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At least 1,063 records · Page 59Linked to original sources
PubMed1999

Effects of irrigation fluid temperature on choroidal circulation during vitrectomy.

PURPOSE: To investigate the effects of irrigation temperature on choroidal circulation during vitrectomy. METHODS: After anesthetized albino rabbits underwent closed vitrectomy, choroidal blood flow was monitored while the vitreous cavity was irrigated with solutions (BSS plus) of various temperatures (6-42 degrees C). Irrigation pressure was maintained at 15 mmHg. A non-contact Doppler laser flowmeter was used to measure choroidal blood flow. Temperature change at the retina and mid-vitreous was also measured during irrigation. RESULTS: Choroidal blood flow showed a downward peak when perfused at 34 degrees C. As irrigation temperatures deviated above or below 34 degrees C, the blood flow increased. However, when irrigation temperature was below 16 degrees C, the blood flow decreased as the temperature declined. The temperature at the retina was maintained at a relatively constant level when irrigation was between 30 degrees C and 40 degrees C. CONCLUSION: The choroid acts as a thermostat to minimize intraocular temperature fluctuations by changing its blood flow.

Animals↗
PubMed1999

Effects of pranidipine, a new calcium antagonist, on circulation in the choroid, retina and optic nerve head.

PURPOSE: To study the effects of pranidipine, a newly developed Ca(2+)-antagonist, on tissue circulation in the optic nerve head (ONH), choroid, and retina in rabbits. METHODS: Pranidipine (5 microg/kg) or vehicle solution was injected intravenously in urethane-anesthetized rabbits and the normalized blur value (NB), a quantitative index of in vivo tissue blood velocity, was measured in the choroid and in an area of the ONH and retina free of visible surface vessels before and for 90 min after injection, using the laser speckle method. Measurements in the ONH and choroid were performed in the same albino rabbit eyes (pranidipine group, n = 10; control group, n = 10) and those in the retina in another group of Dutch rabbits (pranidipine group, n = 10; control group, n = 10). RESULTS: Between 30 and 90 min after injection, the NB in the pranidipine group increased by 24% in the ONH, 19% in the choroid, and 17% in the retina on an average compared to baseline, and was significantly different from that in the control group (P < 0.0001, ANOVA). There were no significant inter-group differences in the systemic parameters, except for a transient decrease in blood pressure in the pranidipine groups. CONCLUSIONS: Pranidipine increased blood velocity and probably blood flow in the ONH, choroid, and retina of rabbits.

Animals↗
PubMed2004

Measurement procedures in confocal choroidal laser Doppler flowmetry.

PURPOSE: To estimate a practical number of measurements within a series of recordings with a confocal choroidal laser Doppler flowmeter, capable of providing an adequate statistical power for future studies. METHODS: Ten independent measurements of choroidal blood flow were obtained within 30 minutes in one randomly selected eye of 24 subjects. In 12 subjects, subsequent series of 10 measurements were also obtained 2 and 7 days after baseline assessment. Average and median values of these series were calculated for the choroidal blood flow parameters velocity, volume, and flux, using either the first 3, the first 4, the first 5, the first 6, the first 7, the first 8, the first 9, or all 10 measurements. The variance between the series was analyzed using non-parametric tests. RESULTS: The average values of a series of independent measurements decreased with an increasing number of independent measurements. More than 5-7 independent recordings did not markedly influence the estimate of the average value of choroidal blood flow parameter for an individual. Baseline measurements showed markedly higher values than subsequent series. Average values obtained with 6 independent measurements seem to provide a reasonable level of statistical power for paired comparisons, 13 subjects providing a 80% power at a probability level of 0.05 to find a significant difference of 15% between two means. CONCLUSION: It seems recommendable that experimental measurements with a confocal choroidal laser Doppler flowmeter are preceded by a session of familiarization and that average values of series of at least 6 measurements are used.

Adult↗
PubMed1999

Quality of life in patients with choroidal melanoma: a pilot study.

PURPOSE: To assess the internal consistency of a short, widely-used health-related quality of life instrument in patients with choroidal melanoma, its appropriateness for use in a large clinical trial in patients with that disease, and the feasibility of various methods of instrument administration. METHODS: The SF-36 was administered to 31 choroidal melanoma patients identified from two ocular oncology practices. Fifteen patients were interviewed by telephone, 4 were interviewed in person at the clinic, and 12 patients completed the instrument themselves while at the clinic. RESULTS: Twenty-three patients had already been treated for choroidal melanoma; 20 patients were treated with some form of radiation. The remaining 8 patients had not yet been treated. Metastasis had not been diagnosed in any of the patients. Patient age ranged from 37 to 85 years with a median of 59 years; 55% of the patients were female. The in-person and telephone interviews performed better than self-administered interviews in terms of missing items due to non-response (0% vs. 3.2%). The overall SF-36 health profile for the choroidal melanoma patients was similar in shape to that expected for a general U.S. population sample with the same age and gender distribution, although the choroidal melanoma patients averaged 4 to 11 points higher, indicating better health-related quality of life, for all scales except the role functioning-emotional scale. CONCLUSIONS: The results supported the internal consistency of the SF-36 in this population. Interviewer administration of the SF-36 either in-person or by telephone was acceptable to the patients and provided more complete data.

Adult↗
PubMed1980

The effect of cholera toxin on choroid plexus carbonic anhydrase activity in vitro.

The effects of the adenylate cyclase agonists cholera toxin and prostaglandin E2 on carbonic anhydrase activity in vitro was measured in choroid plexuses isolated from Sprague-Dawley rats. Choroid plexuses were incubated in buffer at 38 degrees C (pH 7.4) with either cholera toxin or prostaglandin E2 (PGE2) at a concentration and for a time period that had been shown in earlier studies to result in maximal stimulation of cyclic AMP production. Cholera toxin (10 micrograms/ml) caused a twofold increase (p < .001) in choroid plexus carbonic anhydrase activity when cholera toxin treated plexuses [20.92 +/- .46 mol CO2/(min)(mg protein X 10(-8)] were compared with plexuses exposed to heat inactivated cholera toxin (10.92 +/- .43). When choroid plexuses were homogenized and separated into a 10,000 g pellet and a supernatant fraction, the supernatant carbonic anhydrase was unresponsive to cholera toxin stimulation. In the pellet fraction, which contained all the cellular adenylate cyclase, challenge with cholera toxin produced a significant increase in carbonic anhydrase activity (p < .01). Control activity was 10.9 +/- 1.2 mol CO2/(min)(mg protein X 10(-8), while carbonic anhydrase activity in fractions exposed to cholera toxin was 28.4 +/- 0.8. PGE2 had no effect, however, upon choroid plexus carbonic anhydrase activity. Since both PGE2 and cholera toxin stimulate cyclic AMP production in vitro, a compartmental model of secretory control is proposed.

Animals↗
PubMed2006

Intravenous pulse methylprednisolone therapy for acute treatment of serpiginous choroiditis.

PURPOSE: To evaluate the safety and efficacy of high-dose intravenous steroid therapy (HDIST) for the acute treatment of vision-threatening serpiginous choroiditis. METHODS: Retrospective review of the records of five patients with serpiginous choroiditis who were treated with HDIST (1 g methylprednisolone for three days) in addition to their standard immunosuppressive treatment. The visual acuities and improvement of ocular signs after HDIST were evaluated. RESULTS: Twelve episodes of macula-threatening choroiditis in five patients with serpiginous choroiditis were treated during a seven-year period. All patients responded to HDIST with evidence of a decrease in intraocular inflammation immediately after and complete restoration of visual acuity within 10 days of commencing treatment. In one patient, medical intervention was required because of gastric distress. During the follow-up, three out of five patients experienced new attacks and two patients developed subretinal neovascularization. CONCLUSION: HDIST is effective in controlling severe vision-threatening serpiginous choroiditis and in improving visual function in a short period of time. However, the effect of this treatment in long-term disease control is uncertain.

Acute Disease↗
PubMed2002

Role of choroidal drainage in therapeutic keratoplasty.

PURPOSE: To discuss the role of choroidal drainage in the management of positive vitreous pressure during therapeutic keratoplasty for patients with perforated corneal ulcers. METHODS: Over a 2-year period, 8 of 36 (22%) consecutive patients with therapeutic grafts presented with a shallow anterior chamber during or immediately after surgery. These patients underwent choroidal drainage for formation of the anterior chamber. In 5 of them choroidal drainage was done intraoperatively when there was significant positive vitreous pressure and the anterior chamber could not be formed. Three patients had drainage within a week postoperatively for persistent shallow anterior chamber when ultrasonogram showed choroidal detachment. RESULTS: Of the eight cases, seven drained fluid and the chamber could be reformed well. One was a dry tap and the chamber did not reform completely. CONCLUSION: Choroidal detachment (CD) is a previously unpublished cause for positive vitreous pressure in therapeutic keratoplasty for perforated corneal ulcers. In these situations suprachoroidal drainage can be considered as an option for the reformation of the anterior chamber. We recommend that a preoperative B-scan ultrasound be included in the workup of all corneal perforations and that intraoperative drainage of the fluid is considered in cases with significant positive vitreous pressure and confirmed CD.

Anterior Chamber↗
PubMed1998

Production and secretion of endothelin-1 by cultured choroid plexus carcinoma cells.

Choroid plexus carcinoma is a rare neoplasm derived from the epithelium of the choroid plexus. The production and secretion of endothelin-1 (ET-1) by cultured human choroid plexus carcinoma cells were studied by radioimmunoassay and Northern blot analysis. Immunoreactive (IR)-ET was detected in the culture medium (2.78 +/- 0.12 fmol/10(5) cells/24 h; n = 5; mean +/- SEM) but not in the unconditioned medium. Reverse-phase high-performance liquid chromatography of the extract of the culture medium showed a single peak eluting in the position of ET-1. Treatment with tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta) or a combination of interferon-gamma (IFN-gamma), TNF-alpha, and IL-1 beta caused significant increases in the IR-ET levels in the culture medium. Northern blot analysis of total RNA showed the expression of ET-1 mRNA in choroid plexus carcinoma cells. The expression levels of ET-1 mRNA were increased by treatment with a combination of IFN-gamma, TNF-alpha, and IL-1 beta. The present study has shown the production and secretion of ET-1 by cultured human choroid plexus carcinoma cells and suggests the possibility that ET-1 formation is related to the pathophysiology of this tumor.

Blotting, Northern↗
PubMed2001

Amelanotic choroidal nevus and melanoma: cytology, tumor size, and pigmentation as prognostic indicators.

BACKGROUND: Choroidal nevi are fairly common lesions of the posterior pole that can sometimes transform into melanoma, and it is thought that most choroidal melanomas arise from preexisting nevi. Occasionally, these lesions present as nonpigmented or amelanotic variations of their pigmented counterparts. Recent studies suggest a relationship between tumor pigmentation and risk of growth and metastasis, with a better prognosis for lightly pigmented or amelanotic lesions. CASE REPORTS: A case of an amelanotic choroidal nevus and melanoma are presented. In Case 1, a 26-year-old white female was found to have a large amelanotic nevus in the right eye. After 7 years of periodic observation, the lesion has not changed. In Case 2, a 51-year-old white male was diagnosed with a large amelanotic melanoma in the left eye. Due to extensive involvement of the optic nerve, the patient underwent enucleation. Histological evaluation confirmed the lesion as a mixed-cell type malignant amelanotic melanoma. CONCLUSION: Management of choroidal nevi generally consists of periodic observation, and the most widely accepted management of choroidal melanoma is observation, radiotherapy, and transpupillary thermotherapy or enucleation. The therapeutic modality of choice for melanoma will vary depending on the size, growth, and location of the lesion. In addition, recent studies suggest an association between heavy tumor pigmentation, tumor size, cell type, and risk of metastasis. Although many variables will influence the final treatment option, pigmentation of the lesion should also be considered.

Adult↗
PubMed1991

Magnetic resonance imaging in choroidal osteoma.

High resolution magnetic resonance imaging (MRI) with surface coil and contrast material was used to demonstrate the presence of bone in choroidal osteoma. Contrary to initial impressions, choroidal osteoma does not show typical negative image of the bone in MRI scans. The ossifying tumor of the choroid appears as a bright (hyperintense) signal on T1-weighted images and as an area of relative low intensity on T2-weighted images. On contrast T1-weighted scans, the tumor showed gadolinium-DPTA (Gd-DPTA) enhancement. These MRI findings are discussed in relation with histopathologic features of choroidal osteoma and the presence of fat marrow in the intertrabecular spaces of the bone at the level of the choroid.

Adult↗
PubMed1992

Subretinal neovascularization secondary to choroidal septic metastasis from acute bacterial endocarditis.

The clinical features of an infective embolic choroidopathy are described, from its early onset to late complications in a 45-year-old man with acute Staphylococcus aureus endocarditis of the aortic valve. Initial fundus examination revealed, in addition to fresh choroidal lesions, stigmata of a previous embolic episode secondary to endocarditis from Actinobacillus actinomycetemcomitans. The choroidal lesions were extremely asymmetrical, with a clear preference for localization in the left eye. Similar ocular findings were seen in a 78-year-old female with mitral valve prolapse and acute S. aureus endocarditis. In this case, however, choroidal involvement from septic emboli spread was bilateral and roughly symmetrical. Choroidal neovascular membranes arising in scars from choroidal septic emboli occurred in the macular area of the left eye of both patients, 10 months and 5 years after embolization, respectively.

Actinobacillus Infections↗
PubMed1992

Pneumocystis carinii and Mycobacterium avium-intracellulare infection of the choroid.

It has been hypothesized that coinfection with mycobacteria occurs in patients with Pneumocystis carinii choroiditis, but cases demonstrating ocular infection by both organisms have not been reported. This study reports the case of a patient with P. carinii choroiditis who was treated with intravenous trimethoprim and sulfamethoxazole, followed by intravenous trimethoprim and dapsone. The choroidal lesions failed to resolve despite 6 weeks of treatment, and the patient died from massive pulmonary infection caused by P. carinii, Mycobacterium avium-intracellulare, and cytomegalovirus infections. Ocular histologic and electron microscopic examinations revealed choroidal infection by both P. carinii and M. avium-intracellulare. Serum levels of sulfamethoxazole were below the recommended therapeutic range for treating P. carinii infection during the first week of therapy, but adequate drug levels were subsequently obtained. Failure of choroidal lesions of P. carinii to resolve in some cases may suggest insufficient antimicrobial levels in the blood or raise the possibility of coexistent M. avium-intracellulare or other opportunistic infection.

AIDS-Related Opportunistic Infections↗
PubMed1996

Posterior routes of choroidal blood outflow in high myopia.

PURPOSE: A few reports in the ophthalmic literature have described choroidal blood outflow through posterior routes. Most of the patients reported were highly myopic; therefore, a correlation between such posterior routes and high myopia has been suspected. The authors examined highly myopic eyes using indocyanine green (ICG) videoangiography and investigated the prevalence and clinical significance of posterior routes in them. METHODS: The authors examined 255 highly myopic eyes (146 patients) using ICG videoangiography. All had refractive errors greater than--8.25 diopters (D). They also examined a control group consisting of 42 eyes (26 patients) that had refractive errors within +/- 3D. RESULTS: Of 255 highly myopic eyes, 61 (23.9%) had choroidal blood outflow through posterior routes. These routes were classified by type of vein according to its penetration site. One drained into the margin of the optic nerve head, and the other penetrated the sclera near the macula. However, only 1 of the 42 eyes (2.4%) in the control group showed choroidal outflow by a posterior route. The prevalence of posterior routes was significantly higher in the highly myopic eyes than in the control group (P < 0.05). CONCLUSION: Posterior routes of choroidal blood outflow were observed in nearly 25% of highly myopic eyes. These vessels appear to be one of the major routes of posterior choroidal outflow in highly myopic eyes.

Adolescent↗
PubMed2000

Choroidal white lesions as an early manifestation of sarcoidosis.

PURPOSE: To describe the natural history of a series of patients with fine white choroidal lesions and uveitis of previously unknown cause. METHODS: A retrospective chart review of 11 patients with chronic uveitis and multiple, small (50-100 microm), peripheral white lesions of the choroid was performed using a standardized questionnaire form. RESULTS: Ten of 11 patients were white women with an average age of 62 years. Seven of 11 patients had panuveitis; 4 of 11 patients had vitritis; and 6 of 11 patients had cystoid macular edema. Choroidal white lesions were bilateral in all but one patient. Seven of 11 patients were followed up for more than 1 year. During a 12- to 173-month follow-up (mean, 94 months), these patients showed coalescence and atrophy of the white lesions. Initial systemic examination for the cause of the uveitis and white choroidal lesions was negative in all seven patients. With long-term follow-up, sarcoidosis was diagnosed in five of the seven patients followed for more than 1 year. CONCLUSIONS: The pattern of inflammatory white choroidal lesions distributed in the peripheral retina that atrophy and coalesce with time and that are associated with uveitis in middle-aged white women may represent an early form of sarcoidosis.

Adrenal Cortex Hormones↗
PubMed2002

Long-term follow-up of patients with serpinginous choroiditis.

PURPOSE: To evaluate the long-term clinical course of serpiginous choroiditis-a recurrent inflammatory disease that causes progressive visual loss-and to determine the efficacy of immunosuppressive therapy. METHODS: A retrospective study of patients who met inclusion criteria for serpiginous choroiditis at The University of Iowa Hospitals and Clinics was performed. Information collected included duration of follow-up, number of recurrences of inflammation, visual acuities, and development of choroidal neovascularization. The number of recurrences of inflammation in patients treated with immunosuppressive agents was compared with that in patients treated only with corticosteroids or observation. RESULTS: Seventeen patients were identified who had a mean age at presentation of 39.6 years. The mean duration of follow-up was 149.2 months, with 13 patients who were followed up for >60 months. Twelve eyes either presented with or developed macular choroidal neovascularization during follow-up. Thirteen of the patients were followed up for >12 months. Of these 13 patients, 6 received treatment with immunosuppressive agents along with corticosteroids. Four of the six patients developed no further inflammatory recurrence. Seven of the 13 patients were treated with corticosteroids or observation. All of these patients developed recurrences (P = 0.021, Fisher exact test). CONCLUSIONS: Immunosuppressive agents appear to reduce the rate of recurrent disease in serpiginous choroiditis compared with corticosteroids.

Adolescent↗
PubMed2003

Immediate indocyanine green angiography and optical coherence tomography evaluation after photodynamic therapy for subfoveal choroidal neovascularization.

PURPOSE: To better understand the mechanisms of action of photodynamic therapy (PDT) with verteporfin for subfoveal choroidal neovascularization (CNV), the authors evaluated the retinal and choroidal response immediately after treatment with serial optical coherence tomography (OCT) and indocyanine green angiography (ICGA). METHODS: This study was a prospective, noncomparative case series. PDT was performed on nine eyes of nine consecutive patients who presented with subfoveal CNV due to age-related macular degeneration, and serial evaluation with OCT as well as ICGA was performed at 20-minute intervals for the first 2 hours and then at 1 week, 1 month, and 3 months. RESULTS: In the first 2 hours after PDT, OCT showed an increase in the thickness of the retina in the treatment area due to fluid leakage from the neovascular complex as confirmed by ICGA. At 1 week, marked reduction of intraretinal/subretinal fluid was observed in all patients. Neovascular complex nonperfusion by ICGA was associated with some degree of choroidal hypoperfusion in the treatment area. Return of the foveal contour by OCT was optimal after 1 month of treatment. At 3 months, choroidal reperfusion by ICGA and recurrent intraretinal/subretinal fluid by OCT were observed. CONCLUSIONS: Serial OCT and ICGA evaluation after PDT suggests that the initial successful CNV nonperfusion as shown by fluorescein angiography at 1 week occurs by means of selective PDT damage to the lesion and/or reduced choroidal blood flow in the treatment area, thereby decreasing intraretinal/subretinal fluid and facilitating restoration of the retinal architecture.

Aged↗
PubMedDate not supplied

Optical coherence tomography of choroidal nevus in 120 patients.

OBJECTIVE: To describe the optical coherence tomography (OCT) findings of choroidal nevi. METHODS: Retrospective, single-center case series of 120 eyes of 120 consecutive patients with choroidal nevi who were evaluated by OCT. Diagnostic imaging was performed with a Zeiss StratusOCT Model 3000 (Carl Zeiss Ophthalmic Systems, Dublin, CA) using scan acquisition protocols of 6 radial lines and retinal thickness analysis overlying the nevus. RESULTS: The mean patient age was 59 years (median, 60 years; range, 14-87 years). The choroidal nevus was a mean of 5.2 mm in basal dimension and 1.7 mm in thickness and was located a mean of 2.7 mm from the optic disk and 2.5 mm from the foveola. Related retinal findings by ophthalmoscopic evaluation included overlying retina edema (3%), subretinal fluid (16%), retinal thinning (0%), drusen (58%), and retinal pigment epithelium (RPE) detachment (2%). In comparison, related retinal findings at the site of the nevus by OCT included overlying retina edema (15%), subretinal fluid (26%), retinal thinning (22%), drusen (41%), and RPE detachment (12%). Furthermore, OCT permitted classification of the overlying retinal edema as focal cystoid (3%), diffuse cystoid (8%), coalescent cystoid (3%), and noncystoid edema (1%). By OCT, the overlying retina was normal thickness (32%), thinned (22%), or thickened (45%), and photoreceptor loss or attenuation was noted in 51% of cases. Specific OCT findings of the choroidal nevus were limited to its anterior surface with minimal penetration into the mass. These findings included increased thickness of the RPE/choriocapillaris layer (68%) and optical qualities within the anterior portion of the nevus of hyporeflectivity (62%), isoreflectivity (29%), and hyperreflectivity (9%). Hyporeflectivity was observed in 68% of pigmented nevi and 18% of nonpigmented nevi. When comparing OCT with clinical examination, OCT was more sensitive in the detection of related retinal edema, subretinal fluid, retinal thinning, photoreceptor attenuation, and RPE detachment. CONCLUSIONS: OCT is a useful diagnostic modality for imaging the retina overlying a choroidal nevus. Numerous overlying changes such as subretinal fluid, retinal edema, retinal thinning, and photoreceptor attenuation are visible by OCT.

Adolescent↗
PubMed2005

Combined photodynamic therapy and intravitreal triamcinolone for nonsubfoveal choroidal neovascularization.

PURPOSE: To examine the 12-month results for a group of patients with nonsubfoveal choroidal neovascularization who were treated with combined photodynamic therapy (PDT) with verteporfin and intravitreal triamcinolone acetonide. METHODS: Patients with nonsubfoveal choroidal neovascularization, which was defined as either juxtafoveal or extrafoveal neovascularization, were treated with PDT immediately followed by an intravitreal injection of 4 mg of triamcinolone acetonide. Need for retreatment was based on fluorescein angiographic evidence of leakage at 3-month follow-up intervals. The main outcome measures were visual acuity and the proportion of patients developing subfoveal extension. RESULTS: Of the 15 patients, 9 were women and 6 were men (mean age +/- SD, 80 +/- 7.5 years). The mean baseline visual acuity was almost 20/60 (mean logMAR = 0.46), and 14 of the 15 eyes had juxtafoveal choroidal neovascularization. At 3, 6, and 9 months, the patients had significant improvement in the mean visual acuity (P = 0.002, 0.001, and 0.007, respectively), but at the end of the 12-month follow-up period, the mean visual acuity was slightly worse than 20/40 (mean logMAR = 0.34), which was not statistically significant at an alpha level adjusted for multiple comparisons of .013 (P = .057) as compared with the baseline visual acuity. One patient had subfoveal extension of choroidal neovascularization. The mean number of treatments was 1.9. Three patients (20%) developed an intraocular pressure of >24 mmHg during follow-up, a threshold used to institute pressure reduction therapy. No patient developed endophthalmitis. CONCLUSION: The number of patients in this pilot study was limited; however, the visual acuity response and the low incidence of subfoveal extension suggest that PDT combined with intravitreal triamcinolone for the treatment of nonsubfoveal choroidal neovascularization merits further investigation as a first-line treatment.

Aged↗