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Aquaporin-1 in the choroid plexuses of developing mammalian brain.

The normal brain develops within a well-controlled stable internal "milieu" protected by specialised mechanisms referred to collectively as blood-brain barriers. A fundamental feature of this environment is the control of water flow in and out of the developing brain. Because of limited vascularisation of the immature brain, choroid plexuses, via the cerebrospinal fluid, have been proposed as the main route of fluid exchange between the blood and brain interfaces. We describe the temporal expression and appearance of aquaporin-1 (AQP1) which is important for water transfer across adult choroid plexuses. AQP1 expression was studied in rat embryos using real time reverse transcription/polymerase chain reaction. mRNA for AQP1 was present in rat brain at embryonic day 12 (E12) one day before the protein was detectable in the fourth ventricular choroid plexus (the first plexus to appear); its relative levels increased at E13-E14 when more AQP1-immunoreactive cells appeared in all plexuses. The presence of AQP1 was determined immunocytochemically in five different mammalian species (rat, mouse, human, sheep and opossum) in all four choroid plexuses from their earliest appearance. In all five species studied, the appearance of AQP1 immunoreactivity followed the same developmental sequence: the fourth, lateral and, finally, third ventricular choroid plexus. The stage of choroid plexus development when AQP1 was first detected in all five species and in all four choroid plexuses corresponded to the transition between Stages I and II. The cellular localisation of AQP1 in all choroid plexuses, as soon as it was detectable, had the characteristic apical membrane distribution previously described in the adult; a basolateral membrane localisation was also observed.

Animals↗

Ultrastructural localization of adhesion molecules in the healthy and inflamed choroid plexus of the mouse.

The functional expression of vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1) and MAdCAM-1 in the choroid plexus is indicative of a role of this structure in the communication of the immune system with the central nervous system (CNS). In order to gain further insight into the possible functions of adhesion molecules expressed in the choroid plexus, we investigated the exact ultrastructural localization of VCAM-1, ICAM-1 and MAdCAM-1 on semithin and ultrathin cryosections of the choroid plexus of healthy mice and of mice suffering from experimental autoimmune encephalomyelitis (EAE). In the healthy choroid plexus VCAM-1 and ICAM-1, but not MAdCAM-1, could be detected on the apical surface of the choroid plexus epithelial cells. During EAE, immunoreactivity for VCAM-1 and ICAM-1 was dramatically increased. Additionally, apical expression of MAdCAM-1 was observed on individual choroid plexus epithelial cells during EAE. At the same time, VCAM-1, ICAM-1 or MAdCAM-1 were never present on the endothelial cells of the fenestrated capillaries within the choroid plexus. The polar expression of VCAM-1, ICAM-1 and MAdCAM-1 on the apical surface of choroid plexus epithelial cells, which form the blood-cerebrospinal fluid barrier, implies a previously unappreciated function of this barrier in the immunosurveillance of the CNS.

Animals↗

Diffuse villous hyperplasia of choroid plexus.

Diffuse villous hyperplasia of choroid plexus (DVHCP) is a rare condition which is characterized by the presence of diffuse enlargement of the entire choroid plexus throughout the length of the choroidal fissure and overproduction of CSF. The diagnosis of diffuse villous hyperplasia of choroid plexus can be established by the MR demonstration of diffusely large, contrast enhanced choroid plexus in the cases of overproduction hydrocephalus. Although some authors recommend choroid plexus excision or coagulation, ventriculo-atrial shunt insertion is a simple and effective treatment modality in cases of diffuse villous hyperplasia of the choroid plexus. In this report we present a case of diffuse villous hyperplasia of the choroid plexus and a short review of the literature. To our knowledge, in the CT and MRI era only 5 cases of DVHCP cases have been reported.

Cerebrospinal Fluid↗

Are choroid plexus cysts an indication for second-trimester amniocentesis?

Previous series that described fetuses with choroid plexus cysts have been too small to determine whether there is an association with trisomy 18 sufficiently high to warrant amniocentesis. To address this issue, we studied the incidence of choroid plexus cysts and other ultrasonographic abnormalities in 26 consecutive fetuses (13.5 to 36 weeks' gestation) with trisomy 18. Twenty of these 26 fetuses had major sonographic anomalies suggestive of aneuploidy. Seventeen of these 26 fetuses were 15 to 20 weeks and 5 of 17 (30%) had choroid plexus cysts. Six of our total 26 affected fetuses had no sonographic anomalies and therefore, on the basis of our data, 30% of these (1.8 fetuses) with trisomy 18 would have choroid plexus cysts without other findings. The incidence of choroid plexus cysts in all second-trimester fetuses (including normal fetuses and those with trisomy 18) is reportedly 1%. Given the known incidence of trisomy 18 (3/10,000), we calculated a total presumptive sample of 86,667 patients to yield our 26 fetuses with trisomy 18. Our hypothetical sample has 86,641 (86,667 - 26) fetuses without trisomy 18,858 of which would have choroid plexus cysts. Thus there would be one fetus with trisomy 18 for every 477 normal fetuses with choroid plexus cysts with no other defect seen. If amniocentesis were done to seek trisomy 18 in all second-trimester fetuses with choroid plexus cysts, two normal fetuses would be lost for every one with trisomy 18 identified.

Adult↗

Choroidal and ciliary body blood flow analysis: application of laser Doppler flowmetry in experimental animals.

Laser Doppler flowmetry (LDF) measures the flux of red blood cells in a vascular network embedded in tissue. In the present report, choroidal and ciliary body blood flow was measured continuously using an LDF technique in pentobarbital anesthetized cats. Blood flow measurements were made from the choroid beneath the lateral and superior rectus muscles and from the surface above the ciliary body 2-3 mm posterior to the limbus. In some experiments, the sympathetic nerve to the eye was stimulated; in others, intraocular pressure (IOP) was monitored manometrically with a controlled saline infusion delivered into the anterior chamber to gradually elevate IOP. Norepinephrine (NE) and methacholine (MC) also were tested for their effects on choroidal blood flow when given intravenously and intra-arterially. Transient bilateral carotid artery occlusions produced a significant drop in blood flow, but flow did not decrease to zero probably due to collateral contribution of the vertebral circulation. Sympathetic nerve stimulation produced a frequency-dependent decrease in both choroidal and ciliary body blood flow with the latter exhibiting a lower threshold and a greater magnitude of effect. Gradual elevation of IOP produced a proportional decrease in choroidal blood flow. The level of intraocular pressure required to decrease blood flow was dependent on the existing ocular perfusion pressure. Both intravenous and intra-arterially administered NE produced dose-dependent decreases of choroidal blood flow despite graded increases of systemic arterial blood pressure. In contrast, MC produced dose-dependent increases of choroidal blood flow in conjunction with graded decreases of systemic blood pressure. The results of the present report demonstrate the validity of the LDF technique for performing continuous reading of blood flow changes in the choroid and ciliary body of experimental animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

The relationship of choroidal blood flow and accommodation to the control of ocular growth.

We have carried out a number of different studies in chicks to examine the relationship between choroidal blood flow and myopic eye growth, and between accommodation and myopic eye growth. Our studies on choroidal blood flow show that myopic eye growth produced by form vision degradation leads to dramatic reductions in choroidal blood flow. These reductions appear directly attributable to the eye enlargement and the reduction in choroidal blood flow does not appear to be permissive for eye growth, since experimentally reduced choroidal blood flow hinders eye growth. Choroidal blood flow that is slightly above normal, however, may slightly enhance eye growth. Our studies on accommodation do not reveal any major necessary role of accommodation in regulating normal growth or in form vision degradation induced myopic eye growth. We found preliminary evidence, however, that chronically stimulating accommodation over a 2 week period, thereby producing excessive time in accommodation, may be sufficient for yielding a small but significant degree of myopic refractive error. Our studies suggest that neither fluctuations in choroidal blood flow nor an intact accommodative apparatus are essential for normal eye growth or myopic eye growth produced by form deprivation. Further studies are needed to confirm that excessive time in accommodation might be sufficient for producing myopia. Finally, our finding that choroidal blood flow is substantially reduced in myopic eyes may have implications for the etiology of the retinal problems suffered by humans with moderate to severe myopia.

Accommodation, Ocular↗

Distribution within the choroid of cholinergic nerve fibers from the ciliary ganglion in pigeons.

The distribution of the ciliary ganglion (CG) innervation to the pigeon choroid was determined immunohistochemically, using antisera against choline acetyltransferase (CHAT) and a neurofilament-related protein (the 3A10 antigen). Single-labeling revealed that the nerve fibers containing these two antigens were similarly distributed in the pigeon choroid, with the superior and temporal quadrants of the eye containing the most fibers. Both types of fibers surrounded and ramified on choroidal blood vessels. Additionally, CHAT+ varicosities were evident among vessels in the choroid and choriocapillaris. Double-label immunofluorescence revealed that CHAT and the 3A10 antigen were almost completely colocalized in choroidal nerve fibers, but absent from CHAT+ varicosities. Substance P-containing and calcitonin gene-related peptide-containing choroidal nerve fibers were poor in 3A10+ labeling. Transection of the postganglionic fibers of the CG reduced CHAT+ and 3A10+ nerve fibers in the choroid to 3-5% of normal abundance, with most of the residual fibers being located in the nasal and inferior quadrants. The present results suggest that the CG in pigeon preferentially influences choroidal blood flow in the superior and temporal parts of the eye, which are involved in high acuity and binocular vision.

Animals↗

Cardiotrophin-1 in choroid plexus and the cerebrospinal fluid circulatory system.

There is a growing recognition of choroid plexus functioning as a source of neuropeptides, cytokines and growth factors in cerebrospinal fluid (CSF) with diffusional access into brain parenchyma. In this study, choroid plexus and other components of the CSF circulatory system were investigated by Western blotting, reverse transcriptase polymerase chain reaction and immunohistochemistry for production of interleukin-6-related cytokines characterized by neuroactivity [cardiotrophin-1 (CT-1), ciliary neurotrophic factor, leukemia inhibitory factor, oncostatin M] and signaling through the gp130/leukemia inhibitory factor receptor-beta receptor heterodimer. Western blot analysis showed that CT-1 was the only cytokine family member detectable in adult rat choroid plexus, as in leptomeninges. The specificity of detection was verified with blots of the same tissues from CT-1-deficient mice. Levels of both CT-1 mRNA and protein were constitutively high in rat from birth through adulthood in choroid plexus, up-regulated postnatally in leptomeninges and undetectable in brain parenchyma. Using antigen retrieval, CT-1 immunolocalized to choroid epithelial cells in all choroid plexuses in addition to leptomeninges (arachnoid and pial-glial membranes). Ependymal cells lining the ventricular neuroaxis, unlike the central canal, were also CT-1-immunoreactive. Western blots indicated rat choroid epithelial cells express and release CT-1 immunoreactivity under defined culture conditions and also revealed the presence of a CT-1-like protein in human choroid plexus and CSF. Previously, CT-1 has been conceptualized to function as a target-derived factor for PNS neurons. Our study clearly demonstrates production of CT-1 in the postnatal and adult CNS, specifically by cell types comprising the blood-CSF barrier, and its accumulation in ventricular ependyma. This finding has broad implications for CT-1 functioning apart from other leukemia inhibitory factor receptor ligands as a CSF-borne signal of brain homeostasis, one possibly involving regulation of the barrier itself, the ependyma or target cells in the surrounding parenchyma, including the subventricular zone. A rationale for studies examining CT-1-deficient mice in these respects is provided by the data.

Animals↗

Asymmetry of choroidal venous vascular patterns in the human eye.

PURPOSE: To describe the angioarchitecture of choroidal veins in normal subjects using indocyanine green (ICG) angiography. DESIGN: Consecutive observational case series. PARTICIPANTS: Thirty-six eyes of 33 healthy volunteers ranging in age from 21 to 81 years (50.0+/-18.2 [mean +/- standard deviation]). METHODS: Indocyanine green angiography was performed with a modified Topcon fundus ICG camera. Montage images were obtained during the venous phase of the ICG angiogram. MAIN OUTCOME MEASURES: Indocyanine green angiographic montage images covering all areas of the observable fundus. RESULTS: Eighteen of 36 eyes examined (50%) showed asymmetry of choroidal venous vascular patterns consistent with a preferential route of choroidal venous drainage of the macular region. Twelve of the 18 eyes with a preferred drainage route drained superotemporally; the remaining 6 eyes drained by either an inferotemporal or a superonasal route. A preferential choroidal venous drainage route in the macula was identified with equal frequency in young and old subjects. Of 36 eyes examined, 27 (75%) lacked ICG angiographic evidence of symmetric separation of outer choroidal veins. CONCLUSIONS: There is ICG angiographic evidence of asymmetry of choroidal venous drainage in one half of normal individuals. The relative frequency of a resulting preferential drainage route in a group of normal subjects and the equal distribution in young and old subjects indicate that this finding is neither pathologic nor attributable to aging. There is also ICG angiographic evidence for a lack of symmetric separation in the outer choroidal venous system in the majority of normal human subjects tested, indicating that classic watershed zones may not be present or are less prominent in this portion of the choroidal vasculature.

Adult↗

Choroid plexus cysts: Is biochemical testing a valuable adjunct to targeted ultrasonography?

OBJECTIVE: We sought to determine whether biochemical testing is a valuable adjunct to ultrasonography in selecting patients with fetal choroid plexus cysts for amniocentesis. STUDY DESIGN: The study population consists of 128 patients who had fetal choroid plexus cysts detected during ultrasonography performed between 18 and 22 weeks' gestation. The patients had genetic counseling, and amniocentesis and biochemical testing were offered to all patients. The data were analyzed by dividing the patients into 3 groups. Group 1 had targeted ultrasonography only, group 2 had ultrasonography and maternal serum alpha-fetoprotein testing, and group 3 had ultrasonography and triple-screen (maternal serum alpha-fetoprotein, human chorionic gonadotropin, and estriol) testing. Outcome was determined by fetal karyotype or by neonatal examination by a pediatrician for patients who declined amniocentesis. RESULTS: There were 25 patients in group 1. Isolated choroid plexus cysts were detected in 20 fetuses, and all had normal outcomes. Additional anomalies were detected in 5 fetuses. Two had normal karyotypes, and 3 had trisomy 18. There were 52 patients in group 2. The maternal serum alpha-fetoprotein levels were normal in 44 patients, 41 of whom had isolated fetal choroid plexus cysts. Of these 44 patients, 40 had normal outcomes, and 1 patient had a fetus with trisomy 18. The remaining 3 patients with normal maternal serum alpha-fetoprotein levels had additional fetal anomalies on ultrasonography, but the karyotypes were normal. The maternal serum alpha-fetoprotein levels were abnormal in 8 patients, of whom 6 had fetuses with isolated choroid plexus cysts and normal karyotypes. Two patients had additional fetal anomalies detected on ultrasonography and had abnormal karyotypes, 1 with trisomy 21 and 1 with trisomy 18. There were 51 patients in group 3. Results of the triple screen were normal in 32 patients. The choroid plexus cysts were isolated in 29 of the 32 patients, and all 29 fetuses had normal karyotypes. The other 3 patients with normal triple-screen results had additional fetal anomalies on ultrasonography. One fetus had normal chromosomes, and 2 had trisomy 18. The remaining 19 patients had abnormal triple-screen results. Among them, 16 fetuses had isolated choroid plexus cysts, 13 of whom were normal, 2 had trisomy 18, and 2 had a de novo unbalanced translocation. The remaining 3 fetuses had additional anomalies, and all 3 fetuses had trisomy 18. There were 14 fetuses with significant chromosomal abnormalities. Nine mothers were <35 years old, and 5 were >/=35 years old. CONCLUSIONS: This study shows the following: (1) The triple screen is a useful adjunct to targeted ultrasonography in selecting patients with fetal choroid plexus cysts for amniocentesis. (2) A normal triple-screen result and the absence of additional fetal anomalies on ultrasonography reliably exclude an underlying chromosomal abnormality, and amniocentesis is not indicated. (3) If the triple-screen result is abnormal, additional anomalies are seen on ultrasonography, or the mother is aged >/=35 years, then fetal karyotyping is recommended. (4) Patients who decline fetal karyotyping should have follow-up ultrasonography in 34 weeks' time.

Chorionic Gonadotropin↗

Selective use of indocyanine green angiography for occult choroidal neovascularization.

PURPOSE: Indocyanine green angiography is useful in situations where fluorescein angiography shows occult choroidal neovascularization or pigment epithelial detachment. We sought to determine how often the selective application of indocyanine green angiography results in useful information for eyes with occult choroidal neovascularization. METHODS: We reviewed 153 consecutive indocyanine green angiograms and identified 77 in which corresponding fluorescein angiograms showed occult choroidal neovascularization or pigment epithelial detachment. We examined the indocyanine green angiograms to detect areas of hyperfluorescence and to classify the margins of hyperfluorescence as well demarcated or poorly demarcated. RESULTS: Of 77 eyes, 42 (55%) eyes had occult choroidal neovascularization by fluorescein angiography, seven (9%) eyes had both classic and occult choroidal neovascularization by fluorescein angiography, and 28 (36%) eyes had pigment epithelial detachments. Of 42 eyes with occult choroidal neovascularization by fluorescein angiography, 21 (50%) had well-demarcated margins, 13 (31%) had poorly demarcated margins, and eight (19%) had no detectable hyperfluorescence by indocyanine green angiography. Of seven eyes with both classic and occult choroidal neovascularization by fluorescein angiography, two had both poorly demarcated and well-demarcated borders, two had only poorly demarcated borders, and three had well-demarcated borders by indocyanine green. The indocyanine green angiogram showed 23 (82%) of 28 pigment epithelial detachments to have well-demarcated borders of hyperfluorescence; 13 (57%) of 23 were treated. CONCLUSION: Indocyanine green angiography adds clinically useful information to fluorescein angiography by demonstrating well-demarcated areas of hyperfluorescence in 50% of eyes selected because of diagnosis of occult choroidal neovascularization and in 82% of eyes selected because of pigment epithelial detachment.

Choroid↗

Scanning laser ophthalmoscope fundus perimetry after surgery for choroidal neovascularization.

PURPOSE: Submacular surgery is under investigation for the treatment of subfoveal choroidal neovascularization secondary to age-related macular degeneration, ocular histoplasmosis syndrome, and other causes. The aims of this study were to determine whether the macular area from which choroidal neovascularization was removed surgically remained functional and whether there was any qualitative difference between eyes with different disease conditions or between eyes of younger and older patients. METHODS: Our study included 19 patients (19 eyes) with choroidal neovascularization, seven cases caused by age-related macular degeneration and 12 caused by ocular histoplasmosis syndrome, pathologic myopia, or idiopathic causes. All tests were performed at least 6 months after surgical removal of choroidal neovascularization. All patients underwent fundus perimetry with the scanning laser ophthalmoscope for evaluation of dense and relative scotomas and fixation site. RESULTS: After submacular surgery in 19 patients, 10 patients (one with age-related macular degeneration and nine with pathologic myopia, ocular histoplasmosis syndrome, or an idiopathic cause of choroidal neovascularization) fixated within an area that ophthalmoscopically and angiographically was an area of retinal pigment epithelial disturbance occupied by choroidal neovascularization preoperatively. Of 12 patients without age-related macular degeneration, seven of eight patients younger than 50 years of age compared with two of four patients 50 years or older fixated within the area of retinal pigment epithelial disturbance. CONCLUSIONS: Our data suggest that in patients without age-related macular degeneration who undergo submacular surgery, the surgically disturbed area previously occupied by choroidal neovascularization can remain functional postoperatively. Furthermore, occasionally a patient with age-related macular degeneration undergoing submacular surgery still can fixate in the area from which the choroidal neovascularization was removed.

Adolescent↗

Human choroid plexus is an uniquely involved area of the brain in amyloidosis: a histochemical, immunohistochemical and ultrastructural study.

To better understand the characteristics of amyloid deposition in the choroid plexus, we examined autopsied brain by routine histology, immunohistochemistry, and electron microscopy in three group of patients: primary systemic amyloidosis (n = 7), cerebral amyloid angiopathy (CAA, n = 6), and controls (n = 3). Three of the CAA patients had Alzheimer's disease. Congophilic, birefringent amyloid deposits of the choroid plexus were seen in six of the seven cases of systemic light chain amyloidosis. Immunohistochemistry revealed that the deposited amyloids had reactivity for immunoglobulin light chain and amyloid P component. Accumulation of macrophages labeled with monoclonal antibodies against CD 68 and major histocompatibility complex class II antigens were observed around the massive amyloid deposits. The presence of approximately 10 nm amyloid fibrils along the epithelial basement membrane as well as in the vascular walls was ascertained by electron microscopy. In CAA, Congo red-positive amyloid deposits were consistently present in meningeal blood vessels and were often found in senile plaques of the cerebral parenchyma; congophilic amyloid deposits were absent in the choroid plexus. Choroid plexus epithelial cells exhibited immunostaining for beta amyloid precursor protein (APP) with N-terminal- and C-terminal-specific antibodies; in particular, consistent staining was obtained for the latter antibody. Immunoreactivity for amyloid beta protein (A beta) with monoclonal antibodies (6E10, 4G8) was often found in choroid plexus epithelial cells. These findings suggest that amyloid deposition of the choroid plexus depends on the major component protein in amyloidosis, and that the choroid plexus may produce APP and A beta protein although A beta amyloidosis is not evident in the choroid plexus.

Aged↗

Unilateral light-dark transitions affect choroidal blood flow in both eyes.

There is recent evidence that the perfusion of the choroid changes during dark-light transitions. We set out to investigate this response in more detail and to elucidate possible mechanisms involved in this process. For this purpose, the effect of dark-light transitions on choroidal perfusion was studied in healthy subjects. Choroidal blood flow and ocular fundus pulsation amplitude were measured as indices of choroidal perfusion during dark-light transitions using laser Doppler flowmetry and laser interferometry, respectively. In the first experiment, subjects were first kept in room light for 20 min, then light conditions were changed to darkness for 20 min, and thereafter, subjects were exposed to room light again. Both choroidal parameters decreased (-12% to -14%) during darkness but returned to baseline after the final room light period. In the second experiment, the index eye underwent the same procedure, whereas the contralateral eye was kept in light throughout the experiment. Choroidal haemodynamic parameters in the index eye reacted in a way comparable to that seen in the first experiment. The eye that was kept in light also reacted, but the effect tended to be less pronounced than that seen in the index eye (-8% to -10%). The observation that choroidal blood flow in both eyes reacts during unilateral light-dark transitions indicates that choroidal perfusion rate is adapted to retinal illumination conditions by neural control mechanisms.

Adaptation, Ocular↗

Persistence of tight junctions and changes in apical structures and protein expression in choroid plexus epithelium of rats after short-term head-down tilt.

Major alterations of choroidal cell polarity and protein expression were previously shown to be induced in rats by long-term adaptation to space flight (14 days aboard a space shuttle) or anti-orthostatic suspension (14 and 28 days) performed by tilting rats head-down (i.e. using a ground-based model known to simulate several effects of weightlessness). In rabbits, it was hypothesized that the blood-CSF barrier was opened in choroid plexus, after a short head-down suspension. To understand the early responses to fluid shifts induced by head-down tilts and evaluate the tightness of the choroidal junctions, we have investigated the effects of acute adaptations to anti-orthostatic restraints, using hindlimb-suspended Sprague-Dawley and Wistar rats. Ultrastructural and immunocytochemical studies were performed on choroid plexuses from lateral, third and fourth ventricles, after 30, 90 and 180 minutes of head-down tilt. Alterations were not perceptible at the level of choroidal tight junctions, as shown by freeze-fracture, claudin-1 and ZO-1 immunolocalizations and conventional electron microscopy, after intravenous injection of cytochrome C. The apical surface of choroidal cells was clearly more affected. Microvilli were longer and thinner and ezrin was over-expressed during all the periods of time considered, showing an early cytoskeletal response. Several proteins involved in the choroidal production of cerebrospinal fluid (sodium-potassium ATPase, carbonic anhydrase II, aquaporin 1) appeared first increased (30 minutes after the tilt), and then, returned to the control level or were lowered (after a 3-hour head-down suspension). Although head-down tilts do not seem to damage the blood-cerebrospinal fluid barrier in choroid plexus, it seemed that the expression of several apical proteins is affected very early.

Animals↗

Indocyanine green angiographic findings in idiopathic choroidal neovascularisation.

PURPOSE: The authors report the cases of two patients affected with idiopathic choroidal neovascularisation studied with combined fluorescein angiography and indocyanine green (ICG) angiography. In particular the presence of choroidal abnormalities at ICG angiography which could not be detected by fluorescein angiography was studied. METHODS: Both patients underwent a complete systemic and ocular assessment. Fluorescein angiography and ICG angiography were performed in a routine fashion at the time of presentation in both cases and after 14 months in the second patient. RESULTS: Results of the systemic investigations were unremarkable. A distinct dark rim surrounding the choroidal neovascular net was evident until the late phases of ICG angiography despite the presence of subretinal blood. Dilated choroidal vessels were observed beneath the neovascular membrane in both cases. In the first patient a hyperfluorescent area beyond the primary lesion was detected in the affected eye and a distinct leaking subfoveal choroidal venous vessel was found in the fellow eye. The second patient never showed other angiographic alterations either in the affected or in the fellow eye. CONCLUSIONS: ICG angiography has proved to be useful, both to better define and follow up the true extent of the pigment halo (healing response) around the neovascular membrane when subretinal blood and dye leakage at fluorescein angiography prevent its full appreciation, and to rule out other causes of choroidal neovascularisation in young healthy adults associated with either choroidal inflammatory focal lesions or choroidal vascular dynamic or inflammatory alterations.

Adult↗

Dopamine receptor immunohistochemistry in the rat choroid plexus.

1. Earlier studies have demonstrated a high density of dopamine D1-like receptor binding in the choroid plexus by light microscope autoradiography, but the dopaminergic specificity of this binding was questioned. 2. In this study the localization of dopamine receptor subtypes was investigated in the rat choroid plexus by Western blot analysis and immunohistochemistry using antibodies raised against dopamine D1-D5 receptor protein. 3. Western blot analysis revealed reactivity with immune bands of approximately 50 and 51 KDa corresponding to dopamine D1 and D5 receptors, respectively. Dopamine D1-like (D1 and D5) receptor protein immunoreactivity insensitive to superior cervical ganglionectomy was located in smooth muscle of choroid arteries and to a larger extent within choroid plexus epithelium. 4. Western blot analysis revealed reactivity with immune bands of approximately 53 KDa and 40-42 KDa corresponding to dopamine D2 and D4 receptors, respectively, and no dopamine D3 receptor reactivity. Dopamine D2-like receptor protein immunoreactivity displayed a distribution similar to that of tyrosine-hydroxylase (TH)-immunoreactive sympathetic fibres and disappeared after superior cervical ganglionectomy. It consisted in the expression of dopamine D2 and to a lesser extent of D4 receptor protein immunoreactivity perivascularly and associated with choroid epithelium. No D3 receptor protein immunoreactivity was found in rat choroid plexus. 5. The above results indicate that rat choroid plexus expresses dopamine receptor protein, being dopamine D1-like receptors predominant in epithelium and arterial smooth muscle and D2-like receptors in sympathetic nerve fibres supplying choroid plexus epithelium and vasculature. 6. These findings suggests that dopamine receptors with a different anatomical localization may modulate production of cerebrospinal fluid.

Animals↗

[Observations of choroid pulsation].

BACKGROUND: While performing indocyanine-green (ICG) videoangiograms with the Rodenstock scanning laser ophthalmoscope (SLO), we got more and more aware of visible choroidal pulsation mainly during the inflow of ICG into the eye. We wanted to learn more about the frequency and the different forms of this phenomenon. MATERIAL AND METHODS: We examined 187 consecutive ICG angiographies retrospectively, which were performed with a Rodenstock SLO and stored by videotape. Most patients suffered from age-related macular degeneration and had a mean age of about 70 years. We defined 4 groups of different pulsatile dye inflow in the choroid, namely (group 1) the diffuse form, involving the whole macular region; (group 2) the local form, involving an area smaller than the fovea. In group 3 (mixed form) we found the pulsatile inflow diffuse initially, later on remained a local pulsation. In group 4 (special form) we noticed a localized pulsation of a longer duration (10-15 seconds) and of a special type, namely back and forth movements of dye in one or a few choroidal veins. In addition, we examined the presence of pulsation in the central retinal vein. RESULTS: In 173 of 187 angiograms we could examine the choroidal inflow in the macular region. We found in 94 of these 173 angiograms (or in 54%) choroidal pulsation. 84% of all cases were in group 1, 2 and 3. This probably physiological pulsation occurred mostly in the first few seconds after the inflow of the dye. After about 5 seconds it was normally not visible any more. In our group 4 we collected 16 out of 94 angiograms (or 17%). We could not find a correlation between the presence of a pulsation in the central vein and in the choroid. CONCLUSIONS: Choroidal pulsatile inflow of ICG is a frequent (most probably physiological) phenomenon. The localized pulsation found in several older patients with back and forth movements of dye in one or a few veins may be abnormal; it reflects phasic pressure changes in choroidal veins of low flow. We do not know yet if this phenomenon is of any diagnostic value. However, more studies of these interesting dynamic processes seem to be warranted.

Adult↗