敏感检出CNV的血流影像。结论:多模式眼底...     

眼挫伤后脉络膜病变FFA及ICGA的对比观察

目的 应用荧光素和吲哚青绿眼底血管造影，了解眼挫伤后脉络膜血管的病变。方法 应用德国Heidelberg共焦激光扫描眼底血管造影技术对眼挫伤患者16例（17眼）进行荧光素和吲哚青绿血管造影检查，观察脉络膜血管的异常变化。结果 17眼中，眼底荧光素血管造影显示视网膜血管充盈时间和血管形态大致正常，显示高网膜渗漏5眼。眼底吲哚青绿血管造影显示局限性脉络膜充盈延迟16眼、血管扩张5眼、荧光遮蔽2眼及吲哚青绿渗漏8眼。结论 由于脉络膜血管主要供应视膜外层，因此外伤性视网膜脉络膜病变对视功能影响很大，吲哚青绿血管造影提供了对各种程度脉络膜血管损害的分析依据。     

Fundus changes corresponding to visual field defects after vitrectomy for macular hole

OBJECTIVE: Visual field defects are one of the complications of macular hole surgery, and mechanical retinal damage induced by infusion air is a proposed causative factor of this complication. In this study, we examined the fundus to see whether the changes observed corresponded to postoperative visual field defects. DESIGN: Observational case series. PARTICIPANTS: Seventeen eyes of 17 patients who had postoperative visual field defects after vitrectomy for idiopathic macular hole were examined. METHODS: The fundus was examined by ophthalmoscopy and by fluorescein and indocyanine green angiography. MAIN OUTCOME MEASURES: Fundus changes corresponding to postoperative visual field defects. RESULTS: In eight eyes, detectable fundus changes were observed, including regional mottling and degeneration of the retinal pigment epithelium, filling delay of the choroidal circulation, subretinal fibrosis, and epiretinal membrane formation. These findings corresponded exactly to the visual field defects observed. Although the visual field defects had been detected shortly after surgery, fundus changes were detected, on average, more than 8 months after surgery. CONCLUSIONS: Fundus changes become apparent after surgery, and they are progressive. Therefore, it is important to examine eyes with visual field defects for a follow-up period of several years.     

Hyperfluorescence associated with serous retinal pigment epithelial detachment on indocyanine green angiography

PURPOSE: Indocyanine green angiography has been reported to improve detection and delineation of occult choroidal neovascularisation in serous pigment epithelium detachment in age-related macular degeneration. The study aims to evaluate the visual acuity results of eyes affected by serous pigment epithelium detachment in age-related macular degeneration, having had indocyanine green-directed laser photocoagulation, and to correlate them to the pattern of serous pigment epithelium detachment on indocyanine green angiography. METHODS: Thirty-four eyes of 31 patients affected by serous pigment epithelium detachment in age-related macular degeneration were prospectively considered. Each patient underwent an ophthalmological examination including fluorescein and indocyanine green angiography one day before, and 6 weeks, 3 months, 6 months, 9 months, 12 months and 24 months after krypton-laser treatment. The serous pigment epithelium detachment was classified in the late-phases angiograms as either hypofluorescent, isofluorescent or hyperfluorescent comparing the fluorescence of the serous pigment epithelium detachment with the choroidal background fluorescence. RESULTS: The indocyanine green-guided laser treatment was associated with a temporary stabilization and a long-term progressive reduction of visual acuity: after 24 months visual acuity improved in 2.9%, stabilized in 26.5% and worsened in 70.5% of cases. Serous pigment epithelium detachment presenting a pretreatment hyperfluorescence had a final visual acuity of 0.06, with subfoveal choroidal neovascularisation development in 100% of cases, whereas serous pigment epithelium detachment presenting a pretreatment hypofluorescence and isofluorescence showed a final visual acuity of 0.12, with subfoveal choroidal neovascularisation development in 43.5% of eyes, with statistically significant difference. CONCLUSION: Overall visual acuity decreases with time after indocyanine green-guided laser treatment of choroidal neovascularisation in serous pigment epithelium detachment, and serous pigment epithelium detachment becoming hyperfluorescent in the late-phases of indocyanine green angiography has the worst functional outcome.     

视网膜及视网膜色素上皮错构瘤1例

目的：报告1例视网膜及视网膜色素上皮错构瘤，并对其临床表现做出具体描述和分析，以期对眼科医师正确诊断本病有所裨益。方法：对1例诊断为“视网膜色素上皮病变”的患者跟踪随访5年，进行常规直接眼底检查、眼底荧光造影和B超检查。结果：本例患者视力在5年内从0．6下降至0．3，眼底镜检查和眼底荧光血管造影无明显变化。结论：视网膜及视网膜色素上皮错构瘤是临床少见病，病史、眼底表现和荧光造影表现是其确诊的依据。     

中心性浆液性脉络膜视网膜病变的视网膜与脉络膜循环研究

目的 :探讨中心性浆液性脉络膜视网膜病变 (中浆 )患者视网膜与脉络膜循环的改变 ,旨在提供病因依据 ,以指导临床治疗。方法 :随机选取我院门诊已确诊为中浆的患者 16例 ( 2 1只眼 ) ,经双眼散瞳后分别行眼底荧光血管造影 (fundusfluoresceinan giography ,FFA)和吲哚青绿血管造影 (indocyaninegreenangiography ,ICGA) ,对比分析其改变。结果 :1 FFA检查 :所有患者均显示明显的晚期渗漏 ;4只眼 ( 19% )合并视网膜色素上皮脱离 (pigmentepithelialdetachment ,PEDS)。 2 ICGA检查 :( 1) 2例脉络膜动脉充盈缺损 ,余 14例早期呈动脉充盈迟缓。 ( 2 )与FFA中渗漏对应的脉络膜高渗透性 ,范围大于FFA中所见。统计学分析具有明显差异 (P <0 0 0 1)。 ( 3 )FFA未发现异常的区域 ,ICGA可见局灶或多灶性脉络膜的高渗透区。 ( 4 )与FFA中对应的PEDS及多个隐匿性的PEDS ;PEDS在ICGA中具有典型特征。结论 :脉络膜循环障碍及渗透性增强是中浆最基本的病理改变。比较FFA与ICGA检查结果 ,我们认为中浆病人脉络膜循环障碍比视网膜循环障碍更为严重。     

Unilateral Acute Idiopathic Maculopathy

Purpose: To discuss the fluorescein angiographic features and diagnosis as well as differential diagnosis.Methods : In our hospital, we have found three cases of UAIM, one of them has eccentric maculopathy, another has papillitis, and the third associates with pregnancy. Each has characteristic clinical findings. We have made the diagnosis base on ophthalmoscopy and fluorescein angiography (FA).Results: Three patients with UAIM have been experienced sudden unilateral decreased visual acuity. The significant changes on fundus are retinal pigment epithelium (RPE) thickening with neurosensory retinal detachment with in the macular area. FA showed early patchy hypofluorescence and hyperfluorescence at the level of the RPE.' Bull' s eye appearance may occur in the macular area after the acute stage of the disease. The clinical findings are similar to what the foreign report described. But there were no previous reports in China. Conclusion : We can establish the diagnosis on the base of clinical and fundus f