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At least 865 records · Page 48Linked to original sources
PubMed1996

Recurrence of a choroidal neovascular membrane in a patient with punctate inner choroidopathy treated with daily doses of thalidomide.

PURPOSE: To determine whether thalidomide therapy can prevent a recurrence of a choroidal neovascular membrane in a patient with punctate inner choroidopathy. METHODS: Case report. In a 38-year-old woman with bilateral punctate inner choroidopathy, thalidomide therapy was initiated three days after laser photocoagulation of a choroidal neovascular membrane. RESULTS: The patient had a recurrence of the choroidal neovascular membrane eight months after the start of thalidomide therapy. CONCLUSIONS: The failure of thalidomide to prevent a recurrence of a choroidal neovascular membrane in this patient suggests that this medication may have only a limited benefit in preventing recurrences of choroidal neovascular membranes.

Adult↗
PubMed2000

Optical coherence tomography of orange-red subretinal lesions in eyes with idiopathic polypoidal choroidal vasculopathy.

PURPOSE: To study the cross-section images of orange-red lesions in eyes with idiopathic polypoidal choroidal vasculopathy and compare their protrusions quantitatively with those of serous retinal pigment epithelium detachment. METHODS: Optical coherent tomography images scanning remarkable orange-red lesions in eyes with idiopathic polypoidal choroidal vasculopathy and serous retinal pigment epithelium detachment in age-related macular degeneration or central serous chorioretinopathy were prospectively recorded. The correlation between the base diameter and the height of the lesions was analyzed. RESULTS: Optical coherence tomography images show prominent anterior protrusion of the orange-red lesions. The ratio of the height to the base diameter of the orange-red lesions in eyes with idiopathic polypoidal choroidal vasculopathy is 0.32+/-0.05, and it is significantly larger than lesions in eyes with serous retinal pigment epithelium detachment (0.18+/-0.05, P< .001). CONCLUSION: The orange-red lesions in eyes with idiopathic polypoidal choroidal vasculopathy have a more sharply peaked shape than serous retinal pigment epithelium detachment as a subretinal structure, suggesting polypoidal vascular lesions in eyes with idiopathic polypoidal choroidal vasculopathy are situated beneath the Bruch membrane and covered anteriorly with both the retinal pigment epithelium and the Bruch membrane.

Aged↗
PubMedDate not supplied

Geographic choroiditis and retinal vasculitis in rheumatoid arthritis.

A 37-year-old man developed geographic choroiditis and retinal vasculitis in the left eye while taking 3.5 mg/day oral prednisolone for rheumatoid arthritis. The choroidal lesions stopped growing when the dose of prednisolone was increased to 60 mg/day, while its tapering resulted in the recurrence and enlargement of the choroidal lesions to the macula. The patient experienced further recurrence twice in the following year. Indocyanine green angiography demonstrated the obstruction of choroidal arteries in addition to the complete obstruction of the choriocapillaris in a fresh lesion. This case was the first to have geographic choroiditis on the background of a systemic inflammatory disease.

Adult↗
PubMedDate not supplied

Iatrogenic choroidal neovascularization.

Iatrogenic choroidal neovascularization is an uncommon complication of laser photocoagulation and other ocular surgical procedures. It appears to be the result of a number of conditions, including damaged Bruch's membrane and/or retinal pigment epithelium, whose reparative processes trigger the release of angiogenic factors. Inflammatory cells and choroidal ischemia may also play a role. The prognosis varies depending on the underlying disease and the type of choroidal neovascularization (subretinal, chorioretinal, or choriovitreal). Minimizing the amount of laser energy used during laser procedures, avoiding repeat laser treatment to the same retinal area, and minimizing direct mechanical trauma to the retinal pigment epithelium and choroid decrease the chance of inducing iatrogenic choroidal neovascularization.

Choroid↗
PubMed1998

Levels of choroidal body carbonic anhydrase activity and glycogen in farmed halibut.

We postulate that ocular abnormalities in farmed Atlantic halibut occur following aberrant gas production in the choroidal body associated with the enzyme carbonic anhydrase. We investigated choroidal body carbonic anhydrase activity in affected and normal halibut. Immunohistochemical detection of carbonic anhydrase allowed neither quantification of enzyme levels nor determination of enzyme activity. Histochemical detection of carbonic anhydrase, however, allowed microdensitometric quantification of enzyme activity. Mean enzyme activity in affected individuals was over twice that in normal fish. Glycogen, which we suggest is used to fuel oxygen production in the choroidal body, was evaluated by Best's carmine staining. Microdensitometry demonstrated glycogen levels of be significantly higher in affected fish. These findings show that posterior segment gas bubble and cyst formation is associated with aberrantly high choroidal enzyme activity and high choroidal glycogen concentrations.

Animals↗
PubMed1997

[Idiopathic polypoid choroid vasculopathy].

BACKGROUND: The idiopathic polypoidal choroidal vasculopathy, also known as "posterior uveal bleeding syndrome" or "multiple recurrent serosanguineous retinal pigment epithelial detachments in black women" is a rare disease entity. A clincopathologic correlation of a patient with this disease is presented. CASE REPORT: A 47-year-old black woman was evaluated for a decrease of visual acuity in her right eye which had occurred over the last 3 months. Ophthalmic examination of her right eye revealed sub-RPE hemorrhage associated with a reddish-orange subretinal vascular-like lesion. In addition, both eyes displayed a few choroidal vascular-like bulbous structures in the superior temporal peripapillary region. The patient developed an extensive choroidal hemorrhage that led eventually to the enucleation of the eye. CONCLUSION: Choroidal neovascular membranes (CNV) secondary to idiopathic polypoidal choroidal vasculopathy differs in many aspects from other entities associated with CNV including clinical and fluorescein angiographic features, clinical course, and prognosis.

Bruch Membrane↗
PubMed2000

Polypoidal choroidal vasculopathy pattern in age-related macular degeneration: a clinicopathologic correlation.

PURPOSE: To report the histopathologic features of surgically removed submacular tissue from an elderly patient with a pattern of polypoidal choroidal vasculopathy on indocyanine green angiography. METHODS: Clinical examination including fluorescein and indocyanine green angiography and light microscopy of surgical specimen. RESULTS: A thick yellow proteinaceous subretinal fluid was seen in the right macula of an 81-year-old white man. Fluorescein angiography indicated progressive leakage from undetermined source apart from a few focal hyperfluorescent points. Indocyanine green angiography showed several polyps as well as dilated choroidal vessels in the macula and along the superior temporal arcade. A large plaque was visualized in the late phase. Microscopically, the specimen consisted of a thick fibrovascular membrane located on the choroidal side of the retinal pigment epithelium (RPE). The RPE layer was discontinuous whereas on its choroidal side an almost intact layer of diffuse drusen was observed. A group of dilated thin-walled vessels were found that appeared to be saccular on serial sections. Some of these were located almost immediately under the diffuse drusen. CONCLUSION: Histologic examination of submacular tissue removed from an eye with polypoidal choroidal vasculopathy showed several aneurysmal dilatations located directly under diffuse drusen within a sub-RPE, intra-Bruch's fibrovascular membrane.

Aged↗
PubMed2001

Photodynamic therapy of experimental choroidal neovascularization with a hydrophilic photosensitizer: mono-L-aspartyl chlorin e6.

PURPOSE: To demonstrate the selective localization of the hydrophilic photosensitizer mono-L-aspartyl chlorin e6 (NPe6) in experimental choroidal neovascularization in nonhuman primate eyes. METHODS: Sixty-seven experimental choroidal neovascular lesions (CNV) were created in the fundi of Macaca monkeys using the modified Ryan's model and documented by fluorescein and indocyanine green angiography. To determine the biodistribution of NPe6 and the optimal timing of laser irradiation after dye administration, NPe6 angiography and fluorescence microscopy with NPe6 were performed. Photodynamic therapy (PDT) was performed at various dye doses (0.5-10.0 mg/kg) and laser fluences (7.5-225.0 J/cm2) on the CNV and on 10 areas of normal retina and choroid. Treatment outcomes were assessed by fluorescein and indocyanine green angiography and confirmed by light and electron microscopy. RESULTS: NPe6 fluorescence microscopy demonstrated intense fluorescence of CNV and retinal pigment epithelial cells. Choroidal vessel walls and outer retina adjacent to CNV fluoresced moderately; retinal vessel walls and microcapillaries had trace fluorescence. The fluorescence of CNV lesions on fluorescein angiography became stronger than that of retinal vessels 20-60 minutes after dye injection. Choroidal neovascular lesion closure was achieved with NPe6 PDT without significant damage to the sensory retina. Histology demonstrated necrosis of CNV endothelial cells with minimal damage to surrounding tissues. CONCLUSIONS: NPe6 PDT selectively localizes to experimental CNV in nonhuman primates, resulting in occlusion of CNV with sparing of the neurosensory retina.

Animals↗
PubMed2004

Laser-induced macular holes demonstrate impaired choroidal perfusion.

PURPOSE: To evaluate choroidal perfusion following creation of a laser-induced macular hole in a nonhuman primate model. METHODS: Six rhesus monkeys underwent macular exposures delivered by a Q-switched Nd:YAG laser. The lesions were evaluated with fluorescein angiography and indocyanine green angiography using scanning laser ophthalmoscopy. RESULTS: Each lesion produced vitreous hemorrhage and progressed to a full-thickness macular hole. Indocyanine green angiography revealed no perfusion of the choriocapillaris beneath the lesion centers. Fluorescein angiography demonstrated mild enlargement of the foveal avascular zone due to loss of perifoveal capillaries. Histopathologic evaluation showed replacement of the choriocapillaris with fibroblasts and connective tissue. CONCLUSIONS: Nd:YAG laser-induced macular holes result in long-term impairment of choroidal perfusion at the base of the hole due to choroidal scarring and obliteration of the choriocapillaris. Evaluation of choroidal perfusion may be useful in assessment of laser-injured patients. Impairment in choroidal perfusion may have functional implications for surviving photoreceptors.

Animals↗
PubMed2005

The origins of polypoidal choroidal vasculopathy.

BACKGROUND/AIM: There are two theories on the pathogenesis of polypoidal choroidal vasculopathy (PCV): variants in choroidal neovascularisation (CNV) and inner choroidal vessel abnormalities. On indocyanine green angiography (IGA) with a video camera system, PCV has a characteristic appearance, but inadequate image quality has made detailed interpretation difficult. This study aims to improve imaging, using confocal scanning laser ophthalmoscopy (SLO), to elucidate the pathogenesis of PCV. METHODS: High speed IGA with confocal SLO of 45 eyes (44 patients) showed typical PCV findings of a branching vascular network and polypoidal lesions. RESULTS: Vessels comprising branching networks began to fill simultaneously with the surrounding choroidal arteries in 38 eyes. Small numbers of vessels filling within a branching network, in the arterial and arteriovenous phases of IGA, showed focal dilatation, constriction, and tortuousity. Vessel abnormalities, corresponding to polypoidal lesions, existed within a network in eight eyes and included loops similar in calibre to network vessels, and numerous microaneurysmal dilatations of small vessels. Vessel pulsation was seen in 24 eyes. CONCLUSION: PCV is caused by inner choroidal vessel abnormalities, not CNV.

Aged↗
PubMed1992

Immunoimaging of choroidal melanoma: assessment of its diagnostic accuracy and limitations in 101 cases.

Immunoscintigraphy (IS) was performed on 101 patients with space occupying intraocular lesions including choroidal melanomas (85), choroidal naevi (11), non-melanoma metastases (three), and other melanoma simulating lesions (two). Scintigraphic images with conventional and emission computer tomography techniques were obtained after the intravenous injection of 99mTc-labelled F(ab')2 fragments of monoclonal antibody (MoAb) 225.28S directed against the high molecular weight-melanoma associated antigen (HMW-MAA). Immunohistochemistry was performed on sections of four out of 10 melanoma-containing eyes to confirm MoAb binding. IS demonstrated positive scans in 66 out of 85 choroidal melanomas, offering a sensitivity of 78%. Sensitivity was dependent on the lesion size. True negative results were obtained in 15 out of 16 non-melanoma lesions (specificity 94%). False positive antibody accumulation was found in one patient with a post-traumatic subretinal haemorrhage. Immunohistochemistry demonstrated positive MoAb 225.28S binding in all melanoma sections. In summary IS offered substantial sensitivity and specificity in the differentiation of intraocular lesions, particularly choroidal melanomas, naevi, and metastases. In combination with other diagnostic procedures such as ultrasound echography and fluorescein angiography IS proved to be a valuable method in the diagnosis of choroidal melanoma.

Choroid↗
PubMed1998

Clinical application of digital indocyanine green angiography in choroidal neurofibromatosis.

Indocyanine green angiography (ICGA) was used to investigate 2 cases of type 1 systemic neurofibromatosis that had appeared at birth with café-au-lait skin spots, gradually developing into multiple cutaneous neurofibromas. Patients underwent periodical visual acuity examinations, the fundus was checked and fluorescein angiography (FA) was done; all findings appeared extremely stable. In 1995 these 2 patients underwent ICGA to check for pathological choroidal involvement. In both cases the initial examination stages showed multiple extensive areas of hypofluorescence, their morphology and extension coinciding with the retinal pigment epithelium (RPE) lesions shown by FA and by ophthalmoscopic examination. In later stages the hypofluorescent areas became smaller, generally shrinking to small isolated dots in the middle of the original areas. These initially hypofluorescent areas appeared to be due to slow focal choroidal filling caused by deep alterations to the walls of the choroidal arterioles induced by the disease. Chronic hypoperfusion of the choriocapillaris results in impairment of the overlying RPE, causing it to atrophy. The late hypofluorescent areas could be either persistent nonperfused lobules of choriocapillaris or neurofibromatose choroidal nodules. ICGA examination showed that the FA lesions described in the literature as choroidal nodules are in fact alterations to the RPE secondary to areas of hypoperfusion in the choriocapillaris.

Capillaries↗
PubMedDate not supplied

Choroidal vasculature changes in spontaneously hypertensive rats - transmission electron microscopy and scanning electron microscopy with casts.

PURPOSE: The purpose of the present study was to elucidate the specific morphological changes of the choroidal vasculature in long-term hypertension. METHODS: The choroidal vessels of spontaneously hypertensive (SHR) rats were examined with corrosion casts/scanning electron microscope (SEM) and the transmission electron microscope (TEM). RESULTS: In 18-month-old SHRs, corrosion casts and SEM showed tortuosity, caliber irregularity and generalized narrowing of the choroidal arteries. The draining venules were prominently decreased in number. The ampullae of the vortex veins were narrow, but arteriovenous anastomoses, crossing defects and obstruction were not seen. The choriocapillaris was elongated and engorged. TEM of the choroidal vessels showed hypertrophy of smooth muscle cells and irregular thickening of the basement membrane and narrow lumen of the choriocapillaris. The RPE and Bruch's membrane were intact. CONCLUSION: The choroidal vascular bed showed extensive morphological changes. This study revealed that hypertensive choroidopathy has specific features such as tortuosity, caliber irregularity, generalized narrowing of arteries, decreased number of draining venules and elongated and engorged choriocapillaris. These findings indicate that hypertensive choroidopathy is as important as retinopathy.

Animals↗
PubMed1975

Electron microscopic demonstration of hormone-producing metastatic carcinoma of the choroid from the bronchus.

Clinical, laboratory and pathological findings of a patient in bronchial carcinoma with choroidal metastasis were presented. X-ray examination of the chest suggested the tumor shadow in the posterior segmental bronchus of the right upper lobe of the lung (r-B2b), while funduscopy and fluorescein angiography revealed the presence of choroidal tumor. ACTH levels in tumor tissues at autopsy and in serum were measured and definitely demonstrated and elevated. Histopathologically, the primary lesion was r-B2b and diagnosed as a mucocellular type of adenocarcinoma. The choroidal lesion was metastatic carcinoma. Electron microscopic examination of the choroidal lesion reembedded for electron microscopy from celloidin-embedded materials for light microscopy could reveal the presence of characteristic cytoplasmic granules referred to as neurosecretory-type granules. It is extremely rare that a hormone-producing metastatic carcinoma of the choroid from the bronchus has been proved.

Adenocarcinoma↗
PubMed2004

Nicotine increases size and severity of experimental choroidal neovascularization.

PURPOSE: Cigarette smoking is the strongest environmental risk factor for all forms of age-related macular degeneration (AMD). In the present study, the influence of nicotine on the severity of choroidal neovascularization (CNV) in a mouse model of neovascular AMD and its effects on vascular smooth muscle cells derived from mouse choroid were investigated. METHODS: A mouse model for CNV was used to study the effects of nicotine in young and middle-aged mice. Nicotine was administered orally in the drinking water to achieve serum levels consistent with those of chronic smokers. Hexamethonium, a nonspecific nicotinic receptor antagonist, was injected subconjunctivally to counteract the effects of nicotine. A mouse choroidal vascular smooth muscle cell line was exposed to nicotine, vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), or a combination of one of the factors and nicotine. Cell growth was determined by cell counts, and the activity of matrix metalloproteinase (MMP)-2 and -9 was quantified by gel zymography. RESULTS: Nicotine administration resulted in increased size and vascularity of CNV, and older mice developed a greater relative increase than younger mice. This effect was blocked by subconjunctival hexamethonium. Choroidal vascular smooth muscle cells demonstrated a statistically significant increase in growth after exposure to a combination of PDGF and nicotine. Nicotine also reversed VEGF-induced suppression of MMP-2 activity. CONCLUSIONS: Nicotine increases size and severity of experimental CNV in the present mouse model, possibly by potentiating PDGF-mediated upregulation of proliferation of choroidal smooth muscle cells or by other mechanisms. These results suggest that non-neuronal nicotinic receptor activation probably mediates some of the harmful effects of cigarette smoking in wet AMD.

Administration, Oral↗
PubMed2006

Orthotopic human choroidal melanoma xenografts in nude rats with aggressive and nonaggressive PAS staining patterns.

PURPOSE: Choroidal melanoma is the most common primary ocular cancer among the adult population. Patient survival has been linked to the periodic acid-Schiff base (PAS)-positive vascular patterns in the tumors. The presence of PAS-positive loops or cross-linking parallel channels is a marker of an aggressive tumor. The purpose of this study was to develop new xenograft models of human choroidal melanoma that predictably demonstrate the PAS staining patterns associated with nonaggressive and aggressive tumors in humans. METHODS: Three human choroidal melanoma cell lines (C918, M619, and OCM-1) were used. C918 and M619 are considered aggressive, based on their ability to form PAS-positive channels in vitro. The nonaggressive OCM-1 cells do not form these channels. C918, M619, and OCM-1 spheroids were grown and implanted in the suprachoroidal space of 20, 17, and 16 WAG/RijHs-rnu nude rats, respectively. Tumors were grown for 1 to >4 weeks, and histology was performed to evaluate tumor growth and determine PAS labeling patterns. RESULTS: Growth of C918, M619, and OCM-1 xenografts were histologically verified in 20/20, 15/17, and 16/16 rats, respectively. PAS staining revealed loops and cross-linking parallel channels, typical of aggressive tumors in patients, in 90% of C918 and 100% of M619 xenografts. Only 4 of 16 OCM-1 xenografts showed PAS-positive loops. The rest showed no PAS staining or only perivascular staining, indicative of nonaggressive tumors. CONCLUSIONS: It is possible to grow human choroidal melanoma orthotopic xenografts in nude rats that reproduce the PAS staining patterns associated with aggressive and nonaggressive choroidal melanomas in patients.

Animals↗
PubMed2005

Reduced foveolar choroidal blood flow in eyes with increasing AMD severity.

PURPOSE: In an earlier study, the authors reported that foveolar choroidal blood flow (ChBFlow) decreases in patients with AMD and drusen. To explore further the choroidal circulatory changes in patients with AMD, the relationship between ChBFlow and fundus features associated with increased risk of choroidal neovascularization (CNV) were investigated. METHODS: The study included 26 control eyes of 17 normal subjects and 163 eyes with early AMD characteristics of 123 patients with AMD. The AMD study eyes were divided into three groups according to increasing risk for development of CNV: (1) drusen > or =63 microm, no RPE hyperpigmentary changes in the study eye, and no CNV in the fellow eye; (2) drusen > or =63 microm, RPE hyperpigmentary changes in the study eye, and no CNV in the fellow eye; and (3) eyes with CNV in the fellow eye. Laser Doppler flowmetry was used to assess relative foveolar choroidal blood velocity (ChBVel), volume (ChBVol), and flow (ChBFlow). Differences in the mean circulatory parameters were assessed by analysis of variance (ANOVA) and test of linear trend. RESULTS: Mean ChBVel, ChBVol, and ChBFlow decreased with increased risk for CNV (linear trend, P < 0.05). The lowest circulatory parameters were observed in the eyes with the highest risk for CNV development. Trends for ChBVel and ChBFlow were still significant after adjustment for multiple factors. CONCLUSIONS: There is a systematic decrease in choroidal circulatory parameters with an increase in the severity of AMD features associated with risk for the development of CNV, suggesting a role for ischemia in the development of CNV.

Aged↗
PubMed2000

Gamma knife radiosurgery as a primary treatment for prolactinomas.

OBJECT: The purpose of this study was to estimate the efficacy of gamma knife radiosurgery (GKS) in controlling tumor growth and endocrinopathy associated with prolactinomas. METHODS: Between 1993 and 1997, 164 of 469 patients with pituitary adenomas treated by GKS harbored prolactinomas. The dose to the tumor margin ranged from 9 to 35 Gy (mean 31.2 Gy), and the visual pathways were exposed to a dose of less than 10 Gy. The mean tumor diameter was 13.4 mm. The mean follow-up time for 128 cases was 33.2 months (range 6-72 months). Tumor control was observed in all but two patients who underwent surgery 18 and 36 months, respectively, after GKS. Clinical cure was achieved in 67 cases. Clinical improvement was noted with a decrease in the hyperprolactinemia after GKS. Nonetheless, in 31 (29%) of 108 patients who were followed for more than 2 years no improvement in serum prolactin levels was demonstrated, although this could be normalized by bromocriptine administration after treatment. Nine infertile women became pregnant 2 to 13 months after GKS and all gave birth to normal children. There was no visual deterioration related to GKS. Five women experienced premature menopause. In these patients there was subtotal disappearance of the tumor and an empty sella developed. CONCLUSIONS: Gamma knife radiosurgery as a primary treatment for prolactinomas can be safe and effective both for controlling tumor growth and for normalization of prolactin hypersecretion. A higher margin dose (> or = 30 Gy) seemed to be associated with a better clinical outcome. Gamma knife radiosurgery may make prolactinomas more sensitive to the bromocriptine.

Humans↗