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PubMed1997

Indocyanine green angiography in choroidal osteoma.

BACKGROUND: Choroidal osteoma is a rare choroidal tumor; knowledge of its indocyanine green characteristics is limited. METHODS: The fundus photographs and the fluorescein and indocyanine green angiograms of three patients were reviewed. Each patient was examined at least twice with a follow-up varying from 10 to 60 months. RESULTS: Late-phase fluorescein angiograms allow assessment of the extension of the osteoma as it is variably hyperfluorescent due to tumor staining combined with a variable degree of overlying retinal pigment epithelial changes. The hypofluorescent area observed in the early phase of the indocyanine green angiogram corresponds with the extent of the osteoma but the borders may be difficult to demarcate. In the late phase of the indocyanine green angiogram, hypofluorescence due to choriocapillaris loss and hyperfluorescence due to leakage from abnormal choroidal vessels are combined. Infrared angiography high-lights abnormal choroidal vessels and vascular spiders present on the tumor surface. It is difficult to differentiate these choroidal vascular anomalies from subretinal neovascularization. CONCLUSIONS: We find no homogeneous pattern either on fluorescein or on infrared angiography. The findings may change with follow-up, indicating changes within the tumor or the surrounding tissue that are still poorly understood.

Adult↗
PubMed1996

The behaviour of ED1- and ED2-positive cells in the rat iris and choroid following penetrating keratoplasty and cyclosporin A therapy.

BACKGROUND: The presence, morphology and distribution of ED1 and ED2+ cells have been recently reported in detail in the uveal tissues of the rat. These cells, particularly those of dendritic morphology, are possibly capable of antigen presentation and, therefore, may play an important role in immune processes of uveal and other ocular tissues. Using the whole-mount technique, the distribution of ED1+ and ED2- cells in the rat iris and choroid was investigated following penetrating keratoplasty (PKP) and following treatment with cyclosporin A (CsA). METHODS: Lewis (LW) rats received corneal buttons from Lewis-Brown Norway (LW-BN) donors and were randomly assigned to one of two groups: (I) operated, untreated (n = 24); (II) operated, CsA treated (10 mg/kg i.m.: n = 22). Four groups served as controls: normal LW rats (n = 13); (IV) unoperated, CsA treated (16 days' treatment; n = 8); (V) eight corneal sutures only, representing a simulated or "sham" operation (n = 4); (VI) syngeneic operated (LW to LW: n = 4). Animals of groups I and II were killed on the 5th, 9th and 13th postoperative days and on appearance of the corneal rejection (group I, day 13; Group II, day 16). Both eyes were enucleated, immediately fixed, and iris-choroid flat mounts were examined for ED1+ and ED2+ cells using APAAP immunohistochemistry. RESULTS: In the normal LW rat iris, ED1+ and ED2+ cells of both non-dendritic and dendritic morphology were observed. The placement of sutures in the cornea and PKP with or without treatment resulted in a reasonably regular response in both the iris and the choroid in the operated and partner eye. These included: (a) an increase in round iridal ED1+ and ED2+ cells in the operated eye and in round ED1+ cells in the partner eye; (b) a decrease in dendritiform ED2+ cells in the iris of the operated eyes as well as in the partner eye; and (c) a decrease in the dendritiform ED2+ cells in the choroid of the operated and partner eye. CsA treatment alone in unoperated animals resulted in significant decreases in the number of dendritiform ED1+ cells in the iris and in the dendritiform ED2+ cells in the choroid. CONCLUSION: Corneal transplantation in the Lewis rat results in responses in ED1+ and ED2+ cells in uveal tissues in both the operated eye as well as in the partner eye. The differences in cell behaviour supports the idea that distinct immune-competent cell populations are present within uveal tissues and that they may have differing roles in the pathological eye.

Animals↗
PubMed2005

Is a diagnostic CT of the brain indicated in patients with choroidal metastases before radiotherapy?

BACKGROUND AND PURPOSE: There is no evidence in the literature about the incidence of synchronous brain metastases in patients with choroidal metastases. This is of major importance, because the radiation fields of choroidal metastases and, later on, brain metastases, if treated consecutively, are partly overlapping, thus potentially increasing the rate of late side effects such as brain necrosis. The goal of this study was to determine the frequency of synchronous brain metastases. PATIENTS AND METHODS: 50 patients with choroidal metastases were enrolled into a study of the "Arbeitsgemeinschaft Radiologische Onkologie" of the German Cancer Society (ARO 95-08) with standardized 40 Gy radiotherapy, 2 Gy single dose. All patients were staged before treatment with a computed tomography of the brain (CCT). No patient showed clinical signs of brain metastases. RESULTS: 13 out of 50 patients (26%) had brain metastases in the CCT leading to radiotherapy of the brain and choroidal metastases in one volume. CONCLUSION: A CCT is indicated at the diagnosis of choroidal metastases for screening of synchronous brain metastases. The incidence is about 25%, and the diagnosis of brain metastases results in a different target volume: the whole brain including the posterior parts of the eyes compared to the posterior parts of the eyes alone. Therefore, the risk of late side effects could be reduced compared with an additional later radiotherapy of the whole brain with partly overlapping fields.

Adult↗
PubMed2002

[Indocyanine green angiography in choroid metastases].

BACKGROUND: Up to now the diagnosis of choroidal tumors was mainly based on ophthalmoscopy and ultrasound examination. Indocyanine green angiography allows the identification of vascular patterns in these tumors, which could be helpful in the differential diagnosis. The aim of the study was to characterize the staining patterns of choroidal metastases. METHODS: In the years 1996-2000 we performed ICG-A of 15 choroidal metastasis using the scanning laser ophthalmoscope from Rodenstock. The mean tumor height was 3.7 mm (2.0-9.0). These angiographies were compared to the angiographies of 38 choroidal malignant melanomas with a mean height of 3.6 mm (1.4-6-6). RESULTS: All metastases showed a blockage of the background staining and a patchy staining of the tumor surface. Intratumoral vessels could be detected in 13% of all cases of metastases. The choroidal melanomas examined showed a blockage of the background staining in all cases and tumor vessels in 89%. CONCLUSION: The angiographic picture of the metastatic lesions was characteristic. Intratumoral vessels could not be detected using ICG-A. Most of the metastases showed a patchy staining of the tumor surface.

Angiography↗
PubMed1999

[Confocal indocyanine green angiography with 3-dimensional topography. Results in choroid neovascularization (CNV)].

BACKGROUND: Confocal indocyanin green angiography (ICGA) offers detailed two-dimensional imaging of choroidal pathologies. However, the spatial extension of lesions is not reproduced. We developed a novel method for three-dimensional documentation of choroidal vascular abnormalities. METHODS: Focal series were performed using a laser scanning ophthalmoscope (Heidelberg Retina Angiograph). Thirty-two images within a distance of 4 mm were taken at a frequency of 20 Hz. Following correction of dislocation, a surface of normalized fluorescence intensity was determined and displayed topographically. RESULTS: In physiological eyes three-dimensional ICGA demonstrates the homogeneous concavity of the choroid with prominent overlay of retinal vessels. Classic choroidal neovascularization (CNV) imposes as substantial elevation. Occult CNV are demarcated despite negative conventional ICGA due to reduction of blocking phenomena. Therapeutic interventions such as photocoagulation, photodynamic therapy and surgery induce a resolution of CNV with or without residual defects within the choroidal pattern. CONCLUSION: Topographic ICGA allows for the first time in-vivo representation of prominence and depth of vascularized pathologies and provides a tool for improved diagnostic and therapeutic evaluation.

Choroidal Neovascularization↗
PubMed2004

Endoscopic coagulation of choroid plexus as treatment for hydrocephalus: indication and surgical technique.

OBJECT: Choroid plexus surgery, which had been discarded as a treatment for hydrocephalus, was brought back into use with the development of modern neuroendoscopic technology. The object of this article is to describe the author's experience of the surgery with special emphasis on the surgical indication. METHODS: Three infants underwent endoscopic choroid plexus coagulation as a treatment for hydrocephalus. Standard procedure for the surgery was unilateral transparietal insertion of a flexible neuroendoscope and electrical coagulation of the choroid plexus. The results showed the release of increased intracranial pressure in two infants, while the other, whose hydrocephalus was rather progressive, later required a VP shunt. CONCLUSION: Choroid plexus surgery for hydrocephalus seems to be effective in some patients. Advanced modern technology has enabled the application of a neuroendoscope for this procedure. From our limited experience, the key to the success of endoscopic choroid plexus coagulation is the selection of patients. Favorable candidates for the surgery seem to be those who suffer from the slow progressive, severe form of hydrocephalus and who lack the septum pellucidum.

Cerebrospinal Fluid Shunts↗
PubMed2000

Transplantation of iris pigment epithelium into the choroid slows down the degeneration of photoreceptors in the RCS rat.

BACKGROUND: Trophic factors [e.g. basic fibroblast growth factor (bFGF)] released by transplanted retinal pigment epithelial (RPE) cells are able to slow down the hereditary degeneration of the retina in the Royal College of Surgeons rat in sites distant from the site of transplantation where rod outer segment (ROS) phagocytic activity is not reconstituted by the transplants. METHODS: To investigate whether iris pigmented epithelial (IPE) cells are also able to generate this rescue by trophic factors, we transplanted IPE cells from Long-Evans rats into the choroid and subretinal space of 17 young RCS rats. The eyes were enucleated after 6 months and prepared for light microscopy. Six age-matched RCS rats served as controls. Light microscope sections from the whole choroid, healthy choriocapillaris, transplanted cells and the maximum thickness of the choroid, and outer nuclear layer parameters were analyzed by computer-assisted morphometry. RESULTS: In transplanted animals photoreceptor cells were rescued from degeneration although the majority of the transplanted IPE cells were located in the choroid. In the non-transplanted group photoreceptors were absent. CONCLUSIONS: Transplantation of IPE cells slows down degeneration of the photoreceptors in the RCS rat. This photoreceptor-sparing effect by the IPE cells was observed even when the transplants were predominantly located within the choroid. The beneficial effect observed may be related to trophic factors possibly secreted by the transplanted IPE cells.

Animals↗
PubMed2001

Optical coherence tomography (OCT) findings in normal retina and laser-induced choroidal neovascularization in rats.

BACKGROUND: To evaluate the optical coherence tomographic (OCT) features of the retina of rats, we compared the OCT images with the histological appearance of normal retinas and retinas with laser-induced choroidal neovascularization. METHODS: Twelve eyes of 12 adult pigmented rats (Brown-Norway) were used. Color fundus photography, fluorescein angiography (FAG), and OCT images of normal retinas and retinas with laser photocoagulation-induced choroidal neovascularization were studied. RESULTS: OCT showed a double-layered structure in the normal sensory retina with a highly reflective layer located in the inner retina and a low reflective layer located in the outer retina. The retinal pigment epithelium (RPE) and choriocapillaris were imaged as a layer with the highest reflection. On the first day after photocoagulation, OCT showed a disruption of the highly reflective layer corresponding to the RPE, and an enhanced reflectivity in the choroid under the lesion. Choroidal neovascularizations (CNVs) which appeared 2 weeks after photocoagulation was seen as a multi-layered, highly reflective area protruding from the RPE into the subretinal space A CNV beneath a subretinal hematoma was difficult to detect because of the low transmission of the scanning light through the hematoma. The histopathological appearance was well correlated with the OCT images. CONCLUSION: The two reflective bands in the OCT images were identified as coming from the inner layers of the retina and from the photoreceptors. The highest reflective band arose from the RPE and choriocapillaris. In the future, OCT combined with FAG or indocyanine-green angiography will be a useful tool for the evaluation of animal studies of choroidal neovascularization and other retinal diseases.

Animals↗
PubMed2000

Alterations of sensory retinal explants exposed to choroidal melanoma cells ex vivo.

BACKGROUND: Cultures of retinal explants have been established as a useful tool to investigate effects of pathogenic agents in vitro. We used such cultures as a model to study the effects of choroidal melanoma on retinal organisation and function. METHODS: Rabbit retinal explants were co-cultured with human choroidal melanoma cells, or exposed to supernatants from choroidal melanoma cell cultures, for various periods from 1 day to 10 days. The retinal explants were then studied by histology and immunocytochemistry for glial fibrillary acidic protein (GFAP) and vimentin. The release of the pro-inflammatory interleukins IL-6 and IL-8 into the media was measured by enzyme-linked immunosorbent assay. RESULTS: Both in the co-cultures and after treatment with choroidal melanoma cell supernatants for more than 1 week, the layered structure of the retinae became disorganised. Retinal glial (Müller) cells displayed gliosis as indicated by increased GFAP immunoreactivity and decreased immunoreactivity for vimentin. Additionally, the secretion of cytokines, particularly of IL-8, was significantly modulated. The retinal explants produced much less IL-8 than the melanoma cells in separate cultures but increased their IL-8 release significantly after a few days' exposure to melanoma cell-conditioned medium. CONCLUSION: The results show that in cases of choroidal melanoma, the well-known morphological and inflammatory alterations of the retina are accompanied by glial cell reactivity and up-regulated retinal cytokine secretion, and may be caused by soluble factors secreted and induced by the melanoma.

Animals↗
PubMed2000

In vivo gene transfer into choroidal neovascularization by the HVJ liposome method.

PURPOSE: To evaluate the efficacy of the HVJ liposome method for gene transfer in rats with experimentally induced choroidal neovascularization. METHODS: Plasmid DNA containing the LacZ reporter gene, or fluorescein isothiocyanate (FITC)-labeled double-stranded phosphorothioate oligodeoxynucleotides (S-ODNs), was encapsulated in liposomes. The liposomes were coated with the envelope of inactivated hemagglutinating virus of Japan (HVJ). Intense laser burns were applied to the posterior pole of the retina of pigmented rats to induce choroidal neovascularization. Following photocoagulation, HVJ liposome suspension was injected into the vitreous. On days 3, 7, 14, and 28 after injection, the eyes were removed and fixed. The eyes injected with LacZ gene were reacted with X-gal, frozen, and cut into thin sections. The sections were examined for the expression of the LacZ gene by light microscopy. The enucleated eyes injected with double-stranded S-ODNs were frozen, cut into thin sections, and examined a confocal scanning laser microscope for FITC labeling. Eyes without injection of HVJ liposomes served as controls. RESULTS: Expression of LacZ genes (beta-galactosidase activity), or localization of FITC labeling, was observed mainly in the laser-induced choroidal neovascular tissue from 3 to 28 days after the intravitreal injection of HVJ liposome. CONCLUSIONS: We conclude that the HVJ liposome method achieved effective gene transfer into choroidal neovascular tissue. Thus, this method can be used as a nonviral gene therapy system for the treatment of choroidal neovascularization in vivo.

Animals↗
PubMed1999

Evaluation of microvascularization pattern visibility in human choroidal melanomas: comparison of confocal fluorescein with indocyanine green angiography.

BACKGROUND: The presence of specific microvascularization patterns (networks, parallel with and without crosslinking, silent) in histological sections of human choroidal melanomas has prognostic significance for survival. We showed previously in selected patients that the identification of these microvascularization patterns is possible in vivo by using confocal scanning laser indocyanine green angiography and that this technique is superior to fluorescein angiography using a conventional acquisition technique with a fundus camera. We now routinely use simultaneous confocal fluorescein/indocyanine green angiography to study microvascularization patterns in choroidal melanomas. The purpose of this study was to compare the visibility of tumor vessels and microvascularization patterns in fluorescein and indocyanine green angiography in simultaneous confocal series taken with the same instrument in a large prospective series of patients. PATIENTS AND METHODS: The simultaneously procured confocal fluorescein and indocyanine green angiograms of 50 patients with untreated choroidal melanomas (maximal apical height according to standardized A-scan between 2 and 8 mm) were studied for the visibility of tumor vessels and microvascularization patterns. At least one simultaneous confocal optical series (32 images in sequential depth order) during the early arterial venous phase was obtained per patient. RESULTS: Confocal forescein angiography disclosed signs of tumor vascularization in 12 (24%) of the 50 patients examined. However, in only 3 patients (6%) could microvascularization patterns be identified using confocal fluorescein angiography, and only in the very early arterial phase, which is often difficult to capture. In contrast, simultaneously obtained confocal indocyanine green angiograms disclosed tumor vessels in 47 (94%) of the examined 50 patients and microvascularization patterns could be identified in all of these cases. In 3 patients (6%) no tumor vessels could be detected within the tumor borders. CONCLUSION: This study demonstrates that confocal indocyanine green angiography images microvascularization patterns in choroidal melanomas better than fluorescein angiography, even when the images are acquired with the same technique. This can be explained with the different absorption, fluorescence and exudation characteristics of these dyes. In vivo imaging of these microvascularization patterns using confocal indocyanine green angiography offers the possibility of assessing the prognosis of choroidal melanomas without the removal of tissue.

Adult↗
PubMed1999

Cellular transport of subretinal material into choroidal and scleral blood vessels: an electron microscopic study.

BACKGROUND: The fate of indigestible material injected into the subretinal space of rats was investigated. METHODS: The non-toxic dye Monastral Blue (MB), which cannot be digested within the lysosomal compartment, was injected transsclerally into the subretinal space of Long Evans and Wistar rats. After 5 and 12 days respectively the eyes were enucleated and examined by light and electron microscopy. Cryo sections were made of eyes 5 days after MB injection for the application of immunohistochemical techniques using markers for epithelial cells (cytokeratin) and macrophages (ED 1). RESULTS: Retina, choroid and sclera were not altered in their morphology in the circumference of the MB-containing bubble generated by subretinal injection. After both 5 and 12 days no injected material was found extracellularly in the subretinal space. Especially high amounts of MB were found, in particular 5 days after injection, in lysosomes and melanosomes of RPE cells as well as in cells between choroidal melanocytes. Cells containing MB were seen in contact with choroidal and scleral blood vessels. These MB-containing cells in the choroid and in the sclera were positive for macrophage antibodies. CONCLUSION: Subretinal injection was confirmed as a suitable method for placing fluids into the subretinal space without affecting the morphology of the retina. Subretinal injected material was shown to be incorporated into lysosomes and melanosomes of RPE cells. The injected material was subsequently transported through Bruch's membrane to be finally removed from the eye via choroidal and scleral veins, the process involving macrophages.

Animals↗
PubMed2001

Transpupillary thermotherapy (TTT) in circumscribed choroidal hemangioma.

BACKGROUND: Choroidal hemangioma presents a therapeutic dilemma. Although it is a benign tumor, it may lead to massive exudation of subretinal fluid and a loss of visual function. Argon laser photo-coagulation in a grid pattern may be followed by initial absorption of subretinal fluid, but recurrence is common. Trans-scleral cryotherapy is difficult to apply at the posterior pole of the eye. External beam irradiation may bear a risk of maculopathy and papillopathy. Brachytherapy does not allow placement of radiation to the hemangioma sparing other retinal or choroidal structures. We sought to determine whether transpupillary thermotherapy (TTT) is suitable for treatment of choroidal hemangioma at the posterior pole. METHODS: We present ten patients with choroidal hemangioma. All of these received TTT. The mean follow-up period was 13.3 months (3-21 months). TTT was delivered via a slitlamp microscope with a diode laser at 810 nm. RESULTS: After TTT, reduction in tumor prominence was observed in eight patients at 3 months after treatment by A scan sonography. Visual acuity improved by more than three lines in four patients, and remained unchanged in all other patients. Two patients were retreated to achieve complete absorption of fluid. Serous retinal detachment persisted in three patients because the hemangioma could not be treated completely because of proximity to the fovea. CONCLUSION: Our preliminary results suggest that TTT may be used effectively to treat some choroidal hemangiomas in the first instance and prevent fluid leakage provided the lesion does not involve the fovea. However, long-term follow-up and more cases are needed to evaluate the long-term visual outcome and potential risks.

Adult↗
PubMed1997

Fine structure of the choroidal coat of the avian eye. Vascularization, supporting tissue and innervation.

To clarify further the functional anatomy of the avian choroid, including its innervation, 12 adult White-Leghorn chickens were studied by standard electron microscopy and immunoelectron microscopy with somatostatin antibody. The endothelial cells of the blood vessels in the choriocapillaris have fenestrations only facing the retina, while the nuclei are situated toward the sclera. In addition to tight junctions and zonulae adherentes, adjoining endothelial cells form gap junctions and dense plaques with attached filaments resembling those of smooth muscle cells. The fine structure of arteries and veins is similar to that of the vasculature described in other organs. The supporting tissue is organized in trabeculae, i.e., bridges of cellular and fibrous elements that surround and sustain blood and lymphatic vessels. This tissue consists primarily of a system of fusiform or star-shaped smooth muscle cells, connected to each other and to those in the vessels' walls through macular junctions of the adherent type, less prominent than desmosomes, and perhaps also punctiform gap junctions. Occasionally, trabecular smooth muscle cells approach the lymphatic vessels, which lack a muscular tunica, and abut their endothelium with spinous appendages. This stromal muscle tissue may act as a pump for moving the lymph. The suprachoroidea consists of large lymphatic lacunae and the multilayered membrana fusca. The elongated fuscal cells form adherent junctions, tight junctions, and perhaps also gap junctions, suggesting that the membrana fusca exerts complex functions. Nerves containing myelinated axons reach the choroid and divide into smaller branches, a few of which innervate the membrana fusca. Numerous, thin nerve branches reach both the walls of arteries and veins and the trabeculae, and synaptic terminals abut the outer muscular layers of the vessel's wall and the smooth muscle cells of the supporting tissue. Immunocytochemistry reveals the presence of numerous somatostatin-positive and somatostatin-negative axons and synaptic terminals within both trabeculae and vascular tunica media. The somatostatin-positive axons are presumed to be cholinergic axons of the choroid neurons residing in the ciliary ganglion. Taken together, these observations indicate that the avian choroid is a highly vascularized muscular sheath that may be endowed with degrees of motility and elasticity higher than those of the mammalian choroid and may therefore play an important role in compensation for experimental defocus.

Animals↗
PubMed2004

Giant intracerebral choroid plexus calcification.

While small calcifications of the choroid plexus are frequent, a large, single intracerebral calcification originating from the choroid plexus is rare. This report presents a 27-year-old woman who was admitted because of right temporal headache which had persisted for months. There was no neurological deficit. Computed tomography demonstrated a mass of calcium density measuring approximately 3 x 3 x 4 cm in the right temporal region, extending to the temporal skull base and to the rostral edge of the petrous bone. At surgery a very hard, poorly vascularised tumour originating from the choroid plexus of the temporal horn of the right lateral ventricle was completely removed. Histological workup yielded the diagnosis of a markedly calcified choroid plexus with no indication of neoplasia or inflammation. Physiological intracranial calcifications resulting from local tissue dystrophy are usually incidental. In the case presented here, a large intracerebral choroid plexus calcification was detected in a patient presenting with episodes of severe headache. The potential pathogenetic mechanism is discussed.

Adult↗
PubMedDate not supplied

Correlation between angiographic and pathological findings in experimental choroidal neovascular membranes after transpupillary thermotherapy.

PURPOSE: To evaluate the correlation between angiographic and pathological findings in experimental choroidal neovascular membranes after transpupillary thermotherapy (TTT). METHODS: Experimental subretinal choroidal neovascular membranes were produced in the monkey eye macula by intense photocoagulation. TTT was delivered, targeting the choroidal neovascular membranes, using a diode laser at 810 nm. One week and 4 weeks after TTT, indocyanine green angiography (IA), fluorescein angiography (FA), optical coherence tomography (OCT), and histological examinations were performed. RESULTS: One week after TTT, indocyanine green dye leakage from choroidal neovascular membranes was reduced on IA, and FA showed staining in the late phase. Light microscopic examination showed numerous small-caliber blood vessels and persistent subretinal exudation. Four weeks after TTT, there was no indocyanine green dye leakage on IA, and FA showed staining. OCT showed a decrease in retinal detachment. Light microscopic examination showed fewer blood vessels and subretinal exudation had disappeared. Choroidal neovascular membranes were composed of fibrous tissue. CONCLUSIONS: Changes in angiographic and OCT findings observed after TTT were inferred to be the result of accelerated fibrosis due to TTT and the disappearance of exudation.

Animals↗
PubMed1998

Primary culture of choroidal epithelial cells: characterization of an in vitro model of blood-CSF barrier.

A primary rat choroidal epithelial cell culture system was developed to investigate mechanisms of heavy metal toxicity on the blood-cerebrospinal fluid (CSF) barrier. Epithelial cells were dissociated from choroidal tissue by pronase digestion and cultured in standard DMEM culture media supplemented with 10% fetal bovine serum and 10 ng epithelial growth factor per ml. The procedure yielded 2-5 x 10(4) cells from pooled plexuses of three to four rats, and a viability of 77-85%. The cultures displayed a dominant polygonal type of epithelial cells, with a population doubling time of 2-3 d. The cultures were of distinct choroidal epithelial origins. For example, immunocytochemical studies using monospecific rabbit anti-rat TTR polyclonal antibody revealed a strong positive stain of transthyretin (TTR), a thyroxine transport protein exclusively produced by the choroidal epithelia. Also, reverse-transcriptase polymerase chain reaction (PCR) confirmed the presence of specific TTR mRNA in the cultures. The cultures were further adapted to grow on a freely permeable membrane sandwiched between two culture chambers. The formation of an impermeable confluent monolayer occurred within 5 d after seeding and was verified by the presence of a steady electrical resistance across the membrane (80 +/- 10 ohm per cm2). The epithelial barriers appeared to actively transport [125I]-thyroxine from the basal to apical chamber. These results suggest that this primary cell culture system possesses typical choroidal epithelial characteristics and appears to be a suitable model for in vitro mechanistic investigations of blood-CSF barrier.

Animals↗
PubMed1978

Metastatic choroidal melanoma.

We studied the metastatic pattern of 41 patients initially referred with a primary choroidal melanoma who later developed widespread disease. In the order of frequency, the most common sites of metastatic involvement were the liver (56%), subcutaneous tissue (36.5%), and bone (7%). Whereas the median interval between enucleation and the onset of metastatic disease was approximately four years, in rare cases, metastases were diagnosed concurrently with a primary choroidal melanoma. Since patients with choroidal melanomas usually survive less than one year after the development of widespread disease, a metastatic examination should be done in all patients with pigmented choroidal tumors both before and after ocular therapy. From the data obtained in this and other studies on metastatic melanoma, a reasonable basic metastatic examination for choroidal melanoma patients should include a serum lactic dehydrogenase, a serum alkaline phosphatase, a routine chest X-ray, and a general physical examination.

Adult↗