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Objective To evaluate the diagnostic value of Heidelberg retinal angiography(HRA) combined with optical coherence tomography (OCT) to detect neovascularization (CNV) in exudative age-related macular degeneration (AMD) patients. Methods This is a cross-sectional study of a series of clinical cases. AMD diagnosis was established by international standard vision chart, Slit lamp microscope, direct or indirect ophthalmoscope examination. A total of 50 eyes (42 cases) of exudative AMD received HRA and frequency domain OCT scan. All 50 eyes received fundus fluorescein angiography (FFA) and frequency-domain OCT simultaneously, and among them 15 eyes also received indocyanine green angiography (ICGA) at the same time. FFA and ICGA were carried out by conventional methods, CNV was localized by real-time Localization technology of frequency domain OCT. In the radial and grid-like section from the areas with strong fluorescence, image acquisition settings are 7 μm fault for each frame, 30° intervals for radialsection, 10 vertical and 10 horizontal scan lines for grid-like section. CNV can be divided into 4 types (typical CNV, partial typical CNV, occult CNV, CNV scarring) according to their boundaries demonstrated in FFA. Based on the features of the OCT images, there were 3 types of integrated image (sub-RPE type, sub-retinal type and mixed type). Results CNV was detected in all 50 eyes. There were 4 eyes (8%) of typical CNV, 11 eyes (22%) of partial typical CNV, 32 eyes (64 %, including 27 eyes of RPE detachment and 5 eyes of passive late leakage) of occult CNV and 3 eyes (6%) of CNV scarring. There were 4 eyes (8%) of sub-RPE type (CNV under the RPE light band) , 16 eyes (32%) of sub-retinal type(interrupted light band of RPE and choroid capillary layer) and 30 eyes (60%) of mixed type of integrated image. Conclusion The image integration technology of the HRA and frequency domain OCT system provide a valuable tool to classify and measure CNV, which will benefit the clinical treatment of AMD patients. 相似文献
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Vogt-小柳-原田综合征葡萄膜炎期荧光素钠及吲哚菁绿同步眼底血管造影特征分析 总被引:1,自引:0,他引:1
目的探讨Vogt-小柳-原田综合征(Vogt-Koyanagi-Harada disease,VKH)葡萄膜炎期荧光素钠及吲哚菁绿同步眼底血管造影的影像学特征及其临床意义,为诊断及病程监测提供依据。方法回顾性分析11例22眼VKH葡萄膜炎期患者应用海德堡HRA2共焦激光扫描眼底血管造影系统进行的荧光素钠眼底血管造影(fundus fluorescein angiography,FFA)和吲哚菁绿血管造影(indocyanine green angiography,ICGA)同步检查资料,比较2种检查的影像学特征。结果 11例22眼中,FFA检查8眼(36.36%)后极部多处脉络膜充盈迟缓;9眼(40.91%)视盘渗漏水肿;22眼(100.00%)后极部视网膜色素上皮密集针尖状高荧光渗漏,18眼(81.82%)后极部神经上皮脱离部位FFA晚期形成多囊样或多湖状荧光积存;13眼(59.09%)静脉期散在、均匀脉络膜炎性病灶,呈斑点状低荧光。ICGA检查15眼(68.18%)脉络膜充盈迟缓;14眼(63.64%)脉络膜血管扩张;16眼(72.73%)播散状分布、斑点状脉络膜炎性低荧光病灶;18眼(81.82%)后极部神经上皮脱离区大多呈现持续低荧光,晚期部分囊样病灶呈中强荧光;9眼(40.91%)视盘水肿晚期显示视盘及盘周低荧光。FFA和ICGA同步检查结果:FFA检查100.00%患眼静脉期视盘周及后极部密集点状高荧光渗漏,而在ICGA上无此征象;FFA检查视盘表面毛细血管扩张比ICGA显示更明显;ICGA检查脉络膜充盈迟缓15眼(68.18%)及斑点状炎性病灶16眼(72.73%),均高于FFA检查结果的8眼(36.36%)和13眼(59.09%),而且ICGA早期脉络膜血管扩张显示更清晰;后极部神经上皮脱离病灶在FFA静脉期表现为低荧光,晚期形成荧光积存,而病变区域ICGA检查相应部位多为持续低荧光。结论 VKH葡萄膜炎期FFA清晰显示视网膜色素上皮损伤特征以及炎症累及视盘、视网膜的程度和范围;ICGA能够清晰显示脉络膜循环改变及脉络膜炎症的活动性和范围。FFA和ICGA同步检查对VKH诊断及发病机制有重要的指导意义。 相似文献
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目的 研究越橘提取物对改善糖尿病视网膜病变黄斑水肿对比敏感度和眩光功能的作用.方法 选择非增生性糖尿病视网膜病变黄斑水肿患者87例(87眼),单盲法随机对照分为试验组和对照组,试验组45例(45眼),对照组42例(42眼).试验组口服越橘提取物,每次200 mg,每天3次,疗程共3个月;对照组不服任何有关治疗视力的药物.使用自动眩光对比敏感度检查仪对受试者进行对比敏感度及眩光敏感度检测.所有患者均随访3个月.结果 试验前2组患者一般情况指标无明显差异;试验组患者在试食后1.0°-0.7°高频段,2.5°-1.6°中频段,6.3°-4.0低频段对比敏感度和眩光敏感度均较试食前有明显提高,其中以中频和高频段改善最为明显.3个月随诊后的组间对照结果显示,试验组3个月后各频段对比敏感度和眩光敏感度较对照组明显提高.试验组服食3个月后最佳矫正视力为0.42±0.09,较对照组0.39±0.29有所提高,2组试食前后,差异无统计学意义.黄斑厚度在试食3个月前后2组均无明显改变.结论 越橘提取物可明显改善糖尿病视网膜病变黄斑水肿患者对比敏感度和眩光功能. 相似文献
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目的 探讨胰岛素强化治疗后早期糖尿病视网膜病变(DR)患者对比敏感度与眩光敏感度的变化.方法 前瞻性系列病例研究.纳入进行胰岛素强化治疗的糖尿病视网膜病变患者54例(108眼),利用Takagi CGT-1000自动GS检查仪对所有患者的对比敏感度和眩光敏感度进行6个月随访,随访时间点分别为强化治疗前和强化治疗后3个月、6个月.采用重复设计的方差分析和LSD法两两比较分析治疗前后对比敏感度和眩光敏感度变化.结果 强化治疗后3个月对比敏感度在6.3°、2.5°、1.6°、1.0°高于治疗前,差异有统计学意义(t=2.521、3.298、2.808、3.275,P均<0.05);治疗后6个月,对比敏感度在2.5°和1.0°高于治疗前,差异有统计学意义(t=2.096、2.059,P均<0.05).治疗后6个月较治疗后3个月各频段差异并无明显统计学意义.强化治疗后3个月和6个月,眩光敏感度各频率段较治疗前均有升高,但是差异均无统计学意义(F值分布于1.092~3.046,P值均>0.05).结论 胰岛素强化治疗短期内能一定程度改善视功能,延缓早期糖尿病视网膜病变患者视功能损害的进展. 相似文献
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自Hartnett等[1]首次描述了发生于老年性黄斑变性(AMD)患者“深层视网膜血管异常复合体”以来,视网膜血管瘤样增生( RAP)逐渐被认可为一种渗出型AMD的特殊类型[2,3].与其他类型的AMD不同,RAP的新生血管来源于视网膜深层毛细血管,并纵行向视网膜下腔发展,形成视网膜脉络膜吻合.Yannuzi等[4 ]研究发现,RAP常发生于白人,亚洲人中并不常见;且国内关于该病的报道也较少.为此,我们观察了一组RAP患者的影像学特征,现将结果报道如下. 相似文献
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Background Intensive insulin therapy has been found to lessen the progress of diabetic retinopathy (DR) to some extent,while it has also been implicated to be responsible for decrease of DR.We investigated visual function and morphological changes in the macular area in short-term follow-up of patients with type 2 diabetes mellitus after intensive insulin therapy.Methods This was a prospective clinical study of nonproliferative DR patients (102 eyes,120 patients) undergoing intensive insulin therapy.The Contrast Glare Tester (Takagi CGT-1000) was used to examine contrast sensitivity (CS) and Heidelberg Retina Tomograph (HRT) Ⅱ and Stratus Model 3000 OCT were used to observe the changes of morphology in the macular area.Follow-up times were pre-intensive therapy,3 and 6 months post-intensive therapy.Results CS at low and middle frequencies was higher at 3 and 6 months post-therapy compared with pre-therapy (P 〈0.05).Significant differences in CS at low frequency were found between 6 and 3 months post-therapy (P 〈0.05).Macular edema index was lower in the first,second,and third rings of the macular area after intensive therapy compared with pre-therapy (P 〈0.05).Compared with 3 months post-therapy,the macular edema index was lower in the first,second,and third rings of the macular area at 6 months post-therapy (P 〉0.05).No significant differences in the thickness of the first,second,and third rings of the macular area were detected between 3 and 6 months post-therapy and pre-therapy (P〉0.05).Conclusion CS and macular edema indexes were significantly improved in nonproliferative diabetic retinopathy patients after intensive insulin therapy,but thickness of the macular area was unchanged. 相似文献