Possible Tcm Diagnosis

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Eye diagnosis of TCM and retinal image analysis technique

FC Duan Junguo

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Affiliated hospital of Chengdu

University of TCM

S

State clinical research site of TCM

Diagnostic Technique of TCM

FC

W observation

interrogation

auscultation and olfaction

palpation

M S

Syndrome Differentiation

TCM four diagnostic objectification and standardization

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Chinese medicine theory is "virtual"

FC

Four diagnostic information in the existing "instrument" of TCM detection (distortion) is easy to be ignored or deformation

M S

Existing in TCM diagnosis of four diagnostic objectification and standardization is hard to break

Tongue Diagnosis

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Existential issues in Tongue Diagnosis

FC

The observed results are susceptible to external influences

S

M food

Tooth brush

light

M

FC

W

Eye is the mirror of Zangfu and meridians and collaterals

Ophthalmologic sixchannel syndrome differentiation

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Five wheels syndrome differentiation

The eye is the external window of zang-fu organs and meridians

W FC

 Eye and zang-fu

“The vein, all belong to the eye” “liver opens at the eyes”。

 Eye and meridians

M

“The retina belong to the liver” “The macula belong to the spleen”

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Retinal image technology international status

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Eye image standardization research has become the important reference index in the study of international ophthalmology.

S

M

FC

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internal status of retinal image analysis technique

Fundus camera apparatuses become more popular

FC

retinal image analysis mainly depends on experience of doctors

There’s no internationally recognized standardized reading system

M

• misdiagnoses and the erroneous diagnosis are high • The Internationally recognized degrees of domestic relative

S

ophthalmologic clinical research is low

• Lack of relevant research of retinal image and systemic disease

Syndrome

Differentiation — the main character of TCM theory system syndrome differentiation pathological nature syndrome differentiation Zangfu Organ

FC

W

Eight principle

syndrome differentiation Triple burner syndrome differentiation

Defense , qi,construction, and blood

M

syndrome differentiation

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The main syndrome differentiation methods in TCM

The application of ophthalmic local syndrome differentiation in TCM

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Yin deficiency

FC

systemic symptoms

Qi stagnatio n

ophthalmic

Fundus manifesta tion

M

six-channel syndrome differentiation, etc.

Qi deficiency

S

…….

Extensive macroscopic reasoning

FC

W

Limitations of modern ophthalmic local syndrome differentiation

Nonquantitive,nonobjective

M S

Bad repeatability and extensibility

W

Eye diagnosis: Accord with development needs of TCM

TCM theories

Eye diagnosis

S

Tongue diagnosis

M

FC

The progress of diagnostic technique drives the breakthroughs of TCM theories

Establishment of eye diagnosis system

W

Theoretical direction TCM Eight principle syndrome differentiation

Fundus information

TCM syndrome information

Refer to the national standard enroll the textbook cases

relevance

结合脏腑辨证 六经辨证等

TCM Scales

M

FC

Retinal image analysis techniques

data mining

S

TCM eye diagnosis

Theoretical guidelines of TCM eye syndrome differentiation

W sydrome

six-channel Syndrome differentiation

M

FC

Organ Syndrome differentiation

Eight principle Syndrome differentiation

S

Sydrome as the core,eight principle syndrome differentiation is the basic program, combining with Organ, six-channel syndrome differentiation, integration of local and whole body for eye diagnosis and treatment.

Theoretical knowledge integration of TCM eye diagnosis

W FC

TCM ophthalmic theories

Eight principle syndrome differentiation Organ syndrome differentiation six-channel syndrome differentiation

Fundus reading analysis technology Standardized image acquisition Fundus image collection

syndrome

Relevant standards and scales

Standardized TCM syndrome TCM Symptom and sign Scale

S

Based on the workshop of prominent TCM doctors, syndrome as the core

M

knowledge integration

www.themegallery.com

Acquisition of typical TCM symptoms

W Yin deficiency

Yang deficiency

M

FC

Refer to TCM syptoms of national standard

Qi stagnation

Phlegm congeal

Blood stasis

。。。

S

Information acquisition of TCM symptoms and signs

W

Use the Scales to collect the typical TCM symptoms and signs

S

M

FC

Standardized image acquisition

M

FC

W Retinal image acquisition

Standardized location analysis of macular

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Standardized 7-field location analysis of fundus image

Application of relevant retinal analysis and evaluation technology

W

FC

Digital fundus reading techniques of foveal avascular zone area in diabetic retinal microangiopathy

Perifoveal capillary network in enlarged FAZ in FFA image

S

M

This technique improves the accuracy of primary FAZ section measurement methods from 18.13–55.07%to 66.67%-98.69%

Utilizing relevant retinal image analysis evaluation technique

W

S

M

FC

•Measurement of retinal vascular caliber in multiple cross sections

Utilizing relevant retinal image analysis evaluation technique

W

S

M

FC

•Measurement of retinal vascular tortuosity

Utilizing relevant retinal image analysis evaluation technique

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•Analysis of retinal tincture and pigment distribution

S

M

FC

Utilizing relevant retinal image analysis evaluation technique

W

•Retinal fractal dimension

S

M

FC

Utilizing relevant retinal image analysis evaluation technique

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Oxygen saturation measuring technique

S

M

FC The retinal oxygen saturation is determined though detecting reflection spectrum of incident lights in different wavelength

Data mining and analyzing

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analysis

FC

Factor analysis

Correlation

TCM syndrome factors

network analysis

correlation

M

S

Data mining

Retinal information : retinal tincture, haemodynamics, oxygen saturation and etc.

Possible TCM syndrome associated with related retinal changes

FC

W

Optic disk change

Retinal change

M

Macular change

S

Retinal changes

W Optic disk hyperaemia

Light optic disk

Optic disk edema

M

FC deficiency、 intermingled deficiency and excess

deficiency、stasis

S

Blood heat、 blood stasis

Possible TCM Syndromes

Retinal changes

FC

W • blood heat •spleen deficiency

exudate

• deficiency,such as water flood due to Yang deficiency

• excess heat

•excess,such as vein blood stasis

•Qi and blood stasis

S

•stasis

edema

M

haemorrhage

Possible TCM Syndromes

Retinal changes

M

FC

W chromatosis: deficiency

S

atrophy: deficiency organization: enrichment in superficiality

Possible TCM Syndromes

Changes of retinal vascular caliber

2

narrow vessel Qi and blood deficiency, Qi stagnation and blood stasis and etc.

M

FC

W

1

Angiectasis Qi stagnation, blood stasis and etc.

3

Angiemphraxis Blood stasis, Qi stagnation, Qi deficiency, excess heat, deficiency heat and etc.

S

Possible TCM Syndromes

Changes of macula lutea

FC

W Qi deficiency, blood stasis, Qi stagnation



Macular hemorrhage

• Macular

M

• Macular edema

Spleen deficiency、deficiency heat、excess heat and ect.

hyperpigmentation

Deficiency syndrome

S

Possible TCM Syndromes

Definitizing the TCM syndrome characteristics corresponding to fundus changes

W

information mining mathematical modelling

FC

Optic disk changes

exploring and definitizing the TCM syndrome characteristics corresponding to fundus fundus evaluation analysis changes

Work out modern HD image

Retinal changes

M

Macular changes

S

TCM ophthalmology diagnosis method and standard

M

FC

W S

Establish TCM ophthalmology diagnosis system

Application prospect of TCM ophthalmology dianosis system

W

Diagnosis

Treatment

• Reflecting physiological and pathological information of system • “Preventive treatment of disease”

• Remedying traditional tongue diagnosis • Enriching TCM diagnosis methods

• Guiding clinical treatment • Observing clinical effect

S

M

FC

Prognosis

Drive theoretical innovation of TCM

Prognostication of diseases

pathological state: observe disease course, make prognosis of disease

S

M

TCM ophthalmology diagnosis system

preventive treatment of disease

FC

W

physiological state: estimate patients’ habitus

Diagnosis of diseases

FC

W

Reflect microvascular condition directly

Remedy TCM diagnosis methods

M

Differentiate syndrome to guide treatment

S

Treatment of diseases

FC

W

Optic vessel stasis

retinal microangiopathy

Qi and blood in equilibrium

Qi and body fluid comsuption

S

M

FC

W THANK YOU!

S

M

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