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The preprocessing of retinal images for the detection of fluorescein leakage

PHYSICS IN MEDICINE AND BIOLOGY 1999年第1期44卷 293-308页

作者： Cree, MJ Olson, JA McHardy, KC Sharp, PF Forrester, JV Univ Aberdeen Dept Biomed Phys & Bioengn Aberdeen AB9 2ZD Scotland Aberdeen Royal Infirm Eye Clin Aberdeen Scotland Royal Infirm Diabet Clin Aberdeen Scotland Univ Aberdeen Dept Ophthalmol Aberdeen Scotland

Images of the human retina are routinely used in clinical practice for the diagnosis and management of eye disease. Increased permeability of retinal brood vessels, which is a clinically significant feature, can be visualized with a process known as fluorescein angiography as leakage of fluorescence dye into the surrounding tissues. Analyses of such images can be quantified but significant degradation of images due to uneven illumination or occluded optical pathways is often incurred during image capture. We describe a procedure to restore fluorescein angiographic retinal images so that quantitative computation can be reliably performed. Analysis of the image acquisition system reveals that captured images are composed of two functions, one describing the true underlying image and the other the degradation incurred. These two functions are independent of one another and it is possible to estimate the degradation from an isolated captured image and restore it appropriately Any leakage of fluorescein dye is then detected by analysing the restored angiographic sequence over time and finding areas of the image that do not have the usual decrease in fluorescence intensity.

关键词：眼疾病/诊断荧光素血管造影术/仪器和设备荧光素血管造影术/方法荧光素类/药代动力学荧光染料/药代动力学图像处理计算机辅助视网膜/细胞学视网膜/病理学视网膜血管/细胞学视网膜血管/病理学人类

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Intraocular inflammatory reactions without focal necrotizing retinochoroiditis in patients with acquired systemic toxoplasmosis

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AMERICAN JOURNAL OF OPHTHALMOLOGY 1999年第4期128卷 413-420页

作者： Holland, GN Muccioli, C Silveira, C Weisz, JM Belfort, R O'Connor, GR Univ Calif Los Angeles Jules Stein Eye Inst Sch Med Ocular Inflammatory Dis Ctr Los Angeles CA 90095 USA Univ Calif Los Angeles Dept Ophthalmol Sch Med Ocular Inflammatory Dis Ctr Los Angeles CA 90095 USA Escola Paulista Med Dept Ophthalmol Sao Paulo Brazil Erechim Clin Silveira Rio Grande do Sul Brazil Univ Calif San Francisco Dept Ophthalmol San Francisco CA 94143 USA Univ Calif San Francisco Francis I Proctor Fdn Res Ophthalmol San Francisco CA 94143 USA

PURPOSE: To describe the occurrence of intraocular inflammatory reactions as the sole ophthalmic manifestation of acquired systemic toxoplasmosis. METHODS: Review of medical records for 10 patients with uveitis and evidence of recent Toxoplasma gondii infection. RESULTS: Patient ages ranged from 3 to 51 years. Ocular symptoms were present in each of eight adult patients. Inflammation was unilateral in nine patients;it manifested as vitreous humor cells and haze (10 patients), anterior chamber cells (seven patients), and retinal vasculitis (seven patients). No patient had necrotizing retinochoroiditis upon initial examination. Inflammation resolved in each of nine patients who had follow up examinations. Foci of retinitis or inactive retinochoroidal scars were seen in four of these nine patients during follow-up examinations, at intervals of 2.0 weeks to 2.5 years after initial examination. CONCLUSIONS: Retinal vasculitis and associated inflammatory reactions may be the only ophthalmic disorder during the early stages of a newly acquired T. gondii infection. Later development of retinitis or scars consistent with toxoplasmic retinochoroiditis in the same eyes suggests that the initial, isolated inflammation may be caused by the presence of parasites in retinal tissue. These cases may have implications for understanding the original source of retinal infection in patients who have recurrent toxoplasmic retinochoroiditis and for treatment of newly acquired T gondii infection. (Am J Ophthalmol 1999;128:413-420. (C) 1999 by Elsevier Science Inc, All rights reserved.).

关键词：毛细血管通透性脉络膜疾病/寄生虫学脉络膜炎/寄生虫学脉络膜炎/病理学瘢痕/寄生虫学眼内炎/寄生虫学眼内炎/病理学坏死视网膜疾病/寄生虫学视网膜疾病/病理学视网膜血管/代谢视网膜血管/病理学视网膜炎/寄生虫学视网膜炎/病理学弓形虫病/并发症血管炎/寄生虫学血管炎/病理学青少年成年人儿童儿童学龄前女(雌)性人类男(雄)性中年人

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SPONTANEOUS REMODELING OF PERIPHERAL RETINAL VASCULATURE IN SICKLING DISORDERS

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AMERICAN JOURNAL OF OPHTHALMOLOGY 1975年第5期79卷 853-870页

作者： GALINOS, SO ASDOURIAN, GK WOOLF, MB STEVENS, TS LEE, CB GOLDBERG, MF CHOW, JCF BUSSE, BJ UNIV ILLINOIS EYE & EAR INFIRMSICKLE CELL EYE CLINCHICAGOIL 60612

Periodic photographic and angiographic surveys of patients with the earliest stages of sickle retinopathy showed a number of fundus findings. In seven cases (sickle cell anemia, four; sickle cell hemoglobin C, three), these findings included: a variety of vascular abnormalities in the equatorial and post equatorial retina such as segmented dilations of the vessel walls, hairpin shaped vascular loops, hypertrophic, tortuous A-V anastomoses, intraluminal plugs, closure and loss of capillary bed, and terminal budding of capillaries; and a continuous, spontaneous remodeling of the peripheral retinal vasculature due to successive closures and reopenings of equatorial retinal vessels. A centripetal recession of the peripheral retinal vasculature usually resulted. No correlation between the ophthalmoscopic and the systemic condition of the patients could be made.

关键词：贫血镰状细胞性/病理学荧光素血管造影术眼底血红蛋白C病/病理学检眼镜检查视网膜血管/病理学青少年成年人女(雌)性人类男(雄)性

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Management of submacular hemorrhage with intravitreous tissue plasminogen activator injection and pneumatic displacement

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OPHTHALMOLOGY 1999年第10期106卷 1900-1906页

作者： Hassan, AS Johnson, MW Schneiderman, TE Regillo, CD Tornambe, PE Poliner, LS Blodi, BA Elner, SG Univ Michigan WK Kellogg Eye Ctr Dept Ophthalmol Sch Med Ann Arbor MI 48105 USA Pacific Eye Care Poulsbo WA USA Wills Eye Hosp Retina Serv Philadelphia PA USA Retina Consultants San Diego CA USA Univ Wisconsin Dept Ophthalmol Madison WI 53706 USA

Objective: To investigate the efficacy and safety of treating thick submacular hemorrhages with intravitreous tissue plasminogen activator (tPA) and pneumatic displacement. Design: Retrospective, noncomparative case series. Participants: From 5 participating centers, 15 eligible patients had acute (<3 weeks) thick subretinal hemorrhage involving the center of the macula in eyes with pre-existing good visual acuity. Hemorrhages were secondary to age-related macular degeneration in 13 eyes and macroaneurysm and trauma in 1 eye each. Methods: The authors reviewed the medical records of 15 consecutive patients who received intravitreous injection of commercial tPA solution (25-100 mu g in 0.1-0.2 ml) and expansile gas (0.3-0.4 ml of perfluoropropane or sulfur hexafluoride) for thrombolysis and displacement of submacular hemorrhage. After surgery, patients maintained prone positioning for 1 to 5 days (typically, 24 hours). Main Outcome Measures: Degree of blood displacement from under the fovea, best postoperative visual acuity, final postoperative visual acuity, and surgical complications. Results: In 15 (100%) of 15 eyes, the procedure resulted in complete displacement of thick submacular hemorrhage out of the foveal area. Best postprocedure visual acuity improved by 2 lines or greater in 14 (93%) of 15 eyes. After a mean follow-up of 10.5 months (range, 4-19 months), final visual acuity improved by 2 lines or greater in 10 (67%) of 15 eyes and measured 20/80 or better in 6 (40%) of 15 eyes. Complications included breakthrough vitreous hemorrhage in three eyes and endophthalmitis in one eye. Four eyes developed recurrent hemorrhage 1 to 3 months after treatment, three of which were retreated with the same procedure. Conclusions: Intravitreous injection of tPA and gas followed by brief prone positioning is effective in displacing thick submacular blood and facilitating visual improvement in most patients. The rate of serious complications appears low. Final visual outco

关键词：动脉瘤/并发症眼损伤/并发症纤维蛋白溶解药/治疗应用氟碳化合物/治疗应用注射黄斑黄斑变性/并发症手术后并发症俯卧位视网膜出血/药物疗法视网膜出血/病因学视网膜血管/病理学回顾性研究硫六氟化物/治疗应用血栓溶解疗法组织型纤溶酶原激活物/治疗应用治疗结果视敏度玻璃体青少年成年人老年人老年人 80以上女(雌)性人类男(雄)性中年人

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Nystagmus mimicking spasmus nutans as the presenting sign of Bardet-Biedl syndrome

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AMERICAN JOURNAL OF OPHTHALMOLOGY 1999年第6期128卷 770-772页

作者： Gottlob, I Helbling, A Univ Leicester Leicester Royal Infirm Dept Ophthalmol Leicester LE2 7LX Leics England Kantonsspital Dept Strabismus & Neuroophthalmol CH-9007 St Gallen Switzerland

PURPOSE: To investigate the nystagmus of twin brothers presenting with spasmus nutans later diagnosed as Bardet-Biedl syndrome. METHODS: The twins presented at the age of 14 months with a presumed diagnosis of spasmus nutans, They were followed clinically and with quantitative electro-oculographic eye movement recordings until the age of 6 years. RESULTS: Polydactyly, truncal obesity, mild delay in cognitive development, visual acuity of 20/100, attenuated retinal vessels and pale disks, and bilaterally almost extinguished scotopic and photopic electroretinograms were found in both brothers. They had tine, fast, pendular, disconjugate, intermittent, oblique nystagmus. No head nodding was observed. CONCLUSION: As described in patients with other retinal diseases such as achromatopsia and congenital stationary night blindness, nystagmus of patients with Bardet-Biedl syndrome can mimic spasmus nutans. (C) 1999 by Elsevier Science Inc. All rights reserved.

关键词：巴德特-别德尔综合征/诊断认知障碍/诊断诊断鉴别双胎疾病眼电描记术眼球运动眼震病理性/诊断肥胖症/诊断多指(趾)畸形/诊断视网膜疾病/诊断视网膜血管/病理学痉挛婴儿/诊断视敏度人类婴儿男(雄)性

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Retinal vasculitis occurring with common variable immunodeficiency syndrome

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2000年第2期129卷 269-270页

作者： van Meurs, JC Lightman, S de Waard, PWT Baarsma, GS Rotterdam Eye Hosp NL-3011 BH Rotterdam Netherlands Moorfields Eye Hosp Inst Ophthalmol London England Erasmus Univ Dept Pediat Rotterdam Netherlands Univ Rotterdam Hosp Sophia Childrens Hosp Rotterdam Netherlands Erasmus Univ Dept Immunol & Internal Med 3 Rotterdam Netherlands

PURPOSE: To report severe retinal vasculitis causing decreased vision in three patients with the common variable immunodeficiency syndrome. METHOD: Case report. Three patients with common variable immunodeficiency syndrome developed decreased vision secondary to retinal vasculitis, Fluorescein angiography was performed in all three patients. Peribulbar injections were given in one patient, and two patients were treated with oral steroids and cyclosporin. RESULTS: All three patients were young and had classic common variable immunodeficiency syndrome. Bilateral retinal vasculitis and diffuse retinal edema were present in all three patients, and two patients had retinal neovascularization in the absence of ischemia. No evidence of intraocular infection was present, and none was detected systematically. Visual acuity decreased in five of the six eyes and was responsive to treatment in only one patient (both eyes). CONCLUSION: Retinal vasculitis may be another autoimmune manifestation of common variable immunodeficiency syndrome. (Am J Ophthalmol 2000;129:269-270. (C) 2000 by Elsevier Science Inc. All rights reserved.).

关键词：毛细血管通透性普通可变性免疫缺陷/并发症环孢菌素/治疗应用糖皮质激素类/治疗应用视网膜疾病/药物疗法视网膜疾病/病因学视网膜疾病/病理学视网膜新生血管化/药物疗法视网膜新生血管化/病因学视网膜新生血管化/病理学视网膜血管/病理学综合征血管炎/药物疗法血管炎/病因学血管炎/病理学视觉障碍/病因学视敏度儿童儿童学龄前女(雌)性人类男(雄)性

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Clinical variations and complications of coats disease in 150 cases: The 2000 Stanford Gifford Memorial Lecture

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2001年第5期131卷 561-571页

作者： Shields, JA Shields, CL Honavar, SG Demirci, H Thomas Jefferson Univ Wills Eye Hosp Oncol Serv Philadelphia PA 19107 USA

PURPOSE: The purpose of this report is to review the clinical variations and natural course of Coats disease, using strict diagnostic guidelines. METHODS: In a retrospective, consecutive series, Coats disease was defined as idiopathic retinal telangiectasia with intraretinal or subretinal exudation without appreciable signs of retinal or vitreal traction. We reviewed our experience with the clinical features, complications, and diagnostic approaches to Coats disease. RESULTS: In 150 consecutive patients (158 eyes), Coats disease was diagnosed at a median age of 5 years was restricted to the macular area in two eyes (1%);involved mainly the temporal fundus in 66 eyes (42%), inferior fundus in 41 eyes (26%), and more than one sector in 34 eyes (22%). Retinal exudation was present in all 12 clock hours in 86 eyes (55%) and six or more clock hours in 115 eyes (73%). There was a total retinal detachment in 74 eyes (47%) and neovascular glaucoma in 12 (8%). Retinal macrocysts were present in 18 eyes (11%), a vasoproliferative tumor in nine eyes (6%) and retinal neovascularization in four eyes (3%). Fluorescein angiography in 49 of the 158 eyes (37%) disclosed early hyperfluorescence of the telangiectasias and macular edema in 18 of eyes (37%). Ultrasonography typically showed a retinal detachment but no solid mass. CONCLUSIONS: Coats disease is a distinct clinical entity characterized by idiopathic retinal telangiectasia and retinal exudation. It is usually unilateral, occurs mostly in young males, and can cause severe visual loss resulting from exudative retinal detachment. The clinician should follow strict criteria in making the diagnosis, to avoid confusing Coats disease with other forms of exudative retinopathy. (C) 2001 by Elsevier Science Inc. All rights reserved.).

关键词：渗出液和滤出液荧光素血管造影术眼底青光眼新生血管性/诊断青光眼新生血管性/病因学视网膜脱离/病因学视网膜脱离/超声检查视网膜疾病/并发症视网膜疾病/诊断视网膜新生血管化/诊断视网膜新生血管化/病因学视网膜血管/病理学回顾性研究毛细血管扩张/并发症毛细血管扩张/诊断视觉障碍/诊断视觉障碍/病因学视敏度青少年成年人儿童儿童学龄前女(雌)性人类婴儿男(雄)性中年人

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Neutrophils in galactose-fed dogs: Suppressed apoptosis and increased adhesion to retinal capillary endothelial cells

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JOURNAL OF DIABETES AND ITS COMPLICATIONS 1999年第3期13卷 151-158页

作者： Ohta, N Tsai, JY Secchi, EF Kador, PF Sato, S NEI Lab Ocular Therapeut NIH Bethesda MD 20892 USA

Dogs fed a diet containing 30% galactose develop diabetes-like retinal capillary changes. As retinal capillary occlusion is commonly observed in diabetic retinopathy, neutrophil apoptosis and the interaction of neutrophils with retinal capillary endothelial cells were investigated. Neutrophils were isolated with Ficoll-Hypaque centrifugation from dogs fed a 30% galactose diet and dogs fed a normal, control diet containing 30% non-nutrient filler. Apoptosis of neutrophils was microscopically examined after incubation at 37 degrees C for 3 hours with either 100 U/mL tumor necrosis factor alpha (TNF-alpha), 2 mu g/mL cycloheximide or 50 ng/mL phorbol 12-myristate 13-acetate (PMA). Neutrophil adhesion to dog retinal capillary endothelial cells was examined by counting the cells attached to the surface of endothelial cells after the incubation in the presence of either 100 U/mL TNF-alpha or 5 mu g/mL lipopolysaccharides (LPS) at 37 degrees C for 3 hours. With all three stimulants TNF-alpha, cycloheximide and PMA, the rate of apoptosis was significantly lower for neutrophils isolated from galactose-fed dogs compared to control dogs fed a normal diet. Preincubation of neutrophils from control dogs in medium containing 30% galactose for 3 hours did not affect the rate of apoptosis. Neutrophil adhesion to retinal capillary endothelial cells induced by incubation in the presence of either 100 U/mL TNF-alpha or 5 mu g/ml LPS was significantly higher with neutrophils isolated from galactose-fed dogs than those from control dogs. The data indicate that long-term galactose feeding is essential with development of various neutrophil dysfunctions. These neutrophil changes may contribute to the development of retinal microangiopathy associated with diabetes and galactosemia. (C) 1999 Elsevier Science Inc.

关键词：细胞凋亡毛细血管/病理学细胞黏附放线菌酮/药理学 DNA碎片裂糖尿病实验性/化学诱导糖尿病实验性/病理学内皮血管/病理学酶激活/药物作用半乳糖中性白细胞/病理学蛋白激酶C/代谢蛋白质合成抑制药/药理学视网膜血管/病理学十四酰佛波乙酯/药理学肿瘤坏死因子α/药理学动物狗男(雄)性

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Acute annular outer retinopathy: Report of four cases

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2000年第5期130卷 636-644页

作者： Fekrat, S Wilkinson, CP Chang, B Yannuzzi, L Schatz, H Haller, JA Johns Hopkins Med Inst Wilmer Ophthalmol Inst Baltimore MD 21287 USA Duke Univ Med Ctr Ctr Eye Durham NC 27710 USA Greater Baltimore Med Ctr Dept Ophthalmol Baltimore MD USA Manhattan Eye Ear & Throat Hosp New York NY 10021 USA St Marys Hosp Retina Res Fund San Francisco CA USA

PURPOSE: To describe the clinical findings and course in four patients with acute annular outer retinopathy. METHODS: Four patients were evaluated during the course of acute annular outer retinopathy, and the historical and clinical findings were retrospectively collected. RESULTS: Four healthy patients developed the acute onset of visual field loss associated with a localized, white annular outer retinopathy, All patients were caucasian;two were women, aged 29 and 32 years, and two were men, aged 71 and 79 years. The mean follow-up was 3.9 years (range, 1 to 6 years). On presentation, four eyes had an irregular, incomplete, peripapillary, annular band of gray-white, deep retinal opacification with visual acuities that varied from 20/25 without foveal involvement to counting fingers with foveal involvement, Laboratory serologies were unremarkable. Two patients did not receive any treatment, and two received varying courses of oral corticosteroids with subjective improve ment, Of the four eyes, two eyes developed ophthalmoscopic sequelae, one eye did not, and one had evidence of retinal pigment epithelial damage and narrowing of the retinal vessels on presentation. CONCLUSIONS: These four cases of acute annular outer retinopathy expand our knowledge of this disorder. Acute annular outer retinopathy may be a distinct entity or it may represent a variant of acute zonal occult outer retinopathy. As more cases are recognized, the characteristic features of the disease spectrum, the etiology, and treatment options may be better elucidated. (C) 2000 by Elsevier Science Inc. All rights reserved.

关键词：急性病荧光素血管造影术眼底糖皮质激素类/治疗应用色素上皮眼/病理学视网膜疾病/并发症视网膜疾病/诊断视网膜疾病/药物疗法视网膜血管/病理学回顾性研究视觉障碍/并发症视觉障碍/诊断视觉障碍/药物疗法视敏度视野成年人老年人女(雌)性人类男(雄)性

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Ischemic maculopathy in patients with acquired immunodeficiency syndrome

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2001年第5期132卷 727-733页

作者： Cunningham, ET Levinson, RD Jampol, LM Engstrom, RE Lewis, H Holland, GN Univ Calif San Francisco Francis I Proctor Fdn Pearl & Samuel J Kimura Ocular Immunol Lab San Francisco CA 94143 USA Univ Calif San Francisco Dept Ophthalmol San Francisco CA 94143 USA Northwestern Univ Sch Med Dept Ophthalmol Chicago IL 60611 USA Jules Stein Eye Inst Ocular Inflammatory Dis Ctr Los Angeles CA 90024 USA Univ Calif Los Angeles Sch Med Dept Ophthalmol Los Angeles CA 90024 USA Cleveland Clin Fdn Div Ophthalmol Cleveland OH 44195 USA

PURPOSE: To describe the characteristics of ischemic maculopathy in patients with human immunodeficiency virus (HIV) infection, as a means of understanding this uncommon disorder more fully. METHODS: This is a multicenter, retrospective review of clinical data available for five HIV,infected patients who were given the diagnosis of ischemic maculopathy. RESULTS: All cases had been diagnosed on the basis of fluorescein angiograms obtained after patients complained of vision loss. Four of the five patients had bilateral macular disease. Visual acuity at presentation in the nine affected eyes ranged from 20/20 to count fingers. Vision loss was gradual in both eyes of one patient and was abrupt in onset in seven eyes. Each of the seven eyes with abrupt vision loss had opacification of the superficial retina and/or intraretinal hemorrhages near the fovea. Fluorescein angiography revealed enlargement of the foveal avascular zone and mild staining of the juxtafoveal vessels in affected eyes. Six eyes had active or clinically inactive cytomegalovirus retinitis at presentation, and a seventh eye developed cytomegalovirus retinitis 2 weeks later. All patients were receiving anticytomegalovirus drugs when they developed visual symptoms. Visual acuity remained stable in five eyes, became worse in two eyes, and improved in two eyes;final visual acuity ranged from 20/25 to count fingers. CONCLUSIONS: Ischemic maculopathy may cause profound and permanent vision loss in HIV-infected individuals. Fluorescein angiography should be considered in all HIV-infected patients with unexplained loss of vision. The pathogenesis of ischemic maculopathy remains unknown. (C) 2001 by Elsevier Science Inc. All rights reserved.

关键词：获得性免疫缺陷综合征/并发症获得性免疫缺陷综合征/药物疗法抗病毒药/治疗应用 CD4淋巴细胞计数巨细胞病毒视网膜炎/药物疗法巨细胞病毒视网膜炎/病因学荧光素血管造影术缺血/诊断缺血/病因学视网膜疾病/病因学视网膜出血/病因学视网膜血管/病理学回顾性研究视觉障碍/病因学视敏度成年人女(雌)性人类男(雄)性

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