Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Choroiditis”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMed1996

Watershed zone in the human peripheral choroid.

PURPOSE: To evaluate the angioarchitecture and the hemodynamics in the peripheral choroid in humans. METHODS: Choroidal circulation was examined in 23 normal eyes and in 7 with equatorial lattice degeneration by wide-angle indocyanine green (ICG) angiography using a scanning laser ophthalmoscope. A hand-held 30-diopter lens was placed in front of the eye to expand the observation angle from the original 40 degrees to 70 degrees. The peripheral temporal choroid and the ora serrata thus could be seen in one frame. RESULTS: An arterial watershed zone was identified in the temporal peripheral choroid in 21 of 30 eyes. This watershed zone was located in a sectorial region posterior to the ora serrata. It did not form a circular belt along the equator. The area anterior to the watershed zone was supplied by peripheral retrograde choroidal arteries. Inflow of dye into the peripheral retrograde choroidal arteries was consistently later than into the more posterior choroid via short posterior ciliary arteries. The terminal branches of peripheral and short posterior ciliary arteries did not form functional anastomoses. Peripheral retrograde choroidal arteries showed wide variations in number and distribution. These arteries originated from recurrent branches of long posterior ciliary arteries in 18 of 21 eyes and from anterior ciliary arteries in 3 eyes. There was no correlation between the watershed zone and equatorial lattice degeneration in location and extent. CONCLUSION: A peripheral watershed zone is a regular feature in the far temporal sector of the choroid. The far peripheral choroid anterior to the watershed zone was perfused by peripheral retrograde choroidal arteries which originated from the long posterior ciliary arteries and/or the anterior ciliary arteries.

Adolescent↗
PubMedDate not supplied

Functional and morphological assessment of age-related changes in the choroid and outer retina in pigeons.

We sought to determine if choroidal and outer retinal deterioration occur with age in pigeons, as they do in other species, and investigated the relationship between age-related retinal and choroidal changes. In 64 pigeons ranging in age over the pigeon lifespan (0.5-20 years), we measured some or all among the following parameters: choroidal blood flow (ChBF) by laser Doppler flowmetry, choroidal thickness and choriocapillary vessel abundance by LM histology, choriocapillary endothelial cell transport specializations by EM histology, acuity by behavioral methods, and degenerating photoreceptor abundance and total photoreceptor abundance by LM histology. Regression and Receiver Operator Curve (ROC) analyses were used to characterize the pattern of age-related changes and determine the ages at or by which significant changes occurred. For the 45 birds for which we measured choroidal parameters, choriocapillary vessel abundance showed a curvilinear decline with age and half of this decline occurred by 3.5-4.6 years. The endothelial cell transport specializations called channels also declined curvilinearly with age. Choroidal thickness was slightly increased between the ages of 3-6 years, and thereafter declined steadily so that choroidal thickness in the oldest birds was half that in the youngest. ChBF showed an abrupt decline of about 20% at 4 years and a further 20% decline thereafter. In the 53 birds for which we obtained visual acuity and/or photoreceptor data, we observed a curvilinear decline in acuity (with half the decline having occurred by 8 years) and a prominent stepwise decline of about 20% in photoreceptor abundance at 4.7 years, followed by further decline thereafter. The period of major photoreceptor loss coincided with ages during which about 10% of photoreceptors appeared to show degenerative changes (4-8 years of age). Using partial correlation analysis with the common effect of age held constant, ChBF was found to have a positive correlation with acuity. Our results show that ChBF and choroidal vascularity decline significantly with age in pigeons, as do acuity and photoreceptor abundance. Our statistical analyses suggest that prominent choroidal vascular decline preceded the visual decline, and that there is a positive relationship between choroidal and visual functions. Thus, our findings are consistent with the view that age-related decline in choroidal function might contribute to age-related vision loss in pigeons.

Aging↗
PubMed1988

[Choroidal hemodynamics using videoangiography].

The characteristics of choroidal circulation were studied in 100 healthy subjects and differentiated from pathologically delayed filling of the choroid. The method used was videoangiography, which permits slow-motion analysis of choroidal hemodynamics. The sections of the choroid which fill fastest are the macula region, the peripapillary areas and the lower periphery, followed by the temporal and upper periphery and subsequently the nasal half of the fundus. If the beginning of choroidal filling is delayed for more than 3-3.5 s in any region it is 99% certain that the delay is pathologic. If this time is set in relation to the retinal circulation it approximates the early venous circulation time, i.e., the time in which the laminary venous blood flow reaches the optic disk. Videoangiography confirms that it is not possible to detect any functionally effective links between different choroidal lobuli. Choroidal circulation disorders in the event of occlusion of functional end-arteries are a logical consequence of this. Choroidal filling varies over a broad range: five different types of choroidal filling may be distinguished. The constant patterns of choroidal veins found by Hayreh in monkeys are only partially applicable to humans; the supply pattern of the human choroid must be regarded as considerably more complex.

Adolescent↗
PubMed1997

Compensation for spectacle lenses involves changes in proteoglycan synthesis in both the sclera and choroid.

PURPOSE: It has been demonstrated that chick eye growth compensates for defocus imposed by spectacle lenses: the eye elongates in response to hyperopic defocus imposed by negative lenses and slows its elongation in response to myopic defocus imposed by positive lenses. We ask whether the synthesis of scleral extracellular matrix, specifically glycosaminoglycans, changes in parallel with the changes in ocular elongation. In addition, there is a choroidal component to compensation for spectacle lenses; the choroid thickens in response to myopic defocus and thins in response to hyperopic defocus. We ask whether choroidal glycosaminoglycan synthesis changes in parallel with changes in choroidal thickness. METHODS: Chicks wore either a +15 diopter (D) or -15 D spectacle lens over one eye, or they wore one lens of each power over each eye for 5 days. At the end of this period, we measured refractive errors and ocular dimensions by refractometry and A-scan ultrasonography, respectively. Pieces of the scleras and choroids from these eyes were put into culture and the synthesis of glycosaminoglycans was assessed by measuring the incorporation of radioactive inorganic sulfur. RESULTS: We here report that the compensatory modulation of the length of the eye involves changes in the synthesis of glycosaminoglycans in the sclera, with synthesis increasing in eyes wearing -15 D spectacles lenses and decreasing in eyes wearing +15 D lenses. In addition, changes in the synthesis of glycosaminoglycans in the choroid are correlated with changes in choroidal thickness: eyes wearing +15 D lenses develop thicker choroids and these choroids synthesize more glycosaminoglycans than choroids from eyes wearing -15 D lenses. CONCLUSIONS: Changes in scleral glycosaminoglycan synthesis accompany lens-induced changes in the length of the eye. Furthermore, changes in the thickness of the choroid are also associated with changes in the synthesis of glycosaminoglycans. These results are consistent with the regulation of the growth of the eye being bidirectional, and with the retina being able to sense the sign of defocus.

Adaptation, Physiological↗
PubMed2002

Characterization and diabetes-induced impairment of nitric oxide synthase in rat choroid.

PURPOSE: To examine the nitric oxide (NO) system in the choroid of normal rats and rats with streptozotocin (STZ)-induced diabetes. METHODS: We assayed NO synthase (NOS) activity by monitoring the conversion of L-[(14)C] arginine to L-[(14 )C] citrulline, identified the NOS isoforms by immunoblotting, and examined the effects of STZ-induced diabetes on NOS in the rat choroid. RESULTS: Calcium-independent NOS activity was insignificant in the choroid of normal and diabetic rats. Choroidal calcium-dependent NOS activity was high and comparable to that in the cerebellum. Neuronal (n) NOS protein in the choroid was found in both the membrane and cytosolic fractions and showed similar subcellular distribution as NOS activity, while endothelial (e) NOS protein in the choroid was present almost solely in the membrane fraction. Total NOS activity (nNOS + eNOS) and protein levels of nNOS and eNOS in the choroid were significantly reduced 6 weeks after the induction of diabetes. CONCLUSIONS: The high NOS activity in the choroid measured in vitro appears to come mostly from nNOS. Because choroidal nNOS exists in the parasympathetic perivascular nerve fibers, the decrease in choroidal nNOS in diabetic eyes suggests that the choroid undergoes a diabetes-induced neuronal disorder. Thus, diabetic choroidopathy encompasses diabetic neuropathy and microangiopathy.

Animals↗
PubMed1998

Glut1 glucose transporter in the primate choroid plexus endothelium.

The objective of the present study was to define the cellular location of the Glut1 glucose transporter in the primate choroid plexus. Immunogold electron microscopy indicated that Glut1 epitopes were associated primarily with choroid plexus endothelial cells. Digitized analyses of electron microscopic images provided quantitative estimates of the relative number of Glut1 glucose transporter epitopes on luminal and abluminal endothelial cell membranes within the choroid plexuses. We recorded a high density of Glut1 in the microvascular endothelium of primate choroid plexus, which was consistent in vervet monkeys (5-10 Glut1 gold particles per micrometer of endothelial cell plasma membrane), as well as in baboons (5-20 Glut1 gold particles per micrometer of capillary plasma membrane). In the baboon choroid plexus, we observed that perivascular cells (presumed to be pericytes) were also Glut1-positive, but with substantially reduced activity compared with endothelial cells. Occasional Glut1-immunogold particles were also seen in the basolateral membranes of the choroid plexus cuboidal cells. Light microscopic immunocytochemistry confirmed the abundance of Glut1 immunoreactivity in choroid plexus endothelial cells of vervet monkeys and baboons. A similar pattern was observed in surgically resected human choroid plexus, suggesting differences between primates, including humans and laboratory animals. The only difference was that erythrocytes within the human choroid plexus exhibited a florid Glut1-positive response, but were weakly immunoreactive in nonhuman primates. The observation of high glucose transporter densities in choroid plexus endothelial cells is consistent with the suggestion that choroidal epithelia and capillaries provide a metabolic work capability for maintaining ionic gradients and secretory functions across the blood-CSF barriers.

Animals↗
PubMed1993

Decreased choroidal thickness in eyes with secondary angle closure glaucoma. An aetiological factor for deep retinal changes in glaucoma?

A decreased count of retinal photoreceptors all over the fundus and a loss of retinal pigment epithelium cells mainly in the parapapillary region have been reported to be associated with glaucoma. This study addressed the question whether this cell loss in the deep retinal layers may be connected with a change of the choroidal thickness in glaucomatous eyes. Histological sections of 12 eyes with secondary angle closure glaucoma due to a malignant melanoma of the ciliary body and 20 eyes with a malignant choroidal melanoma and normal intraocular pressure were histomorphometrically evaluated. Before enucleation the intraocular pressure was significantly higher in the glaucoma group compared with the control group. Thickness of the choroid was measured at 12 locations from the posterior pole to the fundus periphery. The choroid was significantly thinner in the glaucoma group than in the control group. The decreased choroidal thickness was mainly due to a diminished choroidal vessel diameter. The differences were more marked at the optic disc border than in the fundus periphery. The decreased choroidal thickness in the glaucomatous eyes suggests a reduced choroidal perfusion. It fits with the reported lack of autoregulation of the choroidal blood circulation. Considering the diminished choroidal thickness especially in the parapapillary region, it may be one among other factors explaining the changes of the deep retinal layers in eyes with glaucoma. It indicates that thinning of the choroid, besides the chorioretinal atrophy in the parapapillary region, should be added to the panoply of histological changes in glaucoma.

Adolescent↗
PubMed2003

Localization of preganglionic neurons that innervate choroidal neurons of pterygopalatine ganglion.

PURPOSE: The pterygopalatine ganglion (PPG) receives preganglionic input from the superior salivatory nucleus (SSN) of the facial motor complex and is the main source of parasympathetic input to the choroid in mammals. The present study was undertaken to determine in rats the location and neurotransmitters of SSN neurons innervating those PPG neurons that target the choroid and to determine the location and neurotransmitters of the PPG choroidal neurons themselves. METHODS: Retrograde labeling from rat choroid using a fluorescent tracer, in combination with immunofluorescence labeling for nitric oxide synthase (NOS), vasoactive intestinal polypeptide (VIP), and choline acetyltransferase (ChAT), was used to characterize the location and neurotransmitters of choroidal PPG neurons. To identify SSN neurons that innervate the choroidal PPG neurons, the Bartha strain of the retrograde transneuronal tracer pseudorabies virus (PRV-Ba) was injected into rat choroid, and immunolabeling for NOS or ChAT was used to characterize their neurochemistry. RESULTS: Fluorescent retrograde labeling showed that PPG neurons projecting to the choroid contained NOS, VIP, and ChAT and were widely distributed in PPG and its preganglionic root, the greater petrosal nerve. SSN neurons were ChAT(+), and a subset of them was found to contain NOS. PRV-Ba transneuronal retrograde labeling revealed that choroidal preganglionic neurons were localized to the rostral medioventral part of the ipsilateral SSN. The choroidal SSN neurons were ChAT(+) and appeared largely to correspond to the NOS(+) neurons of the SSN. CONCLUSIONS: These results show that preganglionic neurons in rats that are presumed to regulate choroidal blood flow through the PPG reside within the rostral medioventral SSN, and that NOS is a marker for these SSN neurons.

Animals↗
PubMed1988

The dangling choroid plexus: a sonographic observation of value in excluding ventriculomegaly.

To show that the position of the choroid plexus is dependent on gravity and to prove that this fact can be used as a simple means of avoiding the erroneous diagnosis of ventriculomegaly on fetal sonography, we evaluated 75 fetal sonograms retrospectively. Twenty-five fetuses had ventriculomegaly, and 50 had normal cerebral ventricles. The gestational ages ranged from 15 to 39 weeks. To show objectively that the position of the choroid plexus within the lateral ventricle was gravity dependent, we measured the choroid angle in each case. The choroid angle (the angle between the long axis of the choroid plexus and the linear midline echo on transverse axial sonograms through the body of the lateral ventricles) varied directly with ventricular size. In the group with normal-sized ventricles, the values for choroid angle followed a normal, unimodal distribution and had a mean of 14 degrees, a range of 6-22 degrees, and an SD of 4.3 degrees. In cases of ventriculomegaly, the values for choroid angle did not follow a normal distribution and ranged from 29 to 90 degrees. The choroid "dangled" from its attachment at the foramen of Monro and rested on the dependent wall of the lateral ventricle, resulting in a choroid angle that was increased over normal; the degree of the angle was dependent on the severity of the ventricular enlargement. The resting position of the choroid plexus marked the position of the lateral ventricular wall even when the reflection of ultrasound from the ventricular wall itself could not be seen. Detection of the position of the dependent choroid plexus is a simple observation that can be used to avoid the erroneous diagnosis of fetal ventriculomegaly and to help gauge the severity of true ventricular enlargement.

Cerebral Ventricles↗
PubMed1991

Transthyretin immunoreactivity in choroid plexus neoplasms and brain metastases.

Although choroid plexus papillomas (CPP) and primary choroid plexus carcinomas (CPC) are rare neoplasms of the central nervous system, they have been the subject of a number of immunohistochemical studies. To date, no unique or specific marker for these neoplasms has been found, however. Normal choroid plexus is a major site of transthyretin (TTR) synthesis, and recently this protein has been proposed as a possible specific marker of choroid plexus differentiation in tumors. In this study, we performed immunohistochemistry for TTR on 13 choroid plexus tumors (six CPP and seven CPC) and on 23 carcinomas metastatic to the brain, four of which had a papillary architecture. We also included four ovarian teratomas that contained choroid plexus elements. Two of the CPP had diffuse staining for TTR, while the four others stained only focally. Five of the CPC stained only focally and less intensely than the control, while one case was negative. Only one CPC stained as strongly and diffusely as normal choroid plexus. Two of the papillary and six of the nonpapillary metastases had focal staining similar to that seen in the five focally positive CPC. The choroid plexus elements of the ovarian teratomas stained as strongly as the positive control. These findings indicate that TTR immunoreactivity is not restricted to primary choroid plexus tumors. Furthermore, most choroid plexus carcinomas stain only weakly or not at all. This limits the usefulness of TTR immunohistochemistry in the diagnosis of primary choroid plexus neoplasms and in the distinction of CPC from metastatic carcinoma.

Adenocarcinoma↗
PubMed1994

Species differences in choroidal vasodilative innervation: evidence for specific intrinsic nitrergic and VIP-positive neurons in the human eye.

PURPOSE: There is evidence that vasodilation of choroidal vessels results from facial nerve stimulation. To obtain more information about the role of this innervation, the authors examined the presence and spatial organization of nitrergic and vasoactive intestinal peptide (VIP) immunoreactive nerves in the human choroid. For comparison, the choroid of rabbit and rat eyes, with different types of retinal vascularization and no fovea, were studied. METHODS: Whole mounts of five human, nine rat, and two rabbit choroids were stained for NADPH-diaphorase. In addition, immunocytochemical staining was carried out on tangential frozen sections of two human choroids using antibodies against nitric oxide synthase (NOS), synaptophysin, and VIP. RESULTS: In all species, a perivascular network of diaphorase-positive nerve fibers with varicose terminals accompanied the arteries and arterioles of the choroidal stroma. A striking difference to rat and rabbit choroids was the presence of numerous positively stained ganglion cells in human choroids. Positively stained axons connected the neurons with each other and with the perivascular network. Most of the ganglion cells were concentrated in the temporal-central region, adjacent to the fovea. Immunocytochemically, the choroidal ganglion cells were immunoreactive for NOS. Some ganglion cells stained for VIP. Staining for synaptophysin demonstrated varicose terminals innervating the perikarya of the ganglion cells. Many of these terminals stained for NOS and VIP. CONCLUSIONS: The presence of an intrinsic nerve cell plexus that is specifically localized in human eyes in the temporal-central portion of the choroid indicates a functional significance of the nitrergic choroidal innervation for the fovea.

Aged↗
PubMed1996

Choroidal concentration of interferon after retrobulbar injection.

PURPOSE: To determine whether recombinant human interferon alpha-2a (IFN alpha-2a) would diffuse into the choroid in significant amounts from a retrobulbar depot. METHODS: One million international units of IFN alpha-2a were injected into the retrobulbar space of the eyes of 17 rabbits, and choroidal and serum concentrations were measured at 1, 2, 4, 8, 12, and 24 hours. The same dose of IFN alpha-2a was injected subcutaneously into 10 rabbits, and choroidal and serum concentrations were measured at the same intervals for comparison. Parabulbar and ocular tissues were studied by light microscopy for evidence of local toxicity. RESULTS: Peak concentration IFN alpha-2a in the choroid after retrobulbar injection occurred at 2 hours and averaged 32,000 IU/mg. Peak concentration in the serum occurred at 4 hours and averaged 227 IU/ml. Concentrations in choroid and serum fell rapidly, and IFN alpha-2a was not detectible at 24 hours. No IFN alpha-2a was detected in the choroid of the paired eye, and only a trace (< 50 IU/mg) was found in either eye after subcutaneous injection. Light microscopy revealed some lymphocytes in the fat adjacent to the retrobulbar depot after six daily injections of IFN alpha-2a or saline. Sclera, choroid, and retina appeared unaffected. CONCLUSIONS: IFN alpha-2a diffuses into the choroid from a retrobulbar depot in significant amounts. The serum concentration from a retrobulbar injection is < 1% of the choroidal concentration. The retrobulbar route to the choroid may be optimal for testing the effect of IFN alpha-2a on choroidal neovascularization.

Animals↗
PubMed1998

Indocyanine green angiography patterns of zones of relative decreased choroidal blood flow in patients with exudative age-related macular degeneration.

BACKGROUND AND OBJECTIVE: To investigate the incidence and patterns of posterior zones of relative decreased choroidal blood flow in patients with exudative age-related macular degeneration. PATIENTS AND METHODS: Digital indocyanine green (ICG) angiograms from 100 patients with exudative age-related macular degeneration were reviewed for the presence of posterior zones of relative decreased choroidal blood flow. The patterns of these zones and their location relative to the choroidal neovascular process were noted. RESULTS: Ninety-five percent of the angiograms displayed the presence of either a complete or an incomplete zone of relative choroidal hypoperfusion. The zone was most apparent in the early frames of the angiogram. Five different patterns of relative decreased choroidal blood flow were identified: horizontal (32%), vertical (14%), bipartite (9%), tripartite (31%), and quadripartite (9%). The choroidal neovascular process was located within or at the edge of the zone of relative choroidal hypoperfusion in all cases. CONCLUSION: Most cases of choroidal neovascularization localize to areas of relative choroidal dye nonfilling on ICG angiography. These patterns of choroidal nonfilling may have implications in the pathogenesis and management of choroidal neovascular membranes in age-related macular degeneration.

Choroid↗
PubMed2005

Pigment epithelium-derived factor (PEDF) and vascular endothelial growth factor (VEGF) in aged human choroid and eyes with age-related macular degeneration.

The purpose of this study was to examine the localization and relative levels of vascular endothelial growth factor (VEGF; an angiogenic factor) and pigment epithelium-derived factor (PEDF; an antiangiogenic factor) in aged human choroid and to determine if the localization or their relative levels changed in age-related macular degeneration (AMD). Ocular tissues were obtained from eight aged control donors (age range, 75-86 years; mean age, 79.8 years) with no evidence or history of chorioretinal disease and from 12 donors diagnosed with AMD (age range, 61-105 years; mean age, 83.9 years). Tissues were cryopreserved and streptavidin alkaline phosphatase immunohistochemistry was performed with rabbit polyclonal anti-human VEGF and rabbit polyclonal anti-human PEDF antibodies. Binding of the antibodies was blocked by preincubation of the antibody with an excess of recombinant human PEDF or VEGF peptide. Choroidal blood vessels were identified with mouse anti-human CD-34 antibody in adjacent tissue sections. Three independent observers graded the immunohistochemical reaction product. The most prominent sites of VEGF and PEDF localization in aged control choroid were RPE-Bruch's membrane-choriocapillaris complex including RPE basal lamina, intercapillary septa, and choroidal stroma. There was no significant difference in immunostaining intensity and localization of VEGF and PEDF in aged control choroids. The most intense VEGF immunoreactivity was observed in leukocytes within blood vessels. AMD choroid had a similar pattern and intensity of VEGF immunostaining to that observed in aged controls. However, PEDF immunoreactivity was significantly lower in RPE cells (p=0.0073), RPE basal lamina (p=0.0141), Bruch's membrane (p<0.0001), and choroidal stroma (p=0.0161) of AMD choroids. The most intense PEDF immunoreactivity was observed in disciform scars. Drusen and basal laminar deposits (BLDs) were positive for VEGF and PEDF. In aged control subjects, VEGF and PEDF immunostaining was the most intense in RPE-Bruch's membrane-choriocapillaris complex. In AMD, PEDF was significantly lower in RPE cells, RPE basal lamina, Bruch's membrane and choroidal stroma. These data suggest that a critical balance exists between PEDF and VEGF, and PEDF may counteract the angiogenic potential of VEGF. The decrease in PEDF may disrupt the balance and be permissive for the formation of choroidal neovascularization (CNV) in AMD.

Aged↗
PubMed2006

Comparison of 2D reconstructions of surgically excised subfoveal choroidal neovascularization with fluorescein angiographic features: SST report No. 15.

OBJECTIVES: To compare topographic features of surgically excised subfoveal choroidal neovascularization with preoperative and postoperative fluorescein angiographic features from Submacular Surgery Trials (SST) patients, and to compare histological and angiographic features with preoperative and postoperative visual acuities (VAs). METHODS: Patients enrolled in the SST Groups N, B, and H trials between October 1999 and September 2001 and assigned to the surgery arm had surgically removed choroidal neovascularization sent to the SST Pathology Center. Grossly intact specimens were sectioned serially for 2-dimensional reconstruction and were assigned to growth pattern groups based on topographic mapping of the location of cellular components relative to the retinal pigment epithelium (RPE): sub-RPE, subretinal, combined, or indeterminate. These features were compared with preoperative fluorescein angiographic features. The histological choroidal neovascularization growth pattern was compared with preoperative VAs. RESULTS: Two-dimensional reconstructions of surgically excised choroidal neovascularization could not be matched point for point to fluorescein angiographic features. Among the 52 specimens selected, the growth pattern could be determined by 2-dimensional reconstruction in 34 instances (65%), including 28 (80%) of 35 Group N specimens, 2 (40%) of 5 Group B specimens, and 4 (33%) of 12 Group H specimens. Among the choroidal neovascularization growth patterns that could be determined from specimens submitted, the majority of Group N specimens were combined, and the majority of Group H specimens were subretinal. In most instances for Group B specimens, the growth pattern was indeterminate. The postoperative abnormalities on fluorescein angiography were generally larger than measurements of excised specimens. The subretinal growth pattern was associated with the smallest decrease in 3-month postoperative average VA. CONCLUSIONS: Among the 52 specimens from the SST with adequate tissue to try to evaluate the growth pattern of the neovascular lesion, 34 had patterns that could be determined. The subretinal growth pattern tended to correspond with lesions that were classic choroidal neovascularization without occult choroidal neovascularization on fluorescein angiography. The most favorable visual outcome occurred if the choroidal neovascularization had a subretinal growth pattern. The combined growth pattern tended to correspond with lesions on fluorescein angiography that had both classic choroidal neovascularization and occult choroidal neovascularization. The conclusions must be viewed within the context that 18 (35%) of the 52 participants could not be characterized for histologic growth pattern.

Adult↗
PubMedDate not supplied

Polypoidal choroidal vasculopathy.

Polypoidal choroidal vasculopathy was first described as a peculiar hemorrhagic disorder of the macula, characterized by recurrent sub-retinal and sub-retinal pigment epithelium bleeding in middle aged black women. The use of indocyanine green angiography and subsequently of optical coherent tomography has widened our ability to study and understand the pathophysiology of this disorder. The primary abnormality involves the choroidal circulation, and the characteristic lesion is an inner choroidal vascular network of vessels ending in an aneurysmal bulge or outward projection, visible clinically as a reddish orange, spheroid, polyp-like structure. We have also recognized that individuals of African-American and Asian descents are more at risk for developing polypoidal choroidal vasculopathy as the disorder seems to preferentially affect pigmented individuals. However, it has been shown that while that still holds true, patients of other racial backgrounds may be afflicted. Particularly, polypoidal choroidal vasculopathy has been found to be present in about 8-13% of white patients with clinical appearance of exudative age-related macular degeneration. Polypoidal choroidal vasculopathy has also been reported in Irish, French, German, and Italian patients. The natural course of the disease often follows a remitting-relapsing course, and clinically, it is associated with chronic, multiple, recurrent serosanguineous detachments of the retinal pigment epithelium and neurosensory retina with long-term preservation of good vision. Photodynamic treatment appears to be a promising alternative to conventional laser therapy, for the treatment of polypoidal choroidal vasculopathy. In conclusion, polypoidal choroidal vasculopathy seems to be a distinct clinical entity that should be differentiated from other types of choroidal neovascularization associated with age-related macular degeneration and other known choroidal degenerative, inflammatory, and ischemic disorders.

Choroid↗
PubMed1999

Persistent and bilateral choroidal vascular abnormalities in central serous chorioretinopathy.

BACKGROUND: To clarify the role of choroidal vascular abnormalities in central serous chorioretinopathy (CSC) in active stage, remission, and recurrence. METHODS: Indocyanine green angiography and fluorescein angiography were performed in 105 eyes (104 patients) with active CSC. Forty-six patients were followed up for 6 to 48 months (mean +/- standard deviation, 22.5 +/- 8.9 months) with repeated angiography (mean +/- standard deviation, 3.5 +/- 1.5 times). Indocyanine green angiography and fluorescein angiography also were performed during remission in all 46 eyes with CSC and during recurrent CSC in 6 eyes. Unaffected fellow eyes underwent angiographic examinations in all patients. RESULTS: In active CSC, indocyanine green angiography showed a choroidal filling delay (71%), venous dilation (61%), and focal choroidal hyperfluorescence (96%) surrounding leakage from the retinal pigment epithelium. Focal choroidal hyperfluorescence was present in unaffected areas of affected eyes (55%). The choroidal venous dilation (36%) and choroidal hyperfluorescence (62%) were noted even in unaffected fellow eyes. These choroidal abnormalities persisted during remission after leakage ceased throughout the follow-up period. In the six patients with recurrent CSC, new leakage developed in the areas of persistent choroidal hyperfluorescence. Central serous chorioretinopathy developed in the unaffected fellow eye in one of these six patients. CONCLUSION: Choroidal vascular abnormalities persist in both eyes even after leakage from the retinal pigment epithelium ceases. Central serous chorioretinopathy may recur in areas of choroidal vascular abnormalities.

Adult↗
PubMed2004

Choroidal vascular occlusion in internal carotid artery obstruction.

PURPOSE: To determine choroidal vascular abnormalities in eyes with internal carotid artery obstruction (ICO). METHODS: We examined eight eyes with ICO with wide-angle indocyanine green (ICG) video-angiography beginning in the posterior fundus. Another angiography was performed in three eyes to observe the arterial phase of the temporal peripheral fundus. ICG angiography was done until the late choroidal venous phase or for more than 10 minutes. RESULTS: Slow dye filling in the choroidal arteries and delayed filling of the posterior watershed zone occurred in all eyes. Delayed perfusion or multiple patchy occlusions of choriocapillaris was seen in all eyes. There were delayed perfusion and/or occlusion in the peripheral watershed zone in the examined three eyes. The super-late-phase angiograms showed hyperfluorescent lines corresponding to choroidal veins. CONCLUSION: Elongated arm-to-choroid circulation and delayed intrachoroidal circulation times suggest severe choroidal hypoperfusion. Choroidal hypoperfusion resulted in multiple occlusions of the choriocapillaris and attenuated choroidal vessels. Slow filling or nonperfusion of the peripheral watershed zone was another characteristic finding. Linear hyperfluorescence may reflect severely damaged choroidal venous walls. These findings are useful to understand choroidal angiopathy in ICO or high-grade stenosis, and to diagnose ocular ischemic syndrome.

Aged↗