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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
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State clinical research site of TCM
Diagnostic Technique of TCM
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W observation
interrogation
auscultation and olfaction
palpation
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Syndrome Differentiation
TCM four diagnostic objectification and standardization
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Chinese medicine theory is "virtual"
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Four diagnostic information in the existing "instrument" of TCM detection (distortion) is easy to be ignored or deformation
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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
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The observed results are susceptible to external influences
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M food
Tooth brush
light
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FC
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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
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Eye and zang-fu
“The vein, all belong to the eye” “liver opens at the eyes”。
Eye and meridians
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“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.
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FC
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internal status of retinal image analysis technique
Fundus camera apparatuses become more popular
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retinal image analysis mainly depends on experience of doctors
There’s no internationally recognized standardized reading system
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• misdiagnoses and the erroneous diagnosis are high • The Internationally recognized degrees of domestic relative
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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
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Eight principle
syndrome differentiation Triple burner syndrome differentiation
Defense , qi,construction, and blood
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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
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systemic symptoms
Qi stagnatio n
ophthalmic
Fundus manifesta tion
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six-channel syndrome differentiation, etc.
Qi deficiency
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…….
Extensive macroscopic reasoning
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Limitations of modern ophthalmic local syndrome differentiation
Nonquantitive,nonobjective
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Bad repeatability and extensibility
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Eye diagnosis: Accord with development needs of TCM
TCM theories
Eye diagnosis
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Tongue diagnosis
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The progress of diagnostic technique drives the breakthroughs of TCM theories
Establishment of eye diagnosis system
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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
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Retinal image analysis techniques
data mining
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TCM eye diagnosis
Theoretical guidelines of TCM eye syndrome differentiation
W sydrome
six-channel Syndrome differentiation
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Organ Syndrome differentiation
Eight principle Syndrome differentiation
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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
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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
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Based on the workshop of prominent TCM doctors, syndrome as the core
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knowledge integration
www.themegallery.com
Acquisition of typical TCM symptoms
W Yin deficiency
Yang deficiency
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Refer to TCM syptoms of national standard
Qi stagnation
Phlegm congeal
Blood stasis
。。。
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Information acquisition of TCM symptoms and signs
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Use the Scales to collect the typical TCM symptoms and signs
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Standardized image acquisition
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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
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FC
Digital fundus reading techniques of foveal avascular zone area in diabetic retinal microangiopathy
Perifoveal capillary network in enlarged FAZ in FFA image
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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
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•Measurement of retinal vascular caliber in multiple cross sections
Utilizing relevant retinal image analysis evaluation technique
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•Measurement of retinal vascular tortuosity
Utilizing relevant retinal image analysis evaluation technique
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•Analysis of retinal tincture and pigment distribution
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FC
Utilizing relevant retinal image analysis evaluation technique
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•Retinal fractal dimension
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FC
Utilizing relevant retinal image analysis evaluation technique
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Oxygen saturation measuring technique
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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
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Factor analysis
Correlation
TCM syndrome factors
network analysis
correlation
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Data mining
Retinal information : retinal tincture, haemodynamics, oxygen saturation and etc.
Possible TCM syndrome associated with related retinal changes
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Optic disk change
Retinal change
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Macular change
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Retinal changes
W Optic disk hyperaemia
Light optic disk
Optic disk edema
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FC deficiency、 intermingled deficiency and excess
deficiency、stasis
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Blood heat、 blood stasis
Possible TCM Syndromes
Retinal changes
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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
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•stasis
edema
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haemorrhage
Possible TCM Syndromes
Retinal changes
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W chromatosis: deficiency
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atrophy: deficiency organization: enrichment in superficiality
Possible TCM Syndromes
Changes of retinal vascular caliber
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narrow vessel Qi and blood deficiency, Qi stagnation and blood stasis and etc.
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FC
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Angiectasis Qi stagnation, blood stasis and etc.
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Angiemphraxis Blood stasis, Qi stagnation, Qi deficiency, excess heat, deficiency heat and etc.
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Possible TCM Syndromes
Changes of macula lutea
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W Qi deficiency, blood stasis, Qi stagnation
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Macular hemorrhage
• Macular
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• Macular edema
Spleen deficiency、deficiency heat、excess heat and ect.
hyperpigmentation
Deficiency syndrome
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Possible TCM Syndromes
Definitizing the TCM syndrome characteristics corresponding to fundus changes
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information mining mathematical modelling
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Optic disk changes
exploring and definitizing the TCM syndrome characteristics corresponding to fundus fundus evaluation analysis changes
Work out modern HD image
Retinal changes
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Macular changes
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TCM ophthalmology diagnosis method and standard
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FC
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Establish TCM ophthalmology diagnosis system
Application prospect of TCM ophthalmology dianosis system
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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
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Prognosis
Drive theoretical innovation of TCM
Prognostication of diseases
pathological state: observe disease course, make prognosis of disease
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TCM ophthalmology diagnosis system
preventive treatment of disease
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physiological state: estimate patients’ habitus
Diagnosis of diseases
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Reflect microvascular condition directly
Remedy TCM diagnosis methods
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Differentiate syndrome to guide treatment
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Treatment of diseases
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Optic vessel stasis
retinal microangiopathy
Qi and blood in equilibrium
Qi and body fluid comsuption
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FC
W THANK YOU!
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