W

Eye diagnosis of TCM and retinal

image analysis technique

FC
Duan Junguo

Affiliated hospital of Chengdu

University of TCM

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

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

Existential issues in Tongue Diagnosis

FC

The observed results are

susceptible to external
influences

M
food

Tooth
brush

light

FC

Eye is the mirror of Zangfu and

meridians and collaterals

Ophthalmologic sixchannel syndrome

differentiation

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

The retina belong to the liver The

macula belong to the spleen

Retinal image technology international status

Eye image standardization research has become the important

reference index in the study of international ophthalmology.

FC

internal status of retinal

image analysis technique

Fundus camera apparatuses become more popular

FC

retinal image analysis mainly depends on experience of doctors

Theres no internationally recognized standardized reading system

misdiagnoses and the erroneous diagnosis are high

The Internationally recognized degrees of domestic relative

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

Eight principle

syndrome
differentiation
Triple burner
syndrome differentiation

Defense , qi,construction, and blood

syndrome differentiation

The main syndrome differentiation

methods in TCM

The application of ophthalmic local syndrome

differentiation in TCM

Yin
deficiency

FC

systemic
symptoms

Qi
stagnatio
n

ophthalmic

Fundus
manifesta
tion

six-channel
syndrome
differentiation,
etc.

Qi
deficiency

Extensive macroscopic
reasoning

FC

Limitations of modern ophthalmic local

syndrome differentiation

Nonquantitive,nonobjective

M
S

Bad repeatability and

extensibility

Eye diagnosis: Accord with development

needs of TCM

TCM
theories

Eye
diagnosis

Tongue
diagnosis

FC

The progress of diagnostic technique drives the

breakthroughs of TCM theories

Establishment of eye diagnosis system

Theoretical direction
TCM Eight principle
syndrome differentiation

Fundus
information

TCM syndrome
information

Refer to the
national
standard
enroll the
textbook cases

relevance

TCM
Scales

FC

Retinal image
analysis techniques

data mining

TCM eye diagnosis

Theoretical guidelines of TCM eye syndrome

differentiation

W
sydrome

six-channel
Syndrome
differentiation

FC

Organ
Syndrome
differentiation

Eight principle
Syndrome
differentiation

Sydrome as the coreeight 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

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

knowledge
integration

www.themegallery.com

Acquisition of typical TCM symptoms

W
Yin
deficiency

Yang
deficiency

FC

Refer to TCM syptoms

of national standard

Qi
stagnation

Phlegm
congeal

Blood
stasis

Information acquisition of TCM

symptoms and signs

Use the Scales to collect the typical TCM symptoms and signs

FC

Standardized image acquisition

FC

W
Retinal image
acquisition

Standardized location
analysis of macular

Standardized 7-field location analysis of fundus

image

Application of relevant retinal analysis and

evaluation technology

FC

Digital fundus reading

techniques of foveal
avascular zone area in
diabetic retinal
microangiopathy

Perifoveal capillary network

in enlarged FAZ in FFA image

This technique improves

the accuracy of
primary FAZ section
measurement methods
from 18.1355.07%to
66.67%-98.69%

Utilizing relevant retinal image analysis

evaluation technique

FC

Measurement of retinal
vascular caliber in multiple
cross sections

Utilizing relevant retinal image analysis

evaluation technique

FC

Measurement of retinal
vascular tortuosity

Utilizing relevant retinal image analysis

evaluation technique

Analysis of retinal tincture

and pigment distribution

FC

Utilizing relevant retinal image analysis

evaluation technique

Retinal fractal dimension

FC

Utilizing relevant retinal image analysis

evaluation technique

Oxygen saturation
measuring technique

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

Data mining and analyzing

analysis

FC

Factor
analysis

Correlation

TCM syndrome factors

network
analysis

correlation

Data mining

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

Possible TCM syndrome associated with

related retinal changes

FC

Optic disk change

Retinal change

Macular change

Retinal changes

W
Optic disk
hyperaemia

Light optic disk

Optic disk
edema

FC
deficiency intermingled
deficiency and excess

deficiencystasis

Blood heat
blood stasis

Possible TCM Syndromes

Retinal changes

FC

W
blood heat
spleen
deficiency

exudate

deficiencysuch
as water flood due
to Yang deficiency

excess heat

excesssuch as
vein blood stasis

Qi and blood
stasis

stasis

edema

haemorrhage

Possible TCM Syndromes

Retinal changes

FC

W
chromatosis
deficiency

atrophy
deficiency
organization
enrichment in
superficiality

Possible TCM Syndromes

Changes of retinal vascular caliber

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

FC

Angiectasis
Qi stagnation, blood stasis and etc.

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

Possible TCM Syndromes

Changes of macula lutea

FC

W
Qi deficiency, blood
stasis, Qi stagnation

Macular hemorrhage

Macular

Macular edema

Spleen deficiencydeficiency
heatexcess heat and ect.

hyperpigmentation

Deficiency syndrome

Possible TCM Syndromes

Definitizing the TCM syndrome characteristics

corresponding to fundus changes

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

Macular changes

TCM ophthalmology
diagnosis method and
standard

FC

W
S

Establish TCM ophthalmology diagnosis system

Application prospect of TCM ophthalmology

dianosis system

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

FC

Prognosis

Drive theoretical innovation of TCM

Prognostication of diseases

pathological
state
observe
disease course
make
prognosis of
disease

TCM
ophthalmology
diagnosis
system

preventive
treatment of
disease

FC

physiological
state
estimate
patients
habitus

Diagnosis of diseases

FC

Reflect microvascular
condition directly

Remedy TCM diagnosis

methods

Differentiate syndrome to
guide treatment

Treatment of diseases

FC

Optic
vessel
stasis

retinal
microangiopathy

Qi and blood in equilibrium

Qi and
body fluid
comsuption

FC

W
THANK YOU!