Biomedical subjects

G A Lutty

Publications and source records attributed to G A Lutty.

At least 37 records · Page 2Linked to original sources

PubMed1998

Clinical and histopathologic features of canine oxygen-induced proliferative retinopathy.

PURPOSE: In previous studies the morphologic features of the acute vaso-obliterative and vasoproliferative stages of oxygen-induced retinopathy (OIR) were quantified and described in the dog model of retinopathy of prematurity (ROP). In the present study the sequelae of these events were examined using fluorescein angiography and histologic, enzyme, and immunohistochemical techniques. METHODS: Thirty newborn animals were exposed to 95% to 100% oxygen for 4 days and returned to room air until they were 22 to 45 days of age. Before death some animals were anesthetized, and fluorescein angiography was performed. Retina and vitreous from some animals were processed for adenosine diphosphatase (ADPase) flat-embedding. In other cases, eyes were prepared for full-thickness eyewall sectioning or frozen for histochemical analysis. RESULTS: Fluorescein angiography, funduscopic examination, and ADPase preparations showed dilated and tortuous retinal vessels, pigmentary changes, incomplete vascularization of peripheral retina, vitreous hemorrhage, and persistence of massive intravitreal neovascularization. Full-thickness eyewall sections showed tractional retinal folds, tented intravitreal vascularized membranes, and vitreous synchysis. Immunohistochemical analysis showed inner retinal astrogliosis. Enzyme histochemistry showed high alpha glycerophosphate dehydrogenase activity in poorly differentiated neovascular formations and low activity in formations with mature pericytes and endothelial cells. CONCLUSIONS: End-stage OIR in the neonatal dog shares many features with the chronic human disease. These results provide additional support for the use of this model in experimental studies of ROP.

Animals↗

PubMed1997

Histopathologic features of neovascularization in sickle cell retinopathy.

PURPOSE: To examine the histopathologic and morphometric features of neovascular lesions in human proliferative sickle cell retinopathy. METHODS: Postmortem ocular tissue was obtained from three subjects (aged 20, 28, and 40 years) with SS hemoglobinopathy and prepared for adenosine diphosphatase flat-embedding. Morphometric analysis was performed before serial sectioning. RESULTS: Numerous active and autoinfarcted lesions were found that represented virtually all stages in the life cycle of preretinal neovascularization. These formations ranged from single small loops extending from arteries and veins along the retinal surface to the typical complex, elevated sea fan formations. Sea fans developed at hairpin loops and at arteriovenous crossings. There was an average of 5.6 connections between sea fans and retinal vessels; of these, 45% were arteriolar, 52.5% were venular, and 2.6% were at the capillary level. Six of eight sea fans were located at arteriovenous crossings. Autoinfarction appeared to occur initially within the sea fan capillaries. The average height of sea fans was 123 microns above the retinal surface. CONCLUSIONS: Preretinal neovascularization in sickle cell retinopathy can arise from both the arterial and venous sides of the retinal vasculature and can assume a variety of morphologic configurations. Multiple feeding arterioles and draining venules are common, and autoinfarction appears to occur initially at the preretinal capillary level rather than at feeding arterioles. Arteriovenous crossings may be a preferential site for sea fan development.

Adult↗

PubMed1997

Intrachoroidal microvascular abnormality: a previously unrecognized form of choroidal neovascularization.

PURPOSE: To evaluate the histopathologic and histochemical characteristics of intrachoroidal microvascular abnormality. METHODS: Forty eyes obtained at autopsy from human donors ranging in age from 20 to 91 years (25 diabetics, 15 nondiabetics) were analyzed. Choroids were processed for alkaline phosphatase flat-embedding. Vascular patterns were examined and analyzed before embedding and serial sectioning. RESULTS: Intrachoroidal microvascular abnormality had the most prominent alkaline phosphatase reaction product of choroidal vessels. These formations appeared as ameboid or cobweb-like vascular networks (area, 0.05 to 4.6 mm2) in the choroidal stroma external to the choriocapillaris. They appeared as both single or groups of formations in the posterior pole and equatorial regions in all subjects. Intrachoroidal microvascular abnormality was found in five subjects with diabetes: four with type I diabetes mellitus, and one with type II diabetes mellitus. One subject had proliferative diabetic retinopathy, three had background retinopathy, and one had no retinopathy. Intrachoroidal microvascular abnormality was connected with all levels of choroidal vasculature. Microaneurysms were observed within intrachoroidal microvascular abnormality formations in most subjects but not in other choroidal vessels. CONCLUSIONS: Intrachoroidal microvascular abnormality is a form of intrachoroidal neovascularization. This neovascularization has features similar to intraretinal microvascular abnormalities found in diabetic subjects but seems to form independently of the status of retinopathy. The presence of microaneurysms in intrachoroidal microvascular abnormalities and not other choroidal vessels supports the view that aneurysms may be aborted attempts at neovascularization.

Adult↗

PubMed1997

Relationship of polymorphonuclear leukocytes to capillary dropout in the human diabetic choroid.

Capillary dropout is an initial event in diabetic retinopathy, but the etiology is unknown. Recent evidence suggests that similar events may occur in the diabetic choroid. We have developed a method to evaluate the relationship between the polymorphonuclear leukocytes (PMNs) and capillary dropout in the human diabetic choroid using alkaline phosphatase (APase) histochemistry to label blood vessels and nonspecific esterase activity to identify PMNs. The number and distribution of PMNs in diabetic and nondiabetic choroidal capillaries (choriocapillaris) were analyzed in the flat perspective and the tissue then flat embedded in glycol methacrylate for histological sectioning. The total number of PMNs was increased within the choriocapillaris in five diabetic eyes (170.9 +/- 12.9 PMNs/mm2 of choroid) compared with five nondiabetic eyes (84.2 +/- 16.9 PMNs/mm2; P < 0.001). PMNs were almost always within blood vessel lumens and not in interstitial tissue. In the diabetic choroid, increased numbers of PMNs were present in areas of choriocapillaris with pathological changes (loss in APase activity and choroidal neovascularization) compared with nonpathological choriocapillaris (205.1 +/- 46.9 PMNs/mm2 in pathological versus 152.3 +/- 23.4 PMNs/mm2 in nonpathological areas; P < 0.001). PMNs were often queued up within the lumens of capillaries, demonstrating loss in APase activity. We have observed an increased number of PMNs in diabetic choroid compared with control nondiabetic choroids, and PMNs in diabetic choroid were associated with loss in APase activity, which was related to loss in viable endothelial cells. The results suggest that PMNs contribute to vaso-occlusive processes and endothelial cell injury in the diabetic choroid.

Aged↗

PubMed1997

Vascular endothelial growth factor and vascular permeability changes in human diabetic retinopathy.

PURPOSE: The authors used histochemical analysis to determine whether increased vascular endothelial growth factor (VEGF) immunoreactivity in diabetic retinal vessels is related to increased vascular permeability, as indicated by human serum albumin (HSA) immunostaining, or to presumed retinal hypoxia as demonstrated by decreased vascularity. A correlation between VEGF and HSA in cryosections with angiopathic changes in the adenosine diphosphatase (ADPase) flat-embedded fellow retinas was sought. Because VEGF is a heparin-binding protein, the relation between VEGF and heparan sulfate proteoglycan (HSPG) immunoreactivities was also investigated. METHODS: Cryopreserved eyes from 18 diabetic and 9 nondiabetic subjects removed after death were sectioned and immunohistochemical analysis was performed with antibodies against VEGF, HSA, HSPG, vWf (von Willebrand factor), and collagen IV. The fellow retinas were prepared by our ADPase flat-embedding technique to determine the degree of diabetic retinopathy. The number of positive vessels for each antibody and antibody localizations were determined by light microscopy. RESULTS: The average number of VEGF-stained vessels in diabetic retinas was significantly higher than in nondiabetic retinas (P = 0.04). In diabetic retinas, there was a positive correlation between the distribution of VEGF-positive vessels and the distribution of HSA- and HSPG-positive vessels. No such correlation was observed in nondiabetic eyes. In many cases, HSPG immunoreactivity appeared colocalized with VEGF immunoreactivity, suggesting VEGF binding to HSPG. The comparison with the ADPase flat-embedded fellow retinas suggested that increased VEGF immunoreactivity and vascular permeability may occur before morphologic changes in the vasculature. CONCLUSIONS: Vascular endothelial growth factor immunoreactivity was correlated with increased vascular permeability to macromolecules and appears to be increased in diabetic subjects before the onset of retinopathy.

Adult↗

PubMed1996

Localization of vascular endothelial growth factor in human retina and choroid.

OBJECTIVE: To examine the distribution and relative levels of vascular endothelial growth factor (VEGF) in the nondiabetic and preproliferative diabetic human retina and choroid. METHODS: Immunohistochemical localization was performed on frozen sections from cryopreserved postmortem human tissue using a polyclonal antibody against VEGF and a streptavidin peroxidase system. Eyes from 5 subjects without diabetes and 8 subjects with diabetes were examined and analyzed using a 7-point immunohistochemical grading system. RESULTS: In subjects without diabetes, weak or no VEGF immunoreactivity was associated with retinal blood vessels. In subjects with diabetes, we found significantly increased immunoreactivity in the retinal vascular endothelium and blood vessel walls. Vascular endothelial growth factor immunoreactivity was also associated with intravascular leukocytes in subjects with and without diabetes. In the choroid of subjects without diabetes, immunoreactivity was almost exclusively associated with intravascular leukocytes, whereas in diabetic subjects, immunoreactivity was localized within choriocapillaris endothelium, choroidal neovascular endothelium, and migrating retinal pigment epithelium cells. CONCLUSIONS: The observed increase in VEGF immunoreactivity in the diabetic retina and choroid suggests that VEGF may contribute to 2 well-documented events during retinopathy: increased vascular permeability and angiogenesis.

Adult↗

PubMed1996

A rat model for sickle cell-mediated vaso-occlusion in retina.

Occlusions of the retinal vasculature are the initiating event in sickle cell retinopathy. In order to understand the mechanism(s) of sickle cell-mediated occlusion, a rat model was developed. Red blood cells (RBCs) from patients homozygous for hemoglobin (Hb) S (SS) or double heterozygous for Hb S and Hb C (SC) were separated on Percoll-Larex continuous density gradients, labeled with fluorescein isothiocyanate (FITC), and delivered via the left ventricle to anesthetized, ventilated rats. Blood gas levels were altered by changing inspired gas and monitored via a femoral arterial catheter. After the RBCs circulated for 5 min, animals were perfused with heparinized saline, the eyes enucleated, and the retinas removed and processed by our ADPase flatmount technique. The retinal vasculature was visualized under dark-field illumination and the FITC-RBCs visualized by fluorescence microscopy. Greater numbers of high-density SS cells (SS4, which consist of dense, dehydrated discocytes and irreversible sickled cells) were retained in the normal rat retinal vasculature than normal-density SS cells (SS2, which have the same density as normal AA cells, but consist of reticulocytes and young cells). Retention of SS4 cells was inversely dependent on the arterial oxygen tension. Most SS4s were retained in capillaries, but a few were observed within precapillary arterioles. The retained RBCs occupied the full lumenal diameter of vessels in most cases. In contrast, very few RBCs from SC donors (normal or high density) were retained in the normal retinal vasculature and retention did not increase significantly with hypoxia. This model demonstrates that high-density SS cells, which include irreversibly sickled cells, are retained in normal rat retinal vessels and that the number retained is oxygen dependent. Furthermore, it appears that trapping, not adhesion, is responsible for retention of RBCs in the normal retinal vasculature because there was preferential retention of SS4 cells, which are known to have lower adherence propensity, and the retained RBCs blocked the full diameter of the vessel. These results also demonstrate that the mechanism of vascular obstruction by SS and SC RBCs is different because low retention of SC cells was observed. The well-known propensity of SC patients to have retinal abnormalities must involve extraerythrocytic factors like increased hematocrit, induction of adhesive molecules and integrins, etc.

Anemia, Sickle Cell↗

PubMed1996

Vaso-obliteration in the canine model of oxygen-induced retinopathy.

PURPOSE: To quantify the acute constrictive response of developing retinal blood vessels to hyperoxia and to examine the vaso-obliterative phase of sustained oxygen breathing in the neonatal dog model of retinopathy of prematurity. METHODS: Seven littermates were used to examine the acute constrictive response of the developing retinal vessels to hyperoxia (30 minutes to 96 hours of 100% oxygen). ADPase retinal flatmounts were prepared, and morphometric measurements were made using computer-assisted analysis. Vaso-obliteration also was examined in three animals killed after prolonged exposure to hyperoxia (4 days of 100% oxygen) and in three room air controls using ADPase flat-embedded retinas and cross-sections. Choroids were processed for alkaline phosphatase flat-embedding. RESULTS: After 1 hour of oxygen breathing, all vascular components showed a reduction in diameter: Arteries were reduced 27%, veins 18.3%, and capillaries 27.7%. Capillary constriction peaked by 24 hours (69.4% reduction), whereas arteries and veins continued to close. Although capillary diameters did not decrease significantly after 24 hours, the number of capillaries, as determined by percent vascular area calculations, continued to decrease in all areas through the additional 3 days of oxygen breathing. In contrast, after 4 days of hyperoxia the choriocapillaris lumenal diameters and percent vascular area did not vary significantly from controls. Analysis of sections taken through various retinal regions of these animals revealed significant decreases (40%) in the volume of the extracellular spaces available for blood vessel formation. Hyperoxia also reduced in a 55.6% decrease in the total number of cells (endothelial cells, ablumenal cells, perivascular cells) within the inner retina; however, there was no significant difference in ganglion cell counts in the two groups. CONCLUSIONS: This study demonstrates that the pattern and severity of the reaction of developing retinal vessels to hyperoxia in the newborn dog is similar to that described for the kitten and the premature human. This response is unlike that exhibited by the newborn rat or mouse.

Animals↗

PubMed1996

Vasoproliferation in the neonatal dog model of oxygen-induced retinopathy.

PURPOSE: To examine the time course and relative degree of proliferative response associated with revascularization after hyperoxic insult in the dog model of oxygen-induced retinopathy. METHODS: Mitotic cell profiles (MCPs) were counted in serial cross-sections of ADPase flat-embedded retinas of air-reared control 8-, 15-, and 22-day-old dogs and of age-matched oxygen treated animals (4 days, 100% oxygen) after return to normoxia. Sectioning and analysis were performed along the radial axis of the forming primary vasculature from optic nerve head to periphery. RESULTS: In air-reared control animals, lumenal-associated cell mitosis was low, with an average of 9.6 MCPs/mm2 of nerve fiber layer tissue in the 8-day-old dogs, 6.5 MCPs/mm2 in the 15-day-old dogs, and 8.4 MCPs/mm2 in the 22-day-old dogs. In oxygen-treated animals, however, the number of lumenal-associated MCPs was significantly higher, with an average of 52.5 MCPs/mm2 of tissue in the 8-day-old dogs, 45.1 MCPs/mm2 in the 15-day-old dogs, and 26.8 MCPs/mm2 in the 22-day-old dogs. Additionally, extracellular spaces in avascular retina were obliterated in oxygen-treated animals. CONCLUSIONS: This study demonstrates that in the neonatal dog, revascularization after hyperoxic insult involves a period of marked vasoproliferation that peaks somewhere between 3 to 10 days after return to room air. Oxygen-induced changes in the extravascular milieu are likely to affect the pattern of reforming vasculature and may restrict growth anteriorly.

Aging↗

PubMed1995

Menadione-dependent alpha glycerophosphate and succinate dehydrogenases in the developing canine retina.

Reducing equivalents for the electron transport chain are generated within the mitochondria by the Krebs cycle and in cytoplasm by processes like lipid metabolism. Two mitochondrial enzymes, succinate dehydrogenase (SDH), a prominent enzyme in the Krebs cycle, and alpha-glycerophosphate dehydrogenase (alpha-GPDH), half of the glycerophosphate shuttle system for bringing reducing equivalents from cytoplasm to mitochondria, were examined enzyme histochemically to assess the contribution of each to metabolism of the developing canine retina. SDH activity, a common marker for oxidative metabolism, was insignificant at birth. By 4 days of age, activity was observed only in developing photoreceptor inner segments. By 21 days of age SDH activity was present throughout the retina, especially in photoreceptor inner segments and plexiform layers, and approached the level observed in the adult dog. Menadione-linked alpha-GPDH (M-alpha-GPDH) activity, however, was prominent in developing vasculature and outermost portion of the neuroblastic layer of the 1 day-old retina. Most notable was localization in vascular precursors, angioblasts, found distant from formed vessels in the peripheral nerve fiber layer. Retinal dependence on an oxidative metabolism in neuronal elements, as represented by SDH activity, occurs only when the vasculature is well established.

Aging↗

PubMed1995

Enhanced expression of intracellular adhesion molecule-1 and P-selectin in the diabetic human retina and choroid.

Elevated expression of intercellular adhesion molecule-1 (ICAM-1) as well as E- and P-selectin occurs on the vascular endothelium in a number of disease states and is thought to play an early critical role in the adhesion of circulating leukocytes to the endothelium. The goal of the present study was to investigate the immunolocalization of these molecules in the retina and choroid of postmortem human tissue sections from nondiabetic and diabetic subjects. Whereas ICAM-1 was localized primarily within the choriocapillaris of nondiabetic subjects, immunoreactivity in diabetics was significantly elevated throughout the choroidal vasculature and within retinal blood vessels (P < 0.05). In the choroid, P-selectin was most prominent in veins of the nondiabetic, whereas in diabetics, P-selectin was significantly elevated in arteries (P < 0.001) and veins (P < 0.05) and, in some cases, was also observed in choriocapillaris. P-selectin immunoreactivity was not observed in the retina of any subject. E-selectin immunoreactivity was not observed in choroid or retina in any subjects. Neutrophil numbers per square millimeter of tissue were significantly elevated in diabetic choroid (P < 0.05) and retina (P < 0.001). Our results demonstrate that ICAM-1 and P-selectin are constitutively expressed in the normal choroid and are upregulated in the choroidal vasculature in diabetes, but only ICAM-1 was upregulated in the retina of diabetic subjects. Increased cell adhesion molecule expression may contribute to the retinal and choroidal microangiopathy observed in diabetics by enhancing leukocyte adhesion and consequently the incidence of capillary obstruction and endothelial cell injury.

Adult↗

PubMed1994

Determination of the mechanism of free radical generation in human aortic endothelial cells exposed to anoxia and reoxygenation.

Endothelial cell-derived oxygen free radicals are important mediators of postischemic injury; however, the mechanisms that trigger this radical generation are not known, and it is not known if this process can occur in human cells and tissues. The enzyme xanthine oxidase can be an important source of radical generation; however, it has been reported that this enzyme may not be present in human endothelium. To determine the presence and mechanisms of radical generation in human vascular endothelial cells subjected to anoxia and reoxygenation, electron paramagnetic resonance measurements were performed on cultured human aortic endothelial cells using the spin trap 5,5-dimethyl-1-pyrroline N-oxide (DMPO). These measurements were correlated with cellular injury, xanthine oxidase activity, and alterations in cellular nucleotides. Upon reoxygenation after 60 min of anoxia, large DMPO-OH (aN = aH = 14.9 G) and smaller DMPO-R (aN = 15.8 G, aH = 22.8 G) signals were seen. Superoxide dismutase totally quenched this radical generation. The ferric iron chelator deferoxamine prevented cell death and totally quenched the DMPO-R signal with a 40% decrease in the DMPO-OH signal. Xanthine oxidase was shown to be present in these cells and to be the primary source of free radicals. While the concentration of this enzyme did not change after anoxia, the concentration of its substrate, hypoxanthine, markedly increased, resulting in increased free radical generation upon reoxygenation. Thus, reoxygenated human vascular endothelial cells generate superoxide free radicals, which further react with iron to form the reactive hydroxyl radical, which in turn causes cell death. Xanthine oxidase was the primary source of radical generation with this process triggered by the breakdown of ATP to the substrate hypoxanthine during anoxia.

Aorta↗

PubMed1994

Measurement and characterization of free radical generation in reoxygenated human endothelial cells.

The endothelial cell is thought to be an important site of free radical generation in ischemic tissues. It has been demonstrated that endothelial cells from several species generate a burst of free radical generation upon reoxygenation; however, it has been suggested that human endothelial cells are not similarly capable of generating free radicals on reoxygenation. In view of the central importance of revascularization with accompanying reoxygenation in the clinical treatment of tissue ischemia/infarction, we have performed studies to determine the presence, mechanism, and kinetics of free radical generation in human endothelial cells. Therefore, we subjected cultured human umbilical vein endothelial cells to anoxia followed by reoxygenation. Cell suspensions of 10(7) cells/ml were subjected to varying periods of anoxia and reoxygenation. On reoxygenation with addition of a 50 mM concentration of the spin trap 5,5-dimethyl-1-pyrroline-N-oxide (DMPO), after 90 min of anoxia an electron paramagnetic resonance (EPR) signal was observed consisting of 2 components: a quartet 1:2:2:1 DMPO-OH signal, aN = aH = 14.9 G, and a six-peaked DMPO-R signal, aN = 15.6 G aH = 22.9 G, whereas cells in air gave no signal. The observed signal was quenched by superoxide dismutase (SOD) or catalase. Deferoxamine decreased the measured radical signals by 40%. Cyclooxygenase blockers did not decrease radical generation, but the xanthine oxidase blocker oxypurinol did decrease radical generation by 60%.

Animals↗

PubMed1994

Immunohistochemical insights into sickle cell retinopathy.

Dynamic vaso-occlusive and vaso-proliferative events occur in sickle cell retinopathy. Using streptavidin peroxidase immunohistochemistry, we investigated changes in distribution and relative levels of components in the fibrinolytic system and growth factors in retina and choroid from 2 sickle cell patients: a 20 month old SS patient and a 54 year old SC patient. Antigen localization in the sickle cell patients was compared to localization from 2 non-sickle cell, non-diabetic control subjects. In the fibrinolytic system, tissue plasminogen activator (tPA) localization and immunoreactivity were comparable in all eyes, but plasminogen activator inhibitor-1 (PAI-1) immunoreactivity was elevated within the walls of retinal vessels in the sickle cell tissue. Immunoreactive fibrin was often observed within the lumen of retinal and choroidal vessels and in choroidal neo-vascularization (CNV) in sickle cell subjects. Blood vessels containing fibrin generally exhibited elevated PAI-1 immunoreactivity. Von Willebrand's factor (vWf) and basic fibroblast growth factor (bFGF) immunoreactivity in sickle cell patients were elevated in choriocapillaris and the walls of some retinal vessels. Transforming growth factor-beta 1 (TGF-beta 1) immunoreactivity was significantly lower in sickle cell choriocapillaris than in controls. In chorioretinal pigmented lesions of the SC patient, bFGF and TGF-beta 1, beta 2, and beta 3 immunoreactivity was present within migrating retinal pigment epithelial (RPE) cells. Our interpretation of the data presented in this case study is that fibrin deposition within retinal and choroidal vessels of sickle cell subjects may occur due to elevated PAI-1 activity. Moreover, vaso-occlusions of choroidal vessels may influence the expression of growth factors in choriocapillaris endothelium, which could stimulate formation of choroidal neovascularization. Finally, fibrosis and gliosis in and near chorioretinal pigmented lesions may be stimulated by RPE production of bFGF and TGF-beta's.

Aged↗

PubMed1994

Retinal and choroidal neovascularization in a transgenic mouse model of sickle cell disease.

A complication of sickle cell disease is proliferative retinopathy. We investigated the eyes from a transgenic mouse model of sickle cell disease (alpha H beta S[beta MDD] type) to determine if pathological changes occurred in their retinas and choroids. One retina from each animal was processed by flat-embedding adenosine diphosphatase-reacted retinas in glycol methacrylate. The fellow eye from each animal was embedded whole in glycol methacrylate for histopathological analysis of all ocular structures. Retinal vascular occlusions resulted in nonperfused areas of retina and arterio-venous anastomoses. Intra- and extraretinal neovascularization was observed adjacent to nonperfused areas. Retinal pigmented lesions were formed by the migration of retinal pigment epithelial cells into sensory retina, often ensheathing choroidal neovascularization. The incidence of this bilateral chorioretinopathy was 30% in animals older than 15 months of age. The ocular histopathological changes we observed in the mouse model mimicked many aspects of human proliferative sickle cell retinopathy. Furthermore, this is the first genetically derived animal model for chorio-retinal neovascularization.

Anemia, Sickle Cell↗

PubMed1994

High-resolution histologic analysis of the human choroidal vasculature.

PURPOSE: To develop a high-resolution histologic technique to study the postmortem human choroidal vasculature in dual perspective: vascular pattern in the flat perspective and structure in cross sections. METHODS: Fresh whole human choroids were denuded of retinal pigment epithelium, fixed, incubated for enzyme histochemical demonstration of alkaline phosphatase (APase) activity, bleached with hydrogen peroxide, and flat-embedded in glycol methacrylate. Vascular patterns were examined and documented en bloc, and subsequent serial sectioning was performed through specific sites of interest. RESULTS: APase staining provided excellent visualization of the entire choroidal vasculature en bloc. Reaction product was generally more prominent in the choriocapillaris and collecting venules than in veins or arterioles, whereas arteries had the least activity. Diminished activity within focal regions of the choriocapillaris was observed in the far periphery of most aged subjects and was related to loss of endothelium and capillary atrophy. Hard drusen were generally observed in clusters located near collecting venules and appeared unrelated to any underlying angiopathy, whereas basal linear and laminar deposits were most often associated with regions of capillary dropout. Choroids from patients with diabetes demonstrated angiopathic changes consisting of extensive capillary dropout, beaded capillaries, neovascularization, and Bruch's membrane degeneration. CONCLUSIONS: The benefits afforded by this method of analysis are that choroidal vasculature can be visualized in the native state and that nonvascular structures are retained for simultaneous analysis with vascular pattern and blood vessel structure.

Adolescent↗

PubMed1993

Dual-perspective analysis of vascular formations in sickle cell retinopathy.

OBJECTIVE: To examine the sickle cell retina in dual perspective (vascular patterns en bloc and structure in serial sections) to gain new insights into sickle cell retinopathy. METHODS: We analyzed the retinas of two patients with sickle cell disease (a 54-year-old patient with hemoglobin SC, heterozygous for the S and C mutation in the beta chain of the globin gene, and a 20-month-old patient with sickle cell anemia [SS], homozygous for the S mutation) using the previously described adenosine diphosphatase flat-embedding technique. RESULTS: The dual-perspective analysis afforded by our technique revealed that the primary site of occlusions was located at the precapillary level. An unusual neovascular formation, the hairpin loop, was observed in both patients' retinas and appeared to result from recanalization of the wall of an occluded vessel. Many autoinfarcted pre-retinal neovascular formations were observed in the older SC patient. Two patent preretinal formations were studied in detail and their evolution appeared to be influenced by mechanical factors. The vessels appeared to have been extruded from the retina, perhaps owing to hydrostatic pressure secondary to downstream occlusions. Small pigmented lesions consisting of retinal pigment epithelial cells ensheathing channels that resembled autoinfarcted vessels were found in the eye of the SC patient. CONCLUSIONS: This study illustrates unusual morphological features of intraretinal and preretinal neovascularization and of chorioretinal lesions in sickle cell retinopathy and suggests alternative mechanisms for their formation.

Adult↗

PubMed1993

Heterogeneity in localization of isoforms of TGF-beta in human retina, vitreous, and choroid.

PURPOSE: The purpose of this work was to investigate further the immunohistochemical localization of transforming growth factor (TGF)-beta 1 to photoreceptors, which we had previously observed, to elucidate the cell types of origin for TGF-beta 1, and to determine sites of localization for TGF-beta 2 and beta 3 in the posterior segment of the human eye. METHOD: Streptavidin-peroxidase immunohistochemistry was used to localize TGF-beta antibodies in sections from cryopreserved human posterior segments from six adult donors. Two recently described polyclonal antibodies to TGF-beta 1 (anti-CC[1-30] and anti-LC[1-30]) and antibodies against TGF-beta 2 and beta 3 were employed in this study. Other studies suggest that anti-LC(1-30) antibody recognizes pre-pro-TGF-beta 1 and therefore sites of production, while anti-CC(1-30) recognizes secreted forms of TGF-beta 1. RESULTS: Regional labeling of choriocapillaris was observed in all eyes using anti-LC(1-30) (anti-pre-pro-beta 1). Anti-CC(1-30) (anti-secr-beta 1) was localized predominantly in photoreceptor inner and outer segments in all eyes. Outer segment localization appeared identical to anti-opsin localization, indicating that this form of TGF-beta 1 is most likely intracellular. TGF-beta 2 was observed predominantly in the connective tissue of long ciliary arteries in choroid and in photoreceptor outer segments in all eyes. TGF-beta 3 was observed in isolated individual cells in choroid and retina. Vitreous hyalocytes were the only cell type examined that were immunoreactive for all four forms of TGF-beta studied. CONCLUSION: The heterogeneity in localization of TGF-beta s in the human posterior eye suggests that TGF-beta s are produced, used, and degraded locally. TGF-beta 1 produced by the choriocapillaris may be stored or used by photoreceptors.

Aged↗