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To report the clinical manifestations and results of carotid artery color Doppler imaging (CDI) of ocular ischemic syndrome (OIS).It was a retrospective case series study. Consecutive patients suspected with OIS were retrospectively studied from 1995 to 2009. We evaluated all patients with medical history, visual acuity, slit lamp, direct and indirect funduscopy, Fundus fluorescence angiography. CDI for internal carotid artery (ICA), Diagnostic Cerebral Angiography and magnetic resonance imaging were also performed.17 patients (20 eyes) with OIS were studied, 13 males and 4 females. The age range of patients was 46 to 83 years old (median 70). 13 right eyes and 7 left eyes (3 bilateral) were involved. (1) SYMPTOMS: 70.6% (12/17) of the patients complained of visual decrease. 17.6% (3/17) had history of repeated amaurosis fugax (transient monocular visual loss); 11.8% (2/17) patients presented with floaters. The course before the first presentation was 2 days to 6 years (median 3 months). (2) Visual Acuity (VA): among the 20 involved eyes, the best corrected VA0.05 in 3 eyes (15.0%); 0.05 to0.3 in 7 eyes (35.0%); 0.3 to0.7 in 7 eyes (35.0%); ≥ 0.7 in 3 eyes (15.0%). (3) Fundus manifestations: 15.0% (3/20) eyes had cotton-wool spots; 25.0% (5/20) had retinal hemorrhages; retinal arterioles and vein became narrow; venous beading could be seen in severe cases. 30.0% (6/20) had microaneurysms in mid-peripheral area. The pressure of central retinal artery decreased; 25.0% (5/20) had optic disc or retinal neovascularization; 10.0% (2/20) had iris neovascularization. 5.0% (1/20) had neovascular glaucoma; 5.0% (1/20) had optic atrophy. (4) Fundus fluorescence angiography: arm-retinal circulation time prolonged to 14.5 to 39.9 seconds, (median 20.9 seconds). The retinal and choroidal circulation time was also prolonged. The wall of artery and venous could be staining. Hyperfluorescence dots indicating microaneurysms could be seen in the mid-peripheral area. Arterio-venous shunts, non-perfusion area and the leakage of new vessels were observed in some cases. (5) Internal carotid artery CDI examination: The ipsilateral ICA of the 19 involved eyes (another patient with pulseless disease had abnormal subclavian arterial flow) showed completely occluded in 5 cases (26.4%),80.0% to 95.0% stenosis in 7 cases (36.8%), 52.0% to 80.0% stenosis in 7 cases (36.8%). Among the 14 contralateral eyes of the same group of patients, CDI showed stenosis of 80.0%, 70.0%, 60.0%, 50.0% and 40.0% in 5 eyes, whereas no fundus abnormal was found. Peak of systolic velocity (PSV): Among the 20 involved eyes of the 17 patients, PSV of the ipsilateral ICA was undetectable in 8 cases which occluded completely or stenosis severely. Among the ipsilateral ICA of the other 12 eyes, 11 cases showed abnormal PSV; PSV increased to 92 to 524 cm/s in 9 cases and decreased to 41 cm/s in 1 case. The blood flow of subclavian artery reduced to 20 cm/s in one patient with pulseless disease. The blood flow of subclavian artery reduced to 20 cm/s in one patient with pulseless disease.The patients with OIS are usually older than 60 years of age. It is a chronic disease with unnoticed symptoms. The clinical manifestations may include: amaurosis fugax (transient monocular visual loss), hypoperfusion retinopathy and ischemic optic neuropathy. Internal carotid artery severe stenosis or occlusion are the most frequent cause of this disease. CDI is the best safe, reliable and non-invaded method for carotid artery examination.

To study the morbidity rate of and relevance to coronary stenosis in cerebral infarction patients.CT coronary angiography was performed in 112 cases of cerebral infarction after CT cerebral angiography. Multivariate logistic regression analysis was carried out between the clinical data and coronary stenosis.In 112 cases receiving CT cerebral angiography, the morbidity rate of coronary stenosis was 46.4%. In 95 cerebral infarction patients, the morbidity rate of coronary stenosis was 51.6%. Multivariate logistic analysis showed that age, hypertension, hyperlipidemia, significant narrowing of cerebral artery were identified as independent predictors for coronary stenosis.Heart examination with 64 row CT should be routinely performed after cerebral angiography in cerebral infarction patients, especially in those with age greater than 65 years, hypertension, hyperlipidemia and significant narrowing of cerebral artery so as to detect coronary stenosis early.

To summarize the clinical characteristics of retinal arterial macroaneurysm and to improve the diagnosis accuracy in order to differentiate it from other fundus diseases.It was a retrospective case series.of fluorescein angiography or indocyanine angiography, associated with ultrasound, OCT and several other examinations were analyzed in 22 patients (22 eyes) with retinal arterial macroaneurysm.There were 6 men and 16 women in the 22 patients. The age of all the patients was from 54 to 82 years, and the mean age was 70 years. In the 22 patients, the patient with a single macroaneurysm was 19, and with two macroaneurysms was 3. All 22 patients were affected unilaterally. Macroaneurysms were found only in the temporal artery branches (16 eyes in superior branch and 6 eyes in inferior branch). All macroaneurysms were located in the branches graded 1 to 3. All patients showed pre-retinal hemorrhage and/or vitreous hemorrhage. Sixteen patients suffered from hypertension and five patients had diabetes mellitus. The patient with best corrected visual acuity0.05 was 10, 0.05 to 0.2 was 6, 0.3 to 0.6 was 5 andor = 0.7 was 1. All patients showed retinal arteriosclerosis. After the treatment, 11 patients were pursued,and the patient with best corrected visual acuity0.05 was 1, 0.05 to 0.2 was 4 andor = 0.7 was 1.Clinical features of retinal arterial macroaneurysm include focal dilation of retinal artery with hemorrhages and exudates, associated with retinal arteriosclerosis. These clinical characteristics can be used to differentiate retinal arterial macroaneurysm from other fundus diseases.

To examine the type of macular edema in patients with retinal vein occlusion by using optical coherence tomography (OCT). To compare the sensitivity and specificity between OCT and fundus fluorescein angiography (FFA). To investigate the visual prognosis and risk factors in patients with cystoid macular edema (CME).Ninety-one eyes of 90 patients with various types of retinal vein occlusion were examined by OCT and FFA. There were 54 cases male and 36 cases female. The age of these patients ranged from 20 to 74 years old and averaged (57.8 +/- 13.8) years old. Right eye was affected in 45 cases, and left eye in 46 cases (both eye in 1 case). Central retinal vein, hemicentral retinal vein and branch retinal vein were affected in 54, 9 and 28 eyes, respectively. The average follow-up period was 6.10 months. The sensitivity and specificity of OCT and FFA were measured. The visual prognosis and risk factors were analyzed. Macular central retinal thickness of 54 opposite normal eye was measured for comparison.(1) The classification of macular edema by OCT was cystoid macular edema in 71 eyes (78.0%); subretinal fluid in 14 eyes and laminar macular hole in 1 eye. The minimal and maximal height of intraretinal cystoid space was 94 microm and 1317 microm, respectively and averaged (668.18 +/- 245.58) microm. The minimal and maximal height of macular central retinal thickness of 54 opposite normal eye was 110 microm and 236 microm, respectively and averaged (154.09 +/- 21.85) microm. The maximal height of subretinal fluid space was 1377 microm or even beyond the detective limit of OCT. (2) The sensitivity of OCT for detection of CME was 98.6% and the specificity was 100%. The sensitivity of FFA was 86.1% and the specificity was 100.0%. (3) The visual prognosis of 61 eyes with CME follow-up over 3 months: The difference between the initial and final VA in branch retinal vein occlusion was statistically significant (P0.01), while no difference between initial and final VA in central and hemicentral retinal vein occlusion (P0.05). The factors affected visual prognosis of CME included the duration, the presence of hemorrhage in cystoid space and the severity of occlusion, etc. In CME under 3 months, the visual prognosis after therapy is better than that of before the therapy (P0.01); while in eyes with duration more than 3 months, no difference of vision could be detected before and after the therapy (P0.05).OCT is a safe, high-resolution, non-invasive, reliable and reproducible new examine method for detecting CME. The visual prognosis of CME is poor. It is possible that the visual prognosis can be improved by early detecting CME using OCT.