Unified deep learning model for predicting fundus fluorescein angiography image from fundus structure image

The prediction of fundus fluorescein angiography(FFA)images from fundus structural images is a cutting-edge research topic in ophthalmological image processing.Prediction comprises estimating FFA from fundus camera imaging,single-phase FFA from scanning laser ophthalmoscopy(SLO),and three-phase FFA also from SLO.Although many deep learning models are available,a single model can only perform one or two of these prediction tasks.To accomplish three prediction tasks using a unified method,we propose a unified deep learning model for predicting FFA images from fundus structure images using a supervised generative adversarial network.The three prediction tasks are processed as follows:data preparation,network training under FFA supervision,and FFA image prediction from fundus structure images on a test set.By comparing the FFA images predicted by our model,pix2pix,and CycleGAN,we demonstrate the remarkable progress achieved by our proposal.The high performance of our model is validated in terms of the peak signal-to-noise ratio,structural similarity index,and mean squared error.

Fundus photography,fundus fluorescein angiography,and optical coherence tomography of healthy cynomolgus monkey,New Zealand rabbit,Sprague Dawley rat,and BALB/c mouse retinas

Background:A variety of experimental animal models are used in basic ophthalmological research to elucidate physiological mechanisms of vision and disease pathogenesis.The choice of animal model is based on the measurability of specific parameters or structures,the applicability of clinical measurement technologies,and the similarity to human eye function.Studies of eye pathology usually compare optical parameters between a healthy and altered state,so accurate baseline assessments are critical,but few reports have comprehensively examined the normal anatomical structures and physiological functions in these models.Methods:Three cynomolgus monkeys,six New Zealand rabbits,ten Sprague Dawley(SD)rats,and BALB/c mice were examined by fundus photography(FP),fundus fluorescein angiography(FFA),and optical coherence tomography(OCT).Results:Most retinal structures of cynomolgus monkey were anatomically similar to the corresponding human structures as revealed by FP,FFA,and OCT.New Zealand rabbits have large eyeballs,but they have large optic disc and myelinated retinal nerve fibers in their retinas,and the growth pattern of retinal vessels were also different to the human retinas.Unlike monkeys and rabbits,the retinal vessels of SD rats and BALB/c mice were widely distributed and clear.The OCT performance of them were similar with human beings except the macular.Conclusions:Monkey is a good model to study changes in retinal structure associated with fundus disease,rabbits are not suitable for studies on retinal vessel diseases and optic nerve diseases,and rats and mice are good models for retinal vascular diseases.These measures will help guide the choice of model and measurement technology and reduce the number of experimental animals required.

Fundus photography,fluorescein angiography,optical coherence tomography and electroretinography of preclinical animal models of ocular diseases

The eye is an immune-privileged and sensory organ in humans and animals.Anatomical,physiological,and pathobiological features share significant similarities across divergent species(1).Each compartment of the eye has a unique structure and function.The anterior and posterior compartments of the eye contain endothelium(cornea),epithelium(cornea,ciliary body,iris),muscle(ciliary body),vitreous and neuronal(retina)tissues,which make the eye suitable to evaluate efficacy and safety of tissue specific drugs(2).

Application of non-mydriatic fundus photography-assisted telemedicine in diabetic retinopathy screening

BACKGROUND Early screening and accurate staging of diabetic retinopathy(DR)can reduce blindness risk in type 2 diabetes patients.DR’s complex pathogenesis involves many factors,making ophthalmologist screening alone insufficient for prevention and treatment.Often,endocrinologists are the first to see diabetic patients and thus should screen for retinopathy for early intervention.AIM To explore the efficacy of non-mydriatic fundus photography(NMFP)-enhanced telemedicine in assessing DR and its various stages.METHODS This retrospective study incorporated findings from an analysis of 93 diabetic patients,examining both NMFP-assisted telemedicine and fundus fluorescein angiography(FFA).It focused on assessing the concordance in DR detection between these two methodologies.Additionally,receiver operating characteristic(ROC)curves were generated to determine the optimal sensitivity and specificity of NMFP-assisted telemedicine,using FFA outcomes as the standard benchmark.RESULTS In the context of DR diagnosis and staging,the kappa coefficients for NMFPassisted telemedicine and FFA were recorded at 0.775 and 0.689 respectively,indicating substantial intermethod agreement.Moreover,the NMFP-assisted telemedicine’s predictive accuracy for positive FFA outcomes,as denoted by the area under the ROC curve,was remarkably high at 0.955,within a confidence interval of 0.914 to 0.995 and a statistically significant P-value of less than 0.001.This predictive model exhibited a specificity of 100%,a sensitivity of 90.9%,and a Youden index of 0.909.CONCLUSION NMFP-assisted telemedicine represents a pragmatic,objective,and precise modality for fundus examination,particularly applicable in the context of endocrinology inpatient care and primary healthcare settings for diabetic patients.Its implementation in these scenarios is of paramount significance,enhancing the clinical accuracy in the diagnosis and therapeutic management of DR.This methodology not only streamlines patient evaluation but also contributes substantially to the optimization of clinical outcomes in DR management.

Fundus autofluorescence in central serous chorioretinopathy: association with spectral-domain optical coherence tomography and fluorescein angiography

and FA for identifying pathological abnormalities in CSC. The characteristics of IA AF in CSC were attributable to the modification of melanin in the RPE. IR- AIM: To evaluate the correlation among changes in fundus autofluorescence (AF) measured using infrared fundus AF (IR -AF) and short-wave length fundus AF (SW -AF) with changes in spectral -domain optical coherence tomography (SD -OCT) and fluorescein angiography (FA) in central serous chorioretinopathy (CSC). METHODS: Two hundred and twenty consecutive patients with CSC were included. In addition to AF, patients were assessed by means of SD -OCT and FA. Abnormalities in images of IA -AF, SW -AF, FA were analyzed and correlated with the corresponding outer retinal alterations in SD-OCT findings. RESULTS: Eyes with abnormalities on either IR-AF or SW-AF were found in 256 eyes (58.18%), among them 256 eyes (100%) showed abnormal IR -AF, but SW-AF abnormalities were present only in 213 eyes (83.20%). The hypo-IR-AF corresponded to accumulation of subretinal liquid, collapse of retinal pigment epithelium (APE) or detachment of APE with or without RPE leakage point in the corresponding area. The hyper -IR -AF corresponded to the area with loss of the ellipsoid portion of the inner segments and sub -sensory retinal deposits or focal melanogenesis under sensory retina. The hypo-SW-AF corresponded to accumulation of subretinal liquid or atrophy of RPE. The hyper -SW -AF associated with sub -sensory retinal deposits, detachment of RPE and focal melanogenesis. CONCLUSION: IR-AF was more sensitive than SW-AF AF should be used as a common diagnostic tool for identifying pathological lesion in CSC.

Comparison of fundus fluorescein angiography and fundus photography grading criteria for early diabetic retinopathy

AIM:To compare the assessment outcomes of the characteristics of mild to moderate non-proliferative diabetic retinopathy(NPDR) established by fundus photography and fundus fluorescein angiography(FFA).METHODS:The fundus photos and FFA results of 260 patients with diabetes mellitus were reviewed.Diabetic retinopathy(DR) severity was graded based on the international classification standard.The microaneurysms,hemorrhages,and intraretinal microvascular abnormalities(IRMA) in FFA images of patients with mild to moderate NPDR were observed.The differences between the fundus photos and the FFA results were summarized,analyzed,and compared.RESULTS:The counting of intraretinal hemorrhages identified by FFA revealed that only 9 eyes(1.9%) had more than 20 intraretinal hemorrhages in all four quadrants;15 eyes(3.1%) had more than 20 intraretinal hemorrhages in three quadrants;26 eyes(5.4%) had over 20 intraretinal hemorrhages in two quadrants;and 37 eyes(7.7%) had more than 20 intraretinal hemorrhages in only one quadrant.Furthermore,the number of IRMAs appeared ≥4 in 17 eyes,3 in 35 eyes,2 in 69 eyes,and 1 in 93 eyes.CONCLUSION:FFA has higher detection accuracy of retinal angiopathy than fundus photography.FFA grading results are helpful for timely detection and proper treatment of lesions easily missed by fundus photography.

Can Fundus Fluorescein Angiography be Performed for Diabetic Patients on Oral Metformin

Metformin 是一种 biguanide 广泛地与糖尿病 mellitus 在病人被使用了的血糖过低的代理人。在临床的实践， metformin 是否应该在宫底荧光黄 angiography (船边交货) 前被停止，仍然保持大部分不清楚。一些内分泌学家在船边交货前建议站 metformin。然而，眼科医师总是不在他们的实践采用这条意见。这种状况可以导致医生和病人之间的争论。这篇文章分析了导致对比的 nephropathy (CIN ) 和相关对比代理人，以及荧光黄 angiography 的不利反应。它指出差异可以被在船边交货使用的对比代理人的误解引起。为用碘对比代理人的 angiography，，因为 CIN 的增加的可能性， metformin 必须为使用荧光黄钠的船边交货被停止，没有 CIN 还被报导了。因此，作者相信船边交货为有口头的 metformin 的糖尿病的病人是安全的，在考试前停止 metformin 是不必要的。

Risk factors for adverse reactions of fundus fluorescein angiography

Background:To explore the difference between the outcomes of correlations between a series of variables and adverse reactions(ARs)to fluorescein from univariate and multivariate analysis and to evaluate the nausea effects in different age groups.Methods:A retrospective study of patients undergoing consecutive fluorescein angiography between March2010 and February 2012 was conducted.No patients were excluded on the ground of age,presence of atopy,allergy history,previous procedures without severe allergic ARs,asymptomatic hypertension and kidney failure with serum creatinine levels lower than 250μmol/L or with renal dialysis.Results:A total of 829 patients were enrolled and 22.2%of them had ARs.The majority of reactions were nausea(12.1%)which occurred less when age became old(P<0.0001).When the correlations between a series of variables and ARs were assessed separately,age(P<0.0001),prior reactions(P<0.0001)and motion sickness(P=0.0062)were highly and cardio/cerebrovascular disease(P=0.0015),diabetes(P=0.0001)and renal disease(P=0.0219)were lowly related to ARs.However,when the correlations were assessed simultaneously,only age[odd ratio(OR)0.974;95%confidence interval(CI),0.962–0.986],prior reactions(OR 5.596;95%CI,2.083–15.029)and motion sickness(OR 4.849;95%CI,1.583–14.856)were statistically correlated with ARs.Conclusions:Fluorescein angiography is a safe procedure for patients who are relatively healthy but with a history of any systemic disease.Young age,prior reactions and motion sickness which are highly related to emetic events should be considered in the evaluation of ARs to fluorescein.

Quantitative analysis of retinal vasculature in normal eyes using ultra-widefield fluorescein angiography

AIM:To quantify the area and density of retinal vascularity by ultra-widefield fluorescein angiography(UWFA).METHODS:In a retrospective study,UWFA images were obtained using an ultra-widefield imaging device in 42 normal eyes of 42 patients.Central and peripheral steered images were used to define the edge of retinal vasculature by a certified grader.The length from the center of the optic disc to the edge of retinal vascularity(RVL)in each quadrant and the total retinal vascular perfusion area(RVPA)were determined by the grader using OptosAdvance software.The density of retinal vascularity(RVD)was quantified in different zones of central-steered images using Image J software.RESULTS:Among 42 healthy eyes,the values for mean RVL in each quadrant were 19.007±0.781 mm(superior),18.467±0.869 mm(inferior),17.738±0.622 mm(nasal)and 24.241±1.336 mm(temporal).The mean RVPA was 1140.117±73.825 mm^(2).The mean RVD of the total retina was 4.850%±0.638%.RVD varied significantly between different retina zones(P<0.001),and significant differences existed in the RVD values for total retinal area in patients over 50 years old compared to those under 50 years old(P=0.033).No gender difference was found.CONCLUSION:The UWFA device can be a promising tool for analyzing the overall retinal vasculature and may provide a better understanding of retinal vascular morphology in normal eyes.Aging may be related to lower RVD.

Dynamic versus static ultra-widefield fluorescein angiography in eyes with diabetic retinopathy:a pilot prospective cross-sectional study

AIM:To analyze differences in ultra-widefield fluorescein angiography(UWFA)findings between dynamic and static images of eyes with diabetic retinopathy(DR).METHODS:This cross-sectional study included 28 eyes of 28 patients with DR undergoing UWFA.A series of UWFA images acquired from each patient were converted into a time-lapse video and used as a dynamic image.A single,clear,arteriovenous phase image was chosen as a static image.Non-perfusion index(NPI)and its correlation with vascular abnormalities in different zones were compared between dynamic and static UWFA imaging.RESULTS:NPI appeared to increase from the center to the far-periphery in both groups.Dynamic NPI was lower in the total retinal area(0.26 vs 0.29,P=0.009)and farperiphery(0.33 vs 0.36,adjusted P=0.042),which was contrary to the static NPI.Far-peripheral NPI was associated with intraretinal microvascular abnormality in the posterior area in both groups.CONCLUSION:Time-lapse dynamic UWFA imaging is a useful modality to differentially diagnose hypofluorescence in the most peripheral region.This modality could provide a reliable method for NPI measurement.

Comparison of 24×20 mm^(2) swept-source OCTA and fluorescein angiography for the evaluation of lesions in diabetic retinopathy

AIM: To compare ultra-widefield(24×20 mm^(2)) sweptsource optical coherence tomography angiography(SSOCTA) and fluorescein angiography(FA) in the evaluation of diabetic retinopathy(DR) lesions. METHODS: Forty-six eyes of 23 patients with treatmentna?ve DR were included at Peking University People’s Hospital from September 1, 2021, until December 31, 2021, as well as 23 age and gender matched healthy controls. Quantitative assessments of DR lesions on FA and SS-OCTA(superficial capillary plexus, SCP, 24×20 mm^(2)) were performed.RESULTS: Area of fovea avascular zone(FAZ) was larger in DR cases than controls(0.34±0.069 mm^(2) vs 0.287±0.108 mm^(2), P=0.006). In DR eyes, the mean FAZ area was 0.34±0.069 and 0.334±0.087 mm^(2) on SS-OCTA and FA, respectively(P=0.428), while the median FAZ perimeter was 2.382(IQR, 2.201-2.59) and 2.333(IQR, 2.138-2.6) mm on SS-OCTA and FA images(P=0.733). There was no significant difference in the size of the non-perfusion area(NPA) between the images on SS-OCTA and FA(12.389, IQR 4.96-28.3 and 11.125, IQR 5-28.31 mm^(2), P=0.197). The median total microaneurysm(MA) count was 35(IQR, 19-46) and 73(IQR, 43-93) on SS-OCTA and FA(P<0.001), respectively. No significant difference in intra-retinal microvascular abnormality(IRMA) and neovascularization (NV) count was found between the two techniques. The intraclass coefficient(ICCs) of all the parameters above indicated stable repeatability.CONCLUSION: Ultra-widefield SS-OCTA represents a reliable, noninvasive, and quantitative imaging technique in the assessment of microvasculature in DR, which offers a potential substitute for FA in DR evaluation.

Changes of Indocyanine Green and Fluorescein Angiography in Multiple Evanescent White-dot Syndrome: A Case Report

Purpose: To study the clinicopathological change on "Multiple Evanescent White-dot Syndrome (MEWDS)"through fundus angiogrphy analyses.Methods:Examing the case with fluorescein angiography (FFA) and indocyanine green angiography(ICGA), visual field and following up for 15 months.Results :There exist multiple white dots in the fundus photo and angiography. The changes on ICGA maintain longer than fundus photo and FFA. Papille may be edematous and macula could present with special hypofluorescent flecks.Conclusions:MEWDS has specific angiographic features. Its pathological changes involve deep retinal pigment epithelium(RPE) as well as choroidal capillaries. The prognosis of the visual acuity for MEWDS is very good.

Peripheral arterial filling time and peripheral retina fluorescence features in ultra-widefield angiography

AIM:To evaluate the peripheral arterial filling time(PAFT)and venous filling time(VFT)in eyes without known diseases that may influence filling process using ultra-widefield(UWF)fluorescein angiography(FA),and to review the peripheral retina fluorescence features.METHODS:A total of 30 eyes of 30 patients were retrospectively reviewed in this observational study.UWFFA was performed using Optos 200Tx.PAFT and VFT was recorded.The interval between the arterial or venous filling completion and the previous photo was documented.The appearance of the far peripheral retina was described as either granular background fluorescence or mottled fluorescent band or vascular leakage.Terminal vascular patterns was described as loop pattern or branching pattern.Microvascular abnormalities such as arteriovenous shunting,vessels crossing the horizontal raphe,right angle vessels,terminal networks,capillary nonperfusion,drusen or microaneurysms were evaluated.RESULTS:The normal limits of PAFT was 3.397-8.984s and 4.399-11.753s for VFT.The appearance of the far peripheral retina,defined as granular background(63%),mottled fluorescence(20%),or vascular leakage(17%),was symmetrical between both eyes.Capillary nonperfusion(23%)and microaneurysms(40%)were more frequently found in eyes with loop pattern than in eyes with branching pattern.Other peripheral signs such as right-angle vessels(73%),and terminal networks(80%)were commonly seen on UWF-FA in the normal peripheral retina.CONCLUSION:The main courses of retinal artery and vein filling time are overlapping with each other on UWF-FA.Notably,the arterial filling process is completed in the arteriovenous phase rather than the traditionally named arterial phase.There are various manifestations in the peripheral retina of normal eyes.

光学相干断层扫描血管成像参数诊断非增殖性糖尿病视网膜病变的价值分析

目的:分析光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)诊断非增殖性糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)的价值。方法:连续纳入2021年1月至2023年6月期间在我科门诊收治的122例有2型糖尿病病史(包括伴或不伴有视网膜病变)的患者,均接受眼底荧光血管造影(fundus fluorescein angiography,FFA)检查和OCTA定量检查。以FFA结果为金标准,并将患者根据FFA结果分为对照组(无NPDR)、轻度NPDR组、中度NPDR组和重度NPDR组。OCTA观察指标包括,视网膜黄斑区中央视网膜厚度(central macular thickness,CMT)、血管线性密度(vascular density,VD)、血流灌注密度(perfusion density,PD)、黄斑中心凹无血管区面积(foveal avascular zone area,FAZ-A)、黄斑中心凹无血管区周长(foveal avascular zone perimeter,FAZ-P)、圆形指数(foveal avascular zone circularity index,FAZ-CI)。用单因素方差或非参数方法分析比较各组间定量指标的差异,取其中存在显著组间差异的指标纳入多因素Logistic回归模型,分析反映NPDR患病和严重程度的指标,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析单独或联合指标对于NPDR的诊断价值。结果:VD在各NPDR组中较对照组均显著下降,重度NPDR组较轻度、中度NPDR组均显著下降(P<0.05);PD在中度和重度NPDR组较对照组均显著下降(P<0.05),在重度NPDR组较轻度和中度NPDR组均显著下降(P<0.05);FAZ-A在各NPDR组中较对照组均显著下降(P<0.05),但在各NPDR组间均无统计学差异;FAZ-P在各NPDR组中较对照组均显著下降(P<0.05),但在各NPDR组间均无统计学差异;FAZ-CI在各组间均无统计学差异。多因素Logistic回归分析结果显示,CMT升高、VD和FAZ-P下降与NPDR患病相关(P=0.03,<0.001和0.001);CMT上升和VD下降与NPDR严重程度相关(P=0.01,<0.001)。ROC曲线分析显示,CMT(>260.00μm)、VD(<16.55/mm2)和FAZ-P(<2.15 mm)对NPDR均具有单独诊断价值(AUC分别为0.63、0.78和0.70),其中VD的诊断效能显著高于CMT(P=0.02),CMT与VD或FAZ-P的诊断效能之间则无统计学差异(P均>0.05)。CMT、VD和FAZ-P指标联合诊断NPDR的诊断效能(AUC=0.86)显著高于任一单项指标的诊断效能(P均<0.05)。结论:OCTA检查参数CMT、VD和FAZ-P均独立具备对NPDR的诊断价值,将三者联合使用则能进一步提高其诊断效能。OCTA血流参数联合黄斑形态参数可有效提高NPDR的临床诊断。

超广域SS-OCTA联合超广角激光扫描眼底成像对糖尿病视网膜病变的诊断价值

目的 超广域扫频源光学相干断层扫描血管成像(UWF SS-OCTA)联合超广角激光扫描眼底成像(UWF SLO)对糖尿病视网膜病变(DR)患者病变的检出率以及对DR分级诊断价值的研究。方法 横断面研究。招募在四川省人民医院眼科就诊的糖尿病患者。所有参与者都接受了UWF SS-OCTA、UWF SLO和荧光素眼底血管造影(FFA)检查,用于检测DR病变,包括微动脉瘤(MA)、视网膜内出血(IRH)、视网膜无灌注区(NPAs)、视网膜内微血管异常(IRMAs)、视网膜静脉串珠(VB)、视网膜新生血管(NVE)、视盘新生血管(NVD)及玻璃体积血(VH)。联合三类影像检查(以下简称三联影像)结果作为标准对照,对比不同影像两两联合对DR病变的检出率及对DR严重度分级的一致性。结果 共纳入101例175眼。与三联影像结果相比,UWF SS-OCTA联合UWF SLO对MA、IRH、NPAs、IRMAs、NVE、NVD及VH的检出率分别为91%、83%、77%、69%、27%、10%及12%,Kappa依次为0.812、1.000、1.000、1.000、0.986、0.970及1.000。与三联影像结果相比,UWF SS-OCTA联合UWF SLO对DR的严重度分级具有优异一致性(Kappa=0.943)。结论 UWF SS-OCTA联合UWF SLO能准确识别MA、IRH、NPAs、IRMAs、NVE、NVD及VH,对DR筛查及分级诊断准确性高,适用于临床上对DR的大规模筛查与管理。

多模影像对糖尿病小鼠眼底特征的实验研究

目的观察糖尿病小鼠视网膜影像改变特征,为糖尿病小鼠视网膜病理改变特征提供影像学依据。方法8周龄C57BL/6J小鼠连续5 d腹腔注射链脲佐菌素STZ(50 mg/kg),1周后测量小鼠空腹血糖浓度,模型复制成功的糖尿病小鼠(模型组)与正常小鼠(对照组)喂养5个月,5个月后对正常小鼠和糖尿病小鼠进行双眼光学相干断层扫描/光学相干断层扫描血管造影(OCT/OCTA)及眼底荧光血管造影(FFA)检测,采用图湃软件和Image J软件得出眼底视网膜厚度,血管密度、形态及管径大小,以及荧光素渗漏情况等数据,最后用GraphPad Prism进行统计学分析。结果对照组内层内环视网膜厚度大于模型组(P<0.05),对照组内层中、外环及外层内、中、外环厚度与模型组比较,差异均无统计学意义(P>0.05)。对照组表层及深层内、中、外环视网膜血管密度与模型组比较,差异均无统计学意义(P>0.05)。对照组一、二级血管管径值均窄于模型组、(P<0.05)。应用多模影像技术可以明确糖尿病视网膜病变(DR)的具体部位及捕捉DR的病变特征,包括微血管瘤、视网膜薄变、小血管迂曲扩张,以及迂曲扩张的小血管周围毛细血管网间隙增宽和囊样暗腔样改变。结论OCT/OCTA及FFA的多模影像相结合,可以活体监测DR小鼠视网膜早期损伤及毛细血管早期特征改变,对DR基础研究发挥一定作用。

光学相干断层扫描血管造影在视网膜血管性疾病诊疗中的研究进展

光学相干断层扫描血管造影(OCTA)是一种非侵入性的快速成像方式,其扫描能显示视网膜各个层面的血流信息,可在任意方位显示一系列的二维横断面图像,尽可能量化视网膜形态,目前已广泛用于眼科疾病尤其是视网膜血管性疾病的诊断和病情监测,并提供了前所未有的深度解析信息。随着OCTA扫描速度和分辨率的不断提高,以及减少伪影、提高图像质量和进行定量测量的软件算法的开发,OCTA的临床应用将得到进一步增强,相信今后无创OCTA有望取代相关的有创检查方法成为眼科影像学检查的重要工具。

增生早期糖尿病视网膜病变患者视网膜及视盘新生血管的超广角OCTA与FFA检测结果对比分析

目的 对比分析超广角OCT血管成像(OCTA)与荧光素眼底血管造影(FFA)对增生早期糖尿病视网膜病变(DR)患眼视网膜及视盘新生血管的检测结果。方法 选取2021年11月至2022年5月在四川省人民医院眼科经FFA确诊为增生早期DR的患者62例(98眼)为研究对象,所有患者均行FFA和超广角OCTA检查。超广角OCTA检查选择以黄斑为中心的24 mm×20 mm扫描模式进行。所有图像均由同一位技术员采集,图像分析由同一位医师进行。以FFA的检查结果为标准,分析超广角OCTA对增生早期DR患眼视网膜及视盘新生血管的检出率。结果 共93眼(94.9%)FFA显示出视网膜新生血管,超广角OCTA显示出其中82眼,检出率88.2%,遗漏的患眼均是由于超广角OCTA检测范围受限所致;在FFA未显示出视网膜新生血管的5眼中,超广角OCTA显示出1眼存在新生血管,该新生血管在FFA检查中被误诊为视网膜内微血管异常。共17眼(17.3%)FFA显示出视盘新生血管,超广角OCTA显示出全部17眼,检出率100.0%;在余下的81眼中,超广角OCTA更灵敏地显示出10眼存在视盘新生血管。在FFA检查中,因荧光素渗漏掩盖了新生血管的特征,导致漏诊。结论 超广角OCTA对增生早期DR患眼视网膜及视盘新生血管检出率高,且能发现被FFA遗漏的新生血管。

视网膜大动脉瘤的诊治进展

视网膜大动脉瘤(RAM)是一种获得性视网膜血管异常疾病。其发病机制尚未明确,与高血压、动脉硬化、高血脂等全身情况有关。视网膜大动脉瘤由于管壁薄弱高血压情况下易发生渗出或出血引发其他并发症,临床表现复杂多样,不易诊断。瘤体本身有自行退化倾向,病变未累及黄斑区者视力预后良好。但当渗出和/或出血累及黄斑时,严重影响视力,需一些可行性方案治疗。了解视网膜大动脉瘤的典型影像学表现,有助于明确诊断并给予相应的治疗措施。本文主要综述了多种检查方式下视网膜大动脉瘤的表现及不同类型视网膜大动脉瘤对应的多种治疗方案,旨在为未来早期诊断和治疗视网膜大动脉瘤提供参考。

无赤光血管造影在眼底疾病检查中的图像特征研究

目的 探讨无赤光血管造影(RFA)与眼底荧光素血管造影(FFA)联合吲哚菁绿血管造影(ICGA)检查、光学相干断层成像检查(OCT)及眼底自发荧光检查(FAF)相比,在眼底病变检查中的优势。方法 采用RFA、FFA、ICGA、OCT和FAF对2022年1月至8月期间于中国医科大学附属第一医院就诊的29例(41眼)眼底病变患者进行检查,利用数据和检查图像比较几种检查方法的异同。结果 对于视网膜下积液的观察,RFA比FFA有优势,与ICGA晚期图像和OCT图像判读一致;对于视网膜神经纤维层状态的观察,RFA比FFA和ICGA晚期检查有优势;对于视乳头周围多灶性片状异常荧光病灶的观察,与FFA、ICGA晚期、FAF检查图像判读一致;对于视网膜点片状异常荧光的观察,RFA检查与ICGA晚期检查、FAF检查判读一致,比FFA检查有优势;对于黄斑区膜样高荧光的观察,RFA检查与OCT图像判读一致,比FFA、ICGA晚期检查有优势。结论 RFA检查在眼底病变的检查中,尤其是对视网膜下积液、视网膜神经纤维层等视网膜浅层结构的观察,比FFA、ICGA等检查方法更有优势。