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Eye diagnosis of TCM and retinal

image analysis technique
FC Duan Junguo
Affiliated hospital of Chengdu
M
University of TCM
State clinical research site of TCM
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 Diagnostic Technique of TCM
W
FC
observation interrogation auscultation and olfaction palpation

M
Syndrome S
Differentiation
 TCM four diagnostic
objectification and standardization
W
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
Existing in TCM diagnosis of four
diagnostic objectification and
S
standardization is hard to break
 Tongue Diagnosis
W
Existential issues in Tongue Diagnosis

FC The observed results are

susceptible to external
influences
M
food
S Tooth
brush
light
 Eye is the mirror of Zangfu and
meridians and collaterals
W
FC
M
Five wheels Ophthalmologic six-
syndrome
differentiation
S channel syndrome
differentiation
 The eye is the external window of
zang-fu organs and meridians
W
 Eye and zang-fu
FC
“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”
M
S
 Retinal image technology international status

W
Eye image standardization research has become the important
reference index in the study of international ophthalmology.
FC
M
S
 internal status of retinal
image analysis technique
W Fundus camera apparatuses become more popular

retinal image analysis mainly depends on experience of doctors

FC
There’s no internationally recognized standardized reading system

• misdiagnoses and the erroneous diagnosis are high

M
• The Internationally recognized degrees of domestic relative

ophthalmologic clinical research is low

S
• Lack of relevant research of retinal image and systemic disease
Syndrome Differentiation — the main character
of TCM theory system
W Eight principle
syndrome
differentiation
pathological nature
syndrome differentiation
FC Zangfu Organ
syndrome
differentiation
Triple burner
syndrome differentiation
Defense , qi,construction, and blood
syndrome differentiation
M
The main syndrome differentiation
S
methods in TCM
The application of ophthalmic local syndrome
differentiation in TCM
W Yin
deficiency

FC
systemic
symptoms

ophthalmic
six-channel
Qi
stagnatio
n

syndrome
differentiation,

Fundus
manifesta
tion
M etc. Qi
deficiency

…….
S
Limitations of modern ophthalmic local
syndrome differentiation
W Extensive macroscopic
reasoning
FC
Nonquantitive,nonobjective

M Bad repeatability and

extensibility
S
 Eye diagnosis: Accord with development
needs of TCM
W
The progress of diagnostic technique drives the
breakthroughs of TCM theories
FC
Tongue
M TCM Eye
diagnosis S
theories diagnosis
 Establishment of eye diagnosis system

W Retinal image
Theoretical direction

TCM Eight principle 结合脏腑辨证

analysis techniques syndrome differentiation 六经辨证等

Refer to the
national
standard
FC Fundus TCM syndrome
TCM
enroll the Scales
information information
textbook cases
relevance
Mdata mining

S
TCM eye diagnosis
Theoretical guidelines of TCM eye syndrome
differentiation
W Eight principle
Syndrome
Organ differentiation
six-channel
FCSyndrome
differentiation
Syndrome
differentiation

sydrome
M
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.
S
 Theoretical knowledge integration
of TCM eye diagnosis
W TCM ophthalmic Fundus reading analysis
theories technology

FC
Eight principle syndrome
differentiation
Organ syndrome
differentiation
six-channel syndrome
differentiation
Standardized image
acquisition
Fundus image collection

knowledge
integration
syndrome
Based on the
workshop of
prominent TCM
M Relevant standards and
scales
Standardized TCM syndrome
TCM Symptom and sign
Scale

doctors, syndrome as
the core S www.themegallery.com
 Acquisition of typical TCM symptoms

W Refer to TCM syptoms

of national standard
FC
Yin
deficiency
Yang
deficiency
M 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

FC
M
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 Standardized image acquisition

W
FC
Retinal image
acquisition
M Standardized location
analysis of macular

S
Standardized 7-field location analysis of fundus
image
Application of relevant retinal analysis and
evaluation technology
W Digital fundus reading
techniques of foveal
avascular zone area in
FC diabetic retinal
microangiopathy

This technique improves

M
Perifoveal capillary network
the accuracy of
primary FAZ section
measurement methods
in enlarged FAZ in FFA image
from 18.13–55.07%to
S
66.67%-98.69%
Utilizing relevant retinal image analysis
evaluation technique
W •Measurement of retinal
vascular caliber in multiple
FCcross sections

M
S
Utilizing relevant retinal image analysis
evaluation technique
W
•Measurement of retinal
FC
vascular tortuosity

M
S
 Utilizing relevant retinal image analysis
evaluation technique
W
•Analysis of retinal tincture
and pigment distribution
FC
M
S
Utilizing relevant retinal image analysis
evaluation technique
W •Retinal fractal dimension

FC
M
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 Utilizing relevant retinal image analysis
evaluation technique
W
Oxygen saturation
measuring technique

FC
M
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The retinal oxygen saturation is determined though detecting
reflection spectrum of incident lights in different wavelength
 Data mining and analyzing

W Correlation
Factor analysis
FC
analysis

network
TCM syndrome factors

analysis correlation

M Retinal information :
retinal tincture,
haemodynamics,
oxygen saturation
Data mining S
and etc.
Possible TCM syndrome associated with
related retinal changes
W Optic disk change

FC Retinal change

M Macular change

S
 Retinal changes

W
Optic disk
hyperaemia Light optic disk
Optic disk
edema

FC
Blood heat、
M
deficiency、 intermingled deficiency、stasis
blood stasis deficiency and excess
S
Possible TCM Syndromes
 Retinal changes

W
FC
haemorrhage edema
• blood heat
•spleen
deficiency
M • deficiency，such
as water flood due
to Yang deficiency
exudate
• excess heat
•Qi and blood
stasis
•stasis •excess，such as
S
vein blood stasis
Possible TCM Syndromes
 Retinal changes

W
FC
atrophy：
deficiency
organization：
M chromatosis：
deficiency

enrichment in
superficiality S
Possible TCM Syndromes
Changes of retinal vascular caliber

W Angiectasis
1 Qi stagnation, blood stasis and etc.
FC narrow vessel
2 Qi and blood deficiency, Qi stagnation
and blood stasis and etc.

M3
Angiemphraxis
Blood stasis, Qi stagnation, Qi deficiency,
excess heat, deficiency heat and etc.

S
Possible TCM Syndromes
 Changes of macula lutea

W
FC
• Macular edema • Macular hemorrhage • Macular
Qi deficiency, blood
stasis, Qi stagnation
MSpleen 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
Optic disk changes
FC
Retinal changes
Work out modern HD image
exploring and definitizing
the TCM syndrome
characteristics
corresponding to fundus
fundus evaluation analysis
changes

Macular changes
M TCM ophthalmology
diagnosis method and
standard
S
W
FC
M
Establish TCM ophthalmology diagnosis system
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Application prospect of TCM ophthalmology
dianosis system
W
Prognosis Diagnosis Treatment
FC
• Reflecting
physiological
and pathological
information of
• Remedying
traditional
tongue diagnosis
• Enriching TCM
• Guiding clinical
treatment
• Observing
clinical effect
system diagnosis
• “Preventive methods
treatment of
disease” M
S
Drive theoretical innovation of TCM
Prognostication of diseases

W physiological
state：
FC estimate

disease
treatment of
preventive
patients’
TCM habitus
ophthalmology
diagnosis pathological
system state：
M observe
disease course，
make
prognosis of
disease
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Diagnosis of diseases

W Reflect microvascular
condition directly

FC Remedy TCM diagnosis

methods

M Differentiate syndrome to
guide treatment

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 Treatment of diseases

W
Optic Qi and
vessel
stasis FC retinal
microangiopathy

Qi and blood in equilibrium

body fluid
comsuption

M
S
W
FC
THANK YOU!
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