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Sample records for choroid diseases

  1. Choroidal physiology and primary angle closure disease.

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    Zhang, Xiulan; Wang, Wei; Aung, Tin; Jonas, Jost B; Wang, Ningli

    2015-01-01

    Primary angle closure disease (PACD), prevalent in Asian countries, is generally associated with a shallower anterior chamber, a shorter axial length, thicker lens, hyperopia, and female sex. Other physiologic factors, however, may be important, especially with regard to triggering acute primary angle closure. Thickening of the choroid has been demonstrated in untreated and treated, acute and chronic PACD eyes. Recently, there has been growing interest in studying the role of the choroid in the pathophysiology of PACD. The emergence of new imaging technology such as the enhanced depth imaging mode of spectral-domain optical coherence tomography and swept-source optical coherence tomography has contributed to understanding PACD pathologies. We summarize the functions of the choroid and choroidal changes in the pathogenesis of PACD, and discuss potential future developments. PMID:26164737

  2. Morphologic Characteristics of Choroid in the Major Choroidal Thickening Diseases, Studied by Optical Coherence Tomography.

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    Lee, Hoyoung; Bae, Kunho; Kang, Se Woong; Woo, Se Joon; Ryoo, Na-Kyung; Kim, Sang Jin; Han, Gyule

    2016-01-01

    We investigated morphologic features of choroid in the choroidal thickening diseases, including central serous chorioretinopathy (CSC), polypoidal choroidal vasculopathy (PCV), and Vogt-Koyanagi-Harada disease (VKH), by a novel tomographic classification system of the choroid. This cross-sectional study involved 30 patients with active CSC, 30 patients with active PCV, and 27 patients with active VKH, and 30 normal controls. Utilizing enhanced depth imaging optical coherence tomography, we classified the morphology of the choroid into five categories: 1) Standard (S), 2) Dilated outer layer and Attenuated inner layer (DA), 3) Darkened (D), 4) Marbled (M), and 5) Pauci-Vascular (PV) types. Additional tomographic characteristics of the choroid such as choroidal vascular dilation, convolution, scleral invisibility, and choroidal hyper- or hypo-thickening were identified as well. The distribution of five choroidal tomographic morphology and additional tomographic characteristics in each group were analyzed. The DA type was observed in the CSC group more frequently than in the normal control group (53.3% vs 3.3%, P invisibility (70.4%) than controls (0% for all three findings). In conclusion, CSC and PCV shared common morphologic characteristics of choroid, including dilated outer vascular layer and focally attenuated innermost layer. Dense hypo-reflectivity and convolution of choroid were the specific tomographic markers for acute VKH. A new tomographic classification system of choroid may provide discrimination ability and insight into major pachychoroidopathies. PMID:26766530

  3. Choroidal Coloboma in a Case of Tay-Sachs Disease

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    Nasreen Raees Ahmed; Koushik Tripathy; Vivek Kumar; Varun Gogia

    2014-01-01

    Coloboma as an ocular finding has been documented in various syndromes. Here we have a case of infantile Tay-Sachs disease associated with unilateral choroidal coloboma. To the best of our knowledge, such an association has not been documented in the literature. Whether such an association is a matter of chance or signifies the involvement of ganglioside metabolism in ocular embryogenesis remains to be elucidated.

  4. Choroidal Coloboma in a Case of Tay-Sachs Disease

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    Nasreen Raees Ahmed

    2014-01-01

    Full Text Available Coloboma as an ocular finding has been documented in various syndromes. Here we have a case of infantile Tay-Sachs disease associated with unilateral choroidal coloboma. To the best of our knowledge, such an association has not been documented in the literature. Whether such an association is a matter of chance or signifies the involvement of ganglioside metabolism in ocular embryogenesis remains to be elucidated.

  5. Choroidal coloboma in a case of tay-sachs disease.

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    Ahmed, Nasreen Raees; Tripathy, Koushik; Kumar, Vivek; Gogia, Varun

    2014-01-01

    Coloboma as an ocular finding has been documented in various syndromes. Here we have a case of infantile Tay-Sachs disease associated with unilateral choroidal coloboma. To the best of our knowledge, such an association has not been documented in the literature. Whether such an association is a matter of chance or signifies the involvement of ganglioside metabolism in ocular embryogenesis remains to be elucidated. PMID:25295204

  6. Choroidal OCT

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    Esmaeelpour, Marieh; Drexler, Wolfgang

    Novel imaging devices, imaging strategies and automated image analysis with optical coherence tomography have improved our understanding of the choroid in health and pathology. Non-invasive in-vivo high resolution choroidal imaging has had its highest impact in the investigation of macular diseases such as diabetes macular edema and age-related macular degeneration. Choroidal thickness may provide a clinically feasible measure of disease stage and treatment success. It will even support disease diagnosis and phenotyping as is demonstrated in this chapter. Utilizing color coded thickness mapping of the choroid and its Sattler's and Haller's layer may further strengthen the sensitivity of the investigation findings.

  7. Choroidal thickness profile in inherited retinal diseases in Indian subjects

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    Jay Chhablani

    2015-01-01

    Full Text Available Purpose: To evaluate changes in choroidal thickness (CT in inherited retinal diseases and its relationship with age, spherical equivalent, visual acuity, and macular thickness. Methods: Retrospective analysis of 51 eyes with features of retinal dystrophy of 26 subjects, who underwent enhanced depth imaging using spectral domain (SD optical coherence tomography (OCT, were included. The CT measurements were made at the fovea and at 5 points with an interval of 500 microns in both directions, nasal and temporal from the fovea and were compared with age-matched healthy subjects. Step-wise regression was used to find the relationship between age, spherical equivalent, best-corrected visual acuity (BCVA, central macular thickness (CMT, and subfoveal CT. Results: Disease distribution was as follows: Stargardt′s disease 18 eyes (9 subjects; Best disease 5 eyes (3 subjects; cone-rod dystrophy 26 eyes (13 subjects; and Bietti′s crystalline dystrophy 2 eyes (1 subject. Mean subfoveal CT was 266.33 ± 76 microns. On regression analysis, no significant correlation was found between subfoveal CT and any other variable such as age (P = 0.9, gender (P = 0.5, CMT (P = 0.1, spherical equivalent (P = 0.3 and BCVA (P = 0.6. While comparing with age-matched healthy subjects, no significant statistical difference was noted (P < 0.05 among all age groups. Conclusion: Our study reports quantitative changes in CT in various common inherited retinal diseases seen in Indian populations. To validate changes in choroid, a longitudinal study with larger sample size is warranted.

  8. Measurement and clinical implications of choroidal thickness in patients with inflammatory bowel disease

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    Ibrahim Koral Onal

    2015-10-01

    Full Text Available ABSTRACTPurpose:Ocular inflammation is a frequent extraintestinal manifestation of inflammatory bowel disease (IBD and may parallel disease activity. In this study, we evaluated the utility of a choroidal thickness measurement in assessing IBD activity.Methods:A total of 62 eyes of 31 patients with IBD [Crohn's disease (CD, n=10 and ulcerative colitis (UC, n=21] and 104 eyes of 52 healthy blood donors were included in this study. Choroidal thickness was measured using enhanced depth imaging optical coherence tomography. The Crohn's disease activity index (CDAI and the modified Truelove Witts score were used to assess disease activity in CD and UC, respectively.Results:No significant differences in mean subfoveal, nasal 3000 μm, or temporal 3000 μm choroidal thickness measurements (P>0.05 for all were observed between IBD patients and healthy controls. Age, smoking, CD site of involvement (ileal and ileocolonic involvement, CDAI, CD activity, and UC endoscopic activity index were all found to be significantly correlated with choroidal thickness by univariate analysis (P<0.05. Smoking (P<0.05 and the CD site of involvement (P<0.01 were the only independent parameters associated with increased choroidal thickness at all measurement locations.Conclusions:Choroidal thickness is not a useful marker of disease activity in patients with IBD but may be an indicator of ileal involvement in patients with CD.

  9. Diagnostic imaging of choroid plexus disease pictorial review

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    Guermazi, A.; De Kerviler, E.; Zagdanski, A.-M.; Frija, J

    2000-07-01

    Disorders of the choroid plexus, a central nervous system structure, are rare, but can pose diagnostic difficulties. The purpose of this review is to illustrate the computed tomography and magnetic resonance imaging findings of a wide spectrum of lesions that affect the choroid plexus. The areas covered include (1) neoplasms (papilloma, leukaemia, meningioma, lymphoma and metastases); (2) infections (bacterial, fungal and viral); (3) cysts; (4) haemorrhage; (5) congenital abnormalities (Sturge-Weber syndrome, Klippel-Trenaunay-Weber syndrome and vascular malformations); and (6) non-infectious inflammatory disorders (xanthogranulomas, inflammatory pseudotumour, neurosarcoidosis, rheumatoid nodule and villous hypertrophy). Few of the patterns of choroid plexus involvement are specific for a particular pathological process. Guermazi, A. (2000)

  10. Pathological alteration in the choroid plexus of Alzheimer´s disease: implication for new therapy approaches

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    Agnieszka eKrzyzanowska

    2012-05-01

    Full Text Available Morphological alterations of choroid plexus in Alzheimer´s disease (AD have been extensively investigated. These changes include epithelial atrophy, thickening of the basement membrane and stroma fibrosis. As a result, synthesis, secretory, and transportation functions are significantly altered resulting in decreased cerebrospinal fluid (CSF turnover. Recent studies discuss the potential impacts of these changes, including the possibility of reduced resistance to stress insults and slow clearance of toxic compounds from CSF with specific reference to the amyloid peptide. Here, we review new evidences for AD-related changes in the choroid plexus. The data suggest that the significantly altered functions of the choroid plexus contribute to the multiparametric pathogenesis of late-onset AD.

  11. Choroidal melanoma

    International Nuclear Information System (INIS)

    A useful and practical guide is developed to better track to the uveal melanoma, due to its highly malignant character. Melanoma of the uveal tract (choroid, iris, ciliary body) has been the intraocular tumor most frequent in adults. The biopsy has been inaccessible, due to its location; therefore, the diagnostic should be based on clinical examination and the correct utilization of the diagnostic procedures (ultrasound, fluorescent angiography, computed axial tomography and magnetic resonance). The cases are diagnosed in the histological examination of the operatory piece post-enucleation for other causes. Epidemiological research has been key to determine the associated factors and better to understand the mechanisms of onset of the disease. Anatomopathological studies of choroidal melanoma have permitted to know the natural history of the disease. The decrease of the visual acuity, pain or inflammation are presented as a defect in the visual field. Different techniques to diagnose the disease are explained. Ultrasound in mode A and B, computed axial tomography and magnetic resonance are the diagnostic method of election. Ultrasound has been the primary method of diagnostic, giving the size and vascularisation, useful in tracking, when they are treated in shape conservatively, showing changes in echogenicity and less vascularisation as good response to treatment. The treatments of choroidal melanoma are specified. The correct interpretation of the clinical symptoms and early utilization of diagnostic imaging methods, have permitted to establish the adequate therapeutic and to avoid local and distant metastasis. The uveal melanoma, depending on their size and location, traditionally has been treated by enucleation. Data from the literature and authors, have promoted the conservation of the ocular globe, depending on the size of the tumor. Transpupillary thermotherapy has been an available alternative for small tumors in Costa Rica and level of social security

  12. Indocyanine green angiography-guided management of Vogt-Koyanagi-Harada disease: differentiation between choroidal scars and active lesions.

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    Knecht, Pascal B; Mantovani, Alessandro; Herbort, Carl P

    2013-10-01

    When following Vogt-Koyanagi-Harada disease (VKH), indocyanine green angiography (ICGA) is crucial in the subacute and convalescent stages of the disease in order to detect subclinical choroiditis and prevent the development of 'sunset glow' fundus. Hypofluorescent dark dots (HDDs) indicate persisting granulomas in the choroid. However, probably as a result of the healing process of choroidal granulomas, stromal choroidal fibrosis can also be shown by HDDs. We present two cases where intravenous corticosteroid administration because of persistent HDDs led to resolution of lesions in one case while they persisted in the other case. We reviewed the medical history of two VKH patients. Complete routine work-up for patients with posterior uveitis was performed. The charts were screened for the presence of HDDs by ICGA in the subacute and convalescent stages of the disease before and after administration of body weight-adapted pulse intravenous methylprednisolone (PIM). The evolution of HDDs was studied and compared in both patients. A female patient presented with a persistent bilateral granulomatous panuveitis compatible with VKH. Cerebrospinal fluid analysis had shown lymphocytic pleocytosis. At presentation, therapy consisted of oral prednisone 80 mg/day. Prednisone was tapered down to 22 mg/day over 3 months, when a recurrence occurred with the presence of disseminated HDDs. PIM was administered, followed by oral corticosteroids. After 8 days of therapy, ICGA showed an almost complete disappearance of HDDs. A girl presented with bilateral panuveitis and widespread depigmented areas of her fundus. Cerebrospinal fluid analysis showed monocytic pleocytosis. Because of relative resistance to oral inflammation suppressive therapy (IST), PIM was administered for 3 days. Nevertheless, ICGA showed persistence of HDDs. Therapy was continued, and 3 months later, a follow-up ICGA still depicted numerous HDDs. Another PIM course was given, which had no effect on ICGA signs

  13. Choroidal thickness after intravitreal ranibizumab injections for choroidal neovascularization

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    Ellabban AA

    2012-05-01

    Full Text Available Abdallah A Ellabban, Akitaka Tsujikawa, Ken Ogino, Sotaro Ooto, Kenji Yamashiro, Akio Oishi, Nagahisa YoshimuraDepartment of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, JapanPurpose: To study changes in choroidal thickness with ranibizumab treatment for choroidal neovascularization (CNV.Design: Prospective case series.Methods: This prospective study consisted of 60 CNV-affected eyes of 60 patients treated with intravitreal injections of ranibizumab using an on-demand protocol after an initial loading phase. The eyes studied included 20 with age-related macular degeneration (AMD, 20 with polypoidal choroidal vasculopathy (PCV, and 20 with myopic CNV. In the eyes with AMD and PCV, choroidal thickness at the fovea was measured with optical coherence tomography using enhanced depth imaging. In eyes with myopic CNV, the choroidal thickness was measured using standard optical coherence tomography without the enhanced depth imaging technique.Results: With ranibizumab treatment, central retinal thickness decreased significantly (P < 0.001 and visual acuity improved significantly (P < 0.001. However, central choroidal thickness (167.2 ± 108.3 µm showed no significant change at 1 month after the loading phase (165.2 ± 107.8 µm, P = 0.120 or at final examination (164.8 ± 107.7 µm, P = 0.115. At baseline, central retinal thickness in eyes with AMD was significantly greater that those with PCV (P = 0.005 or high myopia (P = 0.029. However, central choroidal thickness in eyes with myopic CNV was significantly thinner than in eyes with AMD (P < 0.001 or PCV (P < 0.001. In each type of disease, there was no significant change in central choroidal thickness with ranibizumab treatment.Conclusion: The effect of ranibizumab on the choroidal thickness is minimal, if any.Keywords: choroidal thickness, ranibizumab, optical coherence tomography

  14. Clinical applications of choroidal imaging technologies

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    Jay Chhablani

    2015-01-01

    Full Text Available Choroid supplies the major blood supply to the eye, especially the outer retinal structures. Its understanding has significantly improved with the advent of advanced imaging modalities such as enhanced depth imaging technique and the newer swept source optical coherence tomography. Recent literature reports the findings of choroidal changes, quantitative as well as qualitative, in various chorioretinal disorders. This review article describes applications of choroidal imaging in the management of common diseases such as age-related macular degeneration, high myopia, central serous chorioretinopathy, chorioretinal inflammatory diseases, and tumors. This article briefly discusses future directions in choroidal imaging including angiography.

  15. Encapsulated living choroid plexus cells: potential long-term treatments for central nervous system disease and trauma

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    Skinner, S. J. M.; Geaney, M. S.; Lin, H.; Muzina, M.; Anal, A. K.; Elliott, R. B.; Tan, P. L. J.

    2009-12-01

    In neurodegenerative disease and in acute brain injury, there is often local up-regulation of neurotrophin production close to the site of the lesion. Treatment by direct injection of neurotrophins and growth factors close to these lesion sites has repeatedly been demonstrated to improve recovery. It has therefore been proposed that transplanting viable neurotrophin-producing cells close to the trauma lesion, or site of degenerative disease, might provide a novel means for continuous delivery of these molecules directly to the site of injury or to a degenerative region. The aim of this paper is to summarize recent published information and present new experimental data that indicate that long-lasting therapeutic implants of choroid plexus (CP) neuroepithelium may be used to treat brain disease. CP produces and secretes numerous biologically active neurotrophic factors (NT). New gene microarray and proteomics data presented here indicate that many other anti-oxidant, anti-toxin and neuronal support proteins are also produced and secreted by CP cells. In the healthy brain, these circulate in the cerebrospinal fluid through the brain and spinal cord, maintaining neuronal networks and associated cells. Recent publications describe how transplanted CP cells and tissue, either free or in an immunoprotected encapsulated form, can effectively deliver therapeutic molecules when placed near the lesion or site of degenerative disease in animal models. Using simple techniques, CP neuroepithelial cell clusters in suspension culture were very durable, remaining viable for 6 months or more in vitro. The cell culture conditions had little effect on the wide range and activity of genes expressed and proteins secreted. Recently, completed experiments show that implanting CP within alginate-poly-ornithine capsules effectively protected these xenogeneic cells from the host immune system and allowed their survival for 6 months or more in the brains of rats, causing no adverse effects

  16. Choroidal metastasis of a breast carcinoma

    International Nuclear Information System (INIS)

    The case of a 55-year-old woman with diagnosis of multinodular Grade II ductal infiltrating carcinoma in left breast was presented in this article. She presented with temporal visual field defect in her left eye. A choroidal metastatic tumor was diagnosed by indirect binocular ophthalmoscopy, confirmed by ocular echography. The primary tumor was removed by surgery and the choroidal lesion was treated with systemic chemotherapy, hormonal therapy and external beam radiation therapy. Six months after the treatment, the choroidal metastasis showed complete regression, and the best visual acuity of 20/20 was recovered, which was the initial value at the diagnosis of disease

  17. The normal choroidal thickness in southern Thailand

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    Jirarattanasopa P

    2014-11-01

    Full Text Available Pichai Jirarattanasopa,1 Nisa Panon,2 Siriphun Hiranyachattada,2 Patama Bhurayanontachai1 1Department of Ophthalmology, Faculty of Medicine, 2Department of Physiology, Faculty of Science, Prince of Songkla University, Hat Yai, Thailand Objective: To investigate the association between subfoveal choroidal thickness in healthy southern Thailand volunteers and age, axial length, and refractive error.Subjects and methods: This was a prospective cross-sectional case series. A total of 210 eyes of 105 healthy volunteers (86 women, age 23–83 years in southern Thailand were examined with enhanced depth-imaging optical coherence tomography. Subjects with systemic diseases that may affect the choroidal vascular blood vessels, such as diabetes, impaired renal function, and hypertension, were excluded. Refractive error and axial length were measured by autorefractometry and an IOLMaster, respectively. Subfoveal choroidal thickness was measured from the outer border of the retinal pigment epithelium to the inner scleral border in the subfoveal area.Results: The mean subfoveal choroidal thickness was 279.4±75.49 µm, and the mean age was 46.4±16.45 years. Subfoveal choroidal thickness was negatively correlated with age (r2=0.33, P<0.0001 and axial length (r2=0.02, P<0.02. Multivariable regression analysis showed subfoveal choroidal thickness was positively and negatively correlated with a spherical equivalent refractive error and axial length, respectively, when adjusted for age.Conclusion: Age is the most important factor in choroidal thickness rather than axial length and refractive error. Subfoval choroidal thickness was decreased 2.67 µm every year and 14.59 µm with 1 mm increase in axial length. Keywords: choroidal thickness, enhanced depth-imaging optical coherence tomography, swept-source optical coherence tomography

  18. Pediatric choroid plexus neoplasms

    International Nuclear Information System (INIS)

    Purpose: Choroid plexus tumors (CPT) are rare childhood neoplasms. The relatively small number of reported cases and the controversies surrounding the clinical and pathological classification of these tumors have made it difficult to define a standard of care for these patients. Our intention is to contribute to the body of knowledge of these tumors and further define the role of adjuvant therapy. Methods and Materials: We performed a retrospective review of 14 children with choroid plexus neoplasms referred to St. Jude Children's Research Hospital between October 1985 and December 1987. Ten patients had choroid plexus carcinoma (CPC) based on pathologic criteria and evidence of brain invasion at surgery or leptomeningeal disease (M+); 4 patients had choroid plexus papilloma (CPP). Patients with CPP were initially treated with surgery alone whereas patients with CPC were generally treated with postoperative therapy that included chemotherapy (CT) and/or craniospinal irradiation (CSI) with a focal boost to the primary site. For most patients CT consisted of combinations of cyclophosphamide, etoposide, vincristine, and a platinum agent. The median CSI dose was 35.2 Gy (range 24-46.2 Gy). The median primary site dose was 55.2 Gy (range 49.6-64 Gy). Results: Seven of the 10 CPC cases presented with leptomeningeal dissemination; two of these patients have succumbed to disease. Of the 3 patients with M0 status, all are alive with no evidence of disease (NED). The medial time to relapse from the time of surgery was 5.3 mo (range 3-25 mo). Seven CPC patients were treated with gross total resection (GTR). Three of these patients (2 M0, 1 M+) received CT without CSI and are currently NED (27, 69, and 60 mo respectively). One M+ patient progressed on CT and has stable disease after CSI (6 mo), one (M0) received CT and CSI and is NED (120 mo), one (M+) is currently on CT with objective response (3 mo) and one (M+) died of progressive disease (24.5 mo) despite CT and CSI. Three

  19. Choroidal metastasis from tubulopapillary renal cell carcinoma: a case report

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    Elghissassi, Ibrahim; Inrhaoun, Hanane; Ismaili, Nabil; Errihani, Hassan

    2009-01-01

    Choroidal metastases from renal carcinoma are rare. Most reported cases describe a clear cell carcinoma histologic subtype. Metastatic tubulopapillary renal cell carcinoma to the choroid plexus is very exceptional. We report the case of a 31-year-old man with a history of tubulopapillary renal cell carcinoma who presented two years later with metastatic disease to lungs and presternal soft tissue and three months after with choroidal metastasis revealed on ophtalmoscopic examination and magne...

  20. Inflammatory Choroidal Neovascularization

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    Neri, Piergiorgi; Lettieri, Marta; Fortuna, Cinzia; Manoni, Mara; Giovannini, Alfonso

    2009-01-01

    Purpose and Methods: Choroidal neovascularization (CNV) can be a severe sight-threatening sequela, which can be secondary to both infectious and noninfectious uveitis. This review summarizes the different diseases associated with CNV, highlighting new treatment modalities and the possible strategies, which could be applied for the therapy of this occurrence. Results: Since CNV can often originate from posterior pole lesions and can be hard to identify, an accurate examination is mandatory in order to identify the correct diagnosis. In the majority of cases, fluorescein angiography (FA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT) enable the determination of the clinical characteristics of the CNV. An infectious disease should be looked for to include a suitable therapy when available. The treatment strategy for CNV secondary to noninfectious uveal inflammations should be directed at controlling the inflammatory process. Systemic corticosteroids with or without immunosuppressive agents are indicated even when the CNV occurs with apparently inactive uveitis: Chronic subclinical inflammation can be the basis for the pathogenesis of CNV. Additional therapies aimed directly at the neovascular process, such as the intravitreal anti-Vascular Endothelial Growth Factor (VEGF) agents, are recommended particularly when the therapy shows an insufficient response. Conclusion: CNV secondary to uveitis is a severe sequela leading to significant visual impairment. ICGA is mandatory in order to obtain relevant information about the choroidal status. Several therapeutic options have been considered, but no guidelines are provided at the moment. Moreover, the current data are still only based on case reports or small series. For such reasons, further trials are mandatory to validate the preliminary available results. PMID:20404991

  1. Inflammatory choroidal neovascularization

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    Neri Piergiorgio

    2009-01-01

    Full Text Available Purpose and Methods: Choroidal neovascularization (CNV can be a severe sight-threatening sequela, which can be secondary to both infectious and noninfectious uveitis. This review summarizes the different diseases associated with CNV, highlighting new treatment modalities and the possible strategies, which could be applied for the therapy of this occurrence. Results: Since CNV can often originate from posterior pole lesions and can be hard to identify, an accurate examination is mandatory in order to identify the correct diagnosis. In the majority of cases, fluorescein angiography (FA, indocyanine green angiography (ICGA and optical coherence tomography (OCT enable the determination of the clinical characteristics of the CNV. An infectious disease should be looked for to include a suitable therapy when available. The treatment strategy for CNV secondary to noninfectious uveal inflammations should be directed at controlling the inflammatory process. Systemic corticosteroids with or without immunosuppressive agents are indicated even when the CNV occurs with apparently inactive uveitis: Chronic subclinical inflammation can be the basis for the pathogenesis of CNV. Additional therapies aimed directly at the neovascular process, such as the intravitreal anti-Vascular Endothelial Growth Factor (VEGF agents, are recommended particularly when the therapy shows an insufficient response. Conclusion: CNV secondary to uveitis is a severe sequela leading to significant visual impairment. ICGA is mandatory in order to obtain relevant information about the choroidal status. Several therapeutic options have been considered, but no guidelines are provided at the moment. Moreover, the current data are still only based on case reports or small series. For such reasons, further trials are mandatory to validate the preliminary available results.

  2. Choroid Melanoma Metastasis to Spine: A Rare Case Report

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    Hiren Mandaliya

    2016-01-01

    Full Text Available Metastatic choroid melanoma is a highly malignant disease with a limited life expectancy. The liver is the most common site for metastasis of uveal melanoma followed by lung, bone, skin, and subcutaneous tissue. Metastasis from choroidal melanoma usually occurs within the first five years of treatment for primary tumours. Metastatic choroid melanoma to the spine/vertebrae is extremely rare. We report the first case of spinal metastasis from choroid melanoma in a 61-year-old man who had been treated for primary ocular melanoma three years earlier with radioactive plaque brachytherapy. Synchronously, at the time of metastasis, he was also diagnosed as having a new primary lung adenocarcinoma as well. The only other case reported on vertebral metastasis from malignant melanoma of choroid in literature in which primary choroid melanoma was enucleated.

  3. Idiopathic polypoidal choroidal vasculopathy masquerading as choroidal tumors: one year follow-up of a peripheral lesion

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    Rony Carlos Preti

    2015-06-01

    Full Text Available ABSTRACT This case report describes peripheral idiopathic polypoidal choroidal vasculopathy (IPCV with a collection of small aneurysmal dilations that masqueraded as choroidal tumors in an elderly patient. A 68-year-old African American woman was referred to us with a suspected diagnosis of asymptomatic vascular choroidal tumor and choroidal capillary hemangioma, affecting the temporal peripheral fundus. Upon examination, optical coherence tomography (OCT revealed two large hemorrhagic pigment epithelium detachments (PED, and indocyanine green angiography (ICG confirmed the diagnosis of IPCV. One year later, there was reduction in the hemorrhagic pigment epithelium detachments and the lesion took on a different appearance, resembling a choroidal osteoma. No treatment was necessary despite the presence of multiple polyps. IPCV is a rare condition that can resemble other choroidal diseases depending on the stage of presentation. OCT is the best tool to determine the characteristics of the lesions, and indocyanine green angiography should be used to confirm the diagnosis. Not all cases require treatment.

  4. Macular serpiginous choroiditis

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    Sahu Dinesh

    2002-01-01

    Full Text Available Purpose: To report a variant form of serpiginous choroiditis, that initially or predominantly involved the macular area. Methods: Nine eyes of 6 patients with the macular form of serpiginous choroiditis were evaluated clinically and angiographically in a longitudinal fashion for a period of 12-36 months. The active stage and the recurrences were treated by oral and periocular cortico steroids; and two patients were supplemented with oral azathioprine. Most of these patients were referred to our center with varied diagnoses. Results: In this group, 4 were male and 2 were female with an average age of 30.5 years. Three patients had bilateral macular lesions, two had typical serpiginous choroiditis in the fellow eye and the remaining one had unilateral macular involvement alone. The initial visual acuity was 6/60 or less in 60% eyes whereas the final visual acuity was 6/18 or better in 66% eyes. Angiographic findings were typical of serpiginous choroiditis characterised by early hypofluorescence followed by leakage and staining of the borders and the lesion itself without any evidence of choroidal ischaemia or retinal vascular abnormalities. Conclusion: The macular variant of serpiginous choroiditis can mimic many other macular pathologic lesions, thus posing a diagnostic dilemma. Because of its relentless destructive course, early diagnosis and prompt treatment is required to prevent sight-threatening complications.

  5. Choroidal Tuberculoma in an Immunocompetent Young Patient

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    Xiu-fen Yang; Jun Xu; Kai Ma

    2011-01-01

    @@ TUBERCULOSIS (TB) remains one of the leading causes of preventable morbidity and mortality from infectious disease worldwide.1 It is a chronic progressive granulomatous infection caused by Mycobacterium tuberculosis (M.tuberculosis).Ocular involvement in patients with systemic TB has traditionally been considered uncommon.The incidence of ocular TB was reported to be 1.46% among 10 524 patients in a TB sanatorium2 and there are only few reports of choroidal tuberculoma in the literature .3-5 Here we reported a case of choroidal tuberculoma in an immunocompetent young patient with a history of tuberculous pleurisy.

  6. Circumscribed choroidal hemangioma

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    Saeed Karimi

    2015-01-01

    Full Text Available Circumscribed choroidal hemangiomas are benign vascular hamartomas without systemic associations. Generally, they are orange-red elevated masses, which are found posterior to the equator. Lesions are usually solitary and unilateral. Overlying subretinal fluid, serous retinal detachment and cystoid macular edema are common findings. Intravenous fluorescein angiography, indocyanine green angiography, ultrasonography, optical coherence tomography and enhanced depth imaging are helpful ancillary tests for diagnosis of circumscribed choroidal hemangiomas. Asymptomatic circumscribed choroidal hemangiomas do not require treatment. For symptomatic lesions with exudative retinal detachment or cystoid macular edema, photodynamic therapy has emerged as the treatment of choice with high rates of tumor regression, subretinal fluid resorption and minimal complications. Lens-sparing external beam radiotherapy, plaque brachytherapy, proton beam therapy, stereotactic radiosurgery, transpupillary thermotherapy, laser photocoagulation and anti-VEGF injections are other treatment modalities.

  7. Transvitreal retino-choroidal biopsy of suspected malignant lesions of the choroid

    DEFF Research Database (Denmark)

    Jensen, O.A.; Prause, J.U.; Scherfig, E.

    ophthalmology, intraocular biopsy, transvitreal retino-choroidal biopsy, malignant melanoma of choroid, histopathology, brachytherapy......ophthalmology, intraocular biopsy, transvitreal retino-choroidal biopsy, malignant melanoma of choroid, histopathology, brachytherapy...

  8. Central areolar choroidal dystrophy.

    NARCIS (Netherlands)

    Boon, C.J.F.; Klevering, B.J.; Cremers, F.P.M.; Zonneveld-Vrieling, M.N.; Theelen, T.; Hollander, A.I. den; Hoyng, C.B.

    2009-01-01

    OBJECTIVE: To describe the clinical characteristics, follow-up data and molecular genetic background in a large group of patients with central areolar choroidal dystrophy (CACD). DESIGN: Retrospective case series study. PARTICIPANTS: One hundred three patients with CACD from the Netherlands. METHODS

  9. Central Serous Chorioretinopathy Mistaken for Tuberculous Choroiditis

    OpenAIRE

    Marina Papadia; Herbort, Carl P.

    2011-01-01

    Purpose: To report a patient erroneously diagnosed with tuberculous choroiditis who was accordingly treated with long term steroids which in turn, worsened the actual disease process that turned out to be central serous chorioretinopathy (CSC). Case Report: A 59-year-old Caucasian man developed a chorioretinal disease in his right eye in 1997. Having a positive tuberculin skin test, tuberculous chorioretinitis was suspected and antituberculous therapy was administered for 4 months. In 200...

  10. Choroidal Proteins Involved in Cerebrospinal Fluid Production may be Potential Drug Targets for Alzheimer’s Disease Therapy

    OpenAIRE

    Wostyn, Peter; Audenaert, Kurt; De Deyn, Peter Paul

    2011-01-01

    Alzheimer’s disease is known to be the most common form of dementia in the elderly. It is clinically characterized by impairment of cognitive functions, as well as changes in personality, behavioral disturbances and an impaired ability to perform activities of daily living. To date, there are no effective ways to cure or reverse the disease. Genetic studies of early-onset familial Alzheimer’s disease cases revealed causative mutations in the genes encoding β-amyloid precursor protein and the ...

  11. A Case of Choroidal Tubercles

    Institute of Scientific and Technical Information of China (English)

    Chaoran Zhang

    2004-01-01

    Purpose: To report a case of choroidal tubercles in a miliary tuberculosis boy.Method: Clinical features description.Results: A 14-year-old boy was found to have multifocal choroidal tubercles. Angiography was performed. He was followed up for 12 months. The choroidal lesions regressed after using anti-tuberculosis drugs for 8 months. Pigment changes remained. Conclusion: Tuberculosis may present as a posterior segment inflammation. In miliary tuberculosis, choroid is also a target tissue. Eye Science 2004;20:23-24.

  12. Malignant melanoma of choroid

    Directory of Open Access Journals (Sweden)

    Manohar S

    1991-01-01

    Full Text Available Four cases of malignant melanoma of the choroid are reported due to rarity of the condition in India. One of the cases presented with Naevus of Ota. All the cases had typical clinical and investigative features. All cases were enucleated. Histopathologically three of them were of mixed type and one was of the epithelioid type. Two of the cases were seen in patients below 40 years of age.

  13. Primary Culture of Choroid Plexuses from Neonate Rats Containing Progenitor Cells Capable of Differentiation

    OpenAIRE

    Huang, Sheng-Li; He, Xi-jing; LI, ZONG-FANG; Yao, Lu; Yuan, Guo-Lian; Shi, Wei

    2013-01-01

    Background: The choroid plexuses, which could secrete a number of neurotrophins, have recently been used in transplantation in central nervous system diseases. Aims: To study the mechanism of nerve regeneration in the central nervous system by grafting choroid plexus tissues. Study Design: Animal experimentation. Methods: The choroid plexuses from the lateral ventricles of neonatal rats were cultured in adherent culture, and immunocytochemical methods were used t...

  14. Gelsolin Restores Aβ-Induced Alterations in Choroid Plexus Epithelium

    Directory of Open Access Journals (Sweden)

    Teo Vargas

    2010-01-01

    Full Text Available Histologically, Alzheimer's disease (AD is characterized by senile plaques and cerebrovascular amyloid deposits. In previous studies we demonstrated that in AD patients, amyloid-β (Aβ peptide also accumulates in choroid plexus, and that this process is associated with mitochondrial dysfunction and epithelial cell death. However, the molecular mechanisms underlying Aβ accumulation at the choroid plexus epithelium remain unclear. Aβ clearance, from the brain to the blood, involves Aβ carrier proteins that bind to megalin, including gelsolin, a protein produced specifically by the choroid plexus epithelial cells. In this study, we show that treatment with gelsolin reduces Aβ-induced cytoskeletal disruption of blood-cerebrospinal fluid (CSF barrier at the choroid plexus. Additionally, our results demonstrate that gelsolin plays an important role in decreasing Aβ-induced cytotoxicity by inhibiting nitric oxide production and apoptotic mitochondrial changes. Taken together, these findings make gelsolin an appealing tool for the prophylactic treatment of AD.

  15. Is Asthma Related to Choroidal Neovascularization?

    OpenAIRE

    Yaoyao Sun; Wenzhen Yu; Lvzhen Huang; Jing Hou; Peihua Gong; Yi Zheng; Mingwei Zhao; Peng Zhou; Xiaoxin Li

    2012-01-01

    BACKGROUND: Age-related degeneration (AMD) and asthma are both diseases that are related to the activation of the complement system. The association between AMD and asthma has been debated in previous studies. The authors investigated the relationship between AMD and asthma systemically. PRINCIPAL FINDINGS: The epidemiological study showed that asthma was related to choroidal neovascularization (CNV) subtype (OR = 1.721, P = 0.023). However, the meta-analysis showed there was no association b...

  16. Real-time in vivo micromorphology and histopathology of choroidal osteoma using enhanced depth imaging

    Directory of Open Access Journals (Sweden)

    Rameez Hussain

    2015-01-01

    Full Text Available Choroidal osteoma is a usually unilateral benign tumor of the choroid composed of mature bone. Optical coherence tomography (OCT has been used to image osteoma for several years. With the advent of enhanced depth imaging (EDI feature of spectral-domain OCT (SD-OCT, better visualization of the morphology of choroidal lesions has been possible. Herein we present a case of choroidal osteoma in a 45-year-old woman, wherein in vivo morphology of the choroidal osteoma had been visualized using EDI technique of SD-OCT before and after performing photodynamic therapy. EDI OCT has proven to be a valuable noninvasive imaging modality, almost comparable to histopathological examination, for diagnosing choroidal osteomas and for providing an insight into the in vivo micromorphological changes occurring during the course of the disease.

  17. Current perspectives of herpesviral retinitis and choroiditis.

    Science.gov (United States)

    Madhavan, H N; Priya, K; Biswas, J

    2004-10-01

    Vision-threatening viral retinitis are primarily caused by members of the herpesvirus family. The biology and molecular characterization of herpesviruses, clinical presentations of retinopathies, pathology and pathogenesis including the host responses, epidemiology and the laboratory methods of aetiological diagnosis of these diseases are described. Clinical syndromes are acute retinal necrosis (ARN), progressive outer retinal necrosis (PORN), cytomegalovirus (CMV) retinitis, multifocal choroiditis and serpiginous choroiditis besides other viral retinopathies. Herpes simplex virus (HSV) retinitis is more common in immunocompetent persons while varicella zoster virus (VZV) affects both immunocompetent and immunosuppressed patients equally. CMV retinitis is most common among patients with AIDS. The currently employed laboratory methods of antigen detection, virus isolation and antibody detection by enzyme linked immuno-sorbent assay (ELISA) have low sensitivity. Polymerase chain reaction (PCR) has increased the value of diagnosis due to its high clinical sensitivity and absolute specificity in detection of herpesviruses in intraocular specimens. PMID:16295367

  18. Choroidal vascularity index as a measure of vascular status of the choroid: Measurements in healthy eyes from a population-based study

    Science.gov (United States)

    Agrawal, Rupesh; Gupta, Preeti; Tan, Kara-Anne; Cheung, Chui Ming Gemmy; Wong, Tien-Yin; Cheng, Ching-Yu

    2016-02-01

    The vascularity of the choroid has been implicated in the pathogenesis of various eye diseases. To date, no established quantifiable parameters to estimate vascular status of the choroid exists. Choroidal vascularity index (CVI) may potentially be used to assess vascular status of the choroid. We aimed to establish normative database for CVI and identify factors associated with CVI in healthy eyes. In this population-based study on 345 healthy eyes, choroidal enhanced depth imaging optical coherence tomography scans were segmented by modified image binarization technique. Total subfoveal choroidal area (TCA) was segmented into luminal (LA) and stromal (SA) area. CVI was calculated as the proportion of LA to TCA. Linear regression was used to identify ocular and systemic factors associated with CVI and subfoveal choroidal thickness (SFCT). Subfoveal CVI ranged from 60.07 to 71.27% with a mean value of 65.61 ± 2.33%. CVI was less variable than SFCT (coefficient of variation for CVI was 3.55 vs 40.30 for SFCT). Higher CVI was associated with thicker SFCT, but not associated with most physiological variables. CVI was elucidated as a significant determinant of SFCT. While SFCT was affected by many factors, CVI remained unaffected suggesting CVI to be a more robust marker of choroidal diseases.

  19. Choroidal neovascular membrane associated with choroidal osteoma (CO treated with trans-pupillary thermo therapy.

    Directory of Open Access Journals (Sweden)

    Sharma Sumita

    2004-01-01

    Full Text Available Choroidal neovascular membrane, a known complication of choroidal osteoma causing visual loss when located subfoveally, can be successfully treated with transpupillary thermo therapy.

  20. Intravitreal bevacizumab monotherapy for choroidal neovascularisation secondary to choroidal osteoma.

    Science.gov (United States)

    Papastefanou, V P; Pefkianaki, M; Al Harby, L; Arora, A K; Cohen, V M L; Andrews, R M; Sagoo, M S

    2016-06-01

    PurposeThe purpose of this study is to present the outcomes of a series of patients with choroidal neovascular membrane (choroidal neovascularisation (CNV)) secondary to a choroidal osteoma undergoing anti-VEGF monotherapy.Patients and methodsRetrospective series of patients with choroidal neovascularization secondary to choroidal osteoma. All patients underwent clinical and imaging assessment (fundus photo, B-scan ultrasonography, fluorescein angiography, and optical coherence tomography-where available), and were managed with intravitreal anti-VEGF injections (Bevacizumab). Visual acuity and central retinal thickness were recorded pre treatment and at the end of the follow-up period.ResultsEight patients were included in this study. Of this, 6/8 had predominantly classic or classic and 2/8 patients had minimally classic or occult CNV. Each patient received 3-10 injections of bevacizumab. Median follow-up was 9 months (3-15 months). Visual acuity improved in 5 patients, by 2-6 Snellen lines. CNV completely regressed in 5 cases and partially regressed in 3 cases. Mean CRT reduction was 122 μm (6 to -230 μm).ConclusionIntravitreal bevacizumab can be an effective treatment modality in the management of vision threatening CNV secondary to choroidal osteoma. PMID:27034203

  1. Expulsive choroidal haemorrhage

    Directory of Open Access Journals (Sweden)

    Srinivasan M

    1992-01-01

    Full Text Available Expulsive choroidal haemorrhage is a dramatic and serious complication of cataract surgery that occurred in five patients out of ten thousand consecutive cataract surgeries performed by the author during the year 1989 and 1990. Report about this dreaded complication after cataract surgery are scanty and as far as I can remember I have not seen any report in Indian ophthalmic literature recently. Since cataract surgery forms the major part of intra ocular surgeries performed in our country, I thought it would be appropriate to report about this rare complication which may occur to all of us. Out of five cases 3 were males and 2 were females in the age group ranging between 45-72 years. Two eyes regained vision up to 6/12 after intra operative expulsive haemorrhage. All the eyes were salvaged by doing anterior sclerotomy. Diabetes, hypertension, glaucoma and myopia are the commonest predisposing factors.

  2. Peripapillary choroidal thickness in childhood.

    Science.gov (United States)

    Read, Scott A; Alonso-Caneiro, David; Vincent, Stephen J; Collins, Michael J

    2015-06-01

    Changes in the thickness of the invivo peripapillary choroid have been documented in a range of ocular conditions in adults; however, choroidal thickness in the peripapillary region of children has not been examined in detail. This study therefore aimed to investigate the thickness of the peripapillary choroid and the overlying retinal nerve fibre layer (RNFL) in a population of normal children with a range of refractive errors. Ninety-three children (37 myopes and 56 non-myopes) aged between 11 and 16 years, had measurements of peripapillary choroidal and RNFL thickness derived from enhanced depth imaging optical coherence tomography images (EDI-OCT, Heidelberg Spectralis). The average thickness was determined in a series of five 0.25 mm width concentric annuli (each divided into 8 equal sized 45° sectors) centred on the optic nerve head boundary, accounting for individual ocular magnification factors and the disc-fovea angle. Significant variations in peripapillary choroidal thickness were found to occur with both annulus location (p annuli of the nasal and temporal sectors respectively (p < 0.001). RNFL thickness also varied significantly with annulus location and sector (p < 0.001), and showed differences in thickness distribution associated with refractive error. This study establishes the normal variations in the thickness of the peripapillary choroid with radial distance and azimuthal angle from the optic nerve head boundary. A significant thinning of the peripapillary choroid associated with myopia in childhood was also observed in both nasal and temporal regions. The changes in peripapillary RNFL and choroidal thickness associated with refractive error are consistent with a redistribution of these tissues occurring with myopic axial elongation in childhood. PMID:25749004

  3. Choroidal excavation with polypoidal choroidal vasculopathy: a case report

    Directory of Open Access Journals (Sweden)

    Kobayashi W

    2012-08-01

    Full Text Available Wataru Kobayashi,1 Toshiaki Abe,2 Hiroshi Tamai,1 Toru Nakazawa11Department of Ophthalmology, 2Division of Clinical Cell Therapy, Center for Advanced Medical Research and Development (ART, Tohoku University Graduate School of Medical Science, Sendai, JapanPurpose: This is a report of a case of choroidal excavation accompanied by polypoidal choroidal vasculopathy (PCV and retinal pigment epithelium detachment (PED.Methods: A 57-year-old Japanese woman who had begun complaining of metamorphopsia in her left eye 7 months earlier underwent spectral-domain optical coherence tomography (SD-OCT, fluorescein angiography (FA, and indocyanine green angiography (IA, as well as a routine ophthalmological examination.Results: The patient’s intraocular pressure, visual acuity, and visual field were within normal range. Ophthalmoscopy revealed a serous macular detachment, soft drusen, exudates, and a reddish-orange elevated lesion in the macula of the left eye. The right eye was normal. SD-OCT revealed two lesions in the left eye. One was a PED accompanied by a notch sign, and the other was a choroidal excavation. Additionally, FA revealed a window defect in the PED, and IA showed typical PCV. Three monthly injections of antivascular endothelial growth factor preserved visual acuity, but failed to have any visible effect on the lesion during the 6-month follow up period.Conclusions: This is the first report of choroidal excavation accompanied by PED and PCV. The data suggest that choroidal excavation may be associated with various changes that have not been previously reported. Careful observation of such cases may therefore be necessary.Keywords: choroidal excavation, polypoidal choroidal vasculopathy, anti-vascular endothelial growth factor treatment

  4. Central Serous Chorioretinopathy Mistaken for Tuberculous Choroiditis

    Directory of Open Access Journals (Sweden)

    Marina Papadia

    2011-01-01

    Full Text Available Purpose: To report a patient erroneously diagnosed with tuberculous choroiditis who was accordingly treated with long term steroids which in turn, worsened the actual disease process that turned out to be central serous chorioretinopathy (CSC. Case Report: A 59-year-old Caucasian man developed a chorioretinal disease in his right eye in 1997. Having a positive tuberculin skin test, tuberculous chorioretinitis was suspected and antituberculous therapy was administered for 4 months. In 2005, visual symptoms in the same eye recurred and despite negative interferon gamma release assay, tuberculous choroiditis was considered as the diagnosis and the patient further received massive corticosteroid therapy along with antituberculous agents. Despite a deteriorating clinical picture, therapy was continued. Upon initial examination at our center, no sign of inflammation was observed and a diagnosis of CSC was made, consequently steroid therapy was terminated. Conclusion: In some chorioretinopathies, it is difficult to differentiate inflammatory from non-inflammatory causes. One should observe the course of the disease and question the initial diagnosis when no improvement or deterioration occurs despite therapy.

  5. Microstructural effects of intravitreal bevacizumab in idiopathic choroidal neovascularisation

    International Nuclear Information System (INIS)

    Idiopathic choroidal neovascularization (ICNV) is a unilateral ocular disease which occurs in patients younger than 50 years and accounts for approximately 17% of patients with CNV. We evaluated microstructural effects of intravitreal bevacizumab in eyes with treatment-naive idiopathic choroidal neovascularisation. Methods: In this case series study we reviewed the treatment and follow up records of 40 symptomatic eyes having ICNV, who received an intravitreal injection of bevacizumab (1.25 mg/0.05 mL) followed by additional doses based on optical coherence tomography findings, including intraretinal fluid, subretinal fluid, or pigment epithelial detachment. We analysed the results of best-corrected visual acuity, central retinal thickness, neovessels size (thickness and diameter), and disrupted photoreceptor length at baseline and at final visit with paired t-test. Difference in best corrected visual acuity was correlated with difference in optical coherence tomography parameters by Pearson's correlation. Results: Mean logarithm of the minimum angle of resolution best-corrected visual acuity improved from 0.60 initially to 0.24 after treatment (p=0.01). Difference in mean central retinal thickness (82.65 ± 44.1) micro m, choroidal neovessels thickness (149.58 ± 71.1) micro m, choroidal neovessels diameter (1250.8 ± 145.1) micro m, photoreceptor disruption length (2141.20 ± 318.8) micro m were all statistically significant (p=0.01). Difference in best corrected visual acuity was correlated with optical coherence tomography parameters found no statistically significant difference. Conclusion: Intravitreal bevacizumab therapy is safe and well tolerated in ICNV eyes. Restoration of photoreceptor disruption length, decrease in central retinal thickness and choroidal neovessels size has association with visual improvement in idiopathic choroidal neovascularisation. (author)

  6. Choroidal Nevus in an Eye with Polypoidal Choroidal Vasculopathy

    Directory of Open Access Journals (Sweden)

    Kazunobu Asao

    2014-12-01

    Full Text Available Purpose: To report an eye with polypoidal choroidal vasculopathy (PCV and a choroidal nevus. Methods: This is an observational case report. Results: A healthy 69-year-old woman was referred to the Osaka University Hospital with a diagnosis of a macular tumor. She complained of having distorted vision in her left eye. The medical history of the patient was unremarkable. At the initial examination, her best-corrected visual acuity (BCVA was 20/20 in both eyes, and the intraocular pressure was 18 mm Hg in both eyes. A slit-lamp examination showed no abnormalities in the anterior segment of both eyes and a fundus examination of the left eye showed a slightly elevated juxtafoveal chorioretinal lesion and polyp-like reddish-orange lesions. The juxtafoveal choroidal lesion was located beneath a choroidal neovascularization (CNV. An optical coherence tomography confirmed CNV with pigment epithelial detachment (PED. Fluorescein angiography showed juxtafoveal hyperfluorescence due to CNV. Indocyanine green angiography demonstrated a branching choroidal vascular network that resembled polypoidal lesions. A fundus autofluorescence showed a mosaic pattern and a slight hyperautofluorescence at the CNV. We diagnosed the patient as having PCV. Aflibercept was injected intravitreally because of her PED. After the injection, PED improved and her visual acuity remained stable during the 12-month follow-up period. Conclusions: In cases of PCV, FAF images are helpful in determining the status of the posterior pole. Intravitreal injections of aflibercept can improve PED associated with CNV, and the BCVA will remain stable for at least 12 months.

  7. Enhanced Ccl2-Ccr2 signaling drives more severe choroidal neovascularization with aging.

    Science.gov (United States)

    Robbie, Scott J; Georgiadis, Anastasios; Barker, Susie E; Duran, Yanai; Smith, Alexander J; Ali, Robin R; Luhmann, Ulrich F O; Bainbridge, James W

    2016-04-01

    The impact of many inflammatory diseases is influenced by age-related changes in the activation of resident and circulating myeloid cells. In the eye, a major sight-threatening consequence of age-related macular degeneration is the development of severe choroidal neovascularization (CNV). To identify the molecular pathways and myeloid cell populations involved in this increased neovascular response, we characterized the immune status of murine choroid and retina during aging and in the context of experimental CNV. In the choroid, but not in the retina, advancing age is associated with proinflammatory upregulation of CCL2-CCR2 signaling. Genetic excision of CCL2 diminishes age-related inflammatory changes in the choroid, with reduced recruitment of proinflammatory myeloid cells and attenuation of CNV. These findings indicate that CCL2-driven recruitment of myeloid cells contributes to increased severity of CNV with age. Similar mechanisms may be involved in other age-related inflammatory diseases. PMID:26973110

  8. Long-term outcomes of intravitreal injection of bevacizumab for choroidal neovascularization associated with choroidal osteoma

    OpenAIRE

    Yoshikawa, Tadanobu; Takahashi, Kanji

    2015-01-01

    Purpose To describe the outcomes of intravitreal injections of bevacizumab for choroidal neovascularization (CNV) associated with choroidal osteoma. Methods Retrospective consecutive case series. Three eyes of three patients were studied. All patients were treated with intravitreal injections of bevacizumab for CNV associated with choroidal osteoma. Best-corrected visual acuity, central foveal thickness, tumor thickness on spectral domain optical coherence tomography, and subretinal pigmentat...

  9. Metástasis coroideas Choroidal metastases

    Directory of Open Access Journals (Sweden)

    C. Camarillo

    2008-01-01

    . Etiology varies according to the sex of the patient: lung carcinoma metastasises most frequently in men and breast carcinoma in women. These tend to multifocality and are generally localized in the posterior pole. Fifty percent of cases follow an asymptomatic development, but they can cause loss of vision, scotomas, metamorphopsias and photopsias. Charactersitic ophthamoscopic examination shows a placoid, homogenous choroidal lesion with a creamy appearance. The differential diagnosis must consider the amelanotic nevus, choroidal amelanotic melanoma, choroidal haemangioma, rear scleritis, choroidal osteoma, chorioretinitis, Harada’s disease, rhegmatogenous retina detachment, uveal effusion syndrome, and serous central chorioretinopathy. An exhaustive history and complete ophthalmological examination are essential to the diagnosis, to which fluorescein angiography, ocular echography, fine needle puncture aspiration (FNPA, computerized tomography and magnetic resonance can be added as complementary tests. Treatment of these tumours is usually the systemic treatment of the primary tumour; the possibilities of local treatment are observation, external radiotherapy, transpupillary thermotherapy and enucleation.

  10. Unusual Orange-Colored Choroidal Metastases

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    Hatem Krema

    2013-01-01

    Full Text Available Purpose: To report the clinical and paraclinical features of two patients with orangecolored choroidal metastases in whom the primary cancers have not previously been associated with such lesions. Case Report: Orange-colored choroidal lesions were detected on the fundus examination of one patient with metastatic small cell neuroendocrine tumor of the larynx and oropharynx, and in another subject with metastatic alveolar soft part sarcoma of the leg. Although ultrasonographic characteristics of the choroidal masses were comparable to those of choroidal hemangiomas, fluorescein angiography revealed delayed initial fluorescence along with minimal fluorescence in subsequent phases of the angiogram which were in clear distinction from the earlier appearing and progressively intense fluorescence observed with circumscribed choroidal hemangiomas. Conclusion: Small cell neuroendocrine tumors and alveolar soft part sarcomas should be considered among the differential diagnoses for orange-colored choroidal metastases. Identifying these choroidal lesions could facilitate localizing the occult primary tumor. Fluorescein angiography may differentiate a unifocal orange choroidal metastasis from a circumscribed choroidal hemangioma.

  11. The Abnormal Choroidal Vessels in Aged Patients

    Institute of Scientific and Technical Information of China (English)

    Shizhou Huang; Feng Wen; Dezheng Wu; Guangwei Luo; Caijiao Liu

    2002-01-01

    Background: To show the abnormal choroidal vessels in aged patients with indocyanine-green angiography (ICGA).Methods: ICGA was performed in 350 patients with TOPCON TRC-50IA fundus camera.The images were recorded and retrospectively reviewed.Results: Five aged patients out of 350 cases were found to have abnormal choroidalvessels. The incidence was 1.43%. The abnormal choroidal vessels showed round- shapet,focal enlargement, abnormal shape and entrance, satellite appearance, and vascularloops. These might be due to congenital abnormality of choroid.Conclusion: ICGA could be used to observe the abnormal choroidal vessels.

  12. Investigating the choriocapillaris and choroidal vasculature with new optical coherence tomography technologies.

    Science.gov (United States)

    Ferrara, Daniela; Waheed, Nadia K; Duker, Jay S

    2016-05-01

    The body of knowledge of in vivo investigation of the choroid has been markedly enhanced by recent technological advances in optical coherence tomography (OCT). New insights elucidating the morphological features of the choriocapillaris and choroidal vasculature, in both physiological and pathological conditions, indicate that the choroid plays a pivotal role in many posterior segment diseases. In this article, a review of the histological characteristics of the choroid, which must be considered for the proper interpretation of in vivo imaging, is followed by a comprehensive discussion of fundamental principles of the current state-of-the-art in OCT, including cross-sectional OCT, en face OCT, and OCT angiography using both spectral domain OCT and swept source OCT technologies. A detailed review of the tomographic features of the choroid in the normal eye is followed by relevant findings in prevalent chorioretinal diseases, focusing on major causes of vision loss such as typical early and advanced age-related macular degeneration, polypoidal choroidal vasculopathy, central serous chorioretinopathy, pachychoroid spectrum disorders, diabetic choroidopathy, and myopia. PMID:26478514

  13. Modifying Choroidal Neovascularization Development with a Nutritional Supplement in Mice

    OpenAIRE

    Alina Adriana Ivanescu; Patricia Fernández-Robredo; Henar Heras-Mulero; Luis Manuel Sádaba-Echarri; Laura García-García; Vanessa Fernández-García; Maite Moreno-Orduna; Aitor Redondo-Exposito; Sergio Recalde; Alfredo García-Layana

    2015-01-01

    We examined the effect of nutritional supplements (modified Age Related Eye Disease Study (AREDS)-II formulation containing vitamins, minerals, lutein, resveratrol, and omega-3 fatty acids) on choroidal neovascularization (CNV). Supplements were administered alone and combined with intravitreal anti-VEGF in an early-CNV (diode laser-induced) murine model. Sixty mice were evenly divided into group V (oral vehicle, intravitreal saline), group S (oral supplement, intravitreal saline), group V +...

  14. CHOROIDAL TUBERCLES IN ISOLATED TUBERCULOUS MENINGITIS

    Directory of Open Access Journals (Sweden)

    Tharun Tom

    2016-04-01

    Full Text Available Choroidal tubercles are the most common manifestation of intraocular tuberculosis and results from the haematogenous spread of mycobacteria in miliary tuberculosis. However, its presence without the evidence of miliary tuberculosis is a rare entity. We present a case of isolated tuberculous meningitis with choroidal tubercles, who had no features of miliary tuberculosis.

  15. A new animal model of choroidal neovascularization

    DEFF Research Database (Denmark)

    Kiilgaard, Jens Folke; Andersen, Mads Varis Nis; Wiencke, Anne;

    2005-01-01

    The purpose of this study was to evaluate the ability of different methods to induce choroidal neovascularization (CNV) in the domestic pig.......The purpose of this study was to evaluate the ability of different methods to induce choroidal neovascularization (CNV) in the domestic pig....

  16. Choroid plexus carcinoma: Report of two cases

    Directory of Open Access Journals (Sweden)

    Singh Avninder

    2009-07-01

    Full Text Available Choroid plexus carcinomas (CPCs are rare malignant counterparts of choroid plexus papilloma which occur in infants and children with a predilection for the posterior fossa and have a poor prognosis. We report two cases of CPC diagnosed in a 5-year-old boy and a 12-year-old boy and discuss the clinicopathologic features.

  17. Choroid plexus cysts. MR and CT findings

    International Nuclear Information System (INIS)

    The MRI and CT characteristics of choroid plexus cysts in the lateral ventricles were investigated. Of eight patients with choroid plexus cysts, six had bilateral and multiple cysts that were small in size, and two patients had unilateral solitary cysts. Choroid plexus cysts were well visualized on T2-WI and proton density-WI with higher signal intensity than the CSF in the lateral ventricles. The walls of cysts were well enhanced with Gd-DTPA. MRI has a distinct advantage over conventional CT for visualization of choroid plexus cysts that are small in size, which may be multiple and bilateral. With the widespread use of MRI, asymptomatic choroid plexus cysts may become common incidental findings. (author)

  18. Choroidal Metastases From Cutaneous Melanoma.

    Science.gov (United States)

    Mercado, Carmel L; Toy, Brian C; Kistler, Henry B; Moshfeghi, Darius M

    2016-05-01

    A 92-year-old man presented with months of progressive blurry vision, worsening acutely in his right eye. He denied pain, diplopia, or photopsias. His history was significant for multiple myeloma, prostate cancer, and malignant melanoma of his right shoulder treated with local excision. He had local recurrence with hepatic metastasis of the melanoma treated with radiation and chemotherapy. On examination, his visual acuity was counting fingers in the right eye and 20/60 in the left eye. Amsler grid testing demonstrated metamorphopsia in the right eye. Fundus exam of the right and left eyes revealed multiple, elevated, pigmented choroidal lesions, with associated subretinal fluid in the right macula. This appearance is consistent with hematogenous metastasis of cutaneous malignant melanoma to the choroid and associated serous fluid-causing metamorphopsia. The patient was enrolled in a clinical trial combining plasmid IL-12 with pembrolizumab (Keytruda; Merck, Whitehouse Station, NJ). He passed away 2 months after initial presentation to our clinic. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:497.]. PMID:27183558

  19. Choroidal neovascularization associated with coloboma of the choroid: A series of three cases

    Directory of Open Access Journals (Sweden)

    Bhende Muna

    2011-01-01

    Full Text Available Choroidal neovascularization (CNV is a rare complication associated with coloboma of the choroid. We describe three cases of coloboma choroid where there was loss of vision due to CNV development at the edge of the coloboma. One was managed by photodynamic therapy alone and two were managed by a combination of reduced fluence PDT and intravitreal bevacizumab. Significantly we noted that one treatment session was sufficient to achieve regression of the CNV and improvement in visual acuity.

  20. Choroid plexus calcification: clinical, neuroimaging and histopathological correlations in schizophrenia.

    Science.gov (United States)

    Marinescu, Ileana; Udriştoiu, I; Marinescu, D

    2013-01-01

    Schizophrenia is recognized as a psychiatric disorder that causes the most pronounced disturbances of cognition and social integration. In the etiopathogenesis of the disease, genetic, neurobiological and vascular factors are involved. Functional integrity of the brain can be correlated with the integrity of the blood-brain barrier (BBB), and the dysfunction of this barrier is an indicator that suggests neurodevelopmental abnormalities, injuries of various etiologies and dysfunctions within the small vessels of the brain that disrupt the calcium homeostasis. Neuroimaging shows that in patients with poor evolution, cognitive dysfunction and therapeutic resistance, the presence of choroid plexus calcification associated with hippocampal, frontal, temporoparietal and cerebellar atrophies. Antipsychotics with high capacity to block D2 dopamine receptors (haloperidol model) can aggravate apoptotic mechanisms of the brain areas involved in cognition and disrupts the functional integrity of the BBB due to decreased of choroid plexus blood flow because of the narrowing of cerebral small vessels. Choroid plexus calcification may be a predictive indicator of poor evolution or of a neurodegenerative type. PMID:23771083

  1. Is asthma related to choroidal neovascularization?

    Directory of Open Access Journals (Sweden)

    Yaoyao Sun

    Full Text Available BACKGROUND: Age-related degeneration (AMD and asthma are both diseases that are related to the activation of the complement system. The association between AMD and asthma has been debated in previous studies. The authors investigated the relationship between AMD and asthma systemically. PRINCIPAL FINDINGS: The epidemiological study showed that asthma was related to choroidal neovascularization (CNV subtype (OR = 1.721, P = 0.023. However, the meta-analysis showed there was no association between AMD and asthma. In an animal model, we found more fluoresce in leakage of CNV lesions by FA analysis and more angiogenesis by histological analysis in rats with asthma. Western blot demonstrated an elevated level of C3α-chain, C3α'-chain and VEGF. After compstatin was intravitreally injected, CNV leakage decreased according to FA analysis, with the level of C3 and VEGF protein decreasing at the same time. SIGNIFICANCE: This study first investigated the relationship between AMD and asthma systematically, and it was found that asthma could be a risk factor for the development of AMD. The study may provide a better understanding of the disease, which may advance the potential for screening asthma patients in clinical practice.

  2. Differential diagnosis of choroidal melanomas and nervi using scanning laser ophthalmoscopical indocyanine green angiography

    DEFF Research Database (Denmark)

    Andersen, Mads V. Nis; Scherfig, Erik; Prause, J.U.

    1995-01-01

    Ophthalmology, choroidal melanoma, choroidal nevus, fluorescein angiography, indocyanine green (ICG), scanning laser ophthalmoscope (SLO), angiography......Ophthalmology, choroidal melanoma, choroidal nevus, fluorescein angiography, indocyanine green (ICG), scanning laser ophthalmoscope (SLO), angiography...

  3. Enucleation versus plaque irradiation for choroidal melanoma

    International Nuclear Information System (INIS)

    The Collaborative Ocular Melanoma Study (COMS) is an international, multicenter-controlled study. The organization includes an Executive Committee, Steering Committee, 6 Central Units, 32 Clinical Centers, and a Data and Safety Monitoring Committee. Scientifically, the COMS consists of (1) a randomized trial of patients with medium choroidal melanoma treated with enucleation versus iodine-125 plaque irradiation, (2) a randomized trial of patients with large choroidal melanoma treated with enucleation versus preenucleation external beam irradiation and enucleation, and (3) a prospective observational study of patients with small choroidal melanoma to determine whether a randomized trial of treatment is appropriate. In design and conduct of the COMS, special consideration is given to biostatistics and sample size considerations, iodine-125 plaque irradiation of choroidal melanoma, and coordinated ocular melanoma research. Recruitment is in progress. However, the pool of eligible patients is limited and the COMS needs the continued support and cooperation of ophthalmologists throughout the United States and Canada

  4. In Vitro Model of Human Choroidal Neovascular

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Choroidal capillary endothelia cell (CEC) plays a critical role in the development of choroidal neovascularization which is one of the major causes of blindness. An effective method for CEC cultivation was proposed.The isolation of human choroidal CECs using micro dissection followed by the use of superparamagnetic beads (Dynabeads) coated with the CD 31, which selectively binds to the endothelial cell surface. Cells bound to beads were isolated using a magnetic particle concentrator. The CECs were planted into type Ⅳ collagen coated 24 well plates. The results show that the primary cultured CEC is induced to tube formation in collagen Ⅳ coated environment, which can be presented as an in vitro model of choroidal neovascularization.

  5. Choroid plexus carcinoma in an adult

    Directory of Open Access Journals (Sweden)

    Sanjeev Kishore

    2012-01-01

    Full Text Available Choroid plexus carcinoma is a very rare tumor in adults. Here we report a rare case of choroid plexus carcinoma in an adult patient. A 24-year-old male presented with a right temporal intraventricular tumor with a cystic component also extending up to the cortex. Histological examination revealed complex papillary structures and glandular spaces showing stratification and multilayering of cells with nuclear crowding and numerous mitotic figures and large areas of necrosis. The patient went through a complete search for a possible primary keeping in mind the differential diagnosis of metastatic carcinoma that is more common in adults but there was no evidence of any other tumor. Finally a diagnosis of choroid plexus carcinoma was rendered. Immunohistochemical analysis for p53 protein showed positivity. Choroid plexus carcinoma is exceptionally rare in adults but cases do occur.

  6. Choroidal and cutaneous metastasis from gastric adenocarcinoma

    OpenAIRE

    2013-01-01

    Choroidal or cutaneous metastasis of gastric cancer is rare. Gastrointestinal cancer was found in only 4% in patients with uveal metastasis. Choroidal metastasis from gastric cancer was reported in two cases in earlier literature. The frequency of gastric cancer as a primary lesion was 6% in cutaneous metastasis of men, and cutaneous metastasis occurs in 0.8% of all gastric cancers. We report a patient with gastric adenocarcinoma who presented with visual disorder in his left eye and skin pai...

  7. Treatment of Exudative and Vasogenic Chorioretinal Diseases Including Variants of AMD and Other CNV Related Maculopathy

    Science.gov (United States)

    2012-10-24

    Coats' Disease; Idiopathic Retinal Telangiectasia; Retinal Angiomatous Proliferation; Polypoidal Choroidal Vasculopathy; Pseudoxanthoma Elasticum; Pathological Myopia; Multi-focal Choroiditis; Rubeosis Iridis; Von Hippel Lindau Disease; BEST VITELLIFORM MACULAR DYSTROPHY, MULTIFOCAL (Disorder)

  8. A CASE OF GYRATE ATROPHY OF THE CHOROID & RETINA

    Directory of Open Access Journals (Sweden)

    Satyavathi

    2015-01-01

    Full Text Available Gyrate atrophy of the choroid and retina is a rare chorioretinal degeneration inherited by on autosonal recessive mode of transmission. It is caused by mutation in gene for ornithine aminotransferase (OAT, located on chromosome 10. It is characterised by high myopia with astigmatism, night blindness during 2 nd and 3 rd decade with a slowly progressive posterior sub capsular cataract. Once diagnosed paediatrician/physician and Ophthalmologist should be aware of the follow up. No single therapy has been shown to halt the progression of the disease.

  9. Genetics Home Reference: gyrate atrophy of the choroid and retina

    Science.gov (United States)

    ... the choroid. During childhood, they begin experiencing nearsightedness ( myopia ), difficulty seeing in low light (night blindness), and ... the choroid and retina in a child with myopia. Indian Pediatr. 2001 Aug;38(8):914-8. ...

  10. Subretinal lipid exudation associated with untreated choroidal melanoma

    Directory of Open Access Journals (Sweden)

    C K Minija

    2011-01-01

    Full Text Available Subretinal lipid exudation in an untreated choroidal melanoma is very rare. It is seen following plaque radiotherapy in choroidal melanoma. There is only one case report of untreated choroidal melanoma with massive lipid exudation in a patient with metastatic hypernephroma. We report here a rare case of untreated choroidal melanoma with lipid exudation. Subretinal exudation that is rarely seen following plaque brachytherapy was noted at the borders of this untreated tumor. Lipid exudation partially resolved following brachytherapy.

  11. Combination therapy of low-fluence photodynamic therapy and intravitreal ranibizumab for choroidal neovascular membrane in choroidal osteoma

    OpenAIRE

    Morris, Rodney J; Prabhu, Varsha V; Parag K Shah; Narendran, V.

    2011-01-01

    Choroidal osteoma is an unusual form of intraocular calcification seen in otherwise healthy eyes. It is a benign idiopathic osseous tumor of the choroid, typically seen in young females. Choroidal neovascular membrane (CNVM) is a complication seen in one-third of these patients and carries a poor visual outcome. We report a case of a 25-year-old hyperthyroid female with choroidal osteoma and subfoveal CNVM in her left eye which was successfully treated using low-fluence photodynamic therapy (...

  12. Intravitreal bevacizumab (avastin for circumscribed choroidal hemangioma

    Directory of Open Access Journals (Sweden)

    Subrata Mandal

    2011-01-01

    Full Text Available Circumscribed choroidal hemangiomas are rare ophthalmic entities that cause diminution in vision due to accumulation of subretinal and/or intraretinal fluid in the macular area. Various treatment options ranging from conventional laser to photodynamic therapy have been employed to destroy the tumor and reduce the exudation; however, either the inability to penetrate through the exudative fluid or the collateral retinal damage induced by these treatment modalities make them unsuitable for lesions within the macula. We evaluated the role of intravitreal bevacizumab, a pan-vascular endothelial growth factor (VEGF inhibitor, in reducing the sub- and intraretinal fluid in three patients with circumscribed choroidal hemangiomas. All the patients had complete resolution of the serous retinal detachment that was maintained till at least 12 months after the first injection. Intravitreal bevacizumab may be used in combination with thermal laser or photodynamic therapy in treating circumscribed choroidal hemangiomas with subretinal fluid.

  13. Long-term outcomes of intravitreal injection of bevacizumab for choroidal neovascularization associated with choroidal osteoma

    OpenAIRE

    Yoshikawa T; Takahashi K.

    2015-01-01

    Tadanobu Yoshikawa, Kanji Takahashi Department of Ophthalmology, Kansai Medical University, Osaka, Japan Purpose: To describe the outcomes of intravitreal injections of bevacizumab for choroidal neovascularization (CNV) associated with choroidal osteoma. Methods: Retrospective consecutive case series. Three eyes of three patients were studied. All patients were treated with intravitreal injections of bevacizumab for CNV associated with choroidal osteoma. Best-corrected visual acuity, centra...

  14. Long-term outcomes of intravitreal injection of bevacizumab for choroidal neovascularization associated with choroidal osteoma

    OpenAIRE

    Yoshikawa, Tadanobu

    2015-01-01

    Tadanobu Yoshikawa, Kanji Takahashi Department of Ophthalmology, Kansai Medical University, Osaka, Japan Purpose: To describe the outcomes of intravitreal injections of bevacizumab for choroidal neovascularization (CNV) associated with choroidal osteoma. Methods: Retrospective consecutive case series. Three eyes of three patients were studied. All patients were treated with intravitreal injections of bevacizumab for CNV associated with choroidal osteoma. Best-corrected visual acuity, centra...

  15. The choroid plexus response to a repeated peripheral inflammatory stimulus

    Directory of Open Access Journals (Sweden)

    Palha Joana A

    2009-11-01

    Full Text Available Abstract Background Chronic systemic inflammation triggers alterations in the central nervous system that may relate to the underlying inflammatory component reported in neurodegenerative disorders such as multiple sclerosis and Alzheimer's disease. However, it is far from being understood whether and how peripheral inflammation contributes to induce brain inflammatory response in such illnesses. As part of the barriers that separate the blood from the brain, the choroid plexus conveys inflammatory immune signals into the brain, largely through alterations in the composition of the cerebrospinal fluid. Results In the present study we investigated the mouse choroid plexus gene expression profile, using microarray analyses, in response to a repeated inflammatory stimulus induced by the intraperitoneal administration of lipopolysaccharide every two weeks for a period of three months; mice were sacrificed 3 and 15 days after the last lipopolysaccharide injection. The data show that the choroid plexus displays a sustained response to the repeated inflammatory stimuli by altering the expression profile of several genes. From a total of 24,000 probes, 369 are up-regulated and 167 are down-regulated 3 days after the last lipopolysaccharide injection, while at 15 days the number decreases to 98 and 128, respectively. The pathways displaying the most significant changes include those facilitating entry of cells into the cerebrospinal fluid, and those participating in the innate immune response to infection. Conclusion These observations contribute to a better understanding of the brain response to peripheral inflammation and pave the way to study their impact on the progression of several disorders of the central nervous system in which inflammation is known to be implicated.

  16. Characterization of Choroidal Layers in Normal Aging Eyes Using Enface Swept-Source Optical Coherence Tomography.

    Directory of Open Access Journals (Sweden)

    Mehreen Adhi

    nm enables a precise qualitative and quantitative characterization of the individual choroidal layers in normal eyes. Only the CC is relatively thinner in the older eyes. In-vivo evaluation of the choroid at variable depths may be potentially valuable in understanding the natural history of age-related posterior segment disease.

  17. Infantile myofibromatosis involving the choroid plexus

    International Nuclear Information System (INIS)

    We present a case of infantile myofibromatosis manifest as a choroid plexus mass followed by spontaneous regression. Infantile myofibromatosis is a common juvenile fibrous disorder occurring in infancy and early childhood. Intracranial involvement in infantile myofibromatosis is rare. It generally occurs in the dura with calvarial invasion and secondary brain compression. (orig.)

  18. Photodynamic therapy of symptomatic choroidal nevi

    Directory of Open Access Journals (Sweden)

    Luis Amselem

    2011-01-01

    Full Text Available Purpose : To evaluate the role of photodynamic therapy (PDT for patients with symptomatic choroidal nevi involving the fovea or located near the fovea with subretinal fluid extending to the fovea. Materials and Methods : Retrospective review of five patients who underwent PDT for choroidal nevi at two separate centers in Ankara and Barcelona. Results : The mean initial logMAR visual acuity was 0.5 (range: 0 to 1.5. The mean largest tumor base diameter was 3.2 mm (range: 2.1-4.5 mm and the mean tumor thickness was 1.1 mm (range: 0.7-1.6 mm. The mean number of PDT sessions was 1.6 (range:1-3. The mean final tumor thickness was 1.0 mm (range: 0-1.6 mm at a mean follow-up of 19 months (range: 12-32 months. The mean final logMAR visual acuity was 0.4 (range: 0-1.5. Subfoveal fluid disappeared or decreased significantly in 4 of 5 eyes (80% after PDT. Conclusions : PDT led to resolution of subretinal fluid with preservation of visual acuity in many symptomatic choroidal nevi in this study. Careful case selection is important as PDT of indeterminate pigmented tumors may delay the diagnosis and treatment of an early choroidal melanoma and thereby increase the risk for metastasis.

  19. Cerebellopontine Choroid Plexus Papilloma: Case Report

    International Nuclear Information System (INIS)

    We present the case of an adult female patient who presented with a mass in the cerebellopontine angle, corresponding to a choroid plexus papilloma. Due to this uncommon location, we report this case and describe its imaging characteristics and the possible differential diagnoses.

  20. Primary transpupillary thermotherapy of choroidal melanocytic lesions

    Directory of Open Access Journals (Sweden)

    Kaan Gündüz

    2011-01-01

    Full Text Available Purpose : To evaluate the role of primary transpupillary thermotherapy (TTT in the treatment of choroidal melanocytic lesions. Materials and Methods : Retrospective chart review of 24 patients (24 eyes with choroidal melanocytic lesions, including 20 choroidal melanoma and four choroidal nevus treated with primary TTT. Choroidal nevus cases treated with primary TTT either demonstrated risk factors for growth into an early melanoma or had overlying choroidal neovascularization. Results : The mean initial tumor basal diameter was 6.6 (3.0-10.0 mm and the mean initial tumor thickness was 3.0 (1.0-5.0 mm. The mean number of TTT sessions was 2.5 (1-6. The mean decrease in tumor thickness was 1.2 mm (from 3.0 to 1.8 mm at a mean follow-up of 22.7 (range 3-90 months. On the LogMar scale, visual acuity was stable at 1.0. Complications occurred in 50% of eyes. The most frequent complications were vitreous hemorrhage [5 patients (20.8%], focal cataract [5 patients (20.8%], iris atrophy [4 patients (16.6%] and posterior synechia [4 patients (16.6%]. There was no significant difference in the complication rate with respect to tumor thickness >3 mm versus tumor thickness ≤3 mm and juxtapapillary versus nonjuxtapapillary location (Fisher′s exact test, P>0.05. Kaplan-Meier curves showed that 9% of eyes develop recurrence by 1 year and 27% develop recurrence by 5 years after primary TTT. Two eyes (8.3% were enucleated because of neovascular glaucoma and one eye (4.1% was exenterated because of extraocular tumor recurrence. Globe salvage was achieved in 21 patients (87.5%. One patient (4.1% with extraocular tumor recurrence developed liver metastasis and expired. Conclusions : Although TTT may be useful in the treatment of small choroidal melanocytic lesions, the high complication and recurrence rates warrant close monitoring of patients after primary TTT even when a flat chorioretinal scar has been achieved.

  1. Role of echography in diagnostic dilemma in choroidal masses

    Directory of Open Access Journals (Sweden)

    Kopal N Mithal

    2014-01-01

    Full Text Available Purpose: To evaluate the role of echography in diagnosis and management of a diverse array of choroidal masses. Materials and Methods: Sixty-two cases of clinically suspected choroidal masses were prospectively analyzed with B-scan (10 Hz, A-scan, and ultrasound biomicroscopy (UBM (50 Hz after a meticulous history and ocular examination. Ancillary investigations and systemic evaluation were also done. Results: Based on clinical suspicion, acoustic features, response to treatment, and other ancillary tests combined together, the various masses were differentiated. The cases included in the study were as follows: n = 10 malignant melanomas, n = 16 metastasis and infiltrations, n = 9 hemangioma, n = 7 tuberculoma, n = 8 nonspecific inflammatory masses, n = 2 disciform plaques, n = 4 macular cysts or retinoschisis, n = 2 Coat′s disease, n = 1 melanocytoma, and n = 2 osteomas. Ultrasonography (USG alone could identify n = 51 lesions, while UBM in combination with USG was needed in remaining 11 masses. Conclusion: Standardized echography is an important adjunct in the diagnosis and management of eyes with intraocular masses. A better understanding of the clinicopathological and echographic picture of the diverse lesions can help in detection, differentiation, diagnosis, proposing a therapeutic approach, and also monitoring response to treatment. Echography is essential to evaluate tumors for extrascleral and anterior segment extension.

  2. Radiotherapy for choroidal melanoma. An 18-year experience with radon

    International Nuclear Information System (INIS)

    Twenty-three patients were treated with radon therapy for choroidal melanoma at the Ohio State University Hospitals, Columbus, between 1968 and 1976. We present an 18-year experience, including follow-up of at least eight years, in all those receiving therapy. Three patients (13%) died of metastatic disease. Four patients (17.4%) died of other causes. Sixteen patients (69.6%) were alive, with no signs of metastatic disease. Eight patients subsequently required enucleation due to inadequate tumor response. Of the 15 patients who demonstrated successful tumor destruction and retained their eyes, 13 (86.7%) developed substantial irradiation-induced retinopathy, including hard exudates, telangiectasias, neovascularization, microaneurysms, intraretinal and vitreous hemorrhages, secondary glaucoma, and irradiation-induced cataract. Our long-term results indicate a high incidence of both vascular complications and decreased visual acuity

  3. Remodelling of choroidal blood flow in radiation choroidopathy

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Hideo; Muraoka, Kanemitsu; Takahashi, Kyoichi; Sutoh, Noriko [Gunma Univ., Maebashi (Japan). School of Medicine

    1997-02-01

    Two males, aged 68 and 34 years each, presented with radiation retinopathy. One had received radiation therapy to the whole brain for intracranial metastasis of lung carcinoma 29 months before. The other underwent surgery and radiation for melanoma of the upper eyelid 15 years before. When examined by indocyanine green angiography. both cases showed vasoocclusive changes in the choroid involving the choriocapillaris and major vessels in the affected fundus area. In one eye with severe retinal vascular lesions in the superior temporal quadrant, the vortex vein in the quadrant had obliterated. The venous blood in this quadrant was drained into the inferior temporal vortex vein crossing the presumed watershed zone temporal to the macula. Collaterals had formed between choroidal arteries and between choroidal veins. These cases illustrate that choroidal vascular lesions may be present in radiation retinopathy, that the former may be more pronounced than the latter and that choroidal vessels may undergo extensive remodelling to compensate for the disturbed choroidal circulation. (author)

  4. CT of malignant choroidal melanoma - morphology and perfusion characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Heller, M.; Hagemann, J.; Jend, H.H.; Guthoff, R.

    1982-03-01

    The computed tomographic morphology of malignant choroidal melanoma and its perfusion characteristics are described. Thirty-three static and serial CT examinations made on 29 patients with choroidal melanoma, three with pseudotumors of the macula and one with choroidal metastasis revealed the choroidal melanoma to be usually a hyperdense, markedly perfused tumor, while the non-contrast, diagnostically undifferentiable pseudotumors and the choroidal metastasis, revealed no significant change in density after the administration of contrast material. Density values or perfusion characteristics of choroidal melanoma that are outside of the normal range are a result of secondary changes within the immediate surroundings of the tumor, such as detachment of the retina, tumor-induced glaucoma, or tumor necrosis.

  5. High Frequency Color Doppler Image of Choroidal Detachment

    Institute of Scientific and Technical Information of China (English)

    JinghongWu; LijuanZou; 等

    2002-01-01

    Purpose:To study the Color Doppler Image (CDI) characteristics of choroidal detachment and the applied value of CDI.Methods:Seventy-two cases (74 eyes) of choroidal detachment were studied retrospectively.Results:The typical ultragraph of chroridal detachment displayed one or several smooth hemispherical or lobuler circular thick bands, with convex side toward vitreous cavity.Most of the choroidal detachments were located before the equator, a few of them were beyond the equator.CDI displayed blood flow singnal in the band.Pulse Doppler showed the frequency spectrum features of retinal detachment band were similar to those of central retinal vessels, whereas the frequency spectum features of choroidal detachment bend resembled those of ciliary artery in some cases of retinal detachment (RD) accompanied by choroidal detachment.Conclusion:CDI could make a correct and precise diagnosis of choroidal detachment.Eye Science 2000;16:61-64.

  6. Diabetic Retinal and Choroidal Edema in SDT Rats

    OpenAIRE

    Fumihiko Toyoda; Yoshiaki Tanaka; Machiko Shimmura; Nozomi Kinoshita; Hiroko Takano; Akihiro Kakehashi

    2015-01-01

    We evaluated the features of diabetic retinal and choroidal edema in Spontaneously Diabetic Torii (SDT) rats. We measured the retinal and choroidal thicknesses in normal Sprague-Dawley (SD) rats (n = 9) and SDT rats (n = 8). The eyes were enucleated 40 weeks later after they were diagnosed with diabetes, and 4-micron sections were cut for conventional histopathologic studies. The mean retinal and choroidal thicknesses were significantly thicker in the SDT rats than in the normal SD rats. The ...

  7. Choroid plexus transport: gene deletion studies

    Directory of Open Access Journals (Sweden)

    Keep Richard F

    2011-11-01

    Full Text Available Abstract This review examines the use of transporter knockout (KO animals to evaluate transporter function at the choroid plexus (the blood-CSF barrier; BCSFB. Compared to the blood-brain barrier, there have been few such studies on choroid plexus (CP function. These have primarily focused on Pept2 (an oligopeptide transporter, ATP-binding cassette (ABC transporters, Oat3 (an organic anion transporter, Svct2 (an ascorbic acid transporter, transthyretin, ion transporters, and ion and water channels. This review focuses on the knowledge gained from such studies, both with respect to specific transporters and in general to the role of the CP and its impact on brain parenchyma. It also discusses the pros and cons of using KO animals in such studies and the technical approaches that can be used.

  8. The normal choroidal thickness in southern Thailand

    OpenAIRE

    Jirarattanasopa P; Panon N; Hiranyachattada S; Bhurayanontachai P

    2014-01-01

    Pichai Jirarattanasopa,1 Nisa Panon,2 Siriphun Hiranyachattada,2 Patama Bhurayanontachai1 1Department of Ophthalmology, Faculty of Medicine, 2Department of Physiology, Faculty of Science, Prince of Songkla University, Hat Yai, Thailand Objective: To investigate the association between subfoveal choroidal thickness in healthy southern Thailand volunteers and age, axial length, and refractive error.Subjects and methods: This was a prospective cross-sectional case series. A total of 210&n...

  9. The normal choroidal thickness in southern Thailand

    OpenAIRE

    Jirarattanasopa, Pichai

    2014-01-01

    Pichai Jirarattanasopa,1 Nisa Panon,2 Siriphun Hiranyachattada,2 Patama Bhurayanontachai1 1Department of Ophthalmology, Faculty of Medicine, 2Department of Physiology, Faculty of Science, Prince of Songkla University, Hat Yai, Thailand Objective: To investigate the association between subfoveal choroidal thickness in healthy southern Thailand volunteers and age, axial length, and refractive error.Subjects and methods: This was a prospective cross-sectional case series. A total of 2...

  10. Choroidal melanoma recurrence after episcleral brachytherapy and transpupillary thermotherapy

    Directory of Open Access Journals (Sweden)

    Yrbani Lantigua-Dorville

    2016-02-01

    Full Text Available ABSTRACT A 68-year-old man diagnosed with choroidal melanoma (CM in the right eye underwent treatment with episcleral brachytherapy (I125 and transpupillary thermotherapy. Ultrasound, computed tomography, and magnetic resonance imaging were performed and revealed ocular recurrence of CM. Treatment with extended enucleation was performed. Macroscopic and microscopic examinations revealed extraocular extension and malignant cells, respectively. Immunohistochemistry demonstrated tumoral Melan-A and HMB-45 expression. No cytogenic abnormalities were detected with fluorescence in situhybridization of tumor cells using probes against chromosomes 3q27 and 8q24. The patient underwent adjuvant external beam radiotherapy for treatment of residual tumor tissue. This case represents the first reported case of recurrent CM with no cytogenetic abnormalities and the absence of metastatic disease, despite a number of the poorest prognostic factors.

  11. Classification of choroiditis based on inflammatory lesion process rather than fundus appearance: enhanced comprehension through the ICGA concepts of the iceberg and jellyfish effects.

    Science.gov (United States)

    Herbort, C P; Papadia, M; Mantovani, A

    2012-04-01

    Choroidal inflammatory diseases have been classically grouped under the term of white dot syndromes (WDS), a term only based on the appearance (white-yellow dots) of inflammatory fundus lesions. This purely descriptive and vague terminology, regrouping a pot-pourri of posterior inflammatory conditions, probably came into use because the precise exploration of the choroid was not possible, and also because many of the diseases were rare and not well understood. Since the availability of indocyanine green angiography (ICGA) that allows one to explore the choroidal compartment, it became possible to understand the lesion mechanism of choroiditides and to classify this group of diseases according to their pathophysiological behaviour. It was our aim to show here that the term WDS is applied to and encompasses inflammatory conditions that are characterized by completely different lesion mechanisms and should therefore be classified separately from each other. ICGA made it possible to differentiate two types of choroiditides, including on the one hand inflammatory diseases of the choroidal stroma and on the other hand inflammatory diseases of the choriocapillaris. Unfortunately, twenty years after its advent, ICGA is still not used routinely in uveitis centres and the traditional inappropriate but overall useless term of WDS is still used, maintaining the confusion about these diseases. The aim of this work was (i) to illustrate that meaningful exploration of choroidal inflammation, mostly occult and inaccessible to usual investigations, has to be performed using ICGA, (ii) to insist on the crucial importance of ICGA in the management of choroiditis and (iii) to enhance the comprehension of the ICGA-based classification of choroiditis, by using the demonstrative and striking analogue concepts of iceberg and jellyfish effects. PMID:22495994

  12. Combination therapy of low-fluence photodynamic therapy and intravitreal ranibizumab for choroidal neovascular membrane in choroidal osteoma

    Directory of Open Access Journals (Sweden)

    Rodney J Morris

    2011-01-01

    Full Text Available Choroidal osteoma is an unusual form of intraocular calcification seen in otherwise healthy eyes. It is a benign idiopathic osseous tumor of the choroid, typically seen in young females. Choroidal neovascular membrane (CNVM is a complication seen in one-third of these patients and carries a poor visual outcome. We report a case of a 25-year-old hyperthyroid female with choroidal osteoma and subfoveal CNVM in her left eye which was successfully treated using low-fluence photodynamic therapy (PDT with verteporfin followed by a single injection of intravitreal ranibizumab.

  13. Frequency of asymptomatic choroidal metastasis in patients with disseminated breast cancer: results of a prospective screening programme

    OpenAIRE

    Wiegel, T.; Kreusel, K. M.; Bornfeld, N; Bottke, D.; M. Stange; Foerster, M.; Hinkelbein, W.

    1998-01-01

    AIM—To determine the frequency of visually asymptomatic choroidal metastasis in patients with disseminated breast cancer and its dependence on the incidence of metastasis by number and site of other organ metastases.
METHODS—From January 1995 until April 1997 120 patients irradiated for disseminated breast cancer underwent ophthalmological screening for choroidal metastasis. No patient was symptomatic for ocular disease. 68 out of 120 patients were found to have metastases in one organ and 52...

  14. Alectinib for choroidal metastasis in a patient with crizotinib-resistant ALK rearranged positive non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Okuma Y

    2015-06-01

    Full Text Available Yusuke Okuma,1,2 Yuichiro Tanaka,3 Tina Kamei,1 Yukio Hosomi,1 Tatsuru Okamura1 1Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, 2Division of Oncology, Research Center for Medical Sciences, The Jikei University School of Medicine, 3Department of Ophthalmology, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan Abstract: Choroidal metastasis is rare in cancer patients. Small molecules of molecular targeted agents for lung cancer with actionable mutations were reported to be palliated for symptoms caused by choroidal metastasis. Visual disturbance by choroidal metastasis significantly decreases quality of life during the patient’s remaining lifespan; therefore, radiotherapy or laser photocoagulation is proposed with consensus. However, improvement in survival with matched molecular targeted agents for oncogenic driver mutations reminds us to also be concerned with late treatment toxicities. A 30-year-old female patient previously treated with crizotinib harboring ALK rearranged non-small cell lung cancer complained of visual disturbance, fever, and bone pains undergoing anti-PD-1 antibody treatment. A decreased proportion of ALK fusion was demonstrated by fluorescence in situ hybridization in liver metastasis compared to the primary site in a chemo-naïve state. She was diagnosed with low vision, choroidal metastasis and retinal detachment. Therefore, she started alectinib treatment and both her ocular and systemic symptoms were palliated in a week. Later, she temporarily discontinued alectinib because of skin rash although the choroidal metastasis and retinal detachment resolved and she regained low vision completely at 2 weeks. She obtained partial response with alectinib for more than 5 months after recovering from skin rash. Keywords: lung cancer, ALK rearrangement, alectinib, choroidal metastasis, molecular targeted

  15. Effects of vasoactive stimuli on blood flow to choroid plexus

    International Nuclear Information System (INIS)

    The goal of this study was to examine effects of vasoactive stimuli on blood flow to choroid plexus. The authors used microspheres to measure blood flow to choroid plexus and cerebrum in anesthetized dogs and rabbits. A critical assumption of the microsphere method is that microspheres do not pass through arteriovenous shunts. Blood flow values obtained with simultaneous injection of 15- and 50-μm microspheres were similar, which suggest that shunting of 15-μm microspheres was minimal. Blood flow to choroid plexus under control conditions was 287 ± 26 (means ± SE) ml · min-1 · 100 g-1 in dogs and 385 ± 73 ml · min-1 100 g-1 in rabbits. Consecutive measurements under control conditions indicated that values for blood flow are reproducible. Adenosine did not alter blood flow to cerebrum but increased blood flow to choroid plexus two- to threefold in dogs and rabbits. Norepinephrine and phenylephrine did not affect blood flow to choroid plexus and cerebrum but decreased blood flow to choroid plexus by ∼ 50%. The authors suggest that (1) the microsphere method provides reproducible valid measurements of blood flow to the choroid plexus in dogs and rabbits and (2) vasoactive stimuli may have profoundly different effects on blood flow to choroid plexus and cerebrum

  16. Clinical Features of Choroidal Metastases from Carcinoid Tumour

    Institute of Scientific and Technical Information of China (English)

    Huaning She; Yuping Zheng; Xiaohua Wang; Yanlong Quan; Naixue Sun

    2004-01-01

    Purpose :To report ophthalmologic and angiographic features of choroidal metastases from carcinoid tumor and analyze their common clinical manifestation.Methods:Ophthalmologic examinations and fundus fluorescein angiography (FFA) were performed in 30 patients suffered from carcinoid tumor, and four patients diagnosed of breast cancer (2 cases), lung cancer (1 case) and maxillary sinus cancer (1 case) were confirmed with choroidal metastases.Results:Choroidal metastases were found as the initial manifestations of the malignant tumors on 2 patients whose initial and chief complaints were decreasing vision, their fundus lesions were mainly presented in the posterior pole and FFA showed high density of fluorescence of the lesions.Conclusions:This study indicated choroidal metastasis might be the first sign of metastases for patients with cancer. For patients with unknown metastastic cancers, examinations of the choroids may be useful for diagnosis and prognosis. Eye Science 2004;20:15-18.

  17. Diabetic Retinal and Choroidal Edema in SDT Rats.

    Science.gov (United States)

    Toyoda, Fumihiko; Tanaka, Yoshiaki; Shimmura, Machiko; Kinoshita, Nozomi; Takano, Hiroko; Kakehashi, Akihiro

    2016-01-01

    We evaluated the features of diabetic retinal and choroidal edema in Spontaneously Diabetic Torii (SDT) rats. We measured the retinal and choroidal thicknesses in normal Sprague-Dawley (SD) rats (n = 9) and SDT rats (n = 8). The eyes were enucleated 40 weeks later after they were diagnosed with diabetes, and 4-micron sections were cut for conventional histopathologic studies. The mean retinal and choroidal thicknesses were significantly thicker in the SDT rats than in the normal SD rats. The choroidal thickness was correlated strongly with the retinal thickness in both rat models. Diabetic retinopathy (DR) and diabetic choroidopathy appeared as edema in the SDT rats. The retinal thickness was correlated strongly with the choroidal thickness in the SDT rats, which is an ideal animal model of both DR and choroidopathy. PMID:26783535

  18. Recurrent Annular Peripheral Choroidal Detachment after Trabeculectomy

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    Shaohui Liu

    2013-10-01

    Full Text Available We report a challenging case of recurrent flat anterior chamber without hypotony after trabeculectomy in a 54-year-old Black male with a remote history of steroid-treated polymyositis, cataract surgery, and uncontrolled open angle glaucoma. The patient presented with a flat chamber on postoperative day 11, but had a normal fundus exam and intraocular pressure (IOP. Flat chamber persisted despite treatment with cycloplegics, steroids, and a Healon injection into the anterior chamber. A transverse B-scan of the peripheral fundus revealed a shallow annular peripheral choroidal detachment. The suprachoroidal fluid was drained. The patient presented 3 days later with a recurrent flat chamber and an annular peripheral choroidal effusion. The fluid was removed and reinforcement of the scleral flap was performed with the resolution of the flat anterior chamber. A large corneal epithelial defect developed after the second drainage. The oral prednisone was tapered quickly and the topical steroid was decreased. One week later, his vision decreased to count fingers with severe corneal stromal edema and Descemet's membrane folds that improved to 20/50 within 24 h of resumption of the oral steroid and frequent topical steroid. The patient's visual acuity improved to 20/20 following a slow withdrawal of the oral and topical steroid. Eight months after surgery, the IOP was 15 mm Hg without glaucoma medication. The detection of a shallow anterior choroidal detachment by transverse B-scan is critical to making the correct diagnosis. Severe cornea edema can occur if the steroid is withdrawn too quickly. Thus, steroids should be tapered cautiously in steroid-dependent patients.

  19. Intravitreal bevacizumab for treatment of choroidal neovascularization associated with osteogenesis imperfecta

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    Pukhraj Rishi

    2012-01-01

    Full Text Available A 12-year-old girl, diagnosed of osteogenesis imperfecta, presented with sudden visual loss in the left eye. Investigations revealed an active choroidal neovascular membrane. She underwent treatment with intravitreal Bevacizumab (1.25 mg/0.05 ml. Follow-up at 1 month revealed the development of lacquer crack running through the macula, underlying the fovea. The patient received two re-treatments at 1-month intervals, following which the choroidal neovascularization (CNV regressed completely. However, further progression of lacquer cracks was noted. At the last follow-up, 6 months following the last injection, the fundus remained stable and vision was maintained at 20/200. Considering the natural history of the disease and the increased risk of rupture of the Bruch′s membrane in such eyes, the possible complication of a lacquer crack developing must be borne in mind, before initiating treatment.

  20. Lesões expansivas do plexo coróide Choroid plexus mass lesions

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    Ernesto Lima Araújo Melo

    2003-12-01

    Full Text Available As lesões expansivas do plexo coróide constituem um grupo bastante amplo e heterogêneo de doenças e seus simuladores. Tumores, infecções, anomalias congênitas, hemorragias, cistos e fenômenos degenerativos são alguns dos exemplos de causas de lesões expansivas do plexo coróide. No presente trabalho fizemos revisão da literatura pertinente, descrevendo os achados de imagem e ilustrando-os com alguns casos do nosso serviço. Apesar de não existir na literatura descrição de sinais patognomônicos, a avaliação criteriosa e sistemática das características das lesões pode sugerir determinada etiologia.Choroid plexus mass lesions encompass a broad and heterogeneous group of diseases and their simulators. Tumors, infections, congenital anomalies, hemorrhage, cysts and degenerative diseases are some examples of mass lesions affecting the choroid plexus. In this article we review the current literature, describing the imaging findings and illustrating choroid plexus mass lesions with some cases diagnosed at our facility. Despite the inexistence of pathognomonic signs, a careful and systematic evaluation of the imaging characteristics may suggest many etiologies.

  1. Choroidal osteoma secondary to ocular trauma

    International Nuclear Information System (INIS)

    The choroidal osteoma is a benign bony tumor described for the first time in 1978 by Gass and collaborators. It is generally unilateral, with juxtapapillary localization and more frequent in young adult females. It presents unknown etiology, but it is associated to different factors as inflammatory processes, congenital malformations, hormonal alterations and ocular traumas among others. The patient was a 54 year-old woman with a personal history of rheumatic fibromyalgia (osteoarthrosis and osteoporosis) and hypertension. Her ophthalmological antecedent showed myopia and arteriolosclerotic retinopathy. At the beginning of the year, she suffered a traffic accident and was injured in her limbs and periocular region. After this, she began feeling blurred vision of the right eye and she went to our service 6 months later. She was performed an ophthalmologic exam. It was found that the right eye had visual acuity of 0.4, and after correction it reached 1.0. Funduscopy revealed vascular thinness, incomplete posterior vitreous detachment, and a white-orange lesion of 3 papillary diameters that involved inferior temporary arcade with well-defined borders. An angiography was performed, which showed sustained hyperfluorescence and non neovascularization; and the optic coherence tomography revealed a halo of serous retinal detachment. Additionally, the ocular ultrasound yielded a high reflectivity echogenic image that involves choroids with posterior acoustic shadow. It is for this reason that we affirm the traumatic etiology of the lesion. This is a rare pathology that should be diagnosed by imaging techniques. Notably, it is secondary to an ocular trauma

  2. The choroid plexus-cerebrospinal lfuid interface in Alzheimer’s disease:more than just a barrier

    Institute of Scientific and Technical Information of China (English)

    Sriram Balusu; Marjana Brkic; Claude Libert; Roosmarijn E Vandenbroucke

    2016-01-01

    The choroid plexus is a complex structure which hangs inside the ventricles of the brain and consists mainly of choroid plexus epithelial (CPE) cells surrounding fenestrated capillaries. These CPE cells not only form an anatomical barrier, called the blood-cerebrospinal lfuid barrier (BCSFB), but also present an active interface between blood and cerebrospinal lfuid (CSF). CPE cells perform indispensable functions for the development, maintenance and functioning of the brain. Indeed, the primary role of the choroid plexus in the brain is to maintain homeostasis by secreting CSF which contains different molecules, such as nutrients, neurotrophins, and growth factors, as well as by clearing toxic and undesirable molecules from CSF. The choroid plexus also acts as a selective entry gate for leukocytes into the brain. Recent ifndings have revealed distinct changes in CPE cells that are associated with aging and Alzheimer’s disease. In this review, we review some recent ifndings that highlight the importance of the CPE-CSF system in Alzheimer’s dis-ease and we summarize the recent advances in the regeneration of brain tissue through use of CPE cells as a new therapeutic strategy.

  3. Choroid plexus papilloma in a beluga whale (Delphinapterus leucas).

    Science.gov (United States)

    Thomas, Christian; Mergl, June; Gehring, Erica; Paulus, Werner; Martineau, Daniel; Hasselblatt, Martin

    2016-07-01

    We report herein a choroid plexus papilloma in a beluga whale (Delphinapterus leucas). This case was positive for choroid plexus tumor marker Kir7.1 on immunohistochemistry. These results and the high conservation of Kir7.1 across species at the amino acid sequence level strongly suggest that antibodies directed against Kir7.1 not only can be employed for the diagnosis of choroid plexus tumors in cetaceans, but are also likely to be diagnostically useful in other animal species. PMID:27216722

  4. Bilateral anterior choroidal artery infarction presenting with progressive somnolence.

    Science.gov (United States)

    van Son, Brechtje; Vandevenne, Jan; Viaene, Pieter

    2014-09-01

    A 55-year-old woman was admitted with a 3 days history of increasing lethargy with bradyphrenia and apathy. She progressively developed severe somnolence with marked abulia, right hemiparesis, right hemianopsia, and pseudobulbar palsy. Brain magnetic resonance imaging showed the rare image of bilateral acute anterior choroidal artery infarction. Pseudobulbar mutism and in rare cases abulia have been described in acute anterior choroidal artery infarction contralateral to an older lesion in mirror position. Although neurologic deterioration is not infrequent in anterior choroidal artery territory infarcts, the absence of focal neurologic signs on admission is rare and did not raise suspicion of acute stroke. PMID:25106836

  5. Choroidal mast cells in retinal pathology: a potential target for intervention.

    Science.gov (United States)

    Bousquet, Elodie; Zhao, Min; Thillaye-Goldenberg, Brigitte; Lorena, Viera; Castaneda, Beatriz; Naud, Marie Christine; Bergin, Ciara; Besson-Lescure, Bernadette; Behar-Cohen, Francine; de Kozak, Yvonne

    2015-08-01

    Mast cells are important in the initiation of ocular inflammation, but the consequences of mast cell degranulation on ocular pathology remain uncharacterized. We induced mast cell degranulation by local subconjunctival injection of compound 48/80. Initial degranulation of mast cells was observed in the choroid 15 minutes after the injection and increased up to 3 hours after injection. Clinical signs of anterior segment inflammation paralleled mast cell degranulation. With the use of optical coherence tomography, dilation of choroidal vessels and serous retinal detachments (SRDs) were observed and confirmed by histology. Subconjunctival injection of disodium cromoglycate significantly reduced the rate of SRDs, demonstrating the involvement of mast cell degranulation in posterior segment disorders. The infiltration of polymorphonuclear and macrophage cells was associated with increased ocular media concentrations of tumor necrosis factor-α, CXCL1, IL-6, IL-5, chemokine ligand 2, and IL-1β. Analysis of the amounts of vascular endothelial growth factor and IL-18 showed an opposite evolution of vascular endothelial growth factor compared with IL-18 concentrations, suggesting that they regulate each other's production. These findings suggest that the local degranulation of ocular mast cells provoked acute ocular inflammation, dilation, increased vascular permeability of choroidal vessels, and SRDs. The involvement of mast cells in retinal diseases should be further investigated. The pharmacologic inhibition of mast cell degranulation may be a potential target for intervention. PMID:26166807

  6. Flare up of choroiditis and choroidal neovasculazation associated with punctate inner choroidopathy during early pregnancy

    Directory of Open Access Journals (Sweden)

    Rao Vinita

    2011-01-01

    Full Text Available A 28-year-old, healthy female, who had a recent repeated history of miscarriage, presented with bilateral choroidal neovascular membranes (CNVM, for which she received photodynamic therapy with three doses of lucentis, at intervals of one month each, to which she responded. After five months, the patient again presented with complaints of diminution of vision since 15 days. She had a history of miscarriage two days before presenting to our clinic. CNVM was scarred at this time and the fundus picture showed multiple small punctate spots around the fovea at the level of the choroid, which showed early hyperfluroscence on fundus fluorescein angiography, suggestive of punctate inner choroidopathy. She was advised systemic steroids, to which she responded dramatically.

  7. Transscleral sustained vasohibin-1 delivery by a novel device suppressed experimentally-induced choroidal neovascularization.

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    Hideyuki Onami

    Full Text Available We established a sustained vasohibin-1 (a 42-kDa protein, delivery device by a novel method using photopolymerization of a mixture of polyethylene glycol dimethacrylate, triethylene glycol dimethacrylate, and collagen microparticles. We evaluated its effects in a model of rat laser-induced choroidal neovascularization (CNV using a transscleral approach. We used variable concentrations of vasohibin-1 in the devices, and used an enzyme-linked immunosorbent assay and Western blotting to measure the released vasohibin-1 (0.31 nM/day when using the 10 μM vasohibin-1 delivery device [10VDD]. The released vasohibin-1 showed suppression activity comparable to native effects when evaluated using endothelial tube formation. We also used pelletized vasohibin-1 and fluorescein isothiocyanate-labeled 40 kDa dextran as controls. Strong fluorescein staining was observed on the sclera when the device was used for drug delivery, whereas pellet use produced strong staining in the conjunctiva and surrounding tissue, but not on the sclera. Vasohibin-1 was found in the sclera, choroid, retinal pigment epithelium (RPE, and neural retina after device implantation. Stronger immunoreactivity at the RPE and ganglion cell layers was observed than in other retinal regions. Significantly lower fluorescein angiography (FA scores and smaller CNV areas in the flat mounts of RPE-choroid-sclera were observed for the 10VDD, VDD (1 μM vasohibin-1 delivery device, and vasohibin-1 intravitreal direct injection (0.24 μM groups when compared to the pellet, non-vasohibin-1 delivery device, and intravitreal vehicle injection groups. Choroidal neovascularization can be treated with transscleral sustained protein delivery using our novel device. We offer a safer sustained protein release for treatment of retinal disease using the transscleral approach.

  8. Age-based analysis of choroidal thickness and choroidal vessel diameter in primary open-angle glaucoma.

    Science.gov (United States)

    Toprak, Ibrahim; Yaylalı, Volkan; Yildirim, Cem

    2016-04-01

    We aimed to assess choroidal thickness and vessel diameter in patients with primary open-angle glaucoma (POAG) using enhanced depth imaging (EDI) optical coherence tomography (OCT) with age-based analysis. Fifty-four patients with a confirmed diagnosis of POAG and 44 age-sex matched healthy subjects were included into the study. A masked physician performed measurements of largest choroidal vessel diameter and choroidal thicknesses (subfoveal, nasal, and temporal) using EDI OCT. Subgroup analyses were performed to compare choroidal measurements based on age (with a cut point of 70 years). The study cohort comprised 54 patients with POAG (mean age of 63.2 ± 8.8 years) and 44 healthy control subjects (mean age of 62.9 ± 8.5 years) (P = 0.870). We found no significant differences in terms of choroidal measurements (P > 0.05) between the glaucoma and control groups. However, in the glaucoma group, patients with an age ≥70 years had significantly thinner subfoveal and nasal choroid compared to those of the patients with  0.05). Choroidal thickness and vessel caliber seem not to differ between patients with POAG and healthy controls. However, an age ≥70 years might be associated with thinning in subfoveal and nasal choroid in patients with POAG. Further studies are needed to elucidate whether choroidal thinning is a cause or result in POAG. PMID:26077882

  9. Alectinib for choroidal metastasis in a patient with crizotinib-resistant ALK rearranged positive non-small cell lung cancer

    OpenAIRE

    Okuma Y; Tanaka Y; Kamei T; Hosomi Y; Okamura T

    2015-01-01

    Yusuke Okuma,1,2 Yuichiro Tanaka,3 Tina Kamei,1 Yukio Hosomi,1 Tatsuru Okamura1 1Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, 2Division of Oncology, Research Center for Medical Sciences, The Jikei University School of Medicine, 3Department of Ophthalmology, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan Abstract: Choroidal metastasis is rare in cancer patients. S...

  10. Role of Intravitreal Antivascular Endothelial Growth Factor Injections for Choroidal Neovascularization due to Choroidal Osteoma

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    Ahmad M. Mansour

    2014-01-01

    Full Text Available We treated 26 eyes of 25 young patients having a mean age of 30 years with intravitreal vascular endothelial growth factor (VEGF inhibitor for choroidal new vessel (CNV formation overlying choroidal osteoma over a mean follow-up of 26 months. Mean number of injections was 2.4 at 6 months, 3.2 at 12 months, and 5.5 at 24 months. CNV was subfoveal in 14 eyes, juxtafoveal in 5, extrafoveal in 5, and peripapillary in 2. By paired comparison, mean decrease from baseline was 119.7 microns at 6 months (n=15; P=0.001, 105.3 microns at 1 year (n=10; P=0.03, and 157.6 microns at 2 years (n=7; P=0.08. BCVA improved by 3.3 lines at 6 months after therapy (n=26; P<0.001, 2.8 lines (n=20; P=0.01 at 1 year, and 3.1 lines (n=13; P=0.049 at 2 years. We conclude that intravitreal anti-VEGF injections improve vision in majority of eyes with CNV from choroidal osteoma.

  11. Role of Intravitreal Antivascular Endothelial Growth Factor Injections for Choroidal Neovascularization due to Choroidal Osteoma

    Science.gov (United States)

    Mansour, Ahmad M.; Al Kahtani, Eman; Zegarra, Hernando; Anand, Rajiv; Ahmadieh, Hamid; Sisk, Robert A.; Mirza, Salman; Tuncer, Samuray; Navea Tejerina, Amparo; Mataix, Jorge; Ascaso, Francisco J.; Pulido, Jose S.; Guthoff, Rainer; Goebel, Winfried; Roh, Young Jung; Banker, Alay S.; Gentile, Ronald C.; Martinez, Isabel Alonso; Morris, Rodney; Panday, Neeraj; Min, Park Jung; Mercé, Emilie; Lai, Timothy Y. Y.; Massoud, Vicky; Ghazi, Nicola G.

    2014-01-01

    We treated 26 eyes of 25 young patients having a mean age of 30 years with intravitreal vascular endothelial growth factor (VEGF) inhibitor for choroidal new vessel (CNV) formation overlying choroidal osteoma over a mean follow-up of 26 months. Mean number of injections was 2.4 at 6 months, 3.2 at 12 months, and 5.5 at 24 months. CNV was subfoveal in 14 eyes, juxtafoveal in 5, extrafoveal in 5, and peripapillary in 2. By paired comparison, mean decrease from baseline was 119.7 microns at 6 months (n = 15; P = 0.001), 105.3 microns at 1 year (n = 10; P = 0.03), and 157.6 microns at 2 years (n = 7; P = 0.08). BCVA improved by 3.3 lines at 6 months after therapy (n = 26; P < 0.001), 2.8 lines (n = 20; P = 0.01) at 1 year, and 3.1 lines (n = 13; P = 0.049) at 2 years. We conclude that intravitreal anti-VEGF injections improve vision in majority of eyes with CNV from choroidal osteoma. PMID:25147732

  12. Proliferation of cultured mouse choroid plexus epithelial cells.

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    Basam Z Barkho

    Full Text Available The choroid plexus (ChP epithelium is a multifunctional tissue found in the ventricles of the brain. The major function of the ChP epithelium is to produce cerebrospinal fluid (CSF that bathes and nourishes the central nervous system (CNS. In addition to the CSF, ChP epithelial cells (CPECs produce and secrete numerous neurotrophic factors that support brain homeostasis, such as adult hippocampal neurogenesis. Accordingly, damage and dysfunction to CPECs are thought to accelerate and intensify multiple disease phenotypes, and CPEC regeneration would represent a potential therapeutic approach for these diseases. However, previous reports suggest that CPECs rarely divide, although this has not been extensively studied in response to extrinsic factors. Utilizing a cell-cycle reporter mouse line and live cell imaging, we identified scratch injury and the growth factors insulin-like growth factor 1 (IGF-1 and epidermal growth factor (EGF as extrinsic cues that promote increased CPEC expansion in vitro. Furthermore, we found that IGF-1 and EGF treatment enhances scratch injury-induced proliferation. Finally, we established whole tissue explant cultures and observed that IGF-1 and EGF promote CPEC division within the intact ChP epithelium. We conclude that although CPECs normally have a slow turnover rate, they expand in response to external stimuli such as injury and/or growth factors, which provides a potential avenue for enhancing ChP function after brain injury or neurodegeneration.

  13. Keratoconus associated with choroidal neovascularization: a case report

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    Oh Joo

    2010-02-01

    Full Text Available Abstract Introduction Keratoconus and choroidal neovascularization can occur as a result of dysfunction of the epithelium and its basement membrane. Case presentation A 17-year-old Asian man, who was diagnosed with myopic choroidal neovascularization in both eyes and who subsequently underwent intravitreal injection of ranibizumab (Lucentis® five times over six months, presented with further vision decrease and pain in his right eye. Examination showed corneal steepening and stromal edema in the inferocentral cornea of his right eye, both of which were indicative of advanced keratoconus with acute hydrops. Corneal topography also showed features consistent with keratoconus in his left eye. Fluorescein angiography and optical coherence tomography revealed choroidal neovascularization-associated subretinal hemorrhages and lacquer cracks in both eyes. Conclusion Keratoconus and choroidal neovascularization, possibly resulting from dysfunction of the epithelium and its basement membrane, can occur together in the same individual. This would suggest a possible connection in pathogenesis between these two conditions.

  14. Morphological features of choroidal metastases: An OCT analysis

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    Ludovico Iannetti

    2013-01-01

    Full Text Available The morphological characteristics and retinal changes of chroidal metastases using Spectral Domain OCT are described in a case with primary lung adenocarcinoma and secondary choroidal involvement.

  15. Treatment of choroidal neovascularization in high myopia.

    Science.gov (United States)

    Montero, Javier A; Ruiz-Moreno, Jose M

    2010-05-01

    High myopia affects approximately 2% of general population, and is a major cause of legal blindness in many developed countries. Choroidal neovascularization (CNV) is the most common vision-threatening complication of high myopia. Different therapeutic approaches have been attempted such as thermal laser photocoagulation, surgery and photodynamic therapy with verteporfin (PDT). The visual outcome of these therapies has been reported to be better than the natural history of the condition. However, the limited visual acuity improvement after PDT monotherapy and the appearance of subretinal fibrosis and chorioretinal atrophy prompted the association of other therapies. In the past few years a tremendous advance in the knowledge of the mechanisms underling CNV secondary to high myopia and age related macular degeneration has been achieved, leading to new therapeutic targets and novel drugs and combined therapies. These new therapeutic weapons have been designed to achieve a selective shut down of choroidal new vessels. Recent reviews have been published on the natural history and therapies for myopic CNV. Ohno-Matsui reported on the natural history of the condition as well as the outcome of laser photocoagulation, surgical extraction of CNV, foveal translocation and photodynamic therapy on myopic CNV in the short-term. Soubrane et al reviewed the new advances on surgery, laser photocoagulation and PDT, considering some of the potential effects of triamcinolone, pegaptanib and ranibizumab in CNV secondary to age related macular degeneration (AMD). Novack et al reported on the pharmacological therapy of CNV in AMD. The aim of this review is to summarize the recent advances in myopic CNV pathophysiology and the new therapeutic targets and drugs that are changing the clinical management of myopic CNV. PMID:20196722

  16. A novel, microscope based, non invasive Laser Doppler flowmeter for choroidal blood flow assessment

    OpenAIRE

    Strohmaier, C; Werkmeister, RM; Bogner, B; Runge, C; Schroedl, F; Brandtner, H; Radner, W; Schmetterer, L; Kiel, JW; Grabnerand, G; Reitsamer, HA

    2011-01-01

    Impaired ocular blood flow is involved in the pathogenesis of numerous ocular diseases like glaucoma or AMD. The purpose of the present study was to introduce and validate a novel, microscope based, non invasive laser Doppler flowmeter (NILDF) for measurement of blood flow in the choroid. The custom made NI-LDF was compared with a commercial fiber optic based laser Doppler flowmeter (Perimed PF4000). Linearity and stability of the NI-LDF were assessed in a silastic tubing model (i.d. 0.3 mm) ...

  17. Choroidal Metastasis of Papillary Thyroid Carcinoma Demonstrated on SPECT-CT.

    Science.gov (United States)

    Torun, Nese; Reyhan, Mehmet; Yapar, Ali Fuat; Karatas, Muge

    2016-05-01

    We report a 68-year-old woman with papillary thyroid carcinoma metastasizing to choroid. The choroid metastasis was diagnosed with SPECT-CT and then was treated with high-dose radioactive iodine therapy. PMID:26825205

  18. Correlation between clinical and histological features in a pig model of choroidal neovascularization

    DEFF Research Database (Denmark)

    Lassota, Nathan; Kiilgaard, Jens Folke; Prause, Jan Ulrik; la Cour, Morten

    2006-01-01

    To analyse the histological changes in the retina and the choroid in a pig model of choroidal neovascularization (CNV) and to correlate these findings with fundus photographic and fluorescein angiographic features....

  19. Choroidal thickness following extrafoveal photodynamic treatment with verteporfin in patients with central serous chorioretinopathy

    DEFF Research Database (Denmark)

    Pryds, Anders; Larsen, Michael

    2012-01-01

    Purpose: To evaluate the effect of verteporfin photodynamic treatment (PDT) on choroidal thickness in patients with central serous chorioretinopathy (CSC). Methods: Choroidal thickness was measured with enhanced depth imaging- optical coherence tomography (EDI-OCT) before and after verteporfin PDT...

  20. Choroidal metastasis from early rectal cancer: Case report and literature review

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    Mitsuyoshi Tei

    2014-01-01

    CONCLUSION: This is the first report of choroidal metastasis from early rectal cancer. We consider it important to enforce systemic chemotherapy in addition to radiotherapy for choroidal metastasis from colorectal cancer.

  1. Our Treatment Results of Circumscribed and Diffuse Choroidal Hemangiomas

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    Esra Savku

    2013-08-01

    Full Text Available Purpose: To discuss our treatment results of choroidal hemangiomas. Material and Method: The records of 39 cases of choroidal hemangioma followed up at our clinic between July 1999–October 2012 were reviewed retrospectively. Asymptomatic cases were followed up. Symptomatic cases with subretinal fluid and impaired vision received treatment. Results: Mean age of the 39 patients was 44 (12-80 years. Thirty-five of 39 cases had circumscribed choroidal hemangioma, and 4 cases had diffuse choroidal hemangioma. Sturge-Weber syndrome was present in 3 cases with diffuse choroidal hemangioma. Cases with circumscribed choroidal hemangioma and minimal subretinal fluid were treated with TTT in 11 cases, PDT in 12 cases, and PDT+TTT in 1 case. Cases with circumscribed choroidal hemangioma and excessive subretinal fluid were treated with Ru-106 plaque radiotherapy in 1 case, Ru-106 plaque radiotherapy+TTT in 1 case, EBRT in 3 cases, and TTT+EBRT in 1 case. One painful blind eye with neovascular glaucoma and complicated cataract was enucleated. Cases with diffuse choroidal hemangioma and excessive subretinal fluid were treated with Ru-106 plaque radiotherapy+TTT in 1 case and EBRT in 1 case. Ahmed glaucoma valve implantation and FAKO emulsification were applied to a case with neovascular glaucoma and complicated cataract. Complete resorption of subretinal fluid was achieved in 23 (72% of treated 32 cases. When mean initial tumor thickness was 2.6 mm (0.5-6, mean final tumor thickness was 1.4 mm (0-6. When mean initial visual acuity (LogMAR was 1.5 (0-3, mean final visual acuity was 1.1 (0-3. No recurrence was observed. Discussion: The amount of the subretinal fluid determines the method of treatment in circumscribed choroidal hemangioma. While TTT and PDT are effective treatment modalities for minimal subretinal fluid, plaque radiotherapy and EBRT are applied in cases with excessive subretinal fluid. Combination therapies may be necessary according to the

  2. Gamma Knife Radiosurgery for Choroidal Hemangioma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yun Taek; Kang, Se Woong [Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Lee, Jung-Il, E-mail: jilee@skku.edu [Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-12-01

    Purpose: Patients with choroidal hemangioma (CH), a benign ocular hamartoma, frequently presents with visual disturbance as a result of exudative retinal detachment (RD), which originates in subretinal fluid accumulation. We report our experience using the Leksell Gamma Knife in the management of symptomatic CH. Methods and Materials: Seven patients with symptomatic CH (circumscribed form in 3 patients and diffuse form in 4) were treated with the Leksell Gamma Knife at our institution during a 7-year period. All patients presented with exudative RD involving the macula that resulted in severe visual deterioration. The prescription dose to the target margin was 10 Gy in all cases. The mean tumor volume receiving the prescription dose was 536 mm{sup 3} (range, 151-1,057). The clinical data were analyzed in a retrospective fashion after a mean follow-up of 34.4 months (range, 9-76). Results: The resolution of exudative RD was achieved within 6 months, and the visual acuity of the affected eye had improved at the latest follow-up examination (p = .018) in all patients. No recurrence of exudative RD occurred. Thinning of the CHs was observed in most patients; however, symptomatic radiation toxicity had not developed in any of the patients. Conclusion: Symptomatic CHs can be safely and effectively managed with Gamma Knife radiosurgery using a marginal dose of 10 Gy.

  3. Charged particle radiotherapy for choroidal melanoma

    International Nuclear Information System (INIS)

    The phase I/II clinical study of carbon ion radiotherapy (CIRT) for choroidal melanoma was commenced in Jan. 2001 at the National Institute of Radiological Sciences (NIRS), which was based on the long line of the study of proton radiotherapy (PRT) since Oct. 1986. PRT is applied to small to medium sized tumor, and carbon is used to large sized tumor at present. So far 41 patients received PRT. Skin reactions and visual acuity status after the therapy were acceptable. Seven patients developed glaucoma and one of them received enucleation. Local recurrence was observed in one patient and 5-year local control rate was 97.4%. Five-year survival and eye retention rate were 85.4% and 95%, respectively. On the other hand, thirty-three patients received CIRT and 24 patients with follow-up period of more than 6 months were analyzed. Skin reactions after CIRT were comparable to those of PRT. Neovascular glaucoma was observed in 7 patients and the incidence of glaucoma was strongly depending on the site and size of the tumor. All patients were alive without any local recurrence, and only one patient developed liver metastasis at 22.3 months after the treatment. (author)

  4. Modifying Choroidal Neovascularization Development with a Nutritional Supplement in Mice

    Directory of Open Access Journals (Sweden)

    Alina Adriana Ivanescu

    2015-07-01

    Full Text Available We examined the effect of nutritional supplements (modified Age Related Eye Disease Study (AREDS-II formulation containing vitamins, minerals, lutein, resveratrol, and omega-3 fatty acids on choroidal neovascularization (CNV. Supplements were administered alone and combined with intravitreal anti-VEGF in an early-CNV (diode laser-induced murine model. Sixty mice were evenly divided into group V (oral vehicle, intravitreal saline, group S (oral supplement, intravitreal saline, group V + aVEGF (oral vehicle, intravitreal anti-VEGF, and group S + aVEGF (oral supplement, intravitreal anti-VEGF. Vehicle and nutritional supplements were administered daily for 38 days beginning 10 days before laser. Intravitreal injections were administered 48 h after laser. Fluorescein angiography (FA and flat-mount CD31 staining evaluated leakage and CNV lesion area. Expression of VEGF, MMP-2 and MMP-9 activity, and NLRP3 were evaluated with RT-PCR, zymography, and western-blot. Leakage, CNV size, VEGF gene and protein expression were lower in groups V + aVEGF, S + aVEGF, and S than in V (all p < 0.05. Additionally, MMP-9 gene expression differed between groups S + aVEGF and V (p < 0.05 and MMP-9 activity was lower in S + aVEGF than in V and S (both p < 0.01. Levels of MMP-2 and NLRP3 were not significantly different between groups. Nutritional supplements either alone or combined with anti-VEGF may mitigate CNV development and inhibit retinal disease involving VEGF overexpression and CNV.

  5. Modifying Choroidal Neovascularization Development with a Nutritional Supplement in Mice.

    Science.gov (United States)

    Ivanescu, Alina Adriana; Fernández-Robredo, Patricia; Heras-Mulero, Henar; Sádaba-Echarri, Luis Manuel; García-García, Laura; Fernández-García, Vanessa; Moreno-Orduna, Maite; Redondo-Exposito, Aitor; Recalde, Sergio; García-Layana, Alfredo

    2015-07-01

    We examined the effect of nutritional supplements (modified Age Related Eye Disease Study (AREDS)-II formulation containing vitamins, minerals, lutein, resveratrol, and omega-3 fatty acids) on choroidal neovascularization (CNV). Supplements were administered alone and combined with intravitreal anti-VEGF in an early-CNV (diode laser-induced) murine model. Sixty mice were evenly divided into group V (oral vehicle, intravitreal saline), group S (oral supplement, intravitreal saline), group V + aVEGF (oral vehicle, intravitreal anti-VEGF), and group S + aVEGF (oral supplement, intravitreal anti-VEGF). Vehicle and nutritional supplements were administered daily for 38 days beginning 10 days before laser. Intravitreal injections were administered 48 h after laser. Fluorescein angiography (FA) and flat-mount CD31 staining evaluated leakage and CNV lesion area. Expression of VEGF, MMP-2 and MMP-9 activity, and NLRP3 were evaluated with RT-PCR, zymography, and western-blot. Leakage, CNV size, VEGF gene and protein expression were lower in groups V + aVEGF, S + aVEGF, and S than in V (all p < 0.05). Additionally, MMP-9 gene expression differed between groups S + aVEGF and V (p < 0.05) and MMP-9 activity was lower in S + aVEGF than in V and S (both p < 0.01). Levels of MMP-2 and NLRP3 were not significantly different between groups. Nutritional supplements either alone or combined with anti-VEGF may mitigate CNV development and inhibit retinal disease involving VEGF overexpression and CNV. PMID:26153682

  6. Stereotactic Radiosurgical Treatment of Brain Metastases to the Choroid Plexus

    International Nuclear Information System (INIS)

    Purpose: Choroid plexus metastases (CPM) are uncommon lesions. Consequently, optimal management of CPM is uncertain. We summarize our experience with stereotactic radiosurgery (SRS) of CPM. Methods and Materials: Sixteen consecutive patients with presumed CPM treated with SRS between 1997 and 2007 were examined. Twelve were men with a median age at diagnosis of CPM of 61.9 ± 9.9 years; 14 had metastases from renal cell carcinoma (RCC). All patients had controlled primary disease at the time of treatment for CPM. Four patients with RCC and 1 with non-small-cell lung cancer had undergone whole-brain radiotherapy (WBRT) previously and 2 had received SRS to other brain metastases. The disease-free interval from the primary diagnosis to CPM diagnosis averaged 39.3 ± 46.2 months (range, 1.0-156.3). Five patients were asymptomatic; of the remaining 11, none had symptoms related to CPM. All presented with a single CPM. Results: Average maximum diameter of the CPMs was 2.0 ± 1.0 cm (range, 0.9-4.1 cm); mean volume was 2.4 ± 2.6 cm3 (range, 0.2-9.3). Median SRS dose was 24 Gy to the 53% isodose line (range, 14-24 Gy). Survival after SRS to the CPM was 25.3 ± 23.4 months (range, 3.2-101.6). Patients in Recursive Partitioning Analysis (RPA) class I (n = 10) had improved survival compared to those in class II (n = 6), as did those with better GPA scores. There were no local failures. After SRS, 1 patient underwent WBRT, 3 patients had one, and another had two subsequent SRS treatments to other brain lesions. Of the 14 patients who have died, 11 succumbed to systemic disease progression, 2 to progressive, multifocal central nervous system disease, and 1 to systemic disease with concurrent, stable central nervous system disease. There were no complications related to SRS. Conclusions: Most CPMs are associated with RCC. SRS represents a safe and viable treatment option as primary modality for these metastases, with excellent outcomes.

  7. Influx mechanisms in the embryonic and adult rat choroid plexus

    DEFF Research Database (Denmark)

    Saunders, Norman R; Dziegielewska, Katarzyna M; Møllgård, Kjeld;

    2015-01-01

    The transcriptome of embryonic and adult rat lateral ventricular choroid plexus, using a combination of RNA-Sequencing and microarray data, was analyzed by functional groups of influx transporters, particularly solute carrier (SLC) transporters. RNA-Seq was performed at embryonic day (E) 15 and a...... studies suggests that the choroid plexus in embryonic brain plays a major role in supplying the developing brain with essential nutrients.......The transcriptome of embryonic and adult rat lateral ventricular choroid plexus, using a combination of RNA-Sequencing and microarray data, was analyzed by functional groups of influx transporters, particularly solute carrier (SLC) transporters. RNA-Seq was performed at embryonic day (E) 15 and...... in the adult plexus were expressed at higher levels than in embryos. These results are compared with earlier published physiological studies of amino acid and monocarboxylate transport in developing rodents. This comparison shows correlation of high expression of some transporters in the developing...

  8. Optical Coherence Tomography of Retinal and Choroidal Tumors

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    Emil Anthony T. Say

    2011-01-01

    Full Text Available Optical coherence tomography (OCT has revolutionized the field of ophthalmology since its introduction 20 years ago. Originally intended primarily for retina specialists to image the macula, it has found its role in other subspecialties that include glaucoma, cornea, and ocular oncology. In ocular oncology, OCT provides axial resolution to approximately 7 microns with cross-sectional images of the retina, delivering valuable information on the effects of intraocular tumors on the retinal architecture. Some effects include retinal edema, subretinal fluid, retinal atrophy, photoreceptor loss, outer retinal thinning, and retinal pigment epithelial detachment. With more advanced technology, OCT now provides imaging deeper into the choroid using a technique called enhanced depth imaging. This allows characterization of the thickness and reflective quality of small (<3 mm thick choroidal lesions including choroidal nevus and melanoma. Future improvements in image resolution and depth will allow better understanding of the mechanisms of visual loss, tumor growth, and tumor management.

  9. Clinical characteristics and treatment of neurofibroma of the choroid

    Institute of Scientific and Technical Information of China (English)

    WEI Wen-bin; JIE Ying; MO Jing; LI Bin

    2012-01-01

    Background Neurofibroma is a kind of benign neoplasm that derives from nervous tissues.Though this tumor is the most common types in the peripheral nervous system,it is rarely seen in the choroid and easy to be misdiagnosed of choroidal melanoma.The aim of this study was to review the clinical features of neurofibroma of the choroid in the Chinese race.Methods A retrospective case series design was used.Two male and one female patients diagnosed with choroidal neurofibroma in Beijing Tongren Eye Center were included in this study.The clinical histories were abstracted from the patients' medical records.Routine eye examinations including visual acuity,intraocular pressure,slit lamp and ophthalmoscope were performed.Auxiliary examinations included fluorescein fundus angiography (FFA),AB-ultrasound scan,color doppler imaging (CDI),and magnetic resonance imaging (MRI).Local resection of the tumors was performed and the specimens underwent pathological examinations.Results The tumors were of yellow-pink color with pigmentation on the surface.CDI showed arterial blood signals in the tumor and MRI showed high-intensity in the T1-weighted image and a slightly increased intensity in the T2-weighted image.FFA and indocyaninegreen angiography demonstrated the tumors were of hypofluorescence at early stage and hyperfluorescence with prominent leakage at late stage.The pathological examination confirmed the tumors were choroidal neurofibroma.After 5-10-year follow-up,there were no recurrences of the tumors and the retinas were well attached.Conclusions Choroidal neurofibroma is difficult to be diagnosed clinically and pathological confirmation is important.These tumors can be managed conservatively by local resection.

  10. Aβ immunization worsens iron deposits in the choroid plexus and cerebral microbleeds

    Science.gov (United States)

    Joseph-Mathurin, Nelly; Dorieux, Olène; Trouche, Stéphanie G.; Boutajangout, Allal; Kraska, Audrey; Fontès, Pascaline; Verdier, Jean-Michel; Sigurdsson, Einar M.; Mestre-Francés, Nadine; Dhenain, Marc

    2014-01-01

    Anti-Aβ immunotherapy provides potential benefits in Alzheimer’s disease patients. Nevertheless, strategies based on Aβ1-42 peptide induced encephalomyelitis and possible microhemorrhages. These outcomes were not expected from studies performed in rodents. It is critical to determine if other animal models better predict side effects of immunotherapies. Mouse lemur primates can develop amyloidosis with aging. Here we used old lemurs to study immunotherapy based on Aβ1-42 or Aβ-derivative (K6Aβ1-30). We followed anti-Aβ40 IgG and IgM responses as well as Aβ levels in plasma. In-vivo magnetic resonance imaging and histology were used to evaluate amyloidosis, neuroinflammation, vasogenic edema, microhemorrhages, and brain iron deposits. The animals responded mainly to the Aβ1-42 immunogen. This treatment induced immune response and increased Aβ levels in plasma but also microhemorrhages and iron deposits in the choroid plexus. A complementary study of untreated lemurs showed iron accumulation in the choroid plexus with normal aging. Worsening of iron accumulation is thus a potential side effect of Aβ-immunization at prodromal stages of Alzheimer’s disease, and should be monitored in clinical trials. PMID:23796662

  11. The relationship between intervention in the CD40 signal pathway and choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    Zhang P

    2014-02-01

    Full Text Available Peipei Zhang,1,2 Yan Su,1,2 Fang Liu1,2 1Shanghai Tenth People's Hospital of Tongji University, Shanghai, People's Republic of China; 2Wenzhou Ophthalmology and Optometry Hospital, Wenzhou Medical College, Wenzhou, People's Republic of China Abstract: Age-related macular degeneration, pathologic myopia, ocular trauma, and other eye diseases can cause choroidal neovascularization (CNV. In recent years, photodynamic therapy (PDT, anti-vascular endothelial growth factor (anti-VEGF medications, laser treatment, and other measures against CNV have been gradually applied in the clinical setting and in some cases have achieved good results. However, the pathogenesis of CNV has not been fully elucidated. The costimulatory system made up of cluster of differentiation 40 protein (CD40 and its ligand (CD40L is an important signal transduction pathway among immune cells. The activation of CD40 can also stimulate the secretion of a variety of angiogenic growth factors (eg, VEGF and basic fibroblast growth factors that might lead to CNV. The high level expression of CD40 and CD40L has been detected in CNV diseases. Interference with the CD40 signaling pathway may become a new target for CNV treatment. We review the relationship between CD40, CD40L, and CNV. Keywords: choroidal neovascularization, NV, CD40, angiogenesis factor

  12. Transcriptome signature of the adult mouse choroid plexus

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    Marques Fernanda

    2011-01-01

    Full Text Available Abstract Background Although the gene expression profile of several tissues in humans and in rodent animal models has been explored, analysis of the complete choroid plexus (CP transcriptome is still lacking. A better characterization of the CP transcriptome can provide key insights into its functions as one of the barriers that separate the brain from the periphery and in the production of cerebrospinal fluid. Methods This work extends further what is known about the mouse CP transcriptome through a microarray analysis of CP tissue from normal mice under physiological conditions. Results We found that the genes most highly expressed are those implicated in energy metabolism (oxidative phosphorylation, glycolysis/gluconeogenesis and in ribosomal function, which is in agreement with the secretory nature of the CP. On the other hand, genes encoding for immune mediators are among those with lower expression in basal conditions. In addition, we found genes known to be relevant during brain development, and not previously identified to be expressed in the CP, including those encoding for various axonal guidance and angiogenesis molecules and for growth factors. Some of these are known to influence the neural stem cell niche in the subventricular zone, highlighting the involvement of the CP as a likely modulator of neurogenesis. Interestingly, our observations confirm that the CP transcriptome is unique, displaying low homology with that of other tissues. Of note, we describe here that the closest similarity is with the transcriptome of the endothelial cells of the blood-brain barrier. Conclusions Based on the data presented here, it will now be possible to further explore the function of particular proteins of the CP secretome in health and in disease.

  13. The Pediatric Choroidal and Ciliary Body Melanoma Study

    DEFF Research Database (Denmark)

    Al-Jamal, Rana'a T; Cassoux, Nathalie; Desjardins, Laurence;

    2016-01-01

    PURPOSE: To collect comprehensive data on choroidal and ciliary body melanoma (CCBM) in children and to validate hypotheses regarding pediatric CCBM: children younger than 18 years, males, and those without ciliary body involvement (CBI) have more favorable survival prognosis than young adults 18...

  14. Choroideremia associated with choroidal neovascularization treated with intravitreal bevacizumab

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    Palejwala NV

    2014-09-01

    Full Text Available Neal V Palejwala, Andreas K Lauer, Richard G Weleber Oregon Retinal Degeneration Center (ORDC, Ophthalmic Genetics Service and Retina-Vitreous Service, Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA Purpose: To report a rare case of central vision loss in a patient with choroideremia.Patients and methods: A retrospective, interventional case report.Results: A 13-year-old male with history of choroideremia presented with subacute loss of central acuity in his left eye. Examination and diagnostic testing revealed subretinal fibrosis secondary to a choroidal neovascular membrane (CNVM. A trial of anti-vascular endothelial growth factor (VEGF therapy with the injection of intravitreal bevacizumab was attempted. Mild improvements in acuity and anatomy were noted.Conclusion: Choroideremia is a rare hereditary choroidal dystrophy that predominantly affects males in the first and second decades of life. Visual acuity is usually spared until later in life. CNVM is a rare manifestation of choroideremia with only a handful of case reports presented in the literature. This case is unique in that it is the first reported case that received treatment with intravitreal anti-VEGF therapy. Keywords: anti-VEGF therapy, choroideremia, choroidal neovascular membrane, chorioretinal degeneration, hereditary choroidal dystrophy, intravitreal bevacizumab injection

  15. Increased choroidal thickness in patient with high-altitude retinopathy

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    Kyoko Hirukawa-Nakayama

    2014-01-01

    Full Text Available We report a case of high-altitude retinopathy with increased choroidal thickness detected by spectral-domain optical coherence tomography (SD-OCT. A 36-year-old Japanese man developed an acute vision decrease in his left eye after he had trekked at an altitude of 4600 m in Tibet for 1 week. His visual acuity was 20/20 OD and 20/200 OS with refractive errors of − 0.25 diopters (D OD and − 0.50 D OS 3 weeks after the onset of the visual decrease. Funduscopic examinations revealed multiple intraretinal hemorrhages bilaterally and a macular hemorrhage in the left eye. SD-OCT showed that the thickness of choroidal layer at the fovea was 530 μm OD and 490 μm OS which is thicker than that in normal subjects of approximately 300 μm. We suggest that the increase in the retinal blood flow under hypoxic conditions may be associated with an increase in the choroidal blood flow resulting in an increase in choroidal thickness.

  16. Suppression of Experimental Choroidal Neovascularization by Curcumin in Mice

    Science.gov (United States)

    Xie, Ping; Zhang, WeiWei; Yuan, Songtao; Chen, Zhiqiang; Yang, Qin; Yuan, DongQing; Wang, Feng; Liu, QingHuai

    2012-01-01

    Purpose To investigate the effects of curcumin on the development of experimental choroidal neovascularization (CNV) with underlying cellular and molecular mechanisms. Methods C57BL/6N mice were pretreated with intraperitoneal injections of curcumin daily for 3 days prior to laser-induced CNV, and the drug treatments were continued until the end of the study. The CNV area was analyzed by fluorescein-labeled dextran angiography of retinal pigment epithelium (RPE)-choroid flat mounts on day 7 and 14, and CNV leakage was evaluated by fluorescein angiography (FA) on day 14 after laser photocoagulation. The infiltration of F4/80 positive macrophages and GR-1 positive granulocytes were evaluated by immunohistochemistry on RPE-choroid flat mounts on day 3. Their expression in RPE-choroid complex was quantified by real-time PCR (F4/80) and Western blotting (GR-1) on day 3. RPE-choroid levels of vascular endothelial growth factor (VEGF), tumor necrosis factor (TNF)-α, monocyte chemotactic protein (MCP)-1, and intercellular adhesion molecule (ICAM)-1 were examined by ELISA on day 3. Double immunostaining of F4/80 and VEGF was performed on cryo-sections of CNV lesions on day 3. The expression of nuclear factor (NF)-κB and hypoxia-inducible factor (HIF)−1α in the RPE-choroid was determined by Western blotting. Results Curcumin-treated mice had significantly less CNV area (PCurcumin treatment led to significant inhibition of F4/80 positive macrophages (Pcurcumin treatment (PCurcumin inhibited the RPE-choroid levels of TNF-α (PCurcumin treatment led to the suppression of CNV development together with inflammatory and angiogenic processes including NF-κB and HIF−1α activation, the up-regulation of inflammatory and angiogenic cytokines, and infiltrating macrophages and granulocytes. This provides molecular and cellular evidence of the validity of curcumin supplementation as a therapeutic strategy for the suppression of age-related macular degeneration (AMD

  17. Construction of a patterned hydrogel-fibrous mat bilayer structure to mimic choroid and Bruch's membrane layers of retina.

    Science.gov (United States)

    Komez, Aylin; Baran, Erkan T; Erdem, Uzeyir; Hasirci, Nesrin; Hasirci, Vasif

    2016-09-01

    Deterioration of retina and death of the retinal cells due to age, diabetes, or occlusion can cause retinal degeneration which leads to loss of vision. In this study, it is aimed to design a bilayered matrix to mimic the choroid and the Bruch's membrane of the retinal tissue. As choroid, a microchanneled network resembling a fractal tree design was fabricated by photolithography over photo-cross-linkable methacrylated hyaluronic acid hydrogel. Gelatin or collagen was immobilized into the microchannels to enhance adherence of Human Umbilical Vein Endothelial Cells (HUVEC). At late culture periods (2 weeks), formation of tubular structures due to proliferation of the attached cells was observed. As Bruch's membrane, an electrospun fibroin nanofiber mat was produced to grow retinal pigment epithelium (RPE) cells on. Cellular interactions between RPE and HUVEC in the microchannels were investigated in a coculture model in a noncontact mode. It was deduced that by combining the RPE layer on the highly permeable Bruch's membrane with the choroid layer populated by HUVECs, a retinal substitute which might have a potential for use in the treatment of retinal diseases is possible. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 2166-2177, 2016. PMID:27102366

  18. A non membrane-targeted human soluble CD59 attenuates choroidal neovascularization in a model of age related macular degeneration.

    Directory of Open Access Journals (Sweden)

    Siobhan M Cashman

    Full Text Available Age related macular degeneration (AMD is the most common cause of blindness amongst the elderly. Approximately 10% of AMD patients suffer from an advanced form of AMD characterized by choroidal neovascularization (CNV. Recent evidence implicates a significant role for complement in the pathogenesis of AMD. Activation of complement terminates in the incorporation of the membrane attack complex (MAC in biological membranes and subsequent cell lysis. Elevated levels of MAC have been documented on choroidal blood vessels and retinal pigment epithelium (RPE of AMD patients. CD59 is a naturally occurring membrane bound inhibitor of MAC formation. Previously we have shown that membrane bound human CD59 delivered to the RPE cells of mice via an adenovirus vector can protect those cells from human complement mediated lysis ex vivo. However, application of those observations to choroidal blood vessels are limited because protection from MAC- mediated lysis was restricted only to the cells originally transduced by the vector. Here we demonstrate that subretinal delivery of an adenovirus vector expressing a transgene for a soluble non-membrane binding form of human CD59 can attenuate the formation of laser-induced choroidal neovascularization and murine MAC formation in mice even when the region of vector delivery is distal to the site of laser induced CNV. Furthermore, this same recombinant transgene delivered to the intravitreal space of mice by an adeno-associated virus vector (AAV can also attenuate laser-induced CNV. To our knowledge, this is the first demonstration of a non-membrane targeting CD59 having biological potency in any animal model of disease in vivo. We propose that the above approaches warrant further exploration as potential approaches for alleviating complement mediated damage to ocular tissues in AMD.

  19. NSAIDs inhibit neovascularization of choroid through HO-1-dependent pathway.

    Science.gov (United States)

    Yoshinaga, Narimasa; Arimura, Noboru; Otsuka, Hiroki; Kawahara, Ko-Ichi; Hashiguchi, Teruto; Maruyama, Ikuro; Sakamoto, Taiji

    2011-09-01

    Intraocular neovascularization is the leading cause of severe visual loss and anti-vascular endothelial growth factor (VEGF) therapy is currently performed for choroidal neovascularization (CNV). Despite its potent anti-angiogenic effect, there are concerns about its long-term safety. Non-steroidal anti-inflammatory drugs (NSAIDs) are common therapeutic agents used for treating inflammatory diseases, and their anti-stress effects are attracting attention now. We studied the effects of topical NSAIDs on CNV, focusing on anti-stress proteins. Cultured retinal pigment epithelium (RPE) cells were treated with NSAIDs: bromfenac, indomethacin, or vehicle control. Transcription factor NF-E2-related factor 2 (Nrf2) and its downstream anti-oxidant protein heme oxygenase (HO)-1 were assessed using western blot and immunohistochemistry. As a result, NSAIDs induced translocation of Nrf2 into the nucleus and the robust expression of HO-1 in a dose- and time-dependent manner. Flow cytometric analysis revealed that bromfenac inhibited H(2)O(2)-induced apoptosis in cultured RPE cells. Next, we studied the effects of topical bromfenac on laser-induced CNV model in rat. The expressions of Nrf2 and HO-1, infiltrations of ED-1-positive macrophages at CNV lesions and size were analyzed. VEGF in the ocular fluid of these rats was also measured using enzyme-linked immunosorbent assay. Rats administered an inhibitor of HO-1 stannic mesoporphyrin (SnMP) were also studied. The results showed that topical bromfenac led to translocation of Nrf2 and induction of HO-1 in CNV lesions and that the number of infiltrating macrophages at the CNV lesion decreased. The sizes of CNV lesions were significantly smaller in bromfenac-treated rats than control CNV, and the effects were diminished by SnMP. VEGF increased in the ocular fluid after laser treatment and was inhibited by bromfenac and SnMP canceling these effects. NSAIDs inhibit CNV through the novel anti-stress protein HO-1-dependent pathway

  20. Iron oxide magnetic nanoparticles highlight early involvement of the choroid plexus in central nervous system inflammation

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    Carmen Infante‑Duarte

    2013-03-01

    Full Text Available Neuroinflammation during multiple sclerosis involves immune cell infiltration and disruption of the BBB (blood–brain barrier. Both processes can be visualized by MRI (magnetic resonance imaging, in multiple sclerosis patients and in the animal model EAE (experimental autoimmune encephalomyelitis. We previously showed that VSOPs (very small superparamagnetic iron oxide particles reveal CNS (central nervous system lesions in EAE which are not detectable by conventional contrast agents in MRI. We hypothesized that VSOP may help detect early, subtle inflammatory events that would otherwise remain imperceptible. To investigate the capacity of VSOP to reveal early events in CNS inflammation, we induced EAE in SJL mice using encephalitogenic T-cells, and administered VSOP prior to onset of clinical symptoms. In parallel, we administered VSOP to mice at peak disease, and to unmanipulated controls. We examined the distribution of VSOP in the CNS by MRI and histology. Prior to disease onset, in asymptomatic mice, VSOP accumulated in the choroid plexus and in spinal cord meninges in the absence of overt inflammation. However, VSOP was undetectable in the CNS of non-immunized control mice. At peak disease, VSOP was broadly distributed; we observed particles in perivascular inflammatory lesions with apparently preserved glia limitans. Moreover, at peak disease, VSOP was prominent in the choroid plexus and was seen in elongated endothelial structures, co-localized with phagocytes, and diffusely disseminated in the parenchyma, suggesting multiple entry mechanisms of VSOP into the CNS. Thus, using VSOP we were able to discriminate between inflammatory events occurring in established EAE and, importantly, we identified CNS alterations that appear to precede immune cell infiltration and clinical onset.

  1. Choroidal thinning in high myopia measured by optical coherence tomography

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    Ikuno Y

    2013-05-01

    Full Text Available Yasushi Ikuno, Satoko Fujimoto, Yukari Jo, Tomoko Asai, Kohji NishidaDepartment of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, JapanPurpose: To investigate the rate of choroidal thinning in highly myopic eyes.Patients and methods: A retrospective observational study of 37 eyes of 26 subjects (nine males and 17 females, mean age 39.6 ± 7.7 years with high myopia but no pathologies who had undergone spectral domain optical coherence tomography and repeated the test 1 year later (1 ± 0.25 year at Osaka University Hospital, Osaka, Japan. Patients older than 50 years with visual acuity worse than 20/40 or with whitish chorioretinal atrophy involving the macula were excluded. Two masked raters measured the choroidal thicknesses (CTs at the foveda, 3 mm superiorly, inferiorly, temporally, and nasally on the images and averaged the values. The second examination was about 365 days after the baseline examination. The CT reduction per year (CTRPY was defined as (CT 1 year after - baseline CT/days between the two examinations × 365. The retinal thicknesses were also investigated.Results: The CTRPY at the fovea was −1.0 ± 22.0 µm (range –50.2 to 98.5 at the fovea, –6.5 ± 24.3 µm (range −65.8 to 90.2 temporally, –0.5 ± 22.3 µm (range –27.1 to 82.5 nasally, –9.7 ± 21.7 µm (range –40.1 to 60.1 superiorly, and –1.4 ± 25.5 µm (range –85.6 to 75.2 inferiorly. There were no significant differences in the CTRPY at each location (P = 0.34. The CT decreased significantly (P < 0.05 only superiorly. The superior CTRPY was negatively correlated with the axial length (P < 0.05. The retinal thickness at the fovea did not change. Stepwise analysis for CTRPY selected axial length (P = 0.04, R2 = 0.13 and age (P = 0.08, R2 = 0.21 as relevant factors.Conclusions: The highly myopic choroid might gradually thin and be affected by many factors. Location and axial length are key factors to regulate the rate of choroidal

  2. Clinical features and linkage analysis for a Chinese family with autosomal dominant central areolar choroidal dystrophy

    Institute of Scientific and Technical Information of China (English)

    MA Kai; LIU Ning-pu; YANG Xiu-fen; HAN Cui; ZHANG Ning; XU Jun; LIU Shou-bin; LU Hal; Torkel Snellingen; WANG Ning-li

    2009-01-01

    Background A Chinese family with autosomal dominant central areolar choroidal dystrophy (CACD) was identified.The purpose of this study was to collect the clinical findings from the family and to identify the genetic entity by linkage nalysis.Methods Forty-three individuals from 3 generations of the family underwent ophthalmologic examinations, including best-corrected visual acuity, examination of the anterior segments, and inspection of the ocular fundus after pharmacologic mydriasis. Affected family members further underwent color vision test, color fundus photography,fluorescein angiography, automated perimetry, and electroretinography. The family was followed up for 30 months.Peripheral venous blood or buccal swabs were collected from each family member and genomic DNA was extracted.Linkage analysis was performed for candidate genes or loci using microsatellite markers.Results Seven family members in 3 continuous generations were diagnosed as having autosomal dominant CACD.The family showed progressive development of the disease, affecting both male and female. Age of onset of visual disturbances varied between 11 and 50 years. Phenotypic variability among affected individuals was apparent and ranged from relatively normal-appearing fundus with mild parafoveal pigment mottling to geographic atrophy of the macula. Fluorescein angiography showed hyperfluorescent parafoveal changes in early stage or well-demarcated area of chorioretinal atrophy with enhanced visibility of the residual underlying choroidal vessels in the late stage. Peripheral retina and visual fields were normal in affected individuals. Electroretinogram showed normal or mild reduction in the photopic amplitude. Eight candidate genes (STGD4, RCD1, peripherin/RDS, GUCA1A, RIMS1, UNC119, GUC Y2D, and AIPL1) and two genetic loci (4p15.2-16.3, and 17p13) were excluded to be responsible for the disease by linkage analysis.Conclusions The clinical findings of this Chinese family with CACD shared

  3. Long-Term Cyclophosphamide Treatment in a Case with Serpiginous Choroiditis

    OpenAIRE

    Sahin, Ozlem G.

    2010-01-01

    Purpose To report the effect of long-term therapy with the alkylating agent cyclophosphamide in a case with serpiginous choroiditis and thus to contribute to the previously reported few cases showing the beneficial effect of long-term cyclophosphamide therapy for serpiginous choroiditis. Procedures Oral cyclophosphamide therapy for 12 months in a case with unilateral active serpiginous choroiditis. Results The active lesion responded well to long-term therapy with cyclophosphamide without rec...

  4. Intravitreal Bevacizumab Injection Therapy in a Case with Choroidal Neovascular Membrane Secondary to Toxoplasmosis Retinochoroiditis

    OpenAIRE

    Sirel Gür Güngör; İmren Akkoyun; Evin Şingar; Gürsel Yılmaz

    2014-01-01

    A 57-year-old male patient presenting with visual loss in the left eye was diagnosed as choroidal neovascular membrane secondary to inactive toxoplasmosis retinochoroiditis scar. He underwent intravitreal bevacizumab injection as primary therapy. The choroidal neovascular membrane regressed partially and the initial visual acuity improved from 1/10 to 3/10. Intravitreal bevacizumab injection appears to be effective in the treatment of choroidal neovascular membrane secondary to toxop...

  5. Choroidal metastasis from early rectal cancer: Case report and literature review

    OpenAIRE

    Mitsuyoshi Tei; Masaki Wakasugi; Hiroki Akamatsu

    2014-01-01

    INTRODUCTION: Choroidal metastasis from colorectal cancer is rare, and there have been no reported cases of such metastasis from early colorectal cancer. We report a case of choroidal metastasis from early rectal cancer. PRESENTATION OF CASE: A 61 year-old-man experienced myodesopsia in the left eye 2 years and 6 months after primary rectal surgery for early cancer, and was diagnosed with left choroidal metastasis and multiple lung metastases. Radiotherapy was initiated for the left eye an...

  6. Choroid plexus carcinomas in children: MRI features and patient outcomes

    International Nuclear Information System (INIS)

    Choroid plexus carcinomas (CPC) are rare malignant intracranial neoplasms usually occurring in young children. The objectives of this study were to characterize the preoperative MRI features of CPC, determine the frequency of disseminated disease in the CNS at diagnosis, and assess patient outcomes. The preoperative cranial MR images of 11 patients with CPC were retrospectively reviewed for lesion location, lesion size, un-enhanced and enhanced MRI signal characteristics, and presence of disseminated intracranial tumor. Postoperative cranial and spinal MRI images were reviewed for residual, recurrent, and/or disseminated tumor. The study group included six male and five female patients ranging in age from 5 months to 5.3 years (median=1.8 years). CPC were located in the lateral (n=8), fourth (n=1), and third (n=1) ventricles, and foramen of Luschka (n=1). Mean tumor size was 5.2cm x 4.9cm x 5.0 cm. On short-TR images, CPC had heterogeneous, predominantly intermediate signal with foci of high signal in 45% of lesions from areas of hemorrhage. On long-TR/long-TE images, solid portions of CPC typically had heterogeneous, intermediate-to-slightly-high signal. Small zones of low signal on long-TR/long-TE images were seen in 55% of the lesions secondary to areas of hemorrhage and/or calcifications. Tubular flow voids representing blood vessels were seen in 55% of the lesions. Zones of high signal comparable to CSF were seen in 64% of CPC secondary to cystic/necrotic zones. All CPC showed prominent contrast enhancement. Irregular enhancing margins suggesting subependymal invasion were seen in 73% of the lesions. Findings consistent with edema in the brain adjacent to the enhancing lesions were seen in 73% of CPC. CPC caused hydrocephalus in 82% of patients at diagnosis. Two patients died from hemorrhagic complications from surgical biopsies. Disseminated tumor in the leptomeninges was present in 45% of patients at diagnosis and was associated with a poor prognosis. The 1

  7. Current and emerging treatment options for myopic choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    El Matri L

    2015-04-01

    Full Text Available Leila El Matri, Ahmed Chebil, Fedra Kort Department B of Ophthalmology, Hedi Rais Institute of Ophthalmology, Faculty of Medicine of Tunis, University of El Manar, Tunis, Tunisia Abstract: Choroidal neovascularization (CNV is the main cause of visual impairment in highly myopic patients younger than 50 years of age. There are different treatments for myopic CNV (mCNV, with 5- to 10-year outcomes currently. Chorioretinal atrophy is still the most important determinant factor for visual outcome. The purpose of this study is to provide an overview of the current treatments for mCNV, including laser, surgical management, verteporfin photodynamic therapy, and mainly anti-vascular endothelial growth factor therapy. Emerging treatment options are also discussed. Keywords: myopia, choroidal neovascularization, current treatment, emerging treatment

  8. Cataract extraction after brachytherapy for malignant melanoma of the choroid

    International Nuclear Information System (INIS)

    Thirteen eyes of 55 consecutive patients treated with brachytherapy for malignant melanoma of the choroid developed postirradiation cataracts. Cataract development was more common in older patients and in patients with larger and more anterior tumors. Eleven eyes had extracapsular cataract extraction and intraocular lens implantation. Initial visual improvement occurred in 91% of eyes, with an average improvement of 5.5 lines. Visual acuity was maintained at 20/60 or better in 55% of the eyes over an average period of follow-up of 24 months (range, 6 to 40 months). These data suggest that, visually, cataract extraction can be helpful in selected patients who develop a cataract after brachytherapy for malignant melanoma of the choroid

  9. [Histopathologic study of melanoma of the choroid after proton therapy].

    Science.gov (United States)

    Devouassoux Shishe Boran, M; Grange, J D; Patricot, L M; Adeleine, P; Chauvel, P; Chiquet, C; Vitrey, D; Thivolet Béjui, F

    1997-07-01

    To evaluate irradiation effects on choroidal melanomas, histopathologic findings of 18 eyes whose primary treatment was enucleation were compared to 15 eyes enucleated after proton beam irradiation. Irradiated tumors showed more likely necrosis (p = 0.01) had balloon cells (p = 0.01), and inflammatory infiltrate (p = 0.05). In the irradiated group, the prevalence of tumor blood vessel damage was higher (p = 0.0002) and mitotic figures were fewer (p = 0.01). These findings suggest that proton beam irradiation damages tumor cells and alters the tumor's capacity for cellular reproduction. It damages blood vessels leading to tumor necrosis. It induces an inflammatory response of unknown effects. Radiosensitivity of choroidal melanomas cannot be assessed using conventional histologic methods. However, tumor necrosis, mitotic activity and rate of balloon cells can help to establish tumoral sensitivity to irradiation. PMID:9296578

  10. Cataract extraction after brachytherapy for malignant melanoma of the choroid

    Energy Technology Data Exchange (ETDEWEB)

    Fish, G.E.; Jost, B.F.; Snyder, W.I.; Fuller, D.G.; Birch, D.G. (Texas Retina Associates, Dallas (USA))

    1991-05-01

    Thirteen eyes of 55 consecutive patients treated with brachytherapy for malignant melanoma of the choroid developed postirradiation cataracts. Cataract development was more common in older patients and in patients with larger and more anterior tumors. Eleven eyes had extracapsular cataract extraction and intraocular lens implantation. Initial visual improvement occurred in 91% of eyes, with an average improvement of 5.5 lines. Visual acuity was maintained at 20/60 or better in 55% of the eyes over an average period of follow-up of 24 months (range, 6 to 40 months). These data suggest that, visually, cataract extraction can be helpful in selected patients who develop a cataract after brachytherapy for malignant melanoma of the choroid.

  11. Proliferation of Cultured Mouse Choroid Plexus Epithelial Cells

    OpenAIRE

    Barkho, Basam Z.; Monuki, Edwin S.

    2015-01-01

    The choroid plexus (ChP) epithelium is a multifunctional tissue found in the ventricles of the brain. The major function of the ChP epithelium is to produce cerebrospinal fluid (CSF) that bathes and nourishes the central nervous system (CNS). In addition to the CSF, ChP epithelial cells (CPECs) produce and secrete numerous neurotrophic factors that support brain homeostasis, such as adult hippocampal neurogenesis. Accordingly, damage and dysfunction to CPECs are thought to accelerate and inte...

  12. Application of Intravitreal Bevacizumab for Circumscribed Choroidal Hemangioma

    OpenAIRE

    Sagong, Min; Lee, Junyeop; Chang, Woohyok

    2009-01-01

    We report 3 cases of circumscribed choroidal hemangioma (CCH) effectively managed with intravitreal bevacizumab. One patient (case 1) who had recurrent CCH (1.6 mm in thickness) with prior laser photocoagulation was treated with intravitreal bevacizumab alone. Two patients (case 2 and 3) who had CCH (2.4 mm and 2.2 mm in thickness, respectively) with recent visual impairment were treated with bevacizumab followed by photodynamic therapy (PDT). Ophthalmic evaluations included visual acuity, op...

  13. Systemic bevacizumab for simultaneous treatment of cancer and choroidal neovascularisation

    OpenAIRE

    Saffra, Norman; Reinherz, Benjamin

    2014-01-01

    A 47-year-old woman with a medical history of pseudoxanthoma elasticum and associated choroidal neovascularisation that was successfully managed with intravitreal bevacizumab injections developed non-squamous non-small cell lung carcinoma. The patient's oncological medication regimen included systemic bevacizumab. During the 22 months that the patient received systemic bevacizumab for management of her malignancy, intravitreal bevacizumab injections were held and the patient's visual acuity r...

  14. Current and emerging treatment options for myopic choroidal neovascularization

    OpenAIRE

    El Matri L.; Chebil A; Kort F

    2015-01-01

    Leila El Matri, Ahmed Chebil, Fedra Kort Department B of Ophthalmology, Hedi Rais Institute of Ophthalmology, Faculty of Medicine of Tunis, University of El Manar, Tunis, Tunisia Abstract: Choroidal neovascularization (CNV) is the main cause of visual impairment in highly myopic patients younger than 50 years of age. There are different treatments for myopic CNV (mCNV), with 5- to 10-year outcomes currently. Chorioretinal atrophy is still the most important determinant factor for visua...

  15. Current and emerging treatment options for myopic choroidal neovascularization

    OpenAIRE

    El Matri, Leila

    2015-01-01

    Leila El Matri, Ahmed Chebil, Fedra Kort Department B of Ophthalmology, Hedi Rais Institute of Ophthalmology, Faculty of Medicine of Tunis, University of El Manar, Tunis, Tunisia Abstract: Choroidal neovascularization (CNV) is the main cause of visual impairment in highly myopic patients younger than 50 years of age. There are different treatments for myopic CNV (mCNV), with 5- to 10-year outcomes currently. Chorioretinal atrophy is still the most important determinant factor for v...

  16. Myopic choroidal neovascularisation: current concepts and update on clinical management

    OpenAIRE

    Wong, Tien Y.; Ohno-Matsui, Kyoko; Leveziel, Nicolas; Holz, Frank G.; Lai, Timothy Y; Yu, Hyeong Gon; Lanzetta, Paolo; Chen, Youxin; Tufail, Adnan

    2014-01-01

    Choroidal neovascularisation (CNV) is a common vision-threatening complication of myopia and pathological myopia. Despite significant advances in understanding the epidemiology, pathogenesis and natural history of myopic CNV, there is no standard definition of myopic CNV and its relationship to axial length and other myopic degenerative changes. Several treatments are available to ophthalmologists, but with the advent of new therapies there is a need for further consensus and clinical managem...

  17. Choroidal neovascularisation in pathological myopia: an update in management

    OpenAIRE

    Chan, W-M; Ohji, M; Lai, T Y Y; Liu, D T L; Tano, Y.; Lam, D S C

    2005-01-01

    Choroidal neovascularisation (CNV) secondary to pathological myopia is an important cause of significant visual impairment in young and middle aged adults globally and is particularly prevalent in Asian populations. In the past few years, there have been rapid advancements in the different treatments for myopic CNV. The purpose of this perspective is to give an overview of the natural history of myopic CNV and the various treatment options including laser photocoagulation, photodynamic therap...

  18. MGMT promoter methylation and temozolomide response in choroid plexus carcinoma

    OpenAIRE

    Misaki, Kouichi; NAKADA, Mitsutoshi; Mohri, Masanao; Hayashi, Yutaka; Hamada, Jun-ichiro

    2011-01-01

    Choroid plexus carcinoma (CPC) is a malignant tumor with a strong tendency to spread along the cerebrospinal fluid pathway. There is no standardized chemotherapy protocol for this rare tumor. We report a 38-year-old man with CPC in the lateral ventricle with obstructive hydrocephalus. Because of the poor demarcation between thalamus and fornix, subtotal tumor resection was performed. Postoperative spine magnetic resonance (MR) image revealed whole spinal axis dissemination. After diagnosis of...

  19. Early detection of choroidal neovascularization in age related macular degeneration

    OpenAIRE

    Tural Galbinur

    2014-01-01

    Purpose: to identify factors associated with early detection of choroidal neovascularization CNV in clinical practice.Methods: Seventy six AMD patients who had history of CNV in one eye and presented with CNV in the second eye and evaluated for association with visual acuity (VA) at time of presentation. Demographics, clinical data and lesion characteristics were retrospectively collected.Results: Better VA was associated with history of CNV in the fellow eye (p<0.0001), adherence to follo...

  20. Amyloid beta deposition and phosphorylated tau accumulation are key features in aged choroidal vessels in the complement factor H knock out model of retinal degeneration.

    Science.gov (United States)

    Aboelnour, Asmaa; Kam, Jaimie Hoh; Elnasharty, M A; Sayed-Ahmed, Ahmed; Jeffery, Glen

    2016-06-01

    Extra-cellular deposition including amyloid beta (Aβ) is a feature of retinal ageing. It has been documented for Bruch's membrane (BM) where Aβ is elevated in complement factor H knockout mice (Cfh(-/-)) proposed as a model for age related macular degeneration. However, arterial deposition in choroidal vessels prior to perfusion across BM has not been examined. Aβ is associated with tau phosphorylation and these are linked in blood vessels in Alzheimers Disease where they can drive perivascular pathology. Here we ask if Aβ, tau and phosphorylated tau are features of ageing in choroidal vessels in 12 month C57 BL/6 and Cfh(-/-) mice, using immune staining and Western blot analysis. Greater levels of Aβ and phosphorylated tau are found in choroidal vessels in Cfh(-/-) mice. Western blot revealed a 40% increase in Aβ in Cfh(-/-) over C57 BL/6 mice. Aβ deposits coat around 55% of the luminal wall in Cfh(-/-) compared to only about 40% in C57 BL/6. Total tau was similar in both groups, but phosphorylated tau increased by >100% in Cfh(-/-) compared to C57 BL/6 and covered >75% of the luminal wall compared to 50% in C57 BL/6. Hence, phosphorylated tau is a marked choroidal feature in this mouse model. Aβ deposition was clumped in Cfh(-/-) mice and likely to influence blood flow dynamics. Disturbed flow is associated with atherogenesis and may be related to the accumulation of membrane attack complex recently identified between choroidal vessels in those at high risk of macular degeneration due to complement factor H polymorphisms. PMID:27181225

  1. Choroid plexus metastasis of renal-cell carcinoma

    International Nuclear Information System (INIS)

    A rare case of the choroid plexus metastasis of renal-cell carcinoma is reported. A 58-year-old man was admitted on March 3, 1982, with complaints of mild headache and a transient attack of muscle weakness of the left upper extremity. He had undergone a left nephrectomy because of renal-cell carcinoma 2 years before this admission. A CT scan revealed a small mass in the right lateral ventricle that was markedly enhanced by the contrast medium. A carotid angiogram was normal, but a left vertebral angiogram showed a round tumor stain in the distal portion of the right posterior choroidal artery. To determine the nature of the tumor, it was successfully removed via the right frontal transventricular approach. The immediate recovery from the operation was uneventful, but the patient became semicomatose 6 hours later because of a large subdural hematoma over the left hemisphere. An emergency operation for clot removal and external decompression failed to improve the patient's status, and he died on the 3rd postoperative day. An histological examination of the tumor determined the diagnosis of clear-cell-type renal-cell carcinoma. The CT demonstration of choroid plexus metastasis is quite rare. To our knowledge, only two cases have been described. (author)

  2. Visual impairment due to bilateral multifocal choroidal metastasis of parotid adenocarcinoma: a case report.

    Directory of Open Access Journals (Sweden)

    Gerard eWalls

    2014-06-01

    Full Text Available BackgroundOrbital metastases are an uncommon finding, being present in just 9% deceased patients with metastatic cancer. Only a quarter of patients with choroidal metastases have bilateral disease. Parotid cancer is not a common form of head and neck malignancy. Bilateral multifocal metastases from adenocarcinoma ex pleomorphic of parotid gland have been documented just once before in the literature. We present a similar case where palliative EBRT was used to gain local control with minimal toxicity.Case PresentationThe case of a 45 year old Caucasian gentleman who presented to his general practitioner with otalgia and weight loss. Imaging revealed a mass in the deep lobe of the left parotid gland, invading into the medial pterygoid muscle. PET-CT revealed locoregional and distant lymphatic involvement plus disseminated skeletal metastases. Lymph node examination revealed adenocarcinoma ex pleomorphic histology. Within weeks of this diagnosis, the patient developed rapidly progressive visual impairment. Ophthalmologists found multifocal uveal masses bilaterally. Palliative fractions of external beam radiotherapy were delivered to the orbits before combination chemotherapy. We discuss the patient's presentation, histopathology and management, with support from the literature regarding applied and related therapies. SummaryIn this rare presentation of disseminated malignancy affecting the choroid bilaterally, the authors demonstrate the application of palliative EBRT to good local effect. Given the nature of this treatment and that of the metastases, in the setting of incurable disease orbital morbidity is likely to occur again before the patient's death. Awareness of the initial symptoms is important to provide prompt care and maintain quality of life.

  3. Recurrence and massive extraocular extension of choroidal malignant melanoma after vitrectomy and endoresection

    Directory of Open Access Journals (Sweden)

    Mehdi Modarres

    2014-01-01

    Full Text Available Vitrectomy and endoresection is an alternative to enucleation for the treatment of large malignant choroidal melanoma. We report a rare case of extensive recurrence of choroidal malignant melanoma with extraocular extension 11 years after surgical endoresection without adjuvant treatment.

  4. Magnetic resonance imaging in a dog with a choroid plexus carcinoma

    International Nuclear Information System (INIS)

    Magnetic resonance imaging was used ante mortem to confirm the anatomic location of an intracranial lesion in a dog with neurological signs. Necropsy revealed the lesion to be a choroid plexus carcinoma with thalamic invasion. A review of the literature on choroid plexus carcinomas in the dog is included

  5. Suprasellar seeding of a benign choroid plexus papilloma of the fourth ventricle with local recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Irsutti, M.; Thorn-Kany, M.; Arrue, P.; Manelfe, C. [Service de Neuro-Radiologie Diagnostique et Interventionnelle, Centre Hospitalier Universitaire Purpan, Toulouse (France); Richaud, J.; Sol, J.C. [Service de Neurochirurgie, Centre Hospitalier Universitaire Rangueil, Toulouse (France); Delisle, M.B. [Laboratoire d' Anatomie et de Cytologie Pathologiques, Centre Hospitalier Universitaire Rangueil, Toulouse (France)

    2000-09-01

    A suprasellar location of a benign choroid plexus papilloma is reported. Local recurrence within the fourth ventricle was also present, 8 years after apparently complete removal. Imaging and histological findings were similar to those of the initial lesion. At surgery, the suprasellar lesion had no connection with the ventricular system. Seeding of choroid plexus papillomas is discussed, and the pertinent literature reviewed. (orig.)

  6. Anti-VEGF treatment for myopic choroid neovascularization: from molecular characterization to update on clinical application

    Directory of Open Access Journals (Sweden)

    Zhang Y

    2015-07-01

    Full Text Available Yan Zhang,1 Qian Han,2 Yusha Ru,1 Qiyu Bo,1 Rui Hua Wei1 1Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute, College of Optometry and Ophthalmology, Tianjin Medical University, Tianjin, 2Tangshan Eye Hospital, Tangshan, Hebei Province, People’s Republic of China Abstract: Choroidal neovascularization (CNV secondary to pathologic myopia has a very high incidence in global, especially in Asian, populations. It is a common cause of irreversible central vision loss, and severely affects the quality of life in the patients with pathologic myopia. The traditional therapeutic modalities for CNV secondary to pathologic myopia include thermal laser photocoagulation, surgical management, transpupillary thermotherapy, and photodynamic therapy with verteporfin. However, the long-term outcomes of these modalities are disappointing. Recently, intravitreal administration of anti-VEGF biological agents, including bevacizumab, ranibizumab, pegaptanib, aflibercept, and conbercept, has demonstrated promising outcomes for this ocular disease. The anti-VEGF regimens are more effective on improving visual acuity, reducing central fundus thickness and central retina thickness than the traditional modalities. These anti-VEGF agents thus hold the potential to become the first-line medicine for treatment of CNV secondary to pathologic myopia. This review follows the trend of “from bench to bedside”, initially discussing the pathogenesis of myopic CNV, delineating the molecular structures and mechanisms of action of the currently available anti-VEGF drugs, and then systematically comparing the up to date clinical applications as well as the efficacy and safety of the anti-VEGF drugs to the CNV secondary to pathologic myopia. Keywords: formation of new vessels, choroid membrane, pathologic myopia, vascular endothelial growth factor, molecular mechanisms, clinical trials

  7. Shaggy Photoreceptors with Subfoveal Fluid Associated with a Distant Choroidal Melanoma

    Directory of Open Access Journals (Sweden)

    Ann Q. Tran

    2015-01-01

    Full Text Available Purpose. To describe the enhanced depth imaging optical coherence tomography (EDI-OCT findings in a patient with an extra macula choroidal melanoma before and after treatment. Methods. Observational case report. Results. A 45 year-old Caucasian male patient was referred to retina clinic for management of choroidal melanoma. Examination revealed a nasal choroidal melanoma while EDI-OCT illustrated subfoveal fluid pocket with elongated shaggy photoreceptors distant and separate from the tumor. The patient was treated with plaque brachytherapy and intravitreal bevacizumab. One week after plaque removal, there was a dramatic reduction in the shaggy photoreceptors. Conclusion. Choroidal melanomas have effects that are not localized to the area of the tumor. This loculated pocket of subretinal fluid and coinciding changes to photoreceptor morphology may be related to global changes in choroidal function or release of tumor related cytokines.

  8. Effect of vascular endothelial growth factor inhibitors on choroid in patients with macular choroid neovascular membrane and degenerative myopia . Preliminary report

    Directory of Open Access Journals (Sweden)

    V. A. Solomin

    2014-07-01

    Full Text Available Purpose: to assess the effect of vascular endothelial growth factor inhibitors on choroid in patients with myopic macular choroid neovascular membrane.Methods: 12 eyes (12 patients aged 19-47 years with myopia and macular choroid neovascular membrane (mCNV were enrolled in a study group. A control group included fellow eyes with early «dry» form age-related macular degeneration. Eyes with mCNV under- went one intravitreal injection of vascular endothelial growth factor inhibitor Ranibizumab 0.5 mg. Retina and choroid examination was performed with SPECtRALIS HRA+OCt (Heidelberg Engineering. Eyes were examined before treatment, in 1 month and in 3 months after treatment.Results: Mean best corrected visual acuity in 1 moth after ranibizumab 0.5 mg injection improved from 0.37±0.18 to 0.47±0.24. In 3 months after treatment best corrected visual acuity was 0.53±0.24. Mean foveal retinal thickness before treatment was 311.4±57.2 μm; 1 month and 3 months after treatment mean foveal retinal thickness decreased to 229.1±41.8 μm and 221.8±29.3 μm, respec- tively. Mean choroid thickness in 1 moth decreased from 54.4±23.7 μm to 37.4±17.0 μm, in 3 moths mean choroid thickness was 48.9±20.1 μm. In the control group best corrected visual acuity was 0.79±0.18, mean foveal retinal thickness and mean choroid thick- ness were 187.1±10.5 μm and 93.7±24.5 μm, respectively.Conclusion: Injection of vascular endothelial growth factor inhibitor allowed transient choroid thinning.

  9. Three-dimensional choroidal segmentation in spectral OCT volumes using optic disc prior information

    Science.gov (United States)

    Hu, Zhihong; Girkin, Christopher A.; Hariri, Amirhossein; Sadda, SriniVas R.

    2016-03-01

    Recently, much attention has been focused on determining the role of the peripapillary choroid - the layer between the outer retinal pigment epithelium (RPE)/Bruchs membrane (BM) and choroid-sclera (C-S) junction, whether primary or secondary in the pathogenesis of glaucoma. However, the automated choroidal segmentation in spectral-domain optical coherence tomography (SD-OCT) images of optic nerve head (ONH) has not been reported probably due to the fact that the presence of the BM opening (BMO, corresponding to the optic disc) can deflect the choroidal segmentation from its correct position. The purpose of this study is to develop a 3D graph-based approach to identify the 3D choroidal layer in ONH-centered SD-OCT images using the BMO prior information. More specifically, an initial 3D choroidal segmentation was first performed using the 3D graph search algorithm. Note that varying surface interaction constraints based on the choroidal morphological model were applied. To assist the choroidal segmentation, two other surfaces of internal limiting membrane and innerouter segment junction were also segmented. Based on the segmented layer between the RPE/BM and C-S junction, a 2D projection map was created. The BMO in the projection map was detected by a 2D graph search. The pre-defined BMO information was then incorporated into the surface interaction constraints of the 3D graph search to obtain more accurate choroidal segmentation. Twenty SD-OCT images from 20 healthy subjects were used. The mean differences of the choroidal borders between the algorithm and manual segmentation were at a sub-voxel level, indicating a high level segmentation accuracy.

  10. Choroidal Blood-Flow Responses to Hyperoxia and Hypercapnia in Men with Obstructive Sleep Apnea

    Science.gov (United States)

    Tonini, Matthieu; Khayi, Hafid; Pepin, Jean-Louis; Renard, Elisabeth; Baguet, Jean-Philippe; Lévy, Patrick; Romanet, Jean-Paul; Geiser, Martial H.; Chiquet, Christophe

    2010-01-01

    Study Objectives: Obstructive sleep apnea (OSA) impacts on macrovasculature and autonomic function and may therefore interfere with ocular microvascular regulation. We hypothesized that choroidal vascular reactivity to hyperoxia and hypercapnia was altered in patients with OSA compared with matched control subjects and would improve after treatment with continuous positive airway pressure (CPAP). Methods: Sixteen healthy men were matched 1:1 for body mass index, sex, and age with 16 men with newly diagnosed OSA without comorbidities. Subjects underwent sleep studies, 24-hour blood pressure monitoring, arterial stiffness measurements, and cardiac and carotid echography. Overall, patients were middle-aged, lean, and otherwise healthy except for having OSA with a limited amount of desaturation, with, at most, subclinical lesions of the cardiovascular system, stage 1 hypertension, or both. Choroidal laser Doppler flowmetry provides a unique opportunity to assess microvascular function by measuring velocity, (ChBVel), volume (ChBVol), and relative subfoveal choroidal blood flow (ChBF). Vascular choroidal reactivity was studied during hyperoxia and hypercapnia (8% CO2) challenges before and after treatment with nasal CPAP. Results: Patients with OSA and control subjects exhibited similar choroidal reactivity during hyperoxia (stability of choroidal blood flow) and hypercapnia (significant increases in ChBVel of 13.5% and in ChBF of 16%). Choroidal vasoreactivity to CO2 was positively associated with arterial stiffness in patients with OSA. Gas choroidal vasoreactivity was unchanged after 6 to 9 months of CPAP treatment. Conclusion: This study showed unimpaired choroidal vascular reactivity in otherwise healthy men with OSA. This suggests that patients with OSA, without comorbidities, have long-term adaptive mechanisms active in ocular microcirculation. Citation: Tonini M; Khayi H; Pepin JL; Renard E; Baguet JP; Lévy P; Romanet JP; Geiser MH; Chiquet C. Choroidal blood

  11. Choriocapillaris and choroidal microvasculature imaging with ultrahigh speed OCT angiography.

    Directory of Open Access Journals (Sweden)

    WooJhon Choi

    Full Text Available We demonstrate in vivo choriocapillaris and choroidal microvasculature imaging in normal human subjects using optical coherence tomography (OCT. An ultrahigh speed swept source OCT prototype at 1060 nm wavelengths with a 400 kHz A-scan rate is developed for three-dimensional ultrahigh speed imaging of the posterior eye. OCT angiography is used to image three-dimensional vascular structure without the need for exogenous fluorophores by detecting erythrocyte motion contrast between OCT intensity cross-sectional images acquired rapidly and repeatedly from the same location on the retina. En face OCT angiograms of the choriocapillaris and choroidal vasculature are visualized by acquiring cross-sectional OCT angiograms volumetrically via raster scanning and segmenting the three-dimensional angiographic data at multiple depths below the retinal pigment epithelium (RPE. Fine microvasculature of the choriocapillaris, as well as tightly packed networks of feeding arterioles and draining venules, can be visualized at different en face depths. Panoramic ultra-wide field stitched OCT angiograms of the choriocapillaris spanning ∼32 mm on the retina show distinct vascular structures at different fundus locations. Isolated smaller fields at the central fovea and ∼6 mm nasal to the fovea at the depths of the choriocapillaris and Sattler's layer show vasculature structures consistent with established architectural morphology from histological and electron micrograph corrosion casting studies. Choriocapillaris imaging was performed in eight healthy volunteers with OCT angiograms successfully acquired from all subjects. These results demonstrate the feasibility of ultrahigh speed OCT for in vivo dye-free choriocapillaris and choroidal vasculature imaging, in addition to conventional structural imaging.

  12. Carbon-ion radiotherapy for locally advanced or unfavorably located choroidal melanoma: A Phase I/II dose-escalation study

    International Nuclear Information System (INIS)

    Purpose: To evaluate the applicability of carbon ion beams for the treatment of choroidal melanoma with regard to normal tissue morbidity and local tumor control. Methods and Materials: Between January 2001 and February 2006, 59 patients with locally advanced or unfavorably located choroidal melanoma were enrolled in a Phase I/II clinical trial of carbon-ion radiotherapy at the National Institute of Radiologic Sciences. The primary endpoint of this study was normal tissue morbidity, and secondary endpoints were local tumor control and patient survival. Of the 59 subjects enrolled, 57 were followed >6 months and analyzed. Results: Twenty-three patients (40%) developed neovascular glaucoma, and three underwent enucleation for eye pain due to elevated intraocular pressure. Incidence of neovascular glaucoma was dependent on tumor size and site. Five patients had died at analysis, three of distant metastasis and two of concurrent disease. All but one patient, who developed marginal recurrence, were controlled locally. Six patients developed distant metastasis, five in the liver and one in the lung. Three-year overall survival, disease-free survival, and local control rates were 88.2%, 84.8%, and 97.4%, respectively. No apparent dose-response relationship was observed in either tumor control or normal tissue morbidity at the dose range applied. Conclusion: Carbon-ion radiotherapy can be applied to choroidal melanoma with an acceptable morbidity and sufficient antitumor effect, even with tumors of unfavorable size or site

  13. The formation of rats' choroidal neovascularization induced by acrolein

    OpenAIRE

    Guan-Feng Wang; Xiu-Lan Zou; Dong-Hao Li; Chen Wang; Wen-Li Li; Rong-Biao Pi

    2016-01-01

    AIM:To investigate the formation of rats' choroidal neovascularization(CNV)induced by acrolein. METHODS:Twelve Sprague-Dawley rats were randomly divided into three groups. Acrolein 200μL(2.5 mg/kg/d)was poured into the rats' stomach for 4wk as acrolein 4wk and for 8wk as acrolein 8wk group. The same volume of fresh water was also done to the rats as the control group. Remove all eye balls and embed into paraffin with HE staining.RESLUTS:The RPE-Bruch membrane was intact with no obvious abnorm...

  14. In vivo Analysis of Choroid Plexus Morphogenesis in Zebrafish

    OpenAIRE

    Marta García-Lecea; Igor Kondrychyn; Fong, Steven H.; Zhang-Rui Ye; Vladimir Korzh

    2008-01-01

    BACKGROUND: The choroid plexus (ChP), a component of the blood-brain barrier (BBB), produces the cerebrospinal fluid (CSF) and as a result plays a role in (i) protecting and nurturing the brain as well as (ii) in coordinating neuronal migration during neurodevelopment. Until now ChP development was not analyzed in living vertebrates due to technical problems. METHODOLOGY/PRINCIPAL FINDINGS: We have analyzed the formation of the fourth ventricle ChP of zebrafish in the GFP-tagged enhancer trap...

  15. Study of the blood-aqueous barrier in choroidal melanoma.

    OpenAIRE

    Castella, A P; Bercher, L; Zografos, L; Egger, E.; Herbort, C P

    1995-01-01

    AIMS--Aqueous flare was used to determine the frequency and amount of blood-aqueous barrier breakdown and correlate it with tumour variables. METHODS--Aqueous flare was analysed prospectively by laser flare photometry in 139 consecutive patients seen in the oncology unit for choroidal melanoma. Both eyes of patients were examined with a laser flare cell meter in a standard fashion. RESULTS--Mean flare difference between healthy and tumour eyes was 3.01 (SD 2.5) photons per millisecond (ph/ms)...

  16. Current and emerging treatment options for myopic choroidal neovascularization.

    Science.gov (United States)

    El Matri, Leila; Chebil, Ahmed; Kort, Fedra

    2015-01-01

    Choroidal neovascularization (CNV) is the main cause of visual impairment in highly myopic patients younger than 50 years of age. There are different treatments for myopic CNV (mCNV), with 5- to 10-year outcomes currently. Chorioretinal atrophy is still the most important determinant factor for visual outcome. The purpose of this study is to provide an overview of the current treatments for mCNV, including laser, surgical management, verteporfin photodynamic therapy, and mainly anti-vascular endothelial growth factor therapy. Emerging treatment options are also discussed. PMID:25987831

  17. A simplified method to measure choroidal thickness using adaptive compensation in enhanced depth imaging optical coherence tomography.

    Directory of Open Access Journals (Sweden)

    Preeti Gupta

    Full Text Available PURPOSE: To evaluate a simplified method to measure choroidal thickness (CT using commercially available enhanced depth imaging (EDI spectral domain optical coherence tomography (SD-OCT. METHODS: We measured CT in 31 subjects without ocular diseases using Spectralis EDI SD-OCT. The choroid-scleral interface of the acquired images was first enhanced using a post-processing compensation algorithm. The enhanced images were then analysed using Photoshop. Two graders independently graded the images to assess inter-grader reliability. One grader re-graded the images after 2 weeks to determine intra-grader reliability. Statistical analysis was performed using intra-class correlation coefficient (ICC and Bland-Altman plot analyses. RESULTS: Using adaptive compensation both the intra-grader reliability (ICC: 0.95 to 0.97 and inter-grader reliability (ICC: 0.93 to 0.97 were perfect for all five locations of CT. However, with the conventional technique of manual CT measurements using built-in callipers provided with the Heidelberg explorer software, the intra- (ICC: 0.87 to 0.94 and inter-grader reliability (ICC: 0.90 to 0.93 for all the measured locations is lower. Using adaptive compensation, the mean differences (95% limits of agreement for intra- and inter-grader sub-foveal CT measurements were -1.3 (-3.33 to 30.8 µm and -1.2 (-36.6 to 34.2 µm, respectively. CONCLUSIONS: The measurement of CT obtained from EDI SD-OCT using our simplified method was highly reliable and efficient. Our method is an easy and practical approach to improve the quality of choroidal images and the precision of CT measurement.

  18. I-125 plaque therapy for choroidal melanoma

    International Nuclear Information System (INIS)

    Fifty-eight patients have been treated for a chorodial melanoma using an I-125 plaque with a mean follow-up of 43.7 months (range, 15 - 100 mo). The average apical tumor dose was 8.468 cGy with a dose rate of 71 cGy. Tumors in 52 (89%) patients are controlled locally (two were replaqued). There are 46 (79%) NED; seven have died of distant disease and five of other causes. Complications include cataracts (14), angiopathy (four), vitreous homorrhage (five), and neovascular glaucoma (four). Even though 44 patients had posterior tumors (with 25 patients having lesions < 3.0 mm from the optic nerve), no one had optic nerve atrophy

  19. Ageing choroid plexus and experimental models: morphometrical study

    International Nuclear Information System (INIS)

    Morphometric parameters of the light and dark rat choroid plexus epithelial cells were studied during development, after hypokinesia and low doses of ionizing radiation. Morphometric investigations were performed on semi-thin sections by using a point-counting (625 test points) method, performed with combined greed in the ocular of the light microscope for linear and planimetric estimations. Morphometric investigations in the present study and literature data provide further evidence that light and dark choroid plexus epithelial cells finish their differentiation on 30 days postnatum. The cell area of the dark epithelial cells is smaller than the cell area of the light cells and its difference retains up to 22 months. The relative part of the dark cells increases during ontogenesis and at 13 months it is larger than the relative part of the light cells. Morphometric changes of the epithelial cells during development suggest that dark and light cells are modulations of the same basic cells with possible functional differentiation starting from 17 days postconception and continue to 22 months. Morphometric changes of the light and dark epithelial cells during hypokinesia and low doses of ionizing radiation are different for light and dark cells and they depend on the kind of influence. They may be related with differences in the functional activity of the light and dark epithelial cells, specific for the applied extremum influence. (author)

  20. Thrombospondin-1 Expression in RPE and Choroidal Neovascular Membranes

    Institute of Scientific and Technical Information of China (English)

    Shikun He; Francesca Incardona; Manlin Jin; Stephen J. Ryan; David R. Hinton

    2006-01-01

    Purpose: To investigate the expression of thrombospondin 1 (TSP-1) in retinal pigment epithelium (RPE) and choroidal neovascular membranes (CNVMs) from patients with age-related macular degeneration (AMD).Methods: Tissue sections from normal human fetal and adult eyes and surgically removed CNVMs were immunostained for TSP-1 localization. Polymerase chain reaction and Western blotting were used to analyze TSP-1 mRNA and protein from human RPE cells, respectively. TSP-1 in the supernatant of cultured RPE cells and eye explants were measured using enzyme-linked immunosorbent assay. MTT assay was used to evaluate the RPE survival after TSP-1 treatment.Results: The strongest immunostaining for TSP-1 was observed in the RPE monolayer around drusen in early AMD. The intensity of TSP-1 staining in normal eye sections was much weaker than that of early AMD and CNVM. TSP-1 mRNA was positive in cultured fetal and adult RPE cells. There was increasing secretion of TSP-1 into the supernatant of cultured RPE and eye explants. The specific band of TSP-1 was identified by Western blot. No significant inhibition of RPE survival was found with the exposure to TSP-1.Conclusions: TSP-1 expression in drusen and CNVM was upregulated and associated with RPE monolayer. TSP-1 may be a natural negative regulator for choroidal neovascularization.

  1. Pelvis metastasis from primary choroidal melanoma: a case report

    Directory of Open Access Journals (Sweden)

    Xiong Y

    2014-11-01

    Full Text Available Yan Xiong, Yun Lang, Chongqi Tu, Hong Duan Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China Abstract: The patient, a 16-year-old girl, was admitted to our hospital with complaints of right hip pain and claudication. Her past medical history indicated that 2 years earlier she had undergone enucleation of her left eye for a primary choroidal melanoma. Imaging studies revealed a osteolytic destruction with soft tissue mass involving the right hemipelvis (zone I–II. Single-photon emission computed tomography (SPECT and positron emission tomography–computed tomography (PET–CT showed no other sites of metastases. Consequently, the patient underwent hemipelvic prosthesis reconstruction after tumor resection. Postoperative pathological diagnosis was metastatic malignant melanoma. Thirty months after treatment, imaging studies indicated no evidence of recurrence, and functional recovery was excellent. To our knowledge, the literature does not reveal any previously reported cases of ocular choroidal melanoma that metastasized to pelvis, meanwhile was carried out hemipelvic prosthesis reconstruction after pelvic tumor resection. Keywords: melanoma, metastasis, pelvis, tumor, reconstruction

  2. Post-treatment visual acuity in patients treated with episcleral plaque therapy for choroidal melanoma: Dose and dose rate effects

    International Nuclear Information System (INIS)

    Purpose: To determine the relationship between the long-term visual function and the dose and dose rates delivered to critical ocular structures in patients with choroidal melanoma treated with 125I episcleral plaque radiotherapy. Methods and Materials: From 1987 to 1993, 63 patients underwent 125I episcleral plaque application for the treatment of choroidal melanoma. Mean tumor height was 4.6 mm (range 1.7-8.3 mm). Plaques utilized were of COMS design. Doses and dose rates at the tumor apex, macula, and optic disc were obtained. Visual acuity data prior to and after plaque application was available for 52 patients. 9 patients were excluded from analysis secondary to co-morbidities or disease progression. 43 records were scored to assess if a decrease in visual acuity of ≥ 2 lines on a standard Snellen eye chart had occurred. Statistical analysis was performed using chi-square tests of significance. Results: Of the 63 total patients, 59 (93.7%) were alive at a median follow-up of 36 months. Local progression occurred in (7(63)) (11.1%). Median dose and dose rate to the tumor apex were 90 Gy and 97.2 cGy/hr, respectively. Of the 43 patients with post-treatment visual acuity analysis, 28 (65.1%) experienced visual loss of ≥ 2 lines on a standard eye chart. Median time to altered visual acuity was 20 months. Median dose and dose rates to the macula in patients with a significant visual loss were 123.3 Gy and 122.5 cGy/hr, respectively, compared with 38 Gy and 51.9 cGy/hr in those without notable visual change. These differences reached statistical significance at a dose and dose rate to the macula of 82.0 Gy (p125I plaque brachytherapy for choroidal melanoma experienced favorable tumor control, but with a measurable incidence of decreased visual acuity. Both total dose and dose rates to the macula and optic disc correlated strongly with post-treatment visual outcome. This information may be valuable in decisions about the dose and dose rates used to treat

  3. Clinical features, management and visual outcome of polypoidal choroidal vasculopathy in Indian patients

    Directory of Open Access Journals (Sweden)

    Anantharaman Giridhar

    2010-01-01

    Full Text Available Aims: To present the clinical, indocyanine green angiography (ICGA features and results of treatment for polypoidal choroidal vasculopathy (PCV in Indian patients by a retrospective chart review.Materials and Methods: Forty five patients with PCV underwent complete ocular examination, fluorescein angiography (FFA and ICGA. Treatment was advised for patients with macular involvement and progressive loss of visual acuity. Demographic data, clinical features and results of treatment were analyzed.Results: Mean age at presentation was 61.06 years. Mean follow up was 18 months. The disease was more prevalent in males. Forty three patients had unilateral disease. The most common location of polyps in ICGA was subfoveal (42.5%. Exudative form was seen in 34 of the 47 eyes and the remaining 13 eyes had a hemorrhagic presentation. Thirty four eyes underwent treatment which included thermal laser (n = 11, photodynamic therapy (PDT (n = 11 and transpupillary thermo therapy (TTT (n = 12. Statistical analysis was done using the Chi-square test. Subgroup analysis of visual outcome following various modalities of treatment showed that the results of PDT (P < 0.001 and thermal laser (P < 0.001 were statistically significant. Conclusions: PCV is an important differential diagnosis in patients presenting with serosanginous maculopathy and submacular hemorrhage. The disease was more prevalent in males and was unilateral in the Indian population. Timely intervention in cases with symptomatic polyps could achieve stabilization of visual acuity. Thermal laser and PDT were safe and effective.

  4. Cardiac, choroidal and subcutaneous metastases of a follicular thyroid carcinoma

    International Nuclear Information System (INIS)

    Full text of publication follows. Aim: to describe an unusual case of follicular carcinoma of the thyroid with uncommon metastases at the left atrium, the pulmonary vessels, the right eye and a subcutaneous mass. Materials and methods: the patient record was reviewed retrospectively. We analysed clinical outcomes and thyroglobulin rate as well as imaging findings after radio-iodine therapy. Results: we report the case of 43-year-old woman operated in 1995 for multi-nodular goitre by total thyroidectomy. Histopathologic findings were typical of follicular thyroid carcinoma with vascular invasion. The patient was then lost of sight and consulted in 2000 for a neck swelling. She was operated again for lymphadenectomy with resection of two peri-jugular tumoral masses that deviate vascular axes. Histopathologic findings concluded for residual follicular thyroid carcinoma with insular component without lymph node metastasis. The initial chest CT revealed a macro-nodular lung miliairy and the whole body scan post 100 mCi Iodine-131 showed intense cervical uptake and multiple bilateral thoracic fixations. The evolution after 10 cures of Iodine-131 has been marked by a persistently high thyroglobulin levels superior to 800 ng/ml with disappearance of cervical uptake and the persistence of pulmonary fixations. Bone scintigraphy scan was negative. Later, the patient complained of a decreased visual acuity. The last whole body SPECT/CT scan revealed multiple fixations of I-131 located at the right eyeball, lungs, left atrium, liver, sacrum as well as an abdominal subcutaneous solid mass. MRI confirmed a right choroid metastasis. Conclusion: follicular thyroid carcinoma comprises 15% of all thyroid cancers and usually metastases to the lymph nodes, lungs and bone. Other rare sites of metastases are the brain, pituitary, maxilla, larynx, and thymus. Distant metastases of these sites, particularly choroidal are exceptional. Metastatic cardiac involvement occurs most often during

  5. Effect of myopia onset time for macula choroidal thickness

    Directory of Open Access Journals (Sweden)

    Shi-Ming Wang

    2016-03-01

    Full Text Available AIM:To investigate the effect of onset time(Tfor macula choroidal thickness(CTin myopia patient. METHODS:A prospective cohort study was designed.One hundred and twenty-two myopia patients(244 eyes; 67 male and 55 female; aged 30~41 years, mean 35.1±4.6 years oldwho received preoperative examinations from March 2014 to April 2015 were recruited in this study. The patients were divided into three groups according to onset time(T:group A(T≤5a, group B(5aF=1.56,P>0.05,age(F=2.13,P>0.05,best corrected visual acuity(BCVA, F=1.41,P>0.05,corneal curvature(F=1.65,P>0.05and axial length(F=1.89,P>0.05among the three groups. The choroid in macular region was measured by enhanced depth imaging(EDIusing spectral-domain optical coherence tomography(SD-OCT. This study recorded the CT at subfoveal(SFCT, 1mm at temporal(T1mm, nasal(N1mm, superior(S1mmand inferior(I1mmto the fovea and 3mm temporal(T3mm, nasal(N3mm, superior(S3mmand inferior(I3mmto the fovea, respectively. The differences of CT at the same position among the three groups were analyzed.RESULTS:The mean SFCT for group A,B,C were 238.32±57.95μm, 230.58±67.21μm, 221.63±62.37μm respectively in this study. The CT was found no significant difference in different locations except N3mm(tA-B=4.34,P3mm(tB-C=7.61,P3mm(t=0.76,P>0.05between group A and C. Significant difference was found at N3mm(tA-B=4.31,t B-C=7.59,tA-C=12.18; PCONCLUSION:The choroidal thickness decreases as the myopia onset time is earlier, especially at nasal.

  6. Choroid plexus tumors: An institutional series of 25 patients

    Directory of Open Access Journals (Sweden)

    Menon Girish

    2010-01-01

    Full Text Available Purpose : Choroid plexus tumors (CPT are rare neoplasms that pose considerable treatment challenges. This study reviews a single institute′s experience with 25 patients of CPT and attempts to contribute to the general body of knowledge on CPT. Materials and Methods : A retrospective analysis of the case records of 25 patients operated for CPT since January 1998 and having a minimum of 1 year follow-up. Results : The study group included 12 (48% cases of choroid plexus papilloma (CPP, 09 (36% cases of choroid plexus carcinoma (CPC and 4 cases of atypical CPP. The mean age at presentation was 18.6 years (range, 6 months to 54 years; SD, 18.7 and a male preponderance was noted (17:8. Raised intracranial pressure was the commonest presenting symptom (72%. The tumors were distributed as follows: lateral ventricle (16; 64%, fourth ventricle (5; 20%, fourth ventricle with cerebellopontine angle extension (3; 12%, and third ventricle (1; 4%. A complete surgical excision was achieved in 11 cases of CPP and 8 cases of CPC. Operative complications include pneumocephalus (40%, focal deficits (36%, subdural effusion (32%, and persistent hydrocephalus requiring shunt (24%. All patients with CPP had a good outcome at the end of a mean follow-up of 5.4 years, whereas the median survival for patients with CPCs who underwent a subtotal resection with adjuvant therapy was 36 months. Conclusion : CPTs include a spectra ranging from CPP to CPC. Radiologic and histologic characterization of these tumors is difficult and newer immunohistochemical and genetic studies should be done to differentiate them from each other. Total excision offers a good prognosis and should be attempted for all forms of CPTs. CPPs carry a good prognosis, and adjuvant therapy is not indicated even after partial excision. CPCs and atypical CPCs carry a poor prognosis, and adjuvant therapy improves survival marginally after total excision. Spinal drop metastases are common for CPC and

  7. Palladium-103 plaque radiotherapy for choroidal melanoma: an 11-year study

    International Nuclear Information System (INIS)

    Purpose: To describe 11 years of experience with 103Pd ophthalmic plaque brachytherapy for intraocular melanoma. Methods and Materials: Since 1990, 152 patients have been diagnosed with uveal melanoma, found to be negative for metastatic disease, and treated with 103Pd radioactive plaque radiotherapy. This study presents the first 100 patients treated with 103Pd and followed for ≥2 years. Plaques were sewn to the episclera to cover the base of the intraocular tumor. Treatment involved delivery of a mean apical radiation dose of 80.5 Gy during 5-7 days' continuous treatment. Patients were evaluated for local tumor control, visual acuity, radiation damage (retinopathy, optic neuropathy, cataract), and metastatic disease. Results: Patients in this series were followed for a mean of 4.6 years (55.4 months). 103Pd seeds were found to be equivalent to 125I with respect to plaque manufacture and ease of dosimetric calculations. We noted a local control rate of 96% and six secondary enucleations. Including the enucleated patients, the visual acuity evaluations revealed that 35% lost six or more lines of vision and 73% had vision of 20/200 or better. Conclusion: Long-term results now exist describing the use of 103Pd plaque radiotherapy for uveal (iris, ciliary body, and choroidal) melanoma. Compared with the results from centers using 125I, patients in this series experienced equivalent local control rates and better visual function

  8. Multifocal choroiditis following simultaneous hepatitis A, typhoid, and yellow fever vaccination

    Directory of Open Access Journals (Sweden)

    Escott S

    2013-02-01

    Full Text Available Sarah Escott, Ahmad B Tarabishy, Frederick H DavidorfHavener Eye Institute, The Ohio State University, Columbus, OH, USAAbstract: The paper describes the first reported case of multifocal choroiditis following simultaneous hepatitis-A, typhoid, and yellow fever vaccinations. A 33-year-old male developed sudden onset of flashing lights and floaters in his right eye 3 weeks following hepatitis A, typhoid, and yellow fever vaccinations. Fundus examination and angiography confirmed the presence of multiple peripheral chorioretinal lesions. These lesions demonstrated characteristic morphologic changes over a period of 8 weeks which were consistent with a diagnosis of self-resolving multifocal choroiditis. Vaccine-induced intraocular inflammation has been described infrequently. We demonstrate the first case of self-resolving multifocal choroiditis following simultaneous administration of hepatitis A, yellow fever, and typhoid immunizations.Keywords: multifocal choroiditis, vaccination, hepatitis A, typhoid, yellow fever

  9. Knockdown of the Placental Growth Factor Gene Inhibits Laser Induced Choroidal Neovascularization in a Murine Model

    Directory of Open Access Journals (Sweden)

    Ramin Nourinia

    2013-01-01

    Full Text Available Purpose: To evaluate the effect of placental growth factor (PlGF gene knockdown in a murine model of laser-induced choroidal neovascularization. Methods: Choroidal neovascularization was induced in the left eyes of 11 mice by infrared laser. Small interfering RNA (siRNA, 20 picomoles/10 μl corresponding to PlGF mRNA was administered intravitreally by Hamilton syringe in all subjects. One month later, fluorescein angiography and histolologic examination were performed. Results: No leakage was apparent in the 11 eyes treated with siRNA cognate to PlGF. The results of histological evaluation were consistent with angiographic findings showing absence of choroidal neovascularization. Conclusion: Knockdown of the PlGF gene can inhibit the growth of laser-induced choroidal neovascularization in mice.

  10. Surgical induction of choroidal neovascularization in a porcine model

    DEFF Research Database (Denmark)

    Lassota, Nathan; Kiilgaard, Jens Folke; Prause, Jan Ulrik; Qvortrup, Klaus; Scherfig, Erik; la Cour, Morten

    2007-01-01

    PURPOSE: To develop a reproducible surgical technique for the induction of choroidal neovascularization (CNV) in the subretinal space of porcine eyes and to analyse the resulting CNV clinically and histologically. METHODS: Two different modifications of a surgical technique previously described...... were compared with the original method. In ten porcine eyes retinal pigment epithelial (RPE) cells were removed using a silicone tipped cannula, in ten porcine eyes Bruch's membrane was perforated once with a retinal perforator without prior RPE removal and in ten eyes RPE removal was followed by a...... single perforation of Bruch's membrane. Fifteen of the eyes, five from each group, were enucleated 30 minutes after surgery, while the remaining eyes were enucleated after 14 days. Prior to enucleation, at day 14, fundus photographs and fluorescein angiograms were obtained. Eyes were examined by light...

  11. Choroidal Neovascularization Secondary to Myopia, Infection and Inflammation.

    Science.gov (United States)

    Weber, Marissa L; Heier, Jeffrey S

    2016-01-01

    Choroidal neovascularization (CNV) is a significant cause of vision loss in all age groups. The most common cause of CNV is age-related macular degeneration (AMD). However, CNV can also occur as a secondary manifestation of various inherited and acquired conditions, including pathologic myopia, presumed ocular histoplasmosis syndrome, angioid streaks, and various hereditary, traumatic or inflammatory disorders. Fluorescein angiography and optical coherence tomography are useful tools in the diagnosis and evaluation of CNV. Treatment options are similar to those for CNV secondary to AMD, specifically anti-angiogenic therapy, but including laser photocoagulation, photodynamic therapy and surgery. Anti-angiogenic therapy has been associated with better visual outcomes than other treatment modalities and is now advocated as the first-line therapy for CNV secondary to myopia, infection and inflammation. PMID:26501802

  12. Inherited Retinal Degenerative Disease Registry

    Science.gov (United States)

    2016-03-21

    Eye Diseases Hereditary; Retinal Disease; Achromatopsia; Bardet-Biedl Syndrome; Bassen-Kornzweig Syndrome; Batten Disease; Best Disease; Choroidal Dystrophy; Choroideremia; Cone Dystrophy; Cone-Rod Dystrophy; Congenital Stationary Night Blindness; Enhanced S-Cone Syndrome; Fundus Albipunctatus; Goldmann-Favre Syndrome; Gyrate Atrophy; Juvenile Macular Degeneration; Kearns-Sayre Syndrome; Leber Congenital Amaurosis; Refsum Syndrome; Retinitis Pigmentosa; Retinitis Punctata Albescens; Retinoschisis; Rod-Cone Dystrophy; Rod Dystrophy; Rod Monochromacy; Stargardt Disease; Usher Syndrome

  13. The choroid plexus in normal full-term neonate : a study of morphological variety on sonography

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the sonographic features of normal choroid plexus, thus helping avoid misinterpretations such as intraventricular hemorrhage or abnormality. Posterior coronal, parasagittal, and oblique sagittal scans of 400 choroid plexus in normal full-term neonates(100 girls, 100 boys) were reviewed with special attention to coronal configuration, glomus patterns, and the shape of anterior ends. Sonographic features were classified as follows ; tubular(type 1), posterior clubbing(type 2), mid-bulging(type 3), or double choroidal pattern(type 4), as seen on posterior coronal scans; crescent(type 1), superior notching(type 2), dorsal bulging(type 3), or inferior notching(type 4), as seen on parasagittal scans; and anterior tapering(type 1) and clubbing shape (type 2) on oblique parasagittal scans. Maximal diameters of the choroid plexus on posterior coronal scan and the glomus on parasagittal scan were measured. All sonographic measurements of normal choroid plexus were statistically analysed according to gender and side. Four hundred normal choroid plexus were classified as 293 cases(73%) of tubular pattern(type 1), 50 cases(13%) of posterior bulging(type 2), 44 cases (11%) of mid-bulging(type 3) and 13 cases(3%) of double choroidal pattern (type 4) as seen on posterior coronal scans ; 263 cases(66%) of crescent shape(type 1), 70 cases(17%) of superior notching (type 2), 38 cases(9%) of dorsal bulging(type 3), and 29 cases(7%) of inferior notching(type 4), as seen on parasagittal scans; and 233 cases(58%) of anterior tapering(type 1) and 167 cases(42%) of anterior clubbing (type 2), as seen on oblique parasagittal scans. Maximal diameters of the choroid plexus on posterior coronal scan were 7.17±0.12 mm (95% confidence interval [CI]) on the right side and 7.13±0.19 mm (95% CI) on the left side, and 8.13±0.24(95% CI) mm on the right and 8.57±0.29 mm on the left side glomus on parasagittal scan. There were no significant statistical

  14. Quantitative parameter character of choroidal melanoma in contrast-enhanced ultrasound

    Institute of Scientific and Technical Information of China (English)

    YANG Wen-li; WEI Wen-bin; LI Dong-jun

    2012-01-01

    Background Choroidal melanoma is the most common intraocular malignant tumor in adults.It threatens not only the visual function but also the patient's life.Therefore,it is important to find a non-traumatic,quantitative and repetitive diagnostic method.This study investigated the value of quantitative analysis of contrast-enhanced ultrasound (CEUS) in the diagnosis of choroidal melanoma.Methods CEUS were performed in 51 cases of choroidal melanoma,which were diagnosed either pathologically or clinically and in 14 cases of choroidal hemangioma.The characteristics of the time-intensity curve of the contrast agent were analyzed.For the quantitative analysis,the following parameters of the contrast agent in the lesion were included:rising time (RT),time to peak (TTP),maximum intensity (MI) and the mean transit time (MTT).Results Choroidal melanoma had the following characteristics on CEUS:Choroidal lesions were completely filled with contrast agent.The typical filling pattern was centripetal,with the peripheral of the choroidal lesion filled with the contrast agent first and then the center of the lesion.In some cases,areas with contrast agent filling defect were obseved in the lesions.The contrast agent filled the lesion slower than the normal eye and orbital tissue but faded faster in the lesion.Quantitative analysis showed that in choroidal melanoma,MI of contrast agent (191.31%±146.90%) was significantly more than that of the normal tissue (100.00%±0.00%) (P <0.05) and MTT ((63.56±26.04) seconds) was significanly less than that of the normal tissue ((149.87±182.68)seconds) (P <0.05).TTP (22.80±9.85) was less than that of the normal tissue ((29.57±24.76) seconds) and RT ((18.52±7.09) seconds) was less than that of the normal tissue ((26.45±21.83) seconds).Both the differences of TTP and RT were not statistically significant though.Logistic regression showed that to predict choroidal melanoma and choroidal hemangioma with MI and MTT

  15. RAGE regulates immune cell infiltration and angiogenesis in choroidal neovascularization.

    Directory of Open Access Journals (Sweden)

    Mei Chen

    Full Text Available PURPOSE: RAGE regulates pro-inflammatory responses in diverse cells and tissues. This study has investigated if RAGE plays a role in immune cell mobilization and choroidal neovascular pathology that is associated with the neovascular form of age-related macular degeneration (nvAMD. METHODS: RAGE null (RAGE-/- mice and age-matched wild type (WT control mice underwent laser photocoagulation to generate choroidal neovascularization (CNV lesions which were then analyzed for morphology, S100B immunoreactivity and inflammatory cell infiltration. The chemotactic ability of bone marrow derived macrophages (BMDMs towards S100B was investigated. RESULTS: RAGE expression was significantly increased in the retina during CNV of WT mice (p<0.001. RAGE-/- mice exhibited significantly reduced CNV lesion size when compared to WT controls (p<0.05. S100B mRNA was upregulated in the lasered WT retina but not RAGE-/- retina and S100B immunoreactivity was present within CNV lesions although levels were less when RAGE-/- mice were compared to WT controls. Activated microglia in lesions were considerably less abundant in RAGE-/- mice when compared to WT counterparts (p<0.001. A dose dependent chemotactic migration was observed in BMDMs from WT mice (p<0.05-0.01 but this was not apparent in cells isolated from RAGE-/- mice. CONCLUSIONS: RAGE-S100B interactions appear to play an important role in CNV lesion formation by regulating pro-inflammatory and angiogenic responses. This study highlights the role of RAGE in inflammation-mediated outer retinal pathology.

  16. Choroid plexus papilloma presenting as a non-contrast-enhancing fourth ventricular mass in a child

    OpenAIRE

    Pratheesh Ravindran; Moorthy Ranjith; Singh Reecha; Rajshekhar Vedantam

    2009-01-01

    Choroid plexus papilloma (CPP) is a rare benign tumor of the central nervous system with a propensity for location within the lateral ventricle in children. We report a case of a 14-year-old girl who presented with transient facial paresis and ataxia. Her imaging showed a non-enhancing intra fourth ventricular mass, the histology of which was reported as CPP. The atypical clinical and radiological features in this case are discussed. Choroid plexus papillomas should be considered in the diffe...

  17. Atypical presentation of ocular toxoplasmosis: A Case report of exudative retinal detachment and choroidal Ischemia

    Directory of Open Access Journals (Sweden)

    Yahya A Al-Zahrani

    2016-01-01

    Full Text Available A 24-year-old healthy male presented with a chief complaint of blurred vision in the right eye for 1-week. Fundus examination indicated right exudative retinal detachment and choroidal ischemia. The patient responded well to anti-toxoplasmosis medications and steroids. Exudative retinal detachment and choroidal ischemia are atypical presentations of ocular toxoplasmosis. However, both conditions responded well to anti.parasitic therapy with steroid.

  18. Comparison of Choroidal Thickness in Patients with Diabetes by Spectral-domain Optical Coherence Tomography

    OpenAIRE

    Lee, Hyo Kyung; Lim, Ji Won; Shin, Min Cheol

    2013-01-01

    Purpose To evaluate choroidal thickness in diabetes patients using spectral-domain optical coherence tomography. Methods We examined 203 eyes of 203 diabetic participants and 48 eyes of 48 healthy controls. The choroidal thickness at the foveal lesion was measured by enhanced-depth imaging optical coherence tomography. The participants were grouped according to diabetic retinopathy grade: no diabetic change, mild-to-moderate or severe non-proliferative, or proliferative diabetic retinopathy. ...

  19. Newborn with Prenatally Diagnosed Choroidal Fissure Cyst and Panhypopituitarism and Review of the Literature

    OpenAIRE

    Ritu Chitkara; Anand Rajani; Jonathan Bernstein; Sejal Shah; Hahn, Jin S; Patrick Barnes; Hintz, Susan R.

    2011-01-01

    Little has been reported on fetal diagnosis of choroidal fissure cysts and prediction of the clinical complications that can result. We describe the case of a near-term male infant with prenatally diagnosed choroidal fissure cyst and bilateral clubfeet. His prolonged course in the neonatal intensive care nursery was marked by severe panhypopituitarism, late-onset diabetes insipidus, placement of a cystoperitoneal shunt, and episodes of sepsis. Postnatal genetic evaluation also revealed an int...

  20. PRIMARY CHOROIDAL MALIGNANT LYMPHOMA:REPORT OF A CASE AND REVIEW OF LITERATURE

    Directory of Open Access Journals (Sweden)

    F. Asadi Amoli

    2006-06-01

    Full Text Available Non-Hodgkin lymphoma (NHL is one of the masquerade syndromes of malignant melanoma that can occur with two main patterns of presentations in the eye: metastatic involvement of uveal tract, and primary involvement of retina. We report ophthalmic, imaging and histopathological findings in the first case diagnosed as primary choroidal NHL without central nervous system or systemic involvement. A 37-year-old woman presented with the complaint of severe visual loss in her right eye. Significant ocular finding included light perception of vision (LP, 2+ APD, 2+ cells in vitreous and intraocular pressure of 46 mmHg. Fundoscopic examination revealed exudative retinal detachment. Ocular echography showed choroidal thickening in addition to retinal detachment. MRI showed semilunar shape lesion in the posterior right globe suggesting choroidal melanoma. Systemic work-up could not reveal any underlying cause. The patient underwent enucleation with clinical suggestion of choroidal melanoma. Result of histological examination showed NHL (diffuse large Bcell type of choroid. Immunohistochemical staining showed negative staining for HMB-45 and CD3, positive staining for LCA, and CD20. Multiple periodic lumbar puncture, bone marrow biopsies and MRI were unremarkable. No recurrence of tumor in systemic work-up was noted during the 36-months follow-up. Primary choroidal NHL is one of the causes of generalized thickening of choroid and should be considered in differential diagnosis of malignant melanoma. It is recommended to perform fine needle biopsy before performing surgery in any patient who has had an atypical malignant melanoma. This is, so far as we know, the first case diagnosed as primary choroidal NHL.

  1. Fungal Infection in Patients with Serpiginous Choroiditis or Acute Zonal Occult Outer Retinopathy▿

    OpenAIRE

    Pisa, Diana; Ramos, Marta; García, Patricia; Escoto, Remberto; Barraquer, Rafael; Molina, Susana; Carrasco, Luis

    2007-01-01

    The etiologies of a number of retinopathies, including serpiginous choroiditis and acute zonal occult outer retinopathy (AZOOR), remain uncertain. Recently, we provided evidence that AZOOR is caused by Candida famata infection. The purpose of this article was to investigate the presence of fungal infection in five patients affected with serpiginous choroiditis and five patients with diagnosis of AZOOR. To assess the presence of fungal infection the presence of antibodies in human serum sample...

  2. Predictive factors of visual outcome after local resection of choroidal melanoma.

    OpenAIRE

    Damato, B. E.; Paul, J; Foulds, W. S.

    1993-01-01

    Local resection of choroidal melanomas is not widely performed so that the indications for this operation have not previously been defined statistically. Univariate and multivariate Cox regression analyses were used to identify the factors influencing visual acuity after 163 completed local resections for choroidal melanoma in patients with a preoperative visual acuity of counting fingers or better. The variables included in the analyses were patient age and sex; eye laterality and preoperati...

  3. Knockdown of the Placental Growth Factor Gene Inhibits Laser Induced Choroidal Neovascularization in a Murine Model

    OpenAIRE

    Ramin Nourinia; Zahra-Soheila Soheili; Hamid Ahmadieh; Hassan Akrami; Mozhgan Rezaei Kanavi; Shahram Samiei

    2013-01-01

    Purpose: To evaluate the effect of placental growth factor (PlGF) gene knockdown in a murine model of laser-induced choroidal neovascularization. Methods: Choroidal neovascularization was induced in the left eyes of 11 mice by infrared laser. Small interfering RNA (siRNA, 20 picomoles/10 μl) corresponding to PlGF mRNA was administered intravitreally by Hamilton syringe in all subjects. One month later, fluorescein angiography and histolologic examination were performed. Results: No le...

  4. Intravitreal bevacizumab for choroidal neovascular membrane associated with Best's vitelliform dystrophy

    OpenAIRE

    Rishi, Ekta; Rishi, Pukhraj; Mahajan, Sheshadri

    2010-01-01

    Best's vitelliform macular dystrophy is a hereditary form of progressive macular dystrophy that can be complicated by choroidal neovascularization. Authors report successful treatment of choroidal neovascularization with intravitreal bevacizumab in one such eye in an ‘adult’ Indian male with visual improvement. A 23-year-old male presented with diminution of vision in the right eye for the past sixteen months. Visual acuity was 20/400 in the that eye. After three consecutive intravitreal inje...

  5. Intravitreal bevacizumab for choroidal neovascular membrane associated with Best′s vitelliform dystrophy

    OpenAIRE

    Rishi Ekta; Rishi Pukhraj; Mahajan Sheshadri

    2010-01-01

    Best′s vitelliform macular dystrophy is a hereditary form of progressive macular dystrophy that can be complicated by choroidal neovascularization. Authors report successful treatment of choroidal neovascularization with intravitreal bevacizumab in one such eye in an ′adult′ Indian male with visual improvement. A 23-year-old male presented with diminution of vision in the right eye for the past sixteen months. Visual acuity was 20/400 in the that eye. After three consecut...

  6. Intravitreal bevacizumab for choroidal neovascularization secondary to angioid streaks: A report of two patients

    OpenAIRE

    Ozkaya, Abdullah; Alkin, Zeynep; Faiz, Miray; Yazici, Ahmet Taylan; Demirok, Ahmet

    2013-01-01

    The aim of this study is to report clinical course of choroidal neovascularization secondary to angioid streaks (AS) in two patients who underwent intravitreal bevacizumab therapy. Fundus examination, fluorescein angiography (FA) and optical coherence tomography (OCT) revealed the diagnosis of subfoveal classic choroidal neovascularization (CNV) in the right eye in patient 1 and in the left eye in patient 2. After three consecutive bevacizumab injections, visual acuity improved from 20/40 to ...

  7. Choroidal changes observed with enhanced depth imaging optical coherence tomography in patients with mild Graves orbitopathy.

    Science.gov (United States)

    Özkan, B; Koçer, Ç A; Altintaş, Ö; Karabaş, L; Acar, A Z; Yüksel, N

    2016-07-01

    PurposeTo evaluate the choroidal thickness in patients with Graves orbitopathy (GO) using enhanced depth imaging-optical coherence tomography (EDI-OCT).MethodsThirty-one patients with GO were evaluated prospectively. All subjects underwent ophthalmologic examination including best-corrected visual acuity, intraocular pressure measurement, biomicroscopic, and fundus examination. Choroidal thickness was measured at the central fovea. In addition, visual evoked potential measurement and visual field evaluation were performed.ResultsThe mean choroidal thickness was 377.8±7.4 μ in the GO group, and 334±13.7 μ in the control group. (P=0.004). There was a strong correlation between the choridal thickness and the clinical activity scores (CAS) of the patients (r=0.281, P=0.027). Additionally, there was a correlation between the choroidal thickness and the visual-evoked potential (VEP) P100 latency measurements of the patients (r=0.439, P=0.001).ConclusionsThe results of this study demonstrate that choroid is thicker in patients with GO. The choroidal thickness is also correlated with the CAS and VEP P100 latency measurements in these patients. PMID:27315349

  8. Anti-Human VEGF Repebody Effectively Suppresses Choroidal Neovascularization and Vascular Leakage

    Science.gov (United States)

    Hwang, Da-Eun; Ryou, Jeong-Hyun; Oh, Jong Rok; Han, Jung Woo; Park, Tae Kwann; Kim, Hak-Sung

    2016-01-01

    Age-related macular degeneration (AMD) is the leading cause of vision loss and blindness among people over the age of 60. Vascular endothelial growth factor (VEGF) plays a major role in pathological angiogenesis in AMD. Herein, we present the development of an anti- human VEGF repebody, which is a small-sized protein binder consisting of leucine-rich repeat (LRR) modules. The anti-VEGF repebody selected through a phage-display was shown to have a high affinity and specificity for human VEGF. We demonstrate that this repebody effectively inhibits in vitro angiogenic cellular processes, such as proliferation and migration, by blocking the VEGF-mediated signaling pathway. The repebody was also shown to have a strong suppression effect on choroidal neovascularization (CNV) and vascular leakage in vivo. Our results indicate that the anti-VEGF repebody has a therapeutic potential for treating neovascular AMD as well as other VEGF-involved diseases including diabetic retinopathy and metastatic cancers. PMID:27015541

  9. Anti-VEGF treatment for myopic choroid neovascularization: from molecular characterization to update on clinical application.

    Science.gov (United States)

    Zhang, Yan; Han, Qian; Ru, Yusha; Bo, Qiyu; Wei, Rui Hua

    2015-01-01

    Choroidal neovascularization (CNV) secondary to pathologic myopia has a very high incidence in global, especially in Asian, populations. It is a common cause of irreversible central vision loss, and severely affects the quality of life in the patients with pathologic myopia. The traditional therapeutic modalities for CNV secondary to pathologic myopia include thermal laser photocoagulation, surgical management, transpupillary thermotherapy, and photodynamic therapy with verteporfin. However, the long-term outcomes of these modalities are disappointing. Recently, intravitreal administration of anti-VEGF biological agents, including bevacizumab, ranibizumab, pegaptanib, aflibercept, and conbercept, has demonstrated promising outcomes for this ocular disease. The anti-VEGF regimens are more effective on improving visual acuity, reducing central fundus thickness and central retina thickness than the traditional modalities. These anti-VEGF agents thus hold the potential to become the first-line medicine for treatment of CNV secondary to pathologic myopia. This review follows the trend of "from bench to bedside", initially discussing the pathogenesis of myopic CNV, delineating the molecular structures and mechanisms of action of the currently available anti-VEGF drugs, and then systematically comparing the up to date clinical applications as well as the efficacy and safety of the anti-VEGF drugs to the CNV secondary to pathologic myopia. PMID:26170626

  10. Immunohistochemical localization of low density lipoprotein receptor-related protein 1 and α2-Macroglobulin in retinal and choroidal tissue of proliferative retinopathies

    OpenAIRE

    Barcelona, PF; Luna, JD; Chiabrando, GA; Juarez, CP; Bhutto, IA; Baba, T.; McLeod, DS; Sánchez, MC; Lutty, GA

    2010-01-01

    The immunolocalization of the low density lipoprotein receptor-related protein 1 (LRP1) and its ligand alpha 2-Macroglobulin (α2M) was examined in tissues from human donor eyes of normal, diabetic and sickle cell disease subjects. Streptavidin alkaline phosphatase immunohistochemistry was performed with a mouse anti-human LRP1 and rabbit anti-human α2M antibodies. Retinal and choroidal blood vessels were labeled with mouse anti-human CD34 antibody in adjacent tissue sections. Mean scores for ...

  11. Alternative Dose for Choroidal Melanoma Treated With an Iodine-125 Radioactive Plaque: A Single-Institution Retrospective Study

    International Nuclear Information System (INIS)

    Purpose: The Collaborative Ocular Melanoma Study (COMS) established iodine-125 plaque brachytherapy as an accepted standard treatment for medium-size choroidal melanoma. In the COMS, the prescription dose was 85 Gy. This is a retrospective review of our outcomes in patients treated with lower doses than those used in the COMS. Methods and Materials: From 1990 to 2004, 62 patients were treated with iodine-125 plaque brachytherapy for choroidal melanoma. COMS eye plaques were used with dose prescribed to the apex of the tumor. The median and average dose rates at the tumor apex were 63.5 cGy/h and 62.7 cGy/h, respectively. The median and average total doses were 63.0 Gy and 62.5 Gy (range, 56-69 Gy), respectively. The median and mean durations of implant were 100.0 hours and 101.1 hours (range, 71-165 hours). Results: Median follow-up time was 58.2 months. The 5-year outcomes including overall survival, disease-free survival, cause-specific survival, local failure, secondary enucleation rate, and visual acuity (VA) <20/200 were estimated using the Kaplan-Meier method. Overall, there were 7 local failures, 4 distant failures, and 10 secondary enucleations (6 due to local failure and 4 due to treatment complications). Univariate analysis was performed to identify significant prognostic factors associated with disease-free survival (baseline VA in tumor eye, tumor shape), cause-specific survival (diabetic retinopathy), local failure (none found), secondary enucleation rate (diabetic retinopathy, basal tumor dimension) and VA <20/200 (diabetic retinopathy, tumor shape, age, retinal detachment, treatment depth, and history of vision-limiting condition). Conclusions: Our survival and local control outcomes are comparable to those of the COMS. However, VA at 5 years seems to be better. Lower doses of radiation could potentially lead to better visual outcomes.

  12. Near-infrared fundus autofluorescence-visualized melanin in the choroidal abnormalities of neurofibromatosis type 1

    Directory of Open Access Journals (Sweden)

    Ueda-Consolvo T

    2012-07-01

    Full Text Available Tomoko Ueda-Consolvo, Akio Miyakoshi, Hironori Ozaki, Satoshi Houki, Atsushi HayashiDepartment of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, JapanPurpose: To report a series of three cases of neurofibromatosis type 1 examined by near-infrared fundus autofluorescence (NIR-AF with a scanning laser ophthalmoscope and spectral-domain optical coherence tomography (OCT to show the characteristics of choroidal abnormalities.Methods: Retrospective case series. Six eyes of three patients were examined by conventional fundus examinations, near-infrared monochromatic light reflectance (NIR-R and NIR-AF, OCT, fluorescein angiography, and indocyanine green angiography.Results: All eyes showed multiple bright patchy regions in the choroid of the posterior pole with NIR-R. NIR-AF revealed high fluorescent regions of similar sizes at fundus locations identical to those shown by NIR-R. In one case, hypofluorescent regions were shown by indocyanine green angiography in the bright fluorescent region shown by NIR-AF. The other two cases showed no abnormality under conventional fundus examination or fluorescein angiography. OCT images crossing the bright patchy region showed irregular hyper-reflectivity in the choroid in two cases and hyporeflectivity in one case.Conclusions: NIR-AF demonstrated that dense melanin was included in the choroidal nodules of neurofibromatosis type 1. The choroidal nodules showed hyper- or hyporeflectivity in the choroid on OCT, which did not affect the retinal structure.Keywords: near-infrared fundus autofluorescence, neurofibromatosis type 1, choroidal nodule, melanin

  13. Choroidal neovascularization after blunt ocular trauma in angioid streaks

    Directory of Open Access Journals (Sweden)

    Kubota M

    2013-07-01

    Full Text Available Masaomi Kubota, Takaaki Hayashi, Kota Arai, Hiroshi TsuneokaDepartment of Ophthalmology, The Jikei University School of Medicine, Tokyo, JapanBackground: Patients with angioid streaks are prone to develop a subretinal hemorrhage after ocular injury, due to fragility of Bruch's membrane.Objective: The purpose of this study was to report a patient with angioid streaks in whom subfoveal choroidal neovascularization (CNV developed after blunt ocular trauma.Case report: A 60-year-old man was accidentally struck in the left eye with a crowbar handle while engaged in the demolition of wooden building materials in May 2011 and was initially evaluated at our hospital. Corrected visual acuity was 0.3 in the right and 1.2 in the left eye, and relative afferent pupillary defect was negative. Funduscopy revealed choroidal atrophy around the optic papillae and angioid streaks radiating from around the optic discs in both eyes. In the right eye, there was macular atrophy. In the left eye, there was a subretinal hemorrhage around the macular region. Fluorescein angiography of the left eye showed a blockage due to subretinal hemorrhage and increasing hyperfluorescent spots superior to the fovea, suggestive of extrafoveal CNV. Spectral-domain optical coherence tomography showed macular thinning in the right eye and no obvious abnormalities near the subfoveal region in the left eye. Two months later, the patient noticed decreased visual acuity in the left eye and was reevaluated. Visual acuity had decreased to 0.7, and well-defined CNV, one disc diameter in size, was presenting slightly superior to the macula, including the subfoveal region. Two weeks later, anti-vascular endothelial growth factor (anti-VEGF antibody (bevacizumab was injected intravitreally; the CNV then regressed, and visual acuity improved to 1.2.Conclusion: Marked improvement in visual acuity with early treatment has not been reported in angioid streaks with subfoveal CNV after ocular injury

  14. Choroid plexus tumours: classification, MR imaging findings and pathological correlation

    International Nuclear Information System (INIS)

    Choroid plexus tumours (CPTs) are extremely rare intraventricular neoplasms and are prone to bleeding during surgery. The purpose of this study was to summarise the MR imaging characteristics of 13 CPT cases. Magnetic resonance images of 13 patients (six men and seven women; mean age 21.1 years) with pathologically proved CPTs were retrospectively reviewed. MR findings of the tumours were evaluated, with emphasis on their location, size, shape, internal architecture, margin and pattern and degree of enhancement. Differences in signal intensity characteristics were also investigated on MR images and analysed according to histological subtypes. Lesions were in the lateral ventricles (n=7), fourth ventricle (n=5) and cisterna magna (n=1), with a mean size of 5.0cm (range 2.0–7.9 cm). The tumour parenchyma was a mixture of nodular or patchy areas of inhomogeneous isointense to slightly hyperintense signal on T2-weighted images. On postcontrast MR images, all lesions, except for one, had moderate to marked contrast enhancement. Multiple tortuous areas of 'flow void' signal extended through all the tumours except for two. A thin capsule could be seen in six cases. Observation of large intraventricular tumours with inhomogeneity on T2-weighted images and flow void is suggestive of CPTs. Checking for signs of a thin capsule, extensive peritumoural oedema and necrosis may be useful when classifying CPTs.

  15. Macrophage polarization in experimental and clinical choroidal neovascularization

    Science.gov (United States)

    Yang, Yu; Liu, Fang; Tang, Miao; Yuan, Miner; Hu, Andina; Zhan, Zongyi; Li, Zijing; Li, Jiaqing; Ding, Xiaoyan; Lu, Lin

    2016-01-01

    Macrophages play an important role in the development of age-related macular degeneration (AMD). In this study, the spatial and temporal changes and the polarization of macrophages in murine laser-induced choroidal neovascularization (CNV) were investigated, and the polarized M1 and M2 biomarkers in the aqueous humors of neovascular AMD (nAMD) patients were studied. Macrophages, the main infiltrating inflammatory cells in CNV lesions, were evidenced by a significant increase in F4/80 mRNA expression and by the infiltration of F4/80+ cells in the lesions and the vicinity of laser-induced CNV. The mRNA expressions of M1-related markers were dramatically upregulated in the early stage, while the M2-related markers were slightly upregulated in the middle stage and sustained until the late stage. The results of immunostaining showed a similar early-but-transient M1 pattern and a delayed-but-sustained M2 pattern in laser-induced CNV. In addition, a higher M2/M1 ratio was found in both the murine models (Arg-1/iNOS and CCL22/CXCL10) and the aqueous humors of nAMD patients (CCL22/CXCL10) than in the controls. Our results suggested that the dynamic patterns of M1 and M2 were different in both the experimental and clinical CNV. The M2 macrophages were predominant and may play a more important role in the development of CNV. PMID:27489096

  16. Evaluation of Subfoveal Choroidal Thickness in Internal Carotid Artery Stenosis

    Science.gov (United States)

    Akçay, Betül İlkay Sezgin; Kardeş, Esra; Maçin, Sultan; Ünlü, Cihan; Özgürhan, Engin Bilge; Maçin, Aydın; Bozkurt, Tahir Kansu; Ergin, Ahmet; Surmeli, Reyhan

    2016-01-01

    Purpose. To evaluate the relationship between internal carotid artery (ICA) stenosis and subfoveal choroidal thickness (SFCT) in the elderly population. Methods. A total of 42 eyes of 21 patients with more than 70% ICA stenosis (Group 1) on one side and less than 70% stenosis (Group 2) on the other side were recruited for this study. ICA stenosis was diagnosed using both the B-mode and Doppler ultrasound. The two groups were compared in terms of the percentage of stenosis, SFCT measurements, intraocular pressure, ocular perfusion pressure, refractive error, and peak systolic velocity. Eyes were examined with the RTVue-100 OCT device by the EDI-OCT technique. Results. The mean age of the patients was 71.9 ± 10.8 years. The mean percentage of ICA stenosis was 74 ± 4.9% in Group 1 and 47.5 ± 7.7% in Group 2. The mean SFCT was 231.9 ± 44.6 μm in Group 1 and 216.2 ± 46.8 μm in Group 2, which was significantly lower (P = 0.028). A statistically significant positive correlation was found between the percentage of internal carotid artery stenosis and SFCT (r = 0896, P = 0.001). Conclusions. Compensatory SFCT increase can be seen in ipsilateral internal carotid artery stenosis greater than 70%. PMID:26989500

  17. Myopic choroidal neovascularisation: current concepts and update on clinical management.

    Science.gov (United States)

    Wong, Tien Y; Ohno-Matsui, Kyoko; Leveziel, Nicolas; Holz, Frank G; Lai, Timothy Y; Yu, Hyeong Gon; Lanzetta, Paolo; Chen, Youxin; Tufail, Adnan

    2015-03-01

    Choroidal neovascularisation (CNV) is a common vision-threatening complication of myopia and pathological myopia. Despite significant advances in understanding the epidemiology, pathogenesis and natural history of myopic CNV, there is no standard definition of myopic CNV and its relationship to axial length and other myopic degenerative changes. Several treatments are available to ophthalmologists, but with the advent of new therapies there is a need for further consensus and clinical management recommendations. Verteporfin photodynamic therapy has been an established treatment for subfoveal myopic CNV for many years, but this treatment does not restore visual acuity and is associated with long-term chorioretinal atrophy. More recently, clinical trials investigating the efficacy and safety of anti-vascular endothelial growth factor agents in patients with myopic CNV have demonstrated substantial visual acuity gains and quality of life increases compared with photodynamic therapy. These enhanced outcomes provide updated evidence-based clinical management guidelines of myopic CNV, and increase the need for a generally accepted definition for myopic CNV. This review critically summarises the latest myopic CNV literature in the context of clinical experience and recommends a myopic CNV treatment algorithm. PMID:24990871

  18. Early detection of choroidal neovascularization in age related macular degeneration

    Directory of Open Access Journals (Sweden)

    Tural Galbinur

    2014-07-01

    Full Text Available Purpose: to identify factors associated with early detection of choroidal neovascularization CNV in clinical practice.Methods: Seventy six AMD patients who had history of CNV in one eye and presented with CNV in the second eye and evaluated for association with visual acuity (VA at time of presentation. Demographics, clinical data and lesion characteristics were retrospectively collected.Results: Better VA was associated with history of CNV in the fellow eye (p<0.0001, adherence to follow-up every four-months (p=0.015, younger age (p=0.03, smaller lesion (p<0.0001, and non-subfoveal localization (p=0.048. VA of the fellow eye did not correlate with VA at presentation with CNV.Conclusion: these data suggest that experience of CNV, regardless of VA, facilitates early diagnosis in the fellow eye. Adherence to follow-up in the routine clinic setting also facilitates early detection of CNV.

  19. Associations of prenatally detected choroid plexus cysts with biochemical risk for congenital disorders

    Directory of Open Access Journals (Sweden)

    Danielius Serapinas

    2014-06-01

    Full Text Available Introduction: C horoid plexus cysts are one of the foetus ultrasonography findings that raise parents’ concerns about their child’s health. Usually cysts are found in an estimated 1% all performed ultrasonographies. Aim of the research: To evaluate the risk of Down syndrome, Edward’s syndrome and neural tube defect when choroid plexus cysts are found. Material and methods : The risks of Down syndrome, Edward’s syndrome and neural tube defect were calculated by using second-trimester biomarkers (a-fetoprotein, human choriongonadotropin, unconjugated estriol for patients with choroid plexus cysts. A control group was selected randomly with calculated risks and without any abnormal ultrasonography findings. These risks were compared between the two groups. Results: Twelve pregnancies with diagnosed choroid plexus cysts were included in this study during the year 2012. Choroid plexus cyst findings during this case/control study have shown that only one case from the test group had progressed to more serious foetal aberrations (Edward’s syndrome; nonetheless, this progression did not influence statistically significant changes in the test and control groups. No statistically significant changes between the risks of disorders according the PRISCA method were observed in the appearance of Down syndrome or neural tube defect.  Conclusions : There is no data that choroid plexus cysts increase the risk of Down syndrome, Edward’s syndrome and neural tube defect.

  20. Subfoveal Choroidal Thickness in 1323 Children Aged 11 to 12 Years and Association With Puberty

    DEFF Research Database (Denmark)

    Li, Xiao Qiang; Jeppesen, Pia; Larsen, Michael;

    2014-01-01

    choroidal thickness was 369 ± 81 μm in girls and 348 ± 72 μm in boys. Longer axial length was associated with a thinner subfoveal choroid (-27.2 [95% confidence interval (CI) -32.7 to -21.7] μm/mm; P < 0.0001), adjusting for age and sex. There was no difference in choroidal thickness between sexes (P = 0.14......) after adjusting for age and axial length. In girls, the choroid was thickest in participants in the more advanced stage of pubertal development (54.2 [95% CI 20.7-87.7] μm for Tanner 4 versus Tanner 1, P = 0.0015) and increased with body height (19.2 [95% CI 10.8-27.5] μm/10 cm, P < 0.0001). There was......PURPOSE: To investigate subfoveal choroidal thickness and ocular- and systemic-associated factors in a population-based cohort of children. METHODS: Cross-sectional, observational study where 1323 healthy 11- and 12-year-old children were examined with enhanced-depth imaging spectral-domain optical...

  1. Simultaneous development of craniopharyngioma and choroid plexus carcinoma in the childhood -a clinical case

    International Nuclear Information System (INIS)

    We present a clinical case of 9 years old girl with concomitant brain tumors - choroid plexus carcinoma and craniopharyngioma diagnosed in 2009. After three operations, cranio-spinal irradiation with boost for the remaining tumor located in left ventricular trigonum to a total dose of 55 Gy and 7 courses chemotherapy, local tumor control was achieved for the choroid plexus carcinoma. Four years following the achievement of local tumor control of the choroid plexus carcinoma, an increase of the tumor formation located in the left side of the pituitary was reported. The diagnosis cystic craniopharyngeoma was found during the surgical operation. With this clinical case we would like to stress on the achieved local tumor control following the complex treatment of carcinoma of the choroid plexus, as well as on the slow growth of simultaneously diagnosed craniopharyngeoma. This case report raises the question of the genetic predisposition of the brain tumors in children, as well as possibility of malignant transformation of craniopharyngeoma following radiotherapy. The differential diagnosis of neuroectodermal brain tumors requires immunohistochemical analysis and if necessary genetic analysis. Key words: Complex treatment. Choroid plexus carcinoma. Craniopharyngioma. Radiotherapy. Malignant transformation. Simultaneity

  2. Choroidal atrophy in a patient with paraneoplastic retinopathy and anti-TRPM1 antibody.

    Science.gov (United States)

    Ueno, Shinji; Ito, Yasuki; Maruko, Ruka; Kondo, Mineo; Terasaki, Hiroko

    2014-01-01

    The purpose of this paper is to report choroidal atrophy in a patient with cancer-associated retinopathy who had autoantibodies against the transient receptor potential cation channel, subfamily M, member 1 (TRPM1). A 69-year-old man visited our clinic in July 2010 with complaints of blurred vision and night blindness in both eyes. The full-field electroretinograms were negative type, indicating ON bipolar cell dysfunction. General physical examination revealed small cell carcinoma of the lung, and Western blot of the patient's serum showed autoantibodies against TRPM1. We diagnosed this patient with cancer-associated retinopathy and retinal ON bipolar dysfunction due to anti-TRPM1 autoantibody. We followed him for more than 2 years from the initial visit and his symptoms have not changed. However, consistent with the choroidal hypopigmentation of the fundus, spectral domain optical coherence tomography showed a decrease in choroidal thickness of about one third over a 2-year follow-up period. We suggest that this case of gradually progressive choroidal atrophy was caused by the autoantibody against TRPM1 directly, because TRPM1 is expressed not only on ON bipolar cells but also on melanocytes. These findings indicate that we should be aware of choroidal thickness in patients with paraneoplastic retinopathy who have retinal ON bipolar dysfunction with the anti-TRPM1 antibody. PMID:24523577

  3. A Choroid Plexus Epithelial Cell-based Model of the Human Blood-Cerebrospinal Fluid Barrier to Study Bacterial Infection from the Basolateral Side.

    Science.gov (United States)

    Dinner, Stefanie; Borkowski, Julia; Stump-Guthier, Carolin; Ishikawa, Hiroshi; Tenenbaum, Tobias; Schroten, Horst; Schwerk, Christian

    2016-01-01

    The epithelial cells of the choroid plexus (CP), located in the ventricular system of the brain, form the blood-cerebrospinal fluid barrier (BCSFB). The BCSFB functions in separating the cerebrospinal fluid (CSF) from the blood and restricting the molecular exchange to a minimum extent. An in vitro model of the BCSFB is based on cells derived from a human choroid plexus papilloma (HIBCPP). HIBCPP cells display typical barrier functions including formation of tight junctions (TJs), development of a transepithelial electrical resistance (TEER), as well as minor permeabilities for macromolecules. There are several pathogens that can enter the central nervous system (CNS) via the BCSFB and subsequently cause severe disease like meningitis. One of these pathogens is Neisseria meningitidis (N. meningitidis), a human-specific bacterium. Employing the HIBCPP cells in an inverted cell culture filter insert system enables to study interactions of pathogens with cells of the BCSFB from the basolateral cell side, which is relevant in vivo. In this article, we describe seeding and culturing of HIBCPP cells on cell culture inserts. Further, infection of the cells with N. meningitidis along with analysis of invaded and adhered bacteria via double immunofluorescence is demonstrated. As the cells of the CP are also involved in other diseases, including neurodegenerative disorders like Alzheimer`s disease and Multiple Sclerosis, as well as during the brain metastasis of tumor cells, the model system can also be applied in other fields of research. It provides the potential to decipher molecular mechanisms and to identify novel therapeutic targets. PMID:27213495

  4. Asymptomatic choroid plexus cysts in the lateral ventricles: an incidental finding on diffusion-weighted MRI

    International Nuclear Information System (INIS)

    We assessed the role of diffusion-weighted imaging (DWI) in the detection of choroid plexus cysts. We reviewed more than 1000 patients who had undergone MRI in a 1-year period. We reviewed echo-planar DWI with b=1000 s/mm2, acquired at 1.0 tesla, for any difference in signal intensity which might indicate choroid plexus cysts. On conventional images, all cystic lesions were isointense with cerebrospinal fluid, and 72 cysts could not be identified. On DWI, 90 rounded high-signal foci were detected in 58 patients; 64 cysts were bilateral. Focal ventricular expansion due to large cysts was observed in nine cases. DWI were found to show choroid plexus cysts undetected within the cerebrospinal fluid on conventional images. (orig.)

  5. Newborn with Prenatally Diagnosed Choroidal Fissure Cyst and Panhypopituitarism and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ritu Chitkara

    2011-12-01

    Full Text Available Little has been reported on fetal diagnosis of choroidal fissure cysts and prediction of the clinical complications that can result. We describe the case of a near-term male infant with prenatally diagnosed choroidal fissure cyst and bilateral clubfeet. His prolonged course in the neonatal intensive care nursery was marked by severe panhypopituitarism, late-onset diabetes insipidus, placement of a cystoperitoneal shunt, and episodes of sepsis. Postnatal genetic evaluation also revealed an interstitial deletion involving most of band 10q26.12 and the proximal half of band 10q26.13. The patient had multiple readmissions for medical and surgical indications and died at 6 months of age. This case represents the severe end of the spectrum of medical complications for children with choroidal fissure cysts. It highlights not only the importance of comprehensive evaluation and multidisciplinary management and counseling in such cases, but also the need for heightened vigilance in these patients.

  6. Simultaneous choroid plexus carcinoma and pilocytic astrocytoma in a pediatric patient.

    Science.gov (United States)

    Karami, Kristophe J; Poulik, Janet; Rabah, Raja; Krass, Joshua; Sood, Sandeep

    2010-01-01

    Simultaneous primary brain tumors in pediatric patients without prior chemotherapy or radiotherapy, phacomatosis, or known familial history are a rare occurrence. The authors report the case of a 4-year-old boy with simultaneous choroid plexus carcinoma and pilocytic astrocytoma with features of oligodendroglioma. Magnetic resonance imaging studies revealed diffuse heterogeneously enhancing left intraventricular and posterior fossa tumors initially believed most consistent with multicentric choroid plexus carcinomas. A multiple staged resection was carried out for each tumor and gross-total resection was achieved. Upon gross inspection intraoperatively as well as postoperative histological analysis, 2 distinct simultaneous tumors were identified: choroid plexus carcinoma and pilocytic astrocytoma. To the authors' knowledge this is the first case report published identifying 2 distinct tumor types with similar radiological appearances in a pediatric patient with no prior history of radiotherapy, chemotherapy, or phacomatosis. PMID:20043745

  7. OB protein binds specifically to the choroid plexus of mice and rats.

    Science.gov (United States)

    Devos, R; Richards, J G; Campfield, L A; Tartaglia, L A; Guisez, Y; van der Heyden, J; Travernier, J; Plaetinck, G; Burn, P

    1996-05-28

    Binding studies were conducted to identify the anatomical location of brain target sites for OB protein, the ob gene product. 125I-labeled recombinant mouse OB protein or alkaline phosphatase-OB fusion proteins were used for in vitro and in vivo binding studies. Coronal brain sections or fresh tissue from lean, obese ob/ob, and obese db/db mice as well as lean and obese Zucker rats were probed to identify potential central OB protein-binding sites. We report here that recombinant OB protein binds specifically to the choroid plexus. The binding of OB protein (either radiolabeled or the alkaline phosphatase-OB fusion protein) and its displacement by unlabeled OB protein was similar in lean, obese ob/ob, and obese db/db mice as well as lean and obese Zucker rats. These findings suggest that OB protein binds with high affinity to a specific receptor in the choroid plexus. After binding to the choroid plexus receptor, OB protein may then be transported across the blood-brain barrier into the cerebrospinal fluid. Alternatively, binding of OB protein to a specific receptor in the choroid plexus may activate afferent neural inputs to the neural network that regulates feeding behavior and energy balance or may result in the clearance or degradation of OB protein. The identification of the choroid plexus as a brain binding site for OB protein will provide the basis for the construction of expression libraries and facilitate the rapid cloning of the choroid plexus OB receptor. PMID:8643634

  8. Choroidal atrophy in a patient with paraneoplastic retinopathy and anti-TRPM1 antibody

    Directory of Open Access Journals (Sweden)

    Ueno S

    2014-02-01

    Full Text Available Shinji Ueno,1 Yasuki Ito,1 Ruka Maruko,1 Mineo Kondo,2 Hiroko Terasaki1 1Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, 2Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan Abstract: The purpose of this paper is to report choroidal atrophy in a patient with cancer-associated retinopathy who had autoantibodies against the transient receptor potential cation channel, subfamily M, member 1 (TRPM1. A 69-year-old man visited our clinic in July 2010 with complaints of blurred vision and night blindness in both eyes. The full-field electroretinograms were negative type, indicating ON bipolar cell dysfunction. General physical examination revealed small cell carcinoma of the lung, and Western blot of the patient's serum showed autoantibodies against TRPM1. We diagnosed this patient with cancer-associated retinopathy and retinal ON bipolar dysfunction due to anti-TRPM1 autoantibody. We followed him for more than 2 years from the initial visit and his symptoms have not changed. However, consistent with the choroidal hypopigmentation of the fundus, spectral domain optical coherence tomography showed a decrease in choroidal thickness of about one third over a 2-year follow-up period. We suggest that this case of gradually progressive choroidal atrophy was caused by the autoantibody against TRPM1 directly, because TRPM1 is expressed not only on ON bipolar cells but also on melanocytes. These findings indicate that we should be aware of choroidal thickness in patients with paraneoplastic retinopathy who have retinal ON bipolar dysfunction with the anti-TRPM1 antibody. Keywords: choroidal thickness, melanocyte, TRPM1, cancer-associated retinopathy, paraneoplastic retinopathy

  9. Vitrectomy for circumscribed choroidal hemangioma with exudative retinal detachment refractory to transpupillary thermotherapy

    Directory of Open Access Journals (Sweden)

    Shukla Dhananjay

    2007-01-01

    Full Text Available We report successful surgical management of a circumscribed choroidal hemangioma with exudative retinal detachment refractory to transpupillary thermotherapy (TTT. A 33-year-old man with symptomatic serous macular detachment in the left eye (Snellen acuity: 20/200 secondary to a paramacular choroidal hemangioma was treated with TTT. The nonresponsive detachment was subsequently managed by vitrectomy, endophotocoagulation and silicon-oil tamponade. It resulted in complete resolution of the tumor and the detachment. Silicon oil was removed at four months. Visual acuity improved to 20/80 by the last follow-up visit at 10 months without any recurrence.

  10. Choroidal thickness in relation to birth parameters in 11- to 12-year-old children

    DEFF Research Database (Denmark)

    Li, Xiao Q; Munkholm, Anja; Larsen, Michael;

    2015-01-01

    PURPOSE: To examine choroidal thickness in a population-based child cohort in relation to birth parameters. METHODS: The Copenhagen Child Cohort 2000 Eye Study examined 1406 children aged 11 to 12 years using enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT), ocular...... weight children (2500-4500 g, n = 1194, mean 361 ± 78 μm), the difference being -37 (CI95 -60 to -15) μm, P = 0.001 after adjusting for age, sex, height, Tanner stage by sex, axial length, anterior chamber depth, and spherical equivalent refractive error. The subfoveal choroid in high birth weight...

  11. Choroid plexus papilloma of the third ventricle: angiography, preoperative embolization, and histology

    Energy Technology Data Exchange (ETDEWEB)

    Do, H.M. [Interventional Neuroradiology, S-047, Department of Radiology, Stanford University Medical Center (United States); Dept. of Radiology, University of Virginia Health Sciences Center, Charlottesville, VA (United States); Marx, W.F. [Dept. of Radiology, University of Virginia Health Sciences Center, Charlottesville, VA (United States); Khanam, H. [Dept. of Pathology, University of Virginia Health Sciences Center, Charlottesville, VA (United States); Jensen, M.E. [Dept. of Radiology, University of Virginia Health Sciences Center, Charlottesville, VA (United States); Dept. of Neurosurgery, University of Virginia Health Sciences Center, Charlottesville, VA (United States)

    2001-06-01

    We report a unique case of choroid plexus papilloma of the third ventricle in an 8-month-old girl in which preoperative embolization played a salient role in management. Initial surgery was aborted due to excessive bleeding. Cerebral angiography demonstrated enlarged posterior choroidal arteries feeding the tumor, and intense, persistent tumor staining. These vessels were effectively embolized to stasis with polyvinyl alcohol particles. The patient underwent a second craniotomy and complete resection of the tumor with minimal blood loss. Postsurgical histology showed postembolization iatrogenic intratumoral necrosis. (orig.)

  12. Ru 106 Brachytherapy for Management of Choroidal Melanoma: Do we Need to Adjust Total dose According to the New NIST Calibration Measurement?

    International Nuclear Information System (INIS)

    To detect the need of adjusting the apical total dose according to the new NIST calibration measurement introduced by BEBIG Isotopen und Medizintechnik GmbH for the treatment of choroidal melanoma. As the total radiation dose should not be individualized depending on errors pf previous calibration but can be applicable if based on a radiosensitivity test that was able to predict the final response of tumor to radiation for each particular patient. Patients and Methods: Twenty patients with choroidal melanomas were treated between November 2002 and July 2004 at Suzanne Mubarak Eye Tumor Centre, National Eye centre Rod-EL Farag, Cairo, Egypt. The prescribed dose was calculated according to the new NIST calibrated dosimetry introduced by BEBIG, but without dose modification by using a conversion factor F(type,z) from the ASMW calibrated measurement to the NIST calibrated measurement that have been calculated depending on the plaque type and the distance z from the inner concave plaque surface along the central axis. For the treatment of choroidal melanoma in this study the apical dose ranged from 9000-10400 c Gy with a mean of 9855± 385. After a follow up period from 12-28 months (median of 19 months) there was a local control rate of 100 % and the three years actuarial disease specific survival was 95% as only one patient died of liver metastases. Fourteen patients had a best corrected pre-treatment visual acuity of better than 6/60 in the affected eye. At the last follow up available, useful visual acuity of >0.5 was preserved in 7 of the patients. Recalculation of the apical total dose (mostly increasing of the total dose) according to the conversion factor F(type,z), suggested by BEBIG after the new NIST calibration measurement, does not seem to have an effect on both local control and survival, in this study

  13. Subretinal AAV2.COMP-Ang1 suppresses choroidal neovascularization and vascular endothelial growth factor in a murine model of age-related macular degeneration.

    Science.gov (United States)

    Lambert, Nathan G; Zhang, Xiaohui; Rai, Ruju R; Uehara, Hironori; Choi, Susie; Carroll, Lara S; Das, Subrata K; Cahoon, Judd M; Kirk, Brian H; Bentley, Blaine M; Ambati, Balamurali K

    2016-04-01

    To assess whether Tie2-mediated vascular stabilization ameliorates neovascular age-related macular degeneration (AMD), we investigated the impact of adeno-associated virus-mediated gene therapy with cartilage oligomeric matrix protein angiopoietin-1 (AAV2.COMP-Ang1) on choroidal neovascularization (CNV), vascular endothelial growth factor (VEGF), and hypoxia-inducible factor (HIF) in a mouse model of the disease. We treated mice with subretinal injections of AAV2.COMP-Ang1 or control (AAV2.AcGFP, AAV2.LacZ, and phosphate-buffered saline). Subretinal AAV2 localization and plasmid protein expression was verified in the retinal pigment epithelium (RPE)/choroid of mice treated with all AAV2 constructs. Laser-assisted simulation of neovascular AMD was performed and followed by quantification of HIF, VEGF, and CNV in each experimental group. We found that AAV2.COMP-Ang1 was associated with a significant reduction in VEGF levels (29-33%, p < 0.01) and CNV volume (60-70%, p < 0.01), without a concomitant decrease in HIF1-α, compared to all controls. We concluded that a) AAV2 is a viable vector for delivering COMP-Ang1 to subretinal tissues, b) subretinal COMP-Ang1 holds promise as a prospective treatment for neovascular AMD, and c) although VEGF suppression in the RPE/choroid may be one mechanism by which AAV2.COMP-Ang1 reduces CNV, this therapeutic effect may be hypoxia-independent. Taken together, these findings suggest that AAV2.COMP-Ang1 has potential to serve as an alternative or complementary option to anti-VEGF agents for the long-term amelioration of neovascular AMD. PMID:26775053

  14. Radiation therapy for ocular choroidal neovascularization (phase I/II study): preliminary report

    International Nuclear Information System (INIS)

    Purpose/Objective: Choroidal neovascularization (CNV) is a major cause of severe loss of visual acuity in some ocular diseases such as age-related macular degeneration (ARMD) and angioid streaks. Laser photocoagulation has been used to treat patients with subfoveal neovascular lesions with well-demarcated boundaries. However, the treatment method is usually associated with a large decrease in visual acuity. Therefore, indications for this treatment are very limited. Recently, some investigators reported the effect of low dose irradiation on the sub retinal neovascular membranes in CNV. We conducted a Phase I/II study to determine the toxicity and efficacy of external photon beam radiotherapy in patients with CNV. Methods and Materials: Between April, 1994 and July, 1995, 36 patients with choroidal neovascularization (34 with ARMD and 2 with angioid streaks) were treated with radiation therapy. Treatment planning was performed using a CT simulator that enables real-time treatment planning from multiple CT slices. The clinical target volume that included the macula and optic disc received a dose of 10 Gy/5 fractions/1 week (first 18 eyes) or 20 Gy/10 fractions/2 weeks (last 18 eyes). All eyes were irradiated with a single lateral 6 MV photon beam, angled 10 degrees posteriorly to exclude the ipsilateral lens and the contralateral eye from the radiation field. The ipsilateral lens was irradiated with less than 10% of the total reference dose. The field size averaged 3.0 x 2.5 cm. Records of the 17 eyes with CNV referred to our hospital in 1993, which satisfied the eligibility criteria for this study, were retrospectively analyzed for comparison. Results: There was no significant acute morbidity. All patients were followed regularly by both ophthalmologists and radiation oncologists. Cataract formation after 1 year of the treatment was observed in one patient who had received a dose of 20 Gy. One patient who had received 20 Gy complained of transient dry-eye sensation

  15. Ruthenium-106 Plaque Therapy for Diffuse Choroidal Hemangioma in Sturge-Weber Syndrome

    Directory of Open Access Journals (Sweden)

    Agnieszka Kubicka-Trząska

    2011-01-01

    Full Text Available Diffuse choroidal hemangiomas associated with Sturge-Weber syndrome (SWS are classically treated with external beam radiotherapy (EBR, but there are a few reports usually of single cases indicating the usefulness of plaque therapy. We present our observations on two cases of diffuse choroidal hemangiomas with exudative retinal detachment associated with SWS treated with Ruthenium-106 plaque therapy. Outcomes included best-corrected visual acuity (BCVA and regression in tumor thickness measured by ultrasonography. The initial BCVA of the affected eyes was counting fingers at 1 meter and light projection. Pretreatment tumors thickness was 3.5 mm and 4.7 mm. In a follow-up period of 18–24 months, significant reduction in thickness of choroidal hemangiomas up to 1.2 mm and 1.4 mm with prompt resolution of exudative retinal detachment was observed. BCVA achieved 20/200 and 20/400, respectively. The findings in this paper indicate that Ruthenium-106 plaque therapy is effective in treatment of diffuse choroidal hemangiomas associated with SWS.

  16. Evaluation of peripapillary choroidal and retinal nerve fiber layer thickness in eyes with tilted optic disc

    Directory of Open Access Journals (Sweden)

    Muammer Ozcımen

    2014-12-01

    Full Text Available Purpose: This study was performed to evaluate the retinal nerve fiber layer (RNFL and peripapillary choroidal thickness in eyes with tilted optic disc in order to identify characteristic RNFL and peripapillary choroid patterns verified by optical coherence tomography (OCT. Methods: Twenty-nine eyes of 29 patients with tilted optic discs were studied with spectral-domain (SD-OCT and compared with age and sex-matched control subjects in a prospective design. The imaging of RNFL was performed using circular scans of a diameter of 3.4 mm around the optic disc using OCT. For measurements of peripapillary choroidal thickness, the standar d protocol for RNFL assessment was performed. Results: SD-OCT indicated significantly lower superotemporal (p<0.001, superonasal (p=0.001, and global (p=0.005 RNFL thicknesses in the tilted disc group than those of the control group. Peripapillary choroid was significantly thicker at the site of the elevated rim of eyes with tilted disc (p<0.001. Conclusion: This study demonstrated a clinical characterization of the main tilted disc morphologies that may be helpful in differentiating a tilted disc from other altered disc morphologies. Further studies are recommended to study the comparison between glaucoma and tilted disc groups.

  17. Effect of intravitreal hyaluronidase on the clearance of tritiated water from the vitreous to the choroid.

    OpenAIRE

    Foulds, W S; Allan, D.; Moseley, H; Kyle, P M

    1985-01-01

    The rate of transfer of intravitreally injected tritiated water from the mid vitreous to the choroid is significantly increased after depolymerization of vitreous hyaluronic acid by injected hyaluronidase. The significance of this finding is discussed in relation to such conditions as retinal detachment and reattachment.

  18. Simultaneous dual wavelength eye-tracked ultrahigh resolution retinal and choroidal optical coherence tomography

    DEFF Research Database (Denmark)

    Unterhuber, A.; Povaay, B.; Müller, André; Jensen, Ole Bjarlin; Duelk, M.; Le, T.; Petersen, Paul Michael; Velez, C.; Esmaeelpour, M.; Andersen, Peter E.; Drexler, W.

    2013-01-01

    We demonstrate an optical coherence tomography device that simultaneously combines different novel ultrabroad bandwidth light sources centered in the 800 and 1060 nm regions, operating at 66 kHz depth scan rate, and a confocal laser scanning ophthalmoscope-based eye tracker to permit motion...... eye segment or eyes with increased choroidal thickness....

  19. Transcriptomal Changes and Functional Annotation of the Developing Nonhuman Primate Choroid Plexus

    Directory of Open Access Journals (Sweden)

    Joakim eEk

    2015-03-01

    Full Text Available The choroid plexuses are small organs that protrude into each brain ventricle producing cerebrospinal fluid that constantly bathes the brain. These organs differentiate early in development just after neural closure at a stage when the brain is little vascularized. In recent years the plexus has been shown to have a much more active role in brain development than previously appreciated thereby it can influence both neurogenesis and neural migration by secreting factors into the CSF. However, much of choroid plexus developmental function is still unclear. Most previous studies on this organ have been undertaken in rodents but translation into humans is not straightforward since they have a different timing of brain maturation processes. We have collected choroid plexus from three fetal gestational ages of a nonhuman primate, the baboon, which has much closer brain development to humans. The transcriptome of the plexuses was determined by next generation sequencing and Ingenuity Pathway Analysis software was used to annotate functions and enrichment of pathways of changes in the transcriptome. The number of unique transcripts decreased with development and the majority of differentially expressed transcripts were down-regulated through development suggesting a more complex and active plexus earlier in fetal development. The functional annotation indicated changes across widespread biological functions in plexus development. In particular we find age-dependent regulation of genes associated with annotation categories: Gene Expression, Development of Cardiovascular System, Nervous System Development and Molecular Transport. Our observations support the idea that the choroid plexus has roles in shaping brain development.

  20. Transcriptomal changes and functional annotation of the developing non-human primate choroid plexus.

    Science.gov (United States)

    Ek, C Joakim; Nathanielsz, Peter; Li, Cun; Mallard, Carina

    2015-01-01

    The choroid plexuses are small organs that protrude into each brain ventricle producing cerebrospinal fluid that constantly bathes the brain. These organs differentiate early in development just after neural closure at a stage when the brain is little vascularized. In recent years the plexus has been shown to have a much more active role in brain development than previously appreciated thereby it can influence both neurogenesis and neural migration by secreting factors into the CSF. However, much of choroid plexus developmental function is still unclear. Most previous studies on this organ have been undertaken in rodents but translation into humans is not straightforward since they have a different timing of brain maturation processes. We have collected choroid plexus from three fetal gestational ages of a non-human primate, the baboon, which has much closer brain development to humans. The transcriptome of the plexuses was determined by next generation sequencing and Ingenuity Pathway Analysis software was used to annotate functions and enrichment of pathways of changes in the transcriptome. The number of unique transcripts decreased with development and the majority of differentially expressed transcripts were down-regulated through development suggesting a more complex and active plexus earlier in fetal development. The functional annotation indicated changes across widespread biological functions in plexus development. In particular we find age-dependent regulation of genes associated with annotation categories: Gene Expression, Development of Cardiovascular System, Nervous System Development and Molecular Transport. Our observations support the idea that the choroid plexus has roles in shaping brain development. PMID:25814924

  1. Retinal vessel caliber, choroidal thickness and ocular pulse amplitude measurements in essential thrombocythemia

    Directory of Open Access Journals (Sweden)

    Gökhan Pekel

    2016-01-01

    Conclusions: Our results indicate that choroidal thickness and pulsatile blood flow are not significantly affected in ET and under high blood platelet counts. Retinal arteriolar and venular calibers are thinner in ET when compared to age.sex matched healthy controls.

  2. Grossly calcified choroid plexus concealing foramen of Monro meningiomas as an unusual cause of obstructive hydrocephalus.

    Science.gov (United States)

    Kawaguchi, Tomohiro; Fujimura, Miki; Tominaga, Teiji

    2016-01-01

    Various intraventricular tumors can present with calcifications; however, the choroid plexus can also have physiological calcifications. This is the first case report of meningiomas located at the bilateral foramen of Monro (FOM), concealed by a grossly calcified choroid plexus, presenting with obstructive hydrocephalus. A 60-year-old woman with disturbed consciousness was admitted by ambulance. Head computed tomography revealed significantly high-density lesions that smoothly extended from the choroid plexus of the lateral ventricles to the third ventricle. They occupied both sides of the FOM, resulting in obstructive hydrocephalus. The diagnostic endoscopic biopsy was performed using a flexible neuroendoscopic system, and an egg shell-like grossly calcified choroid plexus was found to smoothly extend toward the FOM. Resection was not selected because the calcified lesions had tightly adhered to the veins and fornix; therefore, the patient underwent ventriculo-peritoneal shunting. The lesions were histologically identified as psammomatous meningiomas with low proliferation potential (the Ki-67 labeling index was lower than 1%). She was discharged 10 days after surgery without neurological deficits. As calcifications can have tumoral and nontumoral origins, we considered neuroendoscopic exploration to be essential in order to achieve an accurate diagnosis and select optimal management. PMID:26889294

  3. Novel low-kVp beamlet system for choroidal melanoma

    International Nuclear Information System (INIS)

    Treatment of choroidal melanoma with radiation often involves placement of customized brachytherapy eye-plaques. However, the dosimetric properties inherent in source-based radiotherapy preclude facile dose optimization to critical ocular structures. Consequently, we have constructed a novel system for utilizing small beam low-energy radiation delivery, the Beamlet Low-kVp X-ray, or 'BLOKX' system. This technique relies on an isocentric rotational approach to deliver dose to target volumes within the eye, while potentially sparing normal structures. Monte Carlo N-Particle (MCNP) transport code version 5.0(14) was used to simulate photon interaction with normal and tumor tissues within modeled right eye phantoms. Five modeled dome-shaped tumors with a diameter and apical height of 8 mm and 6 mm, respectively, were simulated distinct positions with respect to the macula iteratively. A single fixed 9 × 9 mm2 beamlet, and a comparison COMS protocol plaque containing eight I-125 seeds (apparent activity of 8 mCi) placed on the scleral surface of the eye adjacent to the tumor, were utilized to determine dosimetric parameters at tumor and adjacent tissues. After MCNP simulation, comparison of dose distribution at each of the 5 tumor positions for each modality (BLOKX vs. eye-plaque) was performed. Tumor-base doses ranged from 87.1–102.8 Gy for the BLOKX procedure, and from 335.3–338.6 Gy for the eye-plaque procedure. A reduction of dose of at least 69% to tumor base was noted when using the BLOKX. The BLOKX technique showed a significant reduction of dose, 89.8%, to the macula compared to the episcleral plaque. A minimum 71.0 % decrease in dose to the optic nerve occurred when the BLOKX was used. The BLOKX technique allows more favorable dose distribution in comparison to standard COMS brachytherapy, as simulated using a Monte Carlo iterative mathematical modeling. Future series to determine clinical utility of such an approach are warranted

  4. Choroid Plexus Papilloma of the Fourth Ventricle Developing Postoperative Intracranial and Rectal Hemorrhage Three Times: A Case Report

    Institute of Scientific and Technical Information of China (English)

    Heng-zhu ZHANG; Lei SHE; Lin YANG; Xian ZHANG; Lun DONG; Xiao-dong WANG; Lin-hai SHEN; Jian LI

    2010-01-01

    @@ Introduction Choroid plexus papilloma (CPP) is a relatively rare, slow-growing benign tumor (WHO level Ⅰ). Recently, an adult patient with fourth ventricle choroid plexus papilloma received surgery via a suboc-cipitai midline approach in our hospital. It has been rare in clini-cal practice to see postoperative hemorrhage occurring in the same patient 3 times. The causes of the hemorrhage were analyzed based on literature regarding postoperative hemorrhage in choroid plexus papilloma and in intracranial tumors. The case involved in our study is described and detailed in the following.

  5. Worsening angle closure glaucoma and choroidal detachments subsequent to closure of a carotid cavernous fistula

    Directory of Open Access Journals (Sweden)

    Thinda Sumeer

    2012-07-01

    Full Text Available Abstract Background Carotid cavernous fistulas are abnormal communications between the cavernous sinus and the external or internal carotid arteries. Although rare, closure of carotid cavernous fistulas can lead to immediate ocular complications. To our knowledge, our case represents the first report of worsening angle closure glaucoma and choroidal detachments over an extended period of two months subsequent to closure of a carotid cavernous fistula. Case presentation A 70-year-old female with a history of primary angle closure glaucoma presented with 4 mm of proptosis, resistance to retropulsion, tortuous corkscrew blood vessels and an orbital bruit of the right eye. Diagnostic cerebral angiogram showed a small indirect Barrow type D right carotid cavernous fistula. Transarterial embolization was planned but repeat cerebral angiography prior to the procedure demonstrated spontaneous partial closure of the carotid cavernous fistula and the procedure was aborted. One month later, our patient was noted to have worsening vision and choroidal detachments of the right eye. She declined further testing and was thus started on self-administered manual carotid jugular compressions. One month later, she developed progressive worsening of her choroidal detachments and angle closure. She eventually opted for surgical intervention but repeat cerebral angiography showed significant thrombosis of the carotid cavernous fistula and no intervention was warranted. Examination two months later showed complete resolution of the choroidal detachments and open angles of both eyes. Conclusions Our patient demonstrated worsening angle closure glaucoma and choroidal detachments after spontaneous closure of her carotid cavernous fistula had been noted. Ocular complications, including acute angle closure, have been reported to occur immediately after closure of carotid cavernous fistulas, but not over months as in our patient. It is imperative that individuals who have

  6. The effect of intravitreal bevacizumab and transpupillary thermotherapy on choroidal metastases and literature review

    Directory of Open Access Journals (Sweden)

    Chun-Ju Lin

    2015-01-01

    Full Text Available Aims : To represent the effects of transpupillary thermotherapy (TTT and intravitreal bevacizumab on choroidal metastases and review the literature. Settings and Design : A retrospective, interventional, noncomparative case series. Materials and Methods : A retrospective, interventional, noncomparative case series of five eyes in three patients with choroidal metastases was conducted. Fundus findings of choroidal metastases were divided into two types: Solitary or diffuse type. The size of the tumor was termed small (15 mm diameter. All eyes received one session of TTT followed by 3 weekly intravitreal bevacizumab injections as an adjuvant therapy. The parameters of treatment for TTT were 1.2-3 mm spot size, 150-300 mW, 60 s with the whole lesion covered confluently. The changes in preoperative and postoperative best-corrected visual acuity (BCVA were recorded. Serial color fundus photography and optical coherent tomography were performed to measure the treatment efficacy. Results : All eight choroidal metastases were solitary type. The size of six tumors was small, the size of one tumor was medium, and the size of one tumor was large. All five eyes of the three patients had improvement of BCVA after treatment. Fundus photos revealed tumor shrinkage and the mean shrinkage percentage was 61.27 ± 21.71%. Optical coherence tomography revealed complete resolution of serous retinal detachment. There was no recurrence after 6 months follow-up. Conclusions : TTT combined with intravitreal bevacizumab injections brought about beneficial effects in reducing tumor size and improving vision in all five eyes of the three patients. Despite the retrospective nature of our study, the absence of control group and the size limitation that, of course, limit the statistical power, TTT combined with intravitreal bevacizumab seems to be efficient in providing another cost-reducing and time-saving treatment option for patients with choroidal metastases. The

  7. Pattern of presentation of idiopathic polypoidal choroidal vasculopathy in Ibadan, Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Oluleye TS

    2013-07-01

    Full Text Available TS Oluleye, Y Babalola Retina and Vitreous Unit, Department of Ophthalmology, University of Ibadan and University College Hospital, Ibadan, Nigeria Background: Idiopathic polypoidal choroidal vasculopathy is an abnormal choroidal vascular pathology similar to age-related macular degeneration. It may present with sudden visual loss from hemorrhagic retinal pigment epithelial detachment and breakthrough vitreous hemorrhage or with chronic recurrent episodes. The condition is not uncommon in the retina clinic at the University College Hospital, Ibadan, Sub-Saharan Africa. This study presents the pattern of presentation in Ibadan. Methods: We review all cases of idiopathic polypoidal choroidal vasculopathy seen from 2007 to 2012 in the retina clinic at the University College Hospital, Ibadan, to determine the major pattern of presentations, available treatment modalities, and visual outcomes. Results: Ten cases were seen during the study period. Their mean age was 58 years, with a male to female ratio of 1:4. The most common presenting complaint was sudden visual loss. Major examination findings were retinal pigment epithelial detachment, orange subretinal lesions, and breakthrough vitreous hemorrhage. The modalities of treatment available included vitrectomy to clear vitreous hemorrhage. Intravitreal bevacizumab reduced the height of the pigment epithelial detachment and cleared vitreous hemorrhage. Thermal laser was applied for extrafoveal lesions. Two patients with subfoveal lesions were referred abroad for photodynamic therapy. Visual outcome showed significant improvement in vitrectomized patients who presented with vitreous hemorrhage. Presenting vision of hand motion and light perception improved to vision ranging from counting fingers to 6/12 after vitrectomy. Conclusion: Idiopathic polypoidal choroidal vasculopathy may not be uncommon in Sub-Saharan Africa. A high index of suspicion is warranted in the diagnosis so as to provide timely

  8. A physical and expression map of the D17S1810-D17S1353 region spanning the central areolar choroidal dystrophy locus.

    Science.gov (United States)

    Lichanska, A M; McGibbon, D; Silvestri, G; Hughes, A E

    2001-01-01

    Central areolar choroidal dystrophy (CACD) causes bilateral irreversible central visual loss in the 5th to 7th decades. The authors previously described a large pedigree with the disorder, which showed linkage to chromosome 17p13.2-->p13.1 between microsatellite markers D17S1353 and D17S1810. 17p13 is very rich in genes that cause retinal diseases. We have now constructed a detailed and ordered physical map of the critical CACD region which spans up to 2.4 Mb. The new transcript map contains thirteen genes and seven expressed sequence tags (ESTs) that are eye-expressed, and therefore are positional candidates. Several of these have been screened, but no disease-causing mutations were found in CACD patients. PMID:11474177

  9. Enhanced depth imaging optical coherence tomography and fundus autofluorescence findings in bilateral choroidal osteoma: a case report

    International Nuclear Information System (INIS)

    The authors present enhanced depth imaging optical coherence tomography (EDI OCT) and fundus autofluorescence (FAF) characteristics of a patient with bilateral choroidal osteoma and try to make a correlation between two imaging techniques. Two eyes of a patient with choroidal osteoma underwent complete ophthalmic examination. Enhanced depth imaging optical coherence tomography revealed a cage-like pattern, which corresponded to the calcified region of the tumor. Fundus autofluorescence imaging of the same area showed slight hyperautofluorescence. Three different reflectivity patterns in the decalcified area were defined. In the areas of subretinal fluid, outer segment elongations similar to central serous chorioretinopathy were observed. Hyperautofluorescent spots were evident in fundus autofluorescence in the same area. Calcified and decalcified portions of choroidal osteoma as well as the atrophy of choriocapillaris demonstrated different patterns with enhanced depth imaging and fundus autofluorescence imaging. Both techniques were found to be beneficial in the diagnosis and follow-up of choroidal osteoma. (author)

  10. Combination of photodynamic therapy with intravitreal bevacizumab for post-peribulbar anesthesia (penetrating trauma)-persistent choroidal neovascular membrane

    OpenAIRE

    Shah Nikunj; Shah Urmi

    2008-01-01

    We report a case of a choroidal neovascular membrane (CNVM) following ocular penetration during peribulbar anesthesia in a 55- year-old male patient. A combination of photodynamic therapy with intravitreal bevacizumab led to resolution of the persistent CNVM.

  11. Enhanced depth imaging optical coherence tomography and fundus autofluorescence findings in bilateral choroidal osteoma: a case report

    Directory of Open Access Journals (Sweden)

    Muhammet Kazim Erol

    2013-06-01

    Full Text Available The authors present enhanced depth imaging optical coherence tomography (EDI OCT and fundus autofluorescence (FAF characteristics of a patient with bilateral choroidal osteoma and try to make a correlation between two imaging techniques. Two eyes of a patient with choroidal osteoma underwent complete ophthalmic examination. Enhanced depth imaging optical coherence tomography revealed a cage-like pattern, which corresponded to the calcified region of the tumor. Fundus autofluorescence imaging of the same area showed slight hyperautofluorescence. Three different reflectivity patterns in the decalcified area were defined. In the areas of subretinal fluid, outer segment elongations similar to central serous chorioretinopathy were observed. Hyperautofluorescent spots were evident in fundus autofluorescence in the same area. Calcified and decalcified portions of choroidal osteoma as well as the atrophy of choriocapillaris demonstrated different patterns with enhanced depth imaging and fundus autofluorescence imaging. Both techniques were found to be beneficial in the diagnosis and follow-up of choroidal osteoma.

  12. Enhanced depth imaging optical coherence tomography and fundus autofluorescence findings in bilateral choroidal osteoma: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Erol, Muhammet Kazim; Coban, Deniz Turgut; Ceran, Basak Bostanci; Bulut, Mehmet, E-mail: muhammetkazimerol@gmail.com [Kazim Erol. Antalya Training and Research Hospital, Ophthalmology Department, Antalya (Turkey)

    2013-11-01

    The authors present enhanced depth imaging optical coherence tomography (EDI OCT) and fundus autofluorescence (FAF) characteristics of a patient with bilateral choroidal osteoma and try to make a correlation between two imaging techniques. Two eyes of a patient with choroidal osteoma underwent complete ophthalmic examination. Enhanced depth imaging optical coherence tomography revealed a cage-like pattern, which corresponded to the calcified region of the tumor. Fundus autofluorescence imaging of the same area showed slight hyperautofluorescence. Three different reflectivity patterns in the decalcified area were defined. In the areas of subretinal fluid, outer segment elongations similar to central serous chorioretinopathy were observed. Hyperautofluorescent spots were evident in fundus autofluorescence in the same area. Calcified and decalcified portions of choroidal osteoma as well as the atrophy of choriocapillaris demonstrated different patterns with enhanced depth imaging and fundus autofluorescence imaging. Both techniques were found to be beneficial in the diagnosis and follow-up of choroidal osteoma. (author)

  13. Transport of thyroid hormones via the choroid plexus into the brain: the roles of transthyretin and thyroid hormone transmembrane transporters

    OpenAIRE

    Samantha J Richardson; Roshen C. Wijayagunaratne; D'Souza, Damian G.; Darras, Veerle M.; Van Herck, Stijn L. J.

    2015-01-01

    Thyroid hormones are key players in regulating brain development. Thus, transfer of appropriate quantities of thyroid hormones from the blood into the brain at specific stages of development is critical. The choroid plexus forms the blood-cerebrospinal fluid barrier. In reptiles, birds and mammals, the main protein synthesized and secreted by the choroid plexus is a thyroid hormone distributor protein: transthyretin. This transthyretin is secreted into the cerebrospinal fluid and moves thyroi...

  14. Iodine 125-lysergic acid diethylamide binds to a novel serotonergic site on rat choroid plexus epithelial cells

    International Nuclear Information System (INIS)

    125I-Lysergic acid diethylamide (125I-LSD) binds with high affinity to serotonergic sites on rat choroid plexus. These sites were localized to choroid plexus epithelial cells by use of a novel high resolution stripping film technique for light microscopic autoradiography. In membrane preparations from rat choroid plexus, the serotonergic site density was 3100 fmol/mg of protein, which is 10-fold higher than the density of any other serotonergic site in brain homogenates. The choroid plexus site exhibits a novel pharmacology that does not match the properties of 5-hydroxytryptamine-1a (5-HT1a), 5-HT1b, or 5-HT2 serotonergic sites. 125I-LSD binding to the choroid plexus site is potently inhibited by mianserin, serotonin, and (+)-LSD. Other serotonergic, dopaminergic, and adrenergic agonists and antagonists exhibit moderate to weak affinities for this site. The rat choroid plexus 125I-LSD binding site appears to represent a new type of serotonergic site which is located on non-neuronal cells in this tissue

  15. Role of wide-field autofluorescence imaging and scanning laser ophthalmoscopy in differentiation of choroidal pigmented lesions

    Institute of Scientific and Technical Information of China (English)

    Lukas; Reznicek; Carmen; Stumpf; Florian; Seidensticker; Anselm; Kampik; Aljoscha; S; Neubauer; Marcus; Kernt

    2014-01-01

    ·AIM:Toevaluatethe diagnostic properties of wide-field fundus autofluorescence(FAF) scanning laser ophthalmoscope(SLO) imaging for differentiating choroidal pigmented lesions.·METHODS: A consecutive series of 139 patients were included, 101 had established choroidal melanoma with13 untreated lesions and 98 treated with radiotherapy.Thirty-eight had choroidal nevi. All patients underwent a full ophthalmological examination, undilated wide-field imaging, FAF and standardized US examination. FAF images and imaging characteristics from SLO were correlated with the structural findings in the two patient groups.·RESULTS: Mean FAF intensity of melanomas was significantly lower than the FAF of choroidal nevi. Only 1out of 38 included eyes with nevi touched the optic disc compared to 31 out of 101 eyes with melanomas. In 18 out of 101 melanomas subretinal fluid was seen at the pigmented lesion compared to none seen in eyes with confirmed choroidal nevi. In "green laser separation", a trend towards more mixed FAF appearance of melanomas compared to nevi was observed. The mean maximal and minimal transverse and longitudinal diameters of melanomas were significantly higher than those of nevi.·CONCLUSION: Wide-field SLO and FAF imaging may be an appropriate non-invasive diagnostic screening tool to differentiate benign from malign pigmented choroidal lesions.

  16. 脑脉络膜裂MRI解剖研究及脉络膜裂囊肿影像分析%MRI anatomic study of choroidal fissure and imaging analysis of choroidal fissure cyst of brain

    Institute of Scientific and Technical Information of China (English)

    邹子仪; 高振华; 胡晓书

    2011-01-01

    Objective To study MRI anatomic characteristics of choroidal fissure of brain in vivo and the clinical significance and CT and MRI findings of choroidal fissure cyst.Methods MR images of choroidal fissures in 90 normal brains aged between 20 and 50 were retrospectively analyzed, combining with the anatomical observation of one cadaveric head.At the same time, MRI findings of 20 patients with choroidal fissure cyst in brain were observed.Results Gross dissection showed C- shaped choroid fissure of brain accompanied with lateral ventricle.Choroid fissures could be clearly shown on MRI, demonstrating the linear fissure full of cerebrospinal fluid and nearly the same width in adult before 50 years old.Choroid fissure cyst was displayed as round or oval foci of cerebrospinal fluid- like density or signal intensity in choroid fissure on CT or MR imaging.Conclusion The understanding of the anatomical characteristics of brain choroid fissure and normal MRI findings may be very significant for the diagnosis of choroidal fissure cyst.%目的 探讨脑脉络膜裂的MRI解剖学特点及脉络膜裂囊肿的CT和MRI表现.方法 结合1例颅脑标本的解剖观察,分析90例20~50岁正常脑脉络膜裂的MRI表现并测量其宽度,同时分析20例脑脉络膜裂囊肿的CT和MRI表现.结果 经颅脑标本解剖观察脑脉络膜裂呈"C"形裂隙,深处由室管膜封闭,侧脑室内的脉络丛附着于此裂隙并与之走行一致.脉络膜裂在MRI上为含脑脊液的线状裂隙,50岁前成人裂隙的宽度相差不大.脑脉络膜裂囊肿CT和MRI表现为脑脉络膜裂内类圆形或椭圆形的脑脊液密度或信号.结论 了解脑脉络膜裂的解剖学特征及其正常MRI表现,对于脉络膜裂囊肿诊断具有重要意义.

  17. Optical Coherence Tomography Angiography Of Pathological Myopia Sourced and Idiopathic Choroidal Neovascularization With Follow-Up.

    Science.gov (United States)

    Liu, Bing; Bao, Li; Zhang, Junjun

    2016-04-01

    To observe optical coherence tomography angiography (OCTA) images during follow-up of choroidal neovascularization (CNV) caused by pathological myopia (PM) or idiopathy and discuss OCTA's clinical applicationsPatients with CNV caused by PM or idiopathic CNV (ICNV) were recruited prospectively from the Department of Ophthalmology, West China Hospital from March 2015 to June 2015. Intravitreal injections of Ranibizumab were conducted on all patients and repeated treatments were performed based on examinations of follow-up. Patients received OCTA the first week after injection, together with measurements of best-corrected visual acuity (BCVA) and central macular thickness (CMT). Subsequent follow-up was done once a month.About 10 eyes of 10 patients were included in this study and mean age was (46.20 ± 10.15) years old. Around 6 (60%) were females and the other 4 (40%) were males and 5 were diagnosed with PM and 5 were ICNV. Mean follow-up was (7.82 ± 2.47) weeks. Except 4 (40%) patients got only 1 injection, 5 (50%) received two injections, and 1 (10%) patient got 4 (once every two weeks) due to his treatment-resistant lesion. Endpoint date of this study was on 25th June, 2015. Mean baseline BCVA was (0.81 ± 0.45) logarithm of minimal angle resolution (logMAR) and increased significantly to (0.50 ± 0.40) at last follow-up (P = 0.005). Average CMT of baseline was (276.90 ± 69.73) um and decreased to (249.70 ± 53.37) um at final follow-up with the statistical significance (P = 0.008). OCTA demonstrated details of reduction of CNV size and vessel density simultaneously.OCTA could demonstrate the valid CNV form having advantages of rapid, noninvasive and repeatable. Combination of OCTA and other examinations had a promising future of clinical application on ocular neovascularization diseases. Further studies with larger sample size and longer follow-up are necessary and more advanced OCTA is being expected. PMID:27057880

  18. Progression of choroidal metastasis of ovarian serous cystoadenocarcinoma after intravitreal bevacizumab treatment

    Directory of Open Access Journals (Sweden)

    Victor E. Reviglio

    2013-02-01

    Full Text Available A 57-year-old woman presented to her ophthalmologist because of rapid deterioration in vision. Dilated funduscopic examination of the right eye showed an elevated, yellow-orange choroidal mass temporal to the fovea; a complete retinal detachment was present in the left eye. The patient was referred to an oncologist. Computerized tomography of the brain, thorax, abdomen, and pelvis were obtained. They revealed an 11-mm mass in the right parietal lobe, a 30-mm mass in the left temporal lobe, 23-mm mass in the right kidney, and multiple nodules in both lungs. Supported by published experience with intravitreal bevacizumab for choroidal metastasis, the patient was injected into the vitreous through the pars plana of the left eye. The tumor mass did not show signs of regression and the visual acuity was unchanged. The patient suffered from end-state complications tumor metastasis and expired one month after the invitreal injection.

  19. Incidence of calcification in the pineal gland, habenular commissure and choroid plexus of the lateral ventricle

    Energy Technology Data Exchange (ETDEWEB)

    Yamagami, Tatsuhito; Ishikawa, Masatsune; Miyake, Hidenori; Aoki, Michio; Takeuchi, Juji

    1984-04-01

    CT scans of 3,000 consecutive normal persons were examined to verify the incidence of calcification in the pineal body, the habenular commissure, and the choroid plexus of the lateral ventricle. In people over 10 years old, pineal calcification was found in 83% (male 83%, female 81%), habenular calcification in 18% (male 22%, female 60%). In people over 30 years of age, pineal calcification was found in 86%, habenular calcification in 20%, and choroid plexus calcification in 69%. There was a preponderance of male cases in almost all decades. The size and shape of the calcification in the pineal region were examined in 29 pineal-region tumors and other germinoma cases. There were no specific differences in calcification between normal persons and the pineal region tumor cases. However, there was a tendency for the pineal body calcification in the pineal teratoma to deviate unilaterally.

  20. Choroidal metastases in testicular choriocarcinoma, successful treatment with chemo- and radiotherapy: a case report

    Directory of Open Access Journals (Sweden)

    Guber Ivo

    2011-12-01

    Full Text Available Abstract Background Choriocarcinoma is a very rare cause of ocular metastasis. Only 18 male patients have been reported on, 4 of whom survived, but with significant loss of vision. Case presentation A 26-year-old Caucasian man, suffering from testicular choriocarcinoma with pulmonary, cerebral, renal, hepatic and osseous metastases, underwent left radical orchiectomy. While being treated with chemotherapy, he presented with loss of vision in the left eye. Ophthalmoscopy revealed bilateral non-pigmented, hemorrhagic choroidal tumours, compatible with secondary lesions. Continued chemotherapy and stereotactic radiotherapy of the skull and spine lead to full remission with excellent vision, after more than 4 years of follow up. Conclusion Testicular choriocarcinoma is an exceptional cause of choroidal metastasis, potentially asymptomatic and with specific clinical features. Radiotherapy can complement radical orchiectomy and chemotherapy, to achieve full remission and maintain good vision.

  1. Photodynamic Therapy for Diffuse Choroidal Hemangioma in Sturge-Weber Syndrome

    Directory of Open Access Journals (Sweden)

    Sílvia Monteiro

    2014-01-01

    Full Text Available Purpose. To report the treatment outcome of photodynamic therapy with verteporfin (PDT for exudative retinal detachment (RD associated with diffuse choroidal hemangioma in Sturge-Weber syndrome (SWS. Methods. An interventional case report of a 10-year-old girl with SWS who developed an exudative RD (visual acuity hand motions that was treated with PDT. She was treated with a first session of multispot PDT. Posteriorly, a choroidotomy for drainage of subretinal fluid was created, combined with an intravitreal injection of gas (SF6 and cryoapplication. Finally, a second session of PDT was applied. Results. Subretinal fluid resolved over a period of one year and visual acuity increased to 20/125. Conclusions. PDT is an effective therapeutic option for exudative RD associated with diffuse choroidal hemangioma.

  2. Unilateral optic nerve head and choroidal metastases from a bronchial carcinoma.

    Science.gov (United States)

    Hayreh, S S; Blodi, F C; Silbermann, N N; Summers, T B; Potter, P H

    1982-01-01

    A 61-year-old man presented with uniocular gradually progressive visual loss, pain in the eye, visual activity of 6/60, markedly constricted visual fields, optic disc edema, retinal pigment epithelial disturbance at the posterior pole, and markedly delayed filling of the choroid on angiography, with a normal fellow eye. He had suffered from recurrent seizures for 15 years, with some evidence of cortical demyelination. Erythrocyte sedimentation rate was elevated. About 5 months after the onset of visual disturbance, evidence of bronchial carcinoma became apparent and he died 6 weeks later. The etiology of his ocular lesions was established only by histopathological evidence of metastases into the optic nerve head and the choroid. Diagnostic problems presented by the ocular findings are discussed. PMID:7145334

  3. Analysis of the effects of sex hormone background on the rat choroid plexus transcriptome by cDNA microarrays.

    Directory of Open Access Journals (Sweden)

    Telma Quintela

    Full Text Available The choroid plexus (CP are highly vascularized branched structures that protrude into the ventricles of the brain, and form a unique interface between the blood and the cerebrospinal fluid (CSF, the blood-CSF barrier, that are the main site of production and secretion of CSF. Sex hormones are widely recognized as neuroprotective agents against several neurodegenerative diseases, and the presence of sex hormones cognate receptors suggest that it may be a target for these hormones. In an effort to provide further insight into the neuroprotective mechanisms triggered by sex hormones we analyzed gene expression differences in the CP of female and male rats subjected to gonadectomy, using microarray technology. In gonadectomized female and male animals, 3045 genes were differentially expressed by 1.5-fold change, compared to sham controls. Analysis of the CP transcriptome showed that the top-five pathways significantly regulated by the sex hormone background are olfactory transduction, taste transduction, metabolism, steroid hormone biosynthesis and circadian rhythm pathways. These results represent the first overview of global expression changes in CP of female and male rats induced by gonadectomy and suggest that sex hormones are implicated in pathways with central roles in CP functions and CSF homeostasis.

  4. Profile of serpiginous choroiditis in a tertiary eye care centre in eastern India

    Directory of Open Access Journals (Sweden)

    Kumar Saurabh

    2013-01-01

    Full Text Available Purpose: To study the clinical profile of serpiginous choroiditis in eastern India. Materials and Methods: Ninety-one eyes of 54 patients with serpiginous choroiditis presenting to a tertiary care centre in eastern India between January 2006 and December 2010 were included in the study. Clinical presentation, treatment given, and visual outcome of the eyes were studied. Results: Thirty-five (64.8% patients were male and 19 (35.2% were female in the age group of 13-62 years (mean age: 34.1 μ 18.7 years. Blurring of vision (71; 78% and floaters (36; 39.5% were commonest symptoms. In 75 (82.4% eyes, choroiditis started from optic nerve head and spreading centrifugally. Overall, 38 (41.75% eyes had macular involvement at first visit. Mantoux test reading was 10 mm or more (Group A in 12 (22.22% patients and less than 10 mm (Group B in 42 (77.77% patients. Difference between Groups A and B in macular involvement at first visit (10; 50% vs. 28; 39.4% and rate of recurrence (3; 15% vs. 14; 19.7% was not statistically significant (P = 0.37 and 0.68. Oral steroid (51; 94.4% was the commonest mode of treatment. Fifty-one (56% eyes had two lines or more improvement in vision. Conclusions: The present study details the clinical presentation, treatment, and visual outcome of serpiginous choroiditis. Mantoux test reading does not affect the clinical presentation or the treatment outcome in these eyes.

  5. Preoperative and early postoperative magnetic resonance imaging in two cases of childhood choroid plexus carcinoma

    International Nuclear Information System (INIS)

    We present and illustrate the MRI appearances of two children with choroid plexus carcinoma. The MRI characteristics of these rare tumours are reviewed. Since total surgical resection is a significant prognostic factor, early postoperative MRI was performed in both cases to ensure surgical clearance. In one case a complete resection was documented and this patient remains well at short-term follow-up. Residual tumour was noted in the second case, but despite ''second look'' surgery there was subsequent local relapse. (orig.)

  6. Analysis of Normal Peripapillary Choroidal Thickness via Spectral Domain Optical Coherence Tomography

    OpenAIRE

    Ho, Joseph; Branchini, Lauren; Regatieri, Caio; Krishnan, Chandrasekharan; Fujimoto, James G.; Jay S Duker

    2011-01-01

    Purpose To analyze the normal peripapillary choroidal thickness utilizing a commercial spectral domain optical coherence tomography (OCT) device and determine the intergrader reproducibility of this method. Design Retrospective, noncomparative, noninterventional case series. Participants Thirty-six eyes of 36 normal patients seen at the New England Eye Center between April and September 2010. Methods All patients underwent high-definition scanning with the Cirrus HD-OCT. ...

  7. Choroidal Thickness in Patients with Mild Cognitive Impairment and Alzheimer's Type Dementia

    Science.gov (United States)

    Bulut, Mehmet; Yaman, Aylin; Erol, Muhammet Kazim; Kurtuluş, Fatma; Toslak, Devrim; Doğan, Berna; Turgut Çoban, Deniz; Kaya Başar, Ebru

    2016-01-01

    Aim. To asses both choroidal thickness differences among Alzheimer's type dementia (ATD) patients, mild cognitive impairment (MCI) patients, and healthy control (C) subjects and choroidal thickness relationships with cognitive performance. Methods. A total of 246 eyes of 123 people (41 ATD, 38 MCI, and 44 healthy C subjects) were included in this study. Complete ophthalmological and neurological examination was performed in all subjects. Choroidal thicknesses (CT) were measured at seven locations: the fovea, 500-1500-3000 μm temporal and 500-1500-3000 μm nasal to the fovea by enhanced depth imaging optical coherence tomography (EDI-OCT). Detailed neurological examination including mini mental state examination (MMSE) test which evaluates the cognitive function was applied to all participants. Results. The ages and genders of all participants were similar in all groups. Compared with healthy C subjects, the CT measurements at all regions were significantly thinner both in patients with ATD and in patients with MCI than in healthy C subjects (p < 0.05). The MMSE scores were significantly different among ATD patients, MCI patients, and healthy C subjects. They were 19.3 ± 1.8, 24.8 ± 0.9, and 27.6 ± 1.2 in ATD, MCI, and healthy controls, respectively (p < 0.001). There were also significant correlation between MMSE score and choroidal thickness at each location (p < 0.05). Conclusions. CT was reduced in ATD patients and MCI patients. Since vascular structures were affected in ATD patients and MCI patients, they had thin CT. Besides CT was correlated with degree of cognitive impairment. Therefore CT may be a new biomarker in diagnosis and follow-up of MCI and ATD patients. PMID:26925259

  8. Multifocal choroiditis following simultaneous hepatitis A, typhoid, and yellow fever vaccination

    OpenAIRE

    Escott S; Tarabishy AB; Davidorf FH

    2013-01-01

    Sarah Escott, Ahmad B Tarabishy, Frederick H DavidorfHavener Eye Institute, The Ohio State University, Columbus, OH, USAAbstract: The paper describes the first reported case of multifocal choroiditis following simultaneous hepatitis-A, typhoid, and yellow fever vaccinations. A 33-year-old male developed sudden onset of flashing lights and floaters in his right eye 3 weeks following hepatitis A, typhoid, and yellow fever vaccinations. Fundus examination and angiography confirmed the presence o...

  9. Anti-VEGF PolysiRNA Polyplex for the Treatment of Choroidal Neovascularization.

    Science.gov (United States)

    Lee, Jihwang; Ryoo, Na-Kyung; Han, Hyounkoo; Hong, Hye Kyoung; Park, Ji Yeon; Park, Sang Jun; Kim, Yong-Kyu; Sim, Changbeom; Kim, Kwangmeyung; Woo, Se Joon; Park, Kyu Hyung; Kim, Hyuncheol

    2016-06-01

    Choroidal neovascularization (CNV) is a major cause of severe vision loss in patients with age-related macular degeneration (AMD). Present ocular siRNA delivery technology is limited due to poor delivery through the retina to the choroid, where CNV originates. Our goal was to develop an optimized nanosized polyRNAi-based therapeutic delivery system to the subretinal space. We developed it by siRNA multimerization (polysiRNA) followed by coating with branched polyethylenimine and hyaluronic acid, and then evaluated its efficacy in vitro and in vivo. The polysiRNA polyplex showed a narrow size distribution (260.7 ± 43.27 nm) and negative charge (-4.98 ± 0.47 mV) owing to the hyaluronic acid outer layer. In vitro uptake of the polysiRNA polyplex by human ARPE cells was discovered, and the direct inhibition of VEGF mRNA translation was confirmed in B16F10 cells. The intravitreally administered polysiRNA polyplex overcame both the vitreous and retina barriers in vivo and reached the subretinal space efficiently. Intravitreal injection of the polysiRNA polyplex was not toxic to the retina in histopathology. Furthermore, intravitreal injections of the polysiRNA polyplex at both 1 and 7 days after laser photocoagulation inhibited laser-induced choroidal neovascularization, compared to that of the control (p < 0.05). These results suggest that anti-VEGF polysiRNA polyplexes show great potential in delivering multimeric RNAi-based therapeutics to treat retinal or choroidal disorders. PMID:27173745

  10. Modulation of choroidal neovascularization by subretinal injection of retinal pigment epithelium and polystyrene microbeads

    OpenAIRE

    Schmack, Ingo; Berglin, Lennart; Nie, Xiaoyan; Wen, Jing; Kang, Shin J; Marcus, Adam I.; Yang, Hua; Lynn, Michael J.; Kapp, Judith A.; Grossniklaus, Hans E.

    2009-01-01

    Purpose The study was conducted to create a rapidly developing and reproducible animal model of subretinal choroidal neovascularization (CNV) that allows a time-dependent evaluation of growth dynamics, histopathologic features, and cytokine expression. Methods C57BL/6 and chemoattractant leukocyte protein-2 deficient (∆Ccl-2) mice were studied. Mice received single or combined subretinal injections of cultured retinal pigment epithelium (RPE; C57BL/6-derived), polystyrene microbeads, or phosp...

  11. Anti-VEGF treatment for myopic choroid neovascularization: from molecular characterization to update on clinical application

    OpenAIRE

    Zhang Y; Han Q; Ru Y; Bo Q; Wei RH

    2015-01-01

    Yan Zhang,1 Qian Han,2 Yusha Ru,1 Qiyu Bo,1 Rui Hua Wei1 1Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute, College of Optometry and Ophthalmology, Tianjin Medical University, Tianjin, 2Tangshan Eye Hospital, Tangshan, Hebei Province, People’s Republic of China Abstract: Choroidal neovascularization (CNV) secondary to pathologic myopia has a very high incidence in global, especially in Asian, populations. It is a common cause of irreversible centra...

  12. Clinical features, management and visual outcome of polypoidal choroidal vasculopathy in Indian patients

    OpenAIRE

    Anantharaman Giridhar; Ramkumar Gudapati; Gopalakrishnan Mahesh; Rajput Alpesh

    2010-01-01

    Aims: To present the clinical, indocyanine green angiography (ICGA) features and results of treatment for polypoidal choroidal vasculopathy (PCV) in Indian patients by a retrospective chart review.Materials and Methods: Forty five patients with PCV underwent complete ocular examination, fluorescein angiography (FFA) and ICGA. Treatment was advised for patients with macular involvement and progressive loss of visual acuity. Demographic data, clinical features and results of treatment were anal...

  13. Evidence of a novel gene HERPUD1 in polypoidal choroidal vasculopathy

    OpenAIRE

    Jin, Enzhong; Bai, Yujing; Huang, Lvzhen; Zhao, Min; Zhang, Chunfang; Zhao, Mingwei; Li, Xiaoxin

    2015-01-01

    Polypoidal choroidal vasculopathy (PCV) is an exudative maculopathy, with clinical features distinct from neovascular age-related macular degeneration (nAMD) which is the leading cause of irreversible blindness in the elderly. Our studies focused on the genetic background and function of a novel gene HERPUD1 in PCV. HERPUD1 has been reported to increase the level of amyloid β (Aβ), which is a component of drusen deposits underlying the retinal pigment epithelium (RPE) layer. To verify the gen...

  14. Macular Hole as a Risk Factor of Choroidal Detachment in Rhegmatogenous Retinal Detachment

    OpenAIRE

    Kang, Jae Hoon; Park, Kyung Ah; Shin, Woo Jae; Kang, Se Woong

    2008-01-01

    Purpose Choroidal detachment (CD) associated with rhegmatogenous retinal detachment (RRD) is a rare, but serious condition, which makes the prognosis worse. Previously reported risk factors for CD in RRD patients include high myopia, aphakia, pseudophakia, and advanced age. However, macular hole has not been discussed as an important factor in increasing the risk of CD in RRD patients. The purpose of this study was to evaluate macular hole as a risk factor for CD in eyes evidencing RRD. Metho...

  15. Rare and Unusual Choroidal Abnormalities in a Patient with Systemic Lupus Erythematosus

    OpenAIRE

    Makino, Shinji; Tampo, Hironobu

    2013-01-01

    Purpose To report a case of rare and unusual choroidal abnormalities in a 42-year-old woman with systemic lupus erythematosus (SLE). Methods Images were obtained using fundus photography, fluorescein angiography, near-infrared reflectance (NIR) imaging, and optical coherence tomography (OCT). Results The patient had a history of SLE and central retinal artery occlusion in her right eye. Fundus examination showed no specific retinochoroidal abnormalities, with the exception of optic disc atrop...

  16. Possible vitreous involvement in a case with rapidly progressing choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    Masayuki Hata

    2012-01-01

    Full Text Available A 65-year-old man with subfoveal choroidal neovascularization (CNV underwent photodynamic therapy (PDT. Despite the sequential treatments, the CNV grew larger and finally penetrated the retina. Vitreous adhesion was observed at the edge of the supraretinal fibrotic tissue. The case highlighted the possible unexpected side-effect of PDT. The upregulation of the vascular endothelial growth factor or the enhanced vitreous traction was considered to be responsible for the event.

  17. Multifocal Electroretinogram Findings after Intravitreal Bevacizumab Injection in Choroidal Neovascularization of Age-Related Macular Degeneration

    OpenAIRE

    Park, Joo Youn; Kim, Seung Hoon; Park, Tae Kwann; Ohn, Young-Hoon

    2011-01-01

    Purpose To evaluate the changes in multifocal electroretinogram (mfERG) and optical coherence tomography (OCT) after intravitreal bevacizumab injection in the treatment of age-related macular degeneration (AMD). Methods Twenty-one eyes with choroidal neovascularization secondary to AMD were studied before and after intravitreal bevacizumab injection for best corrected visual acuity (BCVA), OCT, and mfERG. Results The BCVA improved, while central macular thickness and total macular volume in O...

  18. Combination photodynamic therapy and bevacizumab for choroidal neovascularization associated with toxoplasmosis

    OpenAIRE

    Rishi Pukhraj; Venkataraman Anusha; Rishi Ekta

    2011-01-01

    A 14-year-old girl presenting with visual loss in both eyes was diagnosed to have healed toxoplasma retinochoroiditis in the right eye with active choroidal neovascularization (CNV) secondary to toxoplasmosis in the left. She underwent combination photodynamic therapy (PDT) and intravitreal bevacizumab as primary treatment. PDT was performed as per the ′Treatment of Age-related Macular Degeneration by Photodynamic therapy′ study protocol and was followed by intravitreal bevacizu...

  19. Evaluation of Idiopathic Choroidal Neovascularization with Indocyanine Green Angiography in Patients Undergoing Bevacizumab Therapy

    OpenAIRE

    Rush, Ryan B.; Rush, Sloan W.

    2015-01-01

    Purpose. To examine the clinical implications of change in choroidal neovascularization (CNV) size on indocyanine green (ICG) angiography in subjects with idiopathic CNV undergoing bevacizumab therapy. Methods. The charts of subjects with an idiopathic CNV treated by a modified PRN regimen with intravitreal bevacizumab over a 12-month period were retrospectively reviewed. Results. There were 34 subjects included in the analysis. Baseline CNV sizes of less than 1.0 mm2 on ICG angiography corre...

  20. Short-term Effectiveness of Intravitreal Bevacizumab vs. Ranibizumab Injections for Patients with Polypoidal Choroidal Vasculopathy

    OpenAIRE

    Cho, Han Joo; Baek, Ji Seon; Lee, Dong Won; Kim, Chul Gu; Kim, Jong Woo

    2012-01-01

    Purpose To compare the effectiveness of intravitreal injections of bevacizumab and ranibizumab in patients with treatment-naive polypoidal choroidal vasculopathy (PCV). Methods Records from 106 consecutive patients who received intraviteral bevacizumab (n = 58, 1.25 mg) or ranibizumab (n = 52, 0.5 mg) for treatment of PCV were retrospectively reviewed. After three initial monthly loading injections, injection was performed as needed. The main outcome measures included best-corrected visual ac...

  1. Intravitreal Bevacizumab for Choroidal Neovascularization Secondary to Non-Age-Related Macular Degeneration

    OpenAIRE

    Salehipour, Masoud; Vafi, Nasser; Doozande, Azade; yaseri, Mehdi

    2010-01-01

    Purpose To report the long-term results of intravitreal bevacizumab (Avastin) therapy for choroidal neovascularization (CNV) secondary to non-age-related macular degeneration (non-AMD). Methods This prospective interventional case series was conducted on patients with non-AMD CNV. All patients received 1.25 mg intravitreal bevacizumab and were followed for at least 18 weeks. Indications for retreatment were decreased visual acuity or recurrence of subretinal fluid or hemorrhage associated wit...

  2. Idiopathic Choroidal Neovascularisation as the Inaugural Sign of Multiple Evanescent White Dot Syndrome

    OpenAIRE

    Papadia Marina; Herbort Carl

    2010-01-01

    We report a case of multiple evanescent white dot syndrome (MEWDS) that presented with putative idiopathic choroidal neovascularisation (ICNV) before showing angiographic signs typical of MEWDS. A 16-year-old male presented with unilateral metamorphopsias and visual loss in his left eye. ICNV with subretinal hemorrhage was diagnosed and treated with intravitreal Avastin ® . Fifteen days later, regression of choriodal neovascularization (CNV) was documented together with the appearance ...

  3. Long-term remission of myopic choroidal neovascular membrane after treatment with ranibizumab: a case report

    OpenAIRE

    Kumaran, Neruban; Sim, Dawn A.; Tufail, Adnan

    2009-01-01

    Introduction Myopia has become a big public health problem in certain parts of the world. Sight-threatening complications like choroidal neovascularisation membranes occur in up to 10% of pathological myopia, and natural history studies show a trend towards progressive visual loss. There are long-term financial and quality-of-life implications in this group of patients, and treatment strategies should aim for long-term preservation of vision. Case presentation A 56-year-old Caucasian woman pr...

  4. Long-term remission of myopic choroidal neovascular membrane after treatment with ranibizumab: a case report

    Directory of Open Access Journals (Sweden)

    Kumaran Neruban

    2009-10-01

    Full Text Available Abstract Introduction Myopia has become a big public health problem in certain parts of the world. Sight-threatening complications like choroidal neovascularisation membranes occur in up to 10% of pathological myopia, and natural history studies show a trend towards progressive visual loss. There are long-term financial and quality-of-life implications in this group of patients, and treatment strategies should aim for long-term preservation of vision. Case presentation A 56-year-old Caucasian woman presented with a best-corrected visual acuity of 6/6-1 in her right eye and 6/24 in her left. Fundal examination revealed pathological myopia in both eyes and an elevated lesion associated with pre-retinal haemorrhage in the left macula. Ocular coherence tomography and fundus fluorescein angiogram confirmed a subfoveal classic choroidal neovascularisation membrane. The patient decided to proceed with intravitreal ranibizumab (0.5 mg therapy. One month after treatment, best-corrected visual acuity improved to 6/12 in her left eye, with complete resolution subretinal fluid on ocular coherence tomography. After three months, best-corrected visual acuity further improved to 6/9, which was maintained up to 16 months post-treatment. Conclusion We suggest intravitreal ranibizumab as an alternative treatment for long-term remission of myopic choroidal neovascular membrane. It also suggests that myopic choroidal neovascularisation membranes may require fewer treatments to achieve sustained remission. Furthermore, this could serve as a feasible long-term management option if used in conjunction with ocular coherence tomography.

  5. Long-term remission of myopic choroidal neovascular membrane after treatment with ranibizumab: a case report

    OpenAIRE

    Kumaran Neruban; Sim Dawn A; Tufail Adnan

    2009-01-01

    Abstract Introduction Myopia has become a big public health problem in certain parts of the world. Sight-threatening complications like choroidal neovascularisation membranes occur in up to 10% of pathological myopia, and natural history studies show a trend towards progressive visual loss. There are long-term financial and quality-of-life implications in this group of patients, and treatment strategies should aim for long-term preservation of vision. Case presentation A 56-year-old Caucasian...

  6. Choroidal atrophy in a patient with paraneoplastic retinopathy and anti-TRPM1 antibody

    OpenAIRE

    Ueno S.; Ito Y.; Maruko R; Kondo M; Terasaki H

    2014-01-01

    Shinji Ueno,1 Yasuki Ito,1 Ruka Maruko,1 Mineo Kondo,2 Hiroko Terasaki1 1Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, 2Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan Abstract: The purpose of this paper is to report choroidal atrophy in a patient with cancer-associated retinopathy who had autoantibodies against the transient receptor potential cation channel, subfamily M, member 1 (TRPM1). A 69-year-old man visited ou...

  7. Hemorrhagic choroidal detachment after use of anti-glaucomatous eye drops: case report

    OpenAIRE

    Deniz Turgut Coban; Muhammet Kazim Erol; Ozgur Yucel

    2013-01-01

    Eighty-two-year-old patient with a pacemaker using warfarin due to arrhythmia and having an intraocular lens in the right eye, developed spontaneous hemorrhagic choroidal detachment one day after the use of combined preparation of 0.5% timolol maleate and 0.004% travoprost, due to primary open-angle glaucoma. Hemorrhagic detachment was detected by anterior and posterior segment examination, as well as B-scan ultrasonography. After the detachment, excessive increased intraocular pressure was c...

  8. Local Tumor Control, Visual Acuity, and Survival After Hypofractionated Stereotactic Photon Radiotherapy of Choroidal Melanoma in 212 Patients Treated Between 1997 and 2007

    International Nuclear Information System (INIS)

    Purpose: To evaluate long-term local tumor control, visual acuity, and survival after hypofractionated linear accelerator-based stereotactic photon radiotherapy in patients with choroidal melanoma. Methods and Materials: Between 1997 and 2007, 212 patients with choroidal melanoma unsuitable for ruthenium-106 brachytherapy or local resection were treated stereotactically at a linear accelerator with 6-MV photon beams at the Medical University of Vienna in five fractions over 7 days. Twenty-four patients received a total dose of 70 Gy (five fractions of 14 Gy), 158 a total dose of 60 Gy (five fractions of 12 Gy) and 30 patients a total dose of 50 Gy (five fractions of 10 Gy) applied on the 80% isodose. Ophthalmologic examinations were performed at baseline and every 3 months in the first 2 years, every 6 months until 5 years, and once a year thereafter until 10 years after radiotherapy. Assessment of visual acuity, routine ophthalmologic examinations, and measurement of tumor base dimension and height using standardized A-scan and B-scan echography were done at each visit. Funduscopy and fluorescein angiography were done when necessary to document tumor response. Results: Median tumor height and volume decreased from 4.8 mm and 270.7 mm3 at baseline to 2.6 mm and 86.6 mm3 at the last individual follow-up, respectively (p < 0.001, p < 0.001). Median visual acuity decreased from 0.55 at baseline to hand motion at the last individual follow-up (p < 0.001). Local tumor control was 95.9% after 5 years and 92.6% after 10 years. Thirty-two patients developed metastatic disease, and 22 of these patients died during the follow-up period. Conclusion: Hypofractionated stereotactic photon radiotherapy with 70 to 50 Gy delivered in five fractions in 7 days is sufficient to achieve excellent local tumor control in patients with malignant melanoma of the choroid. Disease outcome and vision are comparable to those achieved with proton beam radiotherapy. Decreasing the total dose

  9. Hypofractionated stereotactic photon radiotherapy of posteriorly located choroidal melanoma with five fractions at ten Gy – Clinical results after six years of experience

    International Nuclear Information System (INIS)

    Purpose: To evaluate long-term safety and efficacy of hypofractionated stereotactic photon radiotherapy with 5 five fractions at 10 Gy each in patients with centrally located choroidal melanoma. Materials and Methods: Ninety-one patients with centrally located choroidal melanoma were treated stereotactically at a linear accelerator with 6 MV photon beams with 5 fractions at 10 Gy each. Examinations were performed at baseline and every 3 months in the first 2 years, then every 6 months until 5 years and yearly thereafter. Median follow-up was 37.8 months (IQR 19.2–49.9). They included visual acuity assessment, routine ophthalmological examinations with fundoscopy, echography for measurement of tumor dimensions, medical examinations and, if necessary, fluorescein angiography. Results: Initial tumor base diameters, height and volume were 11.20 mm (IQR 9.10–13.70), 9.80 mm (IQR 7.80–11.70), 4.53 mm (IQR 3.33–6.43) and 253.8 mm3 (IQR 127.5–477.0). Local tumor control and eye retention rates were 97.7% and 86.4% after 5 years, respectively. Eight patients developed metastatic disease and 3 of them died due to metastatic disease during the follow-up period. Median visual acuity decreased from 0.67 initially to 0.05 at the last individual follow-up (p < 0.001). The most common toxicities (any grade) were radiation retinopathy (n = 39), optic neuropathy (n = 32), radiogenic cataract (n = 21), neovascular glaucoma (n = 15) and dry eye syndrome (n = 10). The 5 year probabilities to remain free of these side effects (any grade) were 26.0%, 45.4%, 55.4%, 72.6% and 80.5%, respectively. The most important prognostic factors for toxicities were the largest tumor base diameter, tumor height and tumor distance to the optic disk. Conclusion: Hypofractionated stereotactic photon radiotherapy with a total dose of 50 Gy delivered in 5 fractions is a highly effective treatment option in patients with centrally located choroidal melanoma and has a moderate toxicity profile

  10. A case of tuberculous meningitis with prominent contrast enhancement of choroid plexus on CT

    International Nuclear Information System (INIS)

    We report a case of tuberculous meningitis with specific CT findings which are different from those of previous reports. A 34-year-old man presented with 4-month history of left cervical lymph-node swelling, low grade fever and headache. He developed vomiting and consciousness disturbance. On admission, neurological examination revealed disorientation as to time, left homonymous hemianopsia, bilateral papilledema, left mydriasis, nuchal rigidity, and left hypereflexia. Tuberculin skin test was positive. CSF analysis revealed 307 WBC/mm3 200 mg/dl protein, 68 mg/dl sugar and 124 mEq/l chlorine. Tryptophan reaction was positive and a fibrinous web was formed. CSF stains and cultures were negative. CT on admission showed ventricular dilatation, low density area in white matter of the right parietal region, and midline shift. A contrast enhanced CT scan showed prominent enhancement in the right choroid plexus and slight enhancement in the basal cisterns. Three months later, the enhancement in the choroid plexus was unchanged but that of the basal cistern was even more striking. Autopsy findings revealed lymphadenopathy with caseous necrosis in lung, liver, pancreas, spleen, and neck. In the central nervous system, the skull base was covered with gelatinous tissues and fibrin nets, and scattered tubercles in the meninges, multiple small infarctions in basal ganglia, and ventricular dilatation were observed. Tuberculoma, which was surrounded by a thick fibrotic wall, was observed in the right choroid plexus. (J.P.N.)

  11. Inhibition on Telomerase Activity and Cytotoxic Effects by Cisplatin in Cultured Human Choroidal Melanoma Cells

    Institute of Scientific and Technical Information of China (English)

    Hao Cheng; Zhongyao Wu; Jianliang Zheng; Guilan Lu; Jianhua Yan; Min Liu; Danping Huang; Jianxian Lin

    2003-01-01

    Purpose: To study the changes of telomerase activity and cytotoxic effects by Cisplatin;cis-dichlorodiamine platinum (CDDP) in cultured human choroidal melanoma.Material and Methods: The primary cultured human choroidal melanoma cells werecultured in the presence and absence of CDDP with different concentration and timerespectively. The toxic effects were evaluated by MTT and the level of telormarse wasdetected by PCR-ELISA assay. And the relationship between telomerase activity andcytotoxic effects were analyzed by a correlation analysis.Results: Following the increase of the concentration and the time of CDDP, graduallyrepressed telomerase activity was detected in cultured cells. Meanwhile, the restrain rateof the cells increased. The telomerase activity at 24h and 1μg/ml was repressedsignificantly compared with the control cells. However, the appearance of cell deathlagged behind the decreasing of telomerase.Conclusions: CDDP is an effective telomerase inhibitor in cultured choroidal melanomacells of human eyes, which presents concentration and time dependency and can causethe death of cultured cells.

  12. Regulation Effect of Vascular Endothelial Growth Factor on Human Fetal Choroid Vascularization

    Institute of Scientific and Technical Information of China (English)

    JinsongZhao; YiWang; 等

    2002-01-01

    Purpose:To investigate the spatial and temporal regulation effect of vascular endothelial growth factor(VEGF) on human fetal choroids vascularization.Methods:The eyeballs of 54 human fetuses from the 9th week to the 40th week due to accidental abortion were studied by immunohistochemically stainin for the expression of VEGF and proliferation cell nuclear antigen (PCNA).Results: (1)The distribution of VEGF expression in the retinal pigment epithelium (RPE) decreased with the incrase of age,the peak of which was between the 9th and 14th week.(2)PCNA immunoreactivity was localized within choriocapillaris endothelium .The expression level decreased alone with fetus age.In this period the choriocapillaris endothelium kept proliferation,differentiation,canalization and remodeled to form the choroids vessels(3)Statistically significant correlations were shown between the expression of VEGF in the PRE and that of PCNA in choriocapillaris endothelium(r=0.933,P<0.01).Couclusin:VEGF expression in PRE was positively involved in modulating human fetal choroids vascularization .Eye Science 2000;16:11-14.

  13. Regulation Effect of Vascular Endothelial Growth Factor on Human Fetal Choroid Vascularization

    Institute of Scientific and Technical Information of China (English)

    Jinsong Zhao; Yue Song; Yi Wang; Xiaoguang Zhang

    2000-01-01

    Purpose: To investigate the spatial and temporal regulation effect of vascular endothelial growth factor(VEGF) on human fetal choroid vascularization. Methods: The eyeballs of 54 human fetuses from the 9th week to the 40th week due to accidental abortion were studied by immunohistochemically staining for the expression of VEGF and proliferation cell nuclear antigen (PCNA). Results: (1) The distribution of VEGF expression in the retinal pigment epithelium (RPE) decreased with the increase of age, the peak of which was between the 9th and 14th week. (2) PCNA immunoreactivity was localized within choriocapillaris endothelium. The expression level decreased alone with fetus age. In this period the choriocapillaris endothelium kept proliferation, differentiation, canalization and remodelled to form the choroid vessels. (3)Statistically significant correlations were shown between the expression of VEGF in the PRE and that of PCNA in choriocapillaris endothelium(r =0. 933, P < 0. 01). Conclusion: VEGF expression in RPE was positively involved in modulating human fetal choroid vascularization. Eye Science 2000; 16:11 ~ 14.

  14. A pilot study of morphometric analysis of choroidal vasculature in vivo, using en face optical coherence tomography.

    Directory of Open Access Journals (Sweden)

    Mahsa Sohrab

    Full Text Available PURPOSE: To study the ability of volumetric spectral domain optical coherence tomography (SD-OCT to perform quantitative measurement of the choroidal vasculature in vivo. METHODS: Choroidal vascular density and vessel size were quantified using en face choroidal scans from various depths below the retinal pigment epithelium (RPE in 58 eyes of 58 patients with either epiretinal membranes (ERM, early age-related macular degeneration (AMD, or reticular pseudo-drusen (RPD. For each patient, we used the macular volume scan (6×6 mm cube for vessel quantification, while high-definition (HD cross-section raster scans were used to qualitatively assess vascularity of the choroidal sub-layers, and measure choroidal thickness. RESULTS: Of the 58 patients, more were female (66% versus 34% male, of whom 14 (24% had ERM, 11 (19% early AMD, and 33 (57% RPD. Compared to intact choriocapillaris in all ERM (100%, none of the RPD and only 5/11 (45% early AMD eyes had visible choriocapillaris on either cross section or C-scans (p-value<0.001. When comparing select regions from the most superficial C-scans, early AMD group had lowest vascular density and RPD had highest (p-value 0.04. Qualitative evaluation of C-scans from all three groups revealed a more granular appearance of the choriocapillaris in ERM versus increased stroma and larger vessels in the RPD eyes. CONCLUSIONS: SD-OCT can be used to qualitatively and quantitatively assess choroidal vascularity in vivo. Our findings correlate to previously reported histopathologic studies. Lack of choriocapillaris on HD cross-sections or C-scans in all RPD and about half of early AMD eyes suggests earlier choroidal involvement in AMD and specifically, RPD.

  15. Changes in choroidal thickness after prophylactic iridectomy in primary angle closure suspect eyes using enhanced depth imaging optical coherence tomography

    Directory of Open Access Journals (Sweden)

    Wei Wang

    2015-01-01

    Full Text Available Purpose: The aim of the present study was to evaluate the effect of surgical peripheral iridectomy (SPI on choroidal thickness in primary angle-closure suspect (PACS eyes. Materials and Methods: This was a prospective observational case series of 30 subjects with PACS. Ocular biometry was performed before SPI (baseline and then 1 week later. Choroid was imaged by enhanced depth imaging optical coherence tomography (EDI-OCT. The choroidal thickness of the subfoveal area at 1 and 3 mm diameter around the fovea was determined. Central anterior chamber depth (ACD, lens thickness (LT, vitreous chamber depth (VCD, and axial length (AL were measured by A-scan ultrasound. Parameters were compared before SPI (baseline and 1 week later. Results: Thirty eyes of 30 patients with mean age of 61.53 ± 7.98 years were studied. There was no significant difference in the choroidal thickness at all macular locations before and after SPI (all P > 0.05. Mean subfoveal choroidal thickness was 279.61 μm ± 65.50 μm before and 274.54 μm ± 63.36 μm after SPI (P = 0.308. There was also no significant change in central ACD, LT, VCD, and LT after SPI (all P > 0.05. Conclusions: SPI does not appear to alter choroidal thickness in PACS eyes, as assessed using EDI-OCT. Long-term follow-up of PACS eyes treated with SPI may provide further insight into the effects of this treatment modality on the choroid.

  16. Alectinib for choroidal metastasis in a patient with crizotinib-resistant ALK rearranged positive non-small cell lung cancer.

    Science.gov (United States)

    Okuma, Yusuke; Tanaka, Yuichiro; Kamei, Tina; Hosomi, Yukio; Okamura, Tatsuru

    2015-01-01

    Choroidal metastasis is rare in cancer patients. Small molecules of molecular targeted agents for lung cancer with actionable mutations were reported to be palliated for symptoms caused by choroidal metastasis. Visual disturbance by choroidal metastasis significantly decreases quality of life during the patient's remaining lifespan; therefore, radiotherapy or laser photocoagulation is proposed with consensus. However, improvement in survival with matched molecular targeted agents for oncogenic driver mutations reminds us to also be concerned with late treatment toxicities. A 30-year-old female patient previously treated with crizotinib harboring ALK rearranged non-small cell lung cancer complained of visual disturbance, fever, and bone pains undergoing anti-PD-1 antibody treatment. A decreased proportion of ALK fusion was demonstrated by fluorescence in situ hybridization in liver metastasis compared to the primary site in a chemo-naïve state. She was diagnosed with low vision, choroidal metastasis and retinal detachment. Therefore, she started alectinib treatment and both her ocular and systemic symptoms were palliated in a week. Later, she temporarily discontinued alectinib because of skin rash although the choroidal metastasis and retinal detachment resolved and she regained low vision completely at 2 weeks. She obtained partial response with alectinib for more than 5 months after recovering from skin rash. PMID:26082648

  17. Correlation of In Vivo and In Vitro Methods in Measuring Choroidal Vascularization Volumes Using a Subretinal Injection Induced Choroidal Neovascularization Model

    Directory of Open Access Journals (Sweden)

    Chuang Nie

    2015-01-01

    Full Text Available Background: In vivo quantification of choroidal neovascularization (CNV based on noninvasive optical coherence tomography (OCT examination and in vitro choroidal flatmount immunohistochemistry stained of CNV currently were used to evaluate the process and severity of age-related macular degeneration (AMD both in human and animal studies. This study aimed to investigate the correlation between these two methods in murine CNV models induced by subretinal injection. Methods: CNV was developed in 20 C57BL6/j mice by subretinal injection of adeno-associated viral delivery of a short hairpin RNA targeting sFLT-1 (AAV.shRNA.sFLT-1, as reported previously. After 4 weeks, CNV was imaged by OCT and fluorescence angiography. The scaling factors for each dimension, x, y, and z (μm/pixel were recorded, and the corneal curvature standard was adjusted from human (7.7 to mice (1.4. The volume of each OCT image stack was calculated and then normalized by multiplying the number of voxels by the scaling factors for each dimension in Seg3D software (University of Utah Scientific Computing and Imaging Institute, available at http://www.sci.utah.edu/cibc-software/seg3d.html. Eighteen mice were prepared for choroidal flatmounts and stained by CD31. The CNV volumes were calculated using scanning laser confocal microscopy after immunohistochemistry staining. Two mice were stained by Hematoxylin and Eosin for observing the CNV morphology. Results: The CNV volume calculated using OCT was, on average, 2.6 times larger than the volume calculated using the laser confocal microscopy. The correlation statistical analysis showed OCT measuring of CNV correlated significantly with the in vitro method (R 2 =0.448, P = 0.001, n = 18. The correlation coefficient for CNV quantification using OCT and confocal microscopy was 0.693 (n = 18, P = 0.001. Conclusions: There is a fair linear correlation on CNV volumes between in vivo and in vitro methods in CNV models induced by subretinal

  18. Equine infectious anemia viral vector-mediated codelivery of endostatin and angiostatin driven by retinal pigmented epithelium-specific VMD2 promoter inhibits choroidal neovascularization.

    Science.gov (United States)

    Kachi, Shu; Binley, Katie; Yokoi, Katsutoshi; Umeda, Naoyasu; Akiyama, Hideo; Muramatu, Daisuke; Iqball, Sharifah; Kan, On; Naylor, Stuart; Campochiaro, Peter A

    2009-01-01

    Equine infectious anemia virus (EIAV) is a nonprimate lentivirus that does not cause human disease. Subretinal injection into mice of a recombinant EIAV lentiviral vector in which lacZ is driven by a CMV promoter (EIAV CMV LacZ) resulted in rapid and strong expression of LacZ in retinal pigmented epithelial (RPE) cells and some other cells including ganglion cells, resulting in the presence of 5-bromo-4-chloro-3-indolyl-beta-D-galactopyranoside within the optic nerve. Substitution of the RPE-specific promoter from the vitelliform macular dystrophy (VMD2) gene for the CMV promoter resulted in prolonged (at least 1 year) expression of LacZ that was restricted to RPE cells, albeit reduced 6- to 10-fold compared with the CMV promoter. Similarly, the amount of FLAG-tagged endostatin detected in eyes injected with the EIAV VMD2 Endo(FLAG) vector was similar to that seen in eyes injected with a vector that expressed both endostatin and angiostatin [EIAV VMD2 Endo(FLAG)/Angio]; expression was approximately 6-fold lower than with identical vectors in which the CMV promoter drove expression. Compared with murine eyes treated with a control EIAV vector, subretinal injection of EIAV vectors expressing murine endostatin alone or in combination with angiostatin driven by either the CMV or VMD2 promoter caused significant suppression of choroidal neovascularization (NV) at laser-induced rupture sites in Bruch's membrane. These data support proceeding toward clinical studies with EIAV-based gene therapy for choroidal NV, using the VMD2 promoter to selectively drive expression of a combination of endostatin and angiostatin in RPE cells. PMID:20377369

  19. Atrofia girata de coróide e retina: relato de caso Girate atrophy of the retina and choroid: case report

    Directory of Open Access Journals (Sweden)

    Emerson Kenji Oyamaguchi

    2003-08-01

    Full Text Available OBJETIVO: Relatar um caso de atrofia girata de coróide e retina com confirmação por meio da bioquímica do plasma. MÉTODO: Aferiu-se a melhor acuidade visual corrigida de ambos olhos (AO em tabela de Snellen. Foram realizados biomicroscopia do segmento anterior, refração, mapeamento de retina, angiografia fluoresceínica, campo visual e dosagem da ornitina sérica (aminoacidograma. RESULTADOS: Paciente de 22 anos, sexo feminino, cor branca, apresentando alta miopia e acuidade visual (AV 20/100 em AO. À biomicroscopia do segmento anterior apresentava catarata subcapsular posterior em AO. À oftalmoscopia foram verificadas lesões atróficas da coróide e da retina bem delimitadas em meia periferia de AO. O aminoacidograma constatou elevação correspondente ao complexo da ornitina. CONCLUSÃO: Relata-se um caso típico de atrofia girata, distrofia retiniana rara associada a hiperornitinemia.PURPOSE: To report a case of gyrate atrophy confirmed by biochemical blood analysis. METHODS: Best corrected visual acuity was evaluated. Biomicroscopy of the anterior segment, indirect ophthalmoscopy, fluorescein angiography and computerized visual fields were performed. Color vision was assessed and plasma ornithine level was determined. RESULTS: 22-year-old white female with high myopia, visual acuity of 20/100 in both eyes. Biomicroscopy showed posterior subcapsular cataract in both eyes. Retinography showed well-delineated atrophic lesions of the choroid and retina in the mid-periphery and around the optic nerve in both eyes. Blood aminoacid determination showed high levels of ornithine. CONCLUSION: We describe here a typical case of girate atrophy of the retina and choroid, a rare disease associated with high levels of plasma ornithine.

  20. A CASE OF HELLP SYNDROME: THE IMPORTANCE OF ANGIOGRAPHY WITH INDOCIANINE GREEN FOR DIAGNOSIS OF RETINIC AND CHOROIDAL VASCULAR OCCLUSION.

    Directory of Open Access Journals (Sweden)

    R. Franceschini

    2012-05-01

    Full Text Available Purpose. To present a case of retinal and choroidal vascular occlusion in conjunction with HELLP syndrome. Methods. A 35 years-old woman presented with HELLP syndrome underwent cesarean delivery for preeclampsia. After 2 months she had a decrease of vision in OD. She had performed an eye examination with FAG and ICG. results. The FAG shows at the posterior pole in the perifoveola temporal area different areas of hyperfluorescence. ICG reveals frameworks of hypoperfusion in perimacular areas, for the probable presence of ischemic foci. After about 5 mounths she presented an improvement in visual acuity and a complete resolution of Ophtalmoscopic findings. Conclusions. Ophtalmic complications are possible during this syndrome. This is the first description of a patient suffering a retinal and choroidal vascolar occlusion after HELLP syndrome, and we report the important of ICG for\tdiagnosis\tof choroidal ischemia.

  1. Stereotactic Fractionated Radiotherapy in the Treatment of Juxtapapillary Choroidal Melanoma: The McGill University Experience

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    Al-Wassia, Rolina; Dal Pra, Alan; Shun, Kitty; Shaban, Ahmed [Department of Oncology, Division of Radiation Oncology, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec (Canada); Corriveau, Christine [Department of Ophthalmology, Notre Dame Hospital, Centre Hospitalier de l' Universite de Montreal, Montreal, Quebec (Canada); Edelstein, Chaim; Deschenes, Jean [Department of Ophthalmology, McGill University Health Centre, Montreal, Quebec (Canada); Ruo, Russel; Patrocinio, Horacio [Department of Medical Physics, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec (Canada); Cury, Fabio L.B. [Department of Oncology, Division of Radiation Oncology, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec (Canada); DeBlois, Francois [Department of Medical Physics, Jewish General Hospital, McGill University, Montreal, Quebec (Canada); Shenouda, George, E-mail: george.shenouda@muhc.mcgill.ca [Department of Oncology, Division of Radiation Oncology, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec (Canada)

    2011-11-15

    Purpose: To report our experience with linear accelerator-based stereotactic fractionated radiotherapy in the treatment of juxtapapillary choroidal melanoma. Methods and Materials: We performed a retrospective review of 50 consecutive patients diagnosed with juxtapapillary choroidal melanoma and treated with linear accelerator-based stereotactic fractionated radiotherapy between April 2003 and December 2009. Patients with small to medium sized lesions (Collaborative Ocular Melanoma Study classification) located within 2 mm of the optic disc were included. The prescribed radiation dose was 60 Gy in 10 fractions. The primary endpoints included local control, enucleation-free survival, and complication rates. Results: The median follow-up was 29 months (range, 1-77 months). There were 31 males and 29 females, with a median age of 69 years (range, 30-92 years). Eighty-four percent of the patients had medium sized lesions, and 16% of patients had small sized lesions. There were four cases of local progression (8%) and three enucleations (6%). Actuarial local control rates at 2 and 5 years were 93% and 86%, respectively. Actuarial enucleation-free survival rates at 2 and 5 years were 94% and 84%, respectively. Actuarial complication rates at 2 and 5 years were 33% and 88%, respectively, for radiation-induced retinopathy; 9.3% and 46.9%, respectively, for dry eye; 12% and 53%, respectively, for cataract; 30% and 90%, respectively, for visual loss [Snellen acuity (decimal equivalent), <0.1]; 11% and 54%, respectively, for optic neuropathy; and 18% and 38%, respectively, for neovascular glaucoma. Conclusions: Linear accelerator-based stereotactic fractionated radiotherapy using 60 Gy in 10 fractions is safe and has an acceptable toxicity profile. It has been shown to be an effective noninvasive treatment for juxtapapillary choroidal melanomas.

  2. [Renal cell carcinoma metastasizing to choroid plexus of lateral ventricle; a case report].

    Science.gov (United States)

    Mizuno, M; Asakura, K; Nakajima, S; Sampei, T; Sayama, I; Kawamura, S; Yasui, N; Fukazawa, H

    1992-04-01

    A rare case of renal cell carcinoma metastasizing to the choroid plexus of the lateral ventricle is reported. A 59-year-old woman was admitted to our institution on November 26, 1987 complaining of left-half headache for one month. She had a past history of right nephrectomy due to renal cell carcinoma 4 years before admission, and of right radical mastectomy due to breast cancer 10 years before admission. She had no abnormal neurological findings and laboratory results were normal. CT scan revealed a well-circumscribed, apparently homogeneously enhancing mass in the left lateral ventricle with mild ventricular dilatation. Left vertebral angiogram showed a tumor stain fed by the left posterior choroidal artery. The most likely diagnosis was thought to be metastasis of renal cell carcinoma. The patient underwent the operation for tumor removal via the posterior interhemispheric transcallosal approach 14 days after admission. A histological examination of the tumor determined the diagnosis of clear-cell type renal cell carcinoma. The operation was uneventful and the patient was discharged 20 days after operation without neurological deficit. But she had recent-memory disturbance, low activity, and gait disturbance in May 1989. CT scan revealed ventricular dilatation and tumor recurrence at the same site. She also suffered from diabetes due to the regrowth and invasion of primary tumor to the pancreas. She was discharged free of neurological defects after ventriculo-peritoneal shunt. In December 1989, she gradually deteriorated due to the regrowth of the intraventricular metastatic lesion, and now she is bedridden. Choroid plexus metastasis is quite rare, and, to our knowledge, only three cases have been described. PMID:1570073

  3. Standardization of choroidal thickness measurements using enhanced depth imaging optical coherence tomography

    Institute of Scientific and Technical Information of China (English)

    Nattapon; Boonarpha; Yalin; Zheng; Alexandros; N.Stangos; Huiqi; Lu; Ankur; Raj; Gabriela; Czanner; Simon; P.Harding; Jayashree; Nair-Sahni

    2015-01-01

    AIM: To describe and evaluate a standardized protocol for measuring the choroidal thickness(Ch T) using enhanced depth imaging optical coherence tomography(EDI OCT).METHODS: Single 9 mm EDI OCT line scans across the fovea were used for this study. The protocol used in this study classified the EDI OCT images into four groups based on the appearance of the choroidal-scleral interface and suprachoroidal space. Two evaluation iterations of experiments were performed: first, the protocol was validated in a pilot study of 12 healthy eyes. Afterwards, the applicability of the protocol was tested in 82 eyes of patients with diabetes. Inter-observer and intra-observer agreements on image classifications were performed using Cohen’s kappa coefficient(κ). Intraclass correlation coefficient(ICC) and Bland-Altman’s methodology were used for the measurement of the Ch T.RESULTS: There was a moderate(κ=0.42) and perfect(κ =1) inter- and intra-observer agreements on image classifications from healthy eyes images and substantial(κ =0.66) and almost perfect(κ =0.86) agreements from diabetic eyes images. The proposed protocol showed excellent inter- and intra-observer agreements for the Ch T measurements on both, healthy eyes and diabetic eyes(ICC >0.90 in all image categories). The Bland-Altman plot showed a relatively large Ch T measurement agreement in the scans that contained less visible choroidal outer boundary. CONCLUSION: A protocol to standardize Ch T measurements in EDI OCT images has been developed;the results obtained using this protocol show that the technique is accurate and reliable for routine clinical practice and research.

  4. Inhibition of RACK1 ameliorates choroidal neovascularization formation in vitro and in vivo.

    Science.gov (United States)

    Liu, Xiaojuan; Zhu, Manhui; Yang, Xiaowei; Wang, Ying; Qin, Bai; Cui, Chen; Chen, Hui; Sang, Aimin

    2016-06-01

    Choroidal neovascularization (CNV) occurs as a result of age-related macular degeneration (AMD) and causes severe vision loss among elderly patients. The receptor for activated C-kinase 1 (RACK1) serves as a scaffold protein which is recently found to promote angiogenesis. However, the impact of RACK1 on the vascular endothelial growth factor (VEGF) expression in endothelial cells and subsequent choroidal angiogenesis formation remains to be elucidated. In this study, we found that RACK1 and VEGF expression increased, and reached the peak at 7d in mouse CNV model by laser application. Furthermore, on RPE/choroid cryosections, RACK1 co-localized with CD31, suggesting that RACK1 was expressed in endothelial cells. In vitro, RF/6A cell hypoxia model showed that RACK1 expression was up-regulated in parallel with hypoxia-induced factor 1 (HIF-1α) and VEGF expression, reaching the peak at 6h. Silencing of RACK1 suppressed the invasion and tube formation activity of RF/6A cells in ARPE-19 and RF/6A co-culture system, possibly through VEGF signal pathway. Overexpression of RACK1 showed the opposite effect. Intravitreal injection of anti-RACK1 monoclonal antibody predominantly decreased RACK1 and VEGF expression in mouse laser-induced CNV model. Meanwhile, anti-RACK1 monoclonal antibody intravitreal injection also decreased incidence of CNV and leakage area. These data indicated that RACK1 promoted CNV formation via VEGF pathway. Additionally, anti-RACK1 monoclonal antibody significantly decreased CNV in mouse model and may have therapeutic potential in human CNV. PMID:27112838

  5. Stereotactic Fractionated Radiotherapy in the Treatment of Juxtapapillary Choroidal Melanoma: The McGill University Experience

    International Nuclear Information System (INIS)

    Purpose: To report our experience with linear accelerator-based stereotactic fractionated radiotherapy in the treatment of juxtapapillary choroidal melanoma. Methods and Materials: We performed a retrospective review of 50 consecutive patients diagnosed with juxtapapillary choroidal melanoma and treated with linear accelerator-based stereotactic fractionated radiotherapy between April 2003 and December 2009. Patients with small to medium sized lesions (Collaborative Ocular Melanoma Study classification) located within 2 mm of the optic disc were included. The prescribed radiation dose was 60 Gy in 10 fractions. The primary endpoints included local control, enucleation-free survival, and complication rates. Results: The median follow-up was 29 months (range, 1–77 months). There were 31 males and 29 females, with a median age of 69 years (range, 30–92 years). Eighty-four percent of the patients had medium sized lesions, and 16% of patients had small sized lesions. There were four cases of local progression (8%) and three enucleations (6%). Actuarial local control rates at 2 and 5 years were 93% and 86%, respectively. Actuarial enucleation-free survival rates at 2 and 5 years were 94% and 84%, respectively. Actuarial complication rates at 2 and 5 years were 33% and 88%, respectively, for radiation-induced retinopathy; 9.3% and 46.9%, respectively, for dry eye; 12% and 53%, respectively, for cataract; 30% and 90%, respectively, for visual loss [Snellen acuity (decimal equivalent), <0.1]; 11% and 54%, respectively, for optic neuropathy; and 18% and 38%, respectively, for neovascular glaucoma. Conclusions: Linear accelerator-based stereotactic fractionated radiotherapy using 60 Gy in 10 fractions is safe and has an acceptable toxicity profile. It has been shown to be an effective noninvasive treatment for juxtapapillary choroidal melanomas.

  6. Cimetidine transport in isolated brush border membrane vesicles from bovine choroid plexus

    International Nuclear Information System (INIS)

    The purpose of this study was to elucidate the mechanisms involved in the transport of cimetidine across the brush border membrane of choroid plexus epithelium. Brush border membrane vesicles were prepared from bovine choroid plexus and the uptake of [3H]cimetidine was studied using the methods of rapid vacuum filtration and scintillation counting. Cimetidine accumulated in the vesicles with time reaching equilibrium within 2 hr. The amount of cimetidine taken up by the vesicles at equilibrium decreased with increasing extravesicular media osmolarity suggesting that cimetidine accumulates in an osmotically reactive intravesicular space. Binding of cimetidine to the membrane was estimated to be less than 18%. Michaelis-Menten studies demonstrated that cimetidine transport involved both a saturable and a nonsaturable component. The Vmax and Km (mean +/- S.E.) were 16.7 +/- 5.9 pmol/sec/mg protein and 58.1 +/- 3.1 microM, respectively, suggesting that cimetidine is transported across the choroid plexus brush border membrane with a lower affinity and a higher capacity than across the renal brush border membrane. The organic cation, quinidine (0.1 mM), and the amino acid, histidine (20 mM), both significantly reduced the initial, but not the equilibrium, uptake of cimetidine. However, high concentrations (5 mM) of more polar organic cations including tetraethylammonium, as well as of several organic anions including salicylate did not inhibit cimetidine transport. Studies with unlabeled cimetidine revealed a countertransport phenomenon. Attempts to drive the concentrative uptake of cimetidine with various ion gradients were unsuccessful. Of note was the fact that an outwardly directed proton gradient could significantly accelerate the uptake of cimetidine

  7. Vestibular syndrome due to a choroid plexus papilloma in a ferret.

    Science.gov (United States)

    van Zeeland, Yvonne; Schoemaker, Nico; Passon-Vastenburg, Maartje; Kik, Marja

    2009-01-01

    A 6-year-old, castrated male ferret (Mustela putorius furo) was presented with progressive neurological signs consisting of a right-sided head tilt and ataxia. Neurological examination revealed hemiparesis and absence of proprioception on the right side, consistent with central vestibular syndrome. Measurement of blood glucose excluded hypoglycemia due to insulinoma. Contrast-enhanced computed tomography revealed the presence of an intracranial mass, consistent with either granuloma or neoplasia. Palliative treatment with prednisolone yielded no improvement. At postmortem examination, a final diagnosis of a choroid plexus papilloma originating from the fourth ventricle was made. This is the first report of such a tumor in a ferret. PMID:19258423

  8. Choroid plexus papilloma of cerebellopontine angle with extension to foramen magnum.

    Directory of Open Access Journals (Sweden)

    Kumar R

    1999-01-01

    Full Text Available A case of choroid plexus papilloma resembling meningioma of cerebellopontine (CP angle with its extension to foramen magnum is presented. Occurrence of this tumour in CP angle is very rare. Its extension towards foramen magnum is further rare. It was a real diagnostic enigma preoperatively as the tumour was resembling meningioma upto some extent on radiological study. Retromastoid craniectomy with microsurgical excision of tumour and its extension was achieved in toto. Tumour was attached to few rootlets of lower cranial nerves which were preserved. Attachment of the tumour with lower cranial nerves again caused diagnostic confusion with neurofibroma intraoperatively.

  9. Ziv-aflibercept: a novel option for the treatment of polypoidal choroidal vasculopathy.

    Science.gov (United States)

    Videkar, Chetan; Kapoor, Aditya; Chhablani, Jay; Narayanan, Raja

    2015-01-01

    Polypoidal choroidal vasculopathy (PCV) is an exudative maculopathy usually treated using photodynamic therapy (PDT) and antivascular endothelial growth factor agents. However, these cases may sometimes be refractory to both PDT and ranibizumab or bevacizumab, and may have persistent intra-retinal fluid. Recently, studies have reported that aflibercept may be effective in such resistant cases. However, high cost and limited availability has restricted its use to only a few countries. Ziv-aflibercept (Zaltrap), a systemic analogue of aflibercept, has been tried recently and it has been effective in macular oedema. We report a case of PCV resistant to PDT and ranibizumab, which responded well to intravitreal ziv-aflibercept. PMID:26682842

  10. Prognostic value of nucleolar size and size pleomorphism in choroidal melanomas

    DEFF Research Database (Denmark)

    Sørensen, Flemming Brandt; Gamel, J W; Jensen, O A; Ladekarl, M; McCurdy, J

    1993-01-01

    Morphometric estimates of nucleolar size have been shown to possess a high prognostic value in patients with uveal melanomas. The authors investigated various quantitative estimators of the mean size and pleomorphism of nucleoli in choroidal melanomas from a consecutive series of 95 Danish patients...... melanoma, and largest macroscopic tumor dimension (LTD), the following histomorphometric estimates were obtained: mean diameter of the 10 largest nucleoli (MLN), point-sampled mean nucleolar profile area (nucleolar ao) and the associated standard deviation of nucleolar ao, the volume-weighted mean...

  11. 5.8 GHz ophthalmic microwave applicator for treatment of choroidal melanoma

    International Nuclear Information System (INIS)

    We report on the use of a 5.8 GHz microwave applicator to treat choroidal melanoma (Greene) in rabbits. The physical requirements needed to treat these intraocular tumors are quite different from those encountered elsewhere in the body. From a trans-scleral approach the penetration needed is minimal (5 to 10 mm.). The fibrous sclera is the only structure between the heat source and the tumor. The sclera has a relatively low water content when compared to tumor. This fact in addition to the frequency dependent interactions of tissue and electromagnetic radiation, results in an advantage to the use of the 5.8 GHz microwave device in treating intraocular malignancies

  12. Radioactive phosphorus uptake test for the diagnosis of malignant melanoma of the choroid

    International Nuclear Information System (INIS)

    The most frequently used radioisotope in ophthalmology is radioactive phosphorus (32P). Since its introduction into ophthalmology in 1951, it has been used primarily as an aid in the diagnosis of malignant melanoma of the choroid. During the thirty years of clinical use, the indications for this test have been clearly defined. The maximum tissue penetration of 32P is 7 mm. Surgical dissection is therefore frequently necessary to enable the ophthalmologist to place the Geiger-Muller probe on the sclera in proximity to the tumor. False positive and false negative results are unusual and the test is between 96% and 100% accurate

  13. Intravitreal bevacizumab as an adjunct in the management of a vascular choroidal granuloma

    OpenAIRE

    Bansal, Reema; Beke, Nikhil; Sharma, Aman; Gupta, Amod

    2013-01-01

    A 43-year-old woman with tubercular choroidal granuloma showed poor response to conventional first-line four-drug antitubercular therapy (ATT) and corticosteroids. A therapeutic trial with intravitreal bevacizumab (1.25 mg in 0.05 mL) injections as an adjunct to ATT and corticosteroids led to a prompt initial regression of granuloma with restoration of visual acuity that was sustained for almost 2 years. A subsequent recurrence of the same lesion with evidence of enhanced vascularity was trea...

  14. A Case of Intravitreal Bevacizumab Injection for the Treatment of Choroidal Neovascularization in Angioid Streaks

    OpenAIRE

    Lee, Ji Woong; Shin, Jae Pil; Kim, Si Yeol

    2011-01-01

    A 56-year-old Korean woman presented with decreased visual acuity of the right eye. She had a history of two photodynamic therapy treatments for choroidal neovascularization (CNV) due to angioid streaks in her left eye with central scarring and low visual acuity. She was diagnosed with subfoveal CNV due to angioid streaks in her right eye and treated with six intravitreal bevacizumab (1.25 mg / 0.05 mL) injections over one year. Best corrected visual acuity improved from 20 / 125 at baseline ...

  15. Anti-angiogenic effects of a mutant endostatin: a new prospect for treating retinal and choroidal neovascularization.

    Directory of Open Access Journals (Sweden)

    Yujing Bai

    Full Text Available Pathological fundus angiogenesis is a major cause of vision loss in retina diseases. Endostatin, a C-terminal fragment of collagen XVIII, is an endogenous anti-angiogenic protein. The present study aimed to investigate the in vitro and in vivo anti-angiogenic properties of two proteins: an N-terminal H1D/H3D mutant endostatin (M-ES and a polyethylene glycol propionaldehyde (PEG covalent M-ES (PEG-M-ES.M-ES and PEG-M-ES properties were characterized in vitro using a zinc ion binding assay and a stability test. Activity assays, including migration, proliferation, and tube formation assays, were performed with human retinal microvascular endothelial cells (HRMECs and human umbilical vein endothelial cells (HUVECs. Mouse oxygen-induced retinopathy (OIR and choroidal neovascularization (CNV models were used to evaluate in vivo anti-angiogenic effects. In addition, a rabbit model was used to study the retinal pharmacokinetic profile following an intravitreal injection.The results indicated that the H1D/H3D mutations of endostatin reduced the zinc binding capacity of M-ES and facilitated PEG covalent binding. PEG-M-ES was more stable and persisted longer in the retina compared with M-ES. The in vitro studies demonstrated that M-ES and PEG-M-ES inhibited HRMEC and HUVEC proliferation, migration, and tube formation more efficiently than ES. In vivo, a single intravitreal injection of M-ES and PEG-M-ES significantly decreased neovascularization in both the OIR and CNV animal models.The present study demonstrated for the first time that PEG-M-ES exhibits a long-term inhibitory effect on neovascularization in vitro and in vivo. These data suggest that PEG-M-ES may represent an innovative therapeutic strategy to prevent fundus neovascularization.

  16. Clinically silent choroid plexus cyst: evaluation by diffusion-weighted MRI

    International Nuclear Information System (INIS)

    We retrospectively reviewed diffusion-weighted magnetic resonance images of 57 patients with a choroid plexus cyst diagnosed by contrast-enhanced T1-weighted imaging. All the cysts appeared to represent incidental findings. Thirty-eight of 57 patients had bilateral cysts and 19 had unilateral ones. On diffusion-weighted images, 78 of 95 cysts showed homogeneously high signal intensity, 12 showed focal high signal areas, and 5 had no portion with a high signal. The apparent diffusion coefficient of the high signal areas in the cysts was (1.46±.14)x10-3 mm2/s, intermediate between the apparent diffusion coefficients of cerebrospinal fluid and cerebral white matter, (3.15±0.67)x10-3 and (0.79±0.22)x10-3mm2/s, respectively. Pathological correlation was available in one case, showing high signal intensity areas in the glomera of the choroid plexuses in the lateral ventricles on diffusion-weighted images corresponding to gelatinous cysts with highly proteinaceous content

  17. Clinically silent choroid plexus cyst: evaluation by diffusion-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kinoshita, Tsohibumi; Sugihara, Shuji; Matsusue, Eiji; Fujii, Shinya [Division of Radiology, Tottori University (Japan); Moritani, Toshio; Hiwatashi, Akio; Numaguchi, Yuji; Wang, H.Z.; Westesson, P.L.A. [Department of Radiology, University of Rochester Medical Center, Rochester, NY (United States); Ohama, Toshidide [Department of Neuropathology, Tottori University, Yonago (Japan)

    2005-04-01

    We retrospectively reviewed diffusion-weighted magnetic resonance images of 57 patients with a choroid plexus cyst diagnosed by contrast-enhanced T1-weighted imaging. All the cysts appeared to represent incidental findings. Thirty-eight of 57 patients had bilateral cysts and 19 had unilateral ones. On diffusion-weighted images, 78 of 95 cysts showed homogeneously high signal intensity, 12 showed focal high signal areas, and 5 had no portion with a high signal. The apparent diffusion coefficient of the high signal areas in the cysts was (1.46{+-}.14) x 10-3 mm{sup 2}/s, intermediate between the apparent diffusion coefficients of cerebrospinal fluid and cerebral white matter, (3.15{+-}0.67) x 10{sup -3} and (0.79{+-}0.22) x 10{sup -3}mm{sup 2}/s, respectively. Pathological correlation was available in one case, showing high signal intensity areas in the glomera of the choroid plexuses in the lateral ventricles on diffusion-weighted images corresponding to gelatinous cysts with highly proteinaceous content.

  18. Histological study of choroidal malignant melanoma treated by carbon ion radiotherapy

    International Nuclear Information System (INIS)

    The purpose of this study was to report, we believe for the first time, a histological study of choroidal malignant melanoma treated by carbon ion beam radiotherapy. A 75-year-old Japanese man was diagnosed as having a choroidal melanoma after undergoing magnetic resonance imaging (MRI). Positron emission tomography (PET) revealed a hot spot in the same location as the intraocular mass seen in MRI. Carbon ion radiotherapy was performed with a total dose of 77 Gy, and the hot spot seen by PET disappeared completely. At 15 months after carbon ion therapy, the eye had to be enucleated because of uncontrollable ocular hypertension. It was examined histologically in serial sections. A large tumor mass (15 x 12 mm) with high pigmentation was found in the vitreous space. Almost all tumor cells showed necrosis in every section. A small number of intact tumor cells were present at the periphery. The overlying retina did not show any necrosis, but showed mild to moderate gliosis. No intraretinal hemorrhage, lipid deposit, or protein exudate was apparent. Almost all tumor cells showed necrosis after radiotherapy with a carbon ion beam. However, the effect on the adjacent tissues was determined as minimal in histological analysis. (author)

  19. SERT and nNOS expression in the choroid plexus of buffalo brain

    Directory of Open Access Journals (Sweden)

    G. Scala

    2010-02-01

    Full Text Available Serotonin (5-HT is a well recognized neurotransmitter in the mammalian central nervous system (CNS. It regulates a variety of physiological functions such as sleep, pain, thermoregulation, feeding, sexual behaviour, and mood. An important component of the 5-HT system is the serotonin transporter SERT which regulates 5-HT homeostasis. Nitric oxide (NO acts as an intercellular messenger in the CNS, and exerts profound effects on the neuroendocrine functions and behaviour. Within neurons, NO is produced by the activity of one of the isoform of NO synthases present in the organism, namely neuronal NO synthase (nNOS. Although a different anatomical distribution of the central neurons synthetizing 5-HT and NO-producing neurons, functional interactions have been demonstrated between the central 5-HT- and NO-generating systems. Recent data indicate that NO may regulate both the intracellular amount of the amine and its intracellular availability by controlling the release and uptake of 5-HT. In this study, we demonstrated the expression of both SERT and nNOS in the choroid plexuses of buffalo brain by scanning electron microscopy (SEM and biochemical analyses. Our findings may provide some insights into the mechanism by which the choroid plexus specific barrier acts for the regulation of the most basic neural functions.

  20. Cilia in the choroid plexus: their roles in hydrocephalus and beyond

    Directory of Open Access Journals (Sweden)

    Keishi eNarita

    2015-02-01

    Full Text Available Cilia are whip-like projections that are widely conserved in eukaryotes and function as a motile propeller and/or sensory platform to detect various extracellular stimuli. In vertebrates, cilia are ubiquitously found in most cells, showing structural and functional diversities depending on the cell type. In this review, we focus on the structure and function of cilia in choroid plexus epithelial cells (CPECs. CPECs form one or two dozen non-motile 9+0 cilia, which display transient acquisition of motility during development. Genetic malfunction of cilia can lead to failure of multiple organs including the brain. Especially, several groups have demonstrated that the defects in CPEC cilia cause the communicating form of hydrocephalus. In order to elucidate the molecular mechanisms underlying the hydrocephalus, we have previously demonstrated that the cilia possess an NPFF receptor for autocrine signaling to regulate transepithelial fluid transport. In this perspective, we also discuss the potential involvement of cilia in the other aspects of choroid plexus functions, such as the regulation of brain development and neuroinflammation.

  1. Targeting choroid plexus epithelia and ventricular ependyma for drug delivery to the central nervous system

    Directory of Open Access Journals (Sweden)

    Stopa Edward G

    2011-01-01

    Full Text Available Abstract Background Because the choroid plexus (CP is uniquely suited to control the composition of cerebrospinal fluid (CSF, there may be therapeutic benefits to increasing the levels of biologically active proteins in CSF to modulate central nervous system (CNS functions. To this end, we sought to identify peptides capable of ligand-mediated targeting to CP epithelial cells reasoning that they could be exploited to deliver drugs, biotherapeutics and genes to the CNS. Methods A peptide library displayed on M13 bacteriophage was screened for ligands capable of internalizing into CP epithelial cells by incubating phage with CP explants for 2 hours at 37C and recovering particles with targeting capacity. Results Three peptides, identified after four rounds of screening, were analyzed for specific and dose dependant binding and internalization. Binding was deemed specific because internalization was prevented by co-incubation with cognate synthetic peptides. Furthermore, after i.c.v. injection into rat brains, each peptide was found to target phage to epithelial cells in CP and to ependyma lining the ventricles. Conclusion These data demonstrate that ligand-mediated targeting can be used as a strategy for drug delivery to the central nervous system and opens the possibility of using the choroid plexus as a portal of entry into the brain.

  2. A missense variant in FGD6 confers increased risk of polypoidal choroidal vasculopathy.

    Science.gov (United States)

    Huang, Lulin; Zhang, Houbin; Cheng, Ching-Yu; Wen, Feng; Tam, Pancy O S; Zhao, Peiquan; Chen, Haoyu; Li, Zheng; Chen, Lijia; Tai, Zhengfu; Yamashiro, Kenji; Deng, Shaoping; Zhu, Xianjun; Chen, Weiqi; Cai, Li; Lu, Fang; Li, Yuanfeng; Cheung, Chui-Ming G; Shi, Yi; Miyake, Masahiro; Lin, Yin; Gong, Bo; Liu, Xiaoqi; Sim, Kar-Seng; Yang, Jiyun; Mori, Keisuke; Zhang, Xiongzhe; Cackett, Peter D; Tsujikawa, Motokazu; Nishida, Kohji; Hao, Fang; Ma, Shi; Lin, He; Cheng, Jing; Fei, Ping; Lai, Timothy Y Y; Tang, Sibo; Laude, Augustinus; Inoue, Satoshi; Yeo, Ian Y; Sakurada, Yoichi; Zhou, Yu; Iijima, Hiroyuki; Honda, Shigeru; Lei, Chuntao; Zhang, Lin; Zheng, Hong; Jiang, Dan; Zhu, Xiong; Wong, Tien-Ying; Khor, Chiea-Chuen; Pang, Chi-Pui; Yoshimura, Nagahisa; Yang, Zhenglin

    2016-06-01

    Polypoidal choroidal vasculopathy (PCV), a subtype of 'wet' age-related macular degeneration (AMD), constitutes up to 55% of cases of wet AMD in Asian patients. In contrast to the choroidal neovascularization (CNV) subtype, the genetic risk factors for PCV are relatively unknown. Exome sequencing analysis of a Han Chinese cohort followed by replication in four independent cohorts identified a rare c.986A>G (p.Lys329Arg) variant in the FGD6 gene as significantly associated with PCV (P = 2.19 × 10(-16), odds ratio (OR) = 2.12) but not with CNV (P = 0.26, OR = 1.13). The intracellular localization of FGD6-Arg329 is distinct from that of FGD6-Lys329. In vitro, FGD6 could regulate proangiogenic activity, and oxidized phospholipids increased expression of FGD6. FGD6-Arg329 promoted more abnormal vessel development in the mouse retina than FGD6-Lys329. Collectively, our data suggest that oxidized phospholipids and FGD6-Arg329 might act synergistically to increase susceptibility to PCV. PMID:27089177

  3. Photodynamic therapy of choroidal neovascularization with enlargement of the spot size to include the feeding complex

    Directory of Open Access Journals (Sweden)

    Ilias Georgalas

    2008-12-01

    Full Text Available Ilias Georgalas, Alexandros A Rouvas, Dimitrios A Karagiannis, Athanasios I Kotsolis, Ioannis D LadasDepartment of Ophthalmology, Medical School of Athens University, Athens, GreeceAbstract: This is a case report of a 83-year-old man with choroidal neovascularization (CNV, due to age-related macular degeneration (AMD in his right eye. Digital fluorescein (FA and indocyanine green angiography (ICG were performed, which disclosed predominantly classic subfoveal CNV and a dilated and tortuous feeding complex. The visual acuity was 20/800. Anti-vascular endothelial growth factor (anti-VEGF treatment was suggested, however, the patient was not keen to receive an intraocular injection. Modified photodynamic therapy (PDT with spot size enlarged, to include not only the CNV lesion but the feeding complex as well, was performed. Ten days after one session of PDT, ICG showed absence of leakage from the CNV and complete occlusion of the feeding complex. The visual acuity gradually improved to 20/100 and remained stable during the following 23 months. No evidence of CNV leakage was seen in the FA and ICG during the follow up period. Adjustment of the PDT spot size to include the detectable by ICG feeding complex might be an additional option in order to close the subfoveal CNV and might be considered as an alternative to intravitreal injection of anti-VEGF in selected cases where anti-VEGF treatment is not available.Keywords: age-related macular degeneration, choroidal neovascularization, photodynamic treatment, feeder vessel

  4. Histopathologic Findings in the Areas of Orange Pigment Overlying Choroidal Melanomas

    Science.gov (United States)

    Garcia, Maria D.; Salomao, Diva R.; Marmorstein, Alan D.; Pulido, Jose S.

    2016-01-01

    Purpose Orange pigment is an important sign of malignancy in melanocytic tumors. There is a question as to whether the pigment accumulation is inside of macrophages or retinal pigment epithelial (RPE) cells. We investigated which cells are involved with this color alteration. Methods We examined enucleated specimens from two patients with choroidal melanoma and dense orange pigment on fundus examination. Color fundus and fundus autofluorescence (FAF) photographs were reviewed followed by examination with fluorescent microscopy, electron microscopy, and immunohistochemistry of enucleated eyes for the specific areas corresponding to the orange pigment. Results Orange pigment was observed on color fundus photography and correlated with areas of hyperautofluorescence on FAF. Fluorescent microscopy of sections of the enucleated eyes showed autofluorescence in the RPE, which were most pronounced where there was a localized retinal detachment and reactive hyperplasia of the RPE. Immunohistochemical studies were done with keratin (OSCAR and AE1/AE3) and S-100 stained RPE cells, which still were attached to Bruch's membrane. Histiocytes present in the detached retina stained with anti-CD163 antibody and did not show autofluorescence. Electron microscopy studies of the same areas showed the presence of lipofuscin and melanolipofuscin within the clustered RPE cells. Conclusions Orange pigment in choroidal melanocytic lesions originates from the RPE cells, rather than macrophages, and is most abundant where there is proliferation of the RPE. Translational Relevance The orange pigment tumoral biomarker arises and is in the retinal pigment epithelium. PMID:27190699

  5. Low-dose radiation therapy for choroidal neovascularization in age-related macular degeneration

    International Nuclear Information System (INIS)

    The efficacy of low-dose radiation was evaluated in the treatment of eyes with subfoveal or juxtafoveal choroidal neovascularization in age-related macular degeneration. Ten eyes of ten patients received a total dose of 14 Gy of 10 MV X-rays in seven fractions and the mean follow-up time was 12 months (range 9-18 months). Thirteen control eyes of thirteen patients were followed for an average of 18 months (range 12-24 months). Visual acuity was improved in 2 eyes (20%), unchanged in 3 eyes (30%), and deteriorated in 5 eyes (50%) of treated patients, and it was improved in no eyes (0%), unchanged in 5 eyes (32%), and deteriorated in 8 eyes (50%) of the control patients at their last follow-up examinations. Funduscopic and angiographic findings were improved in 3 eyes (30%), unchanged in 2 eyes (20%), and deteriorated in 5 eyes (50%) of treated patients, and they were improved in no eyes (0%), unchanged in 5 eyes (32%), and deteriorated in 8 eyes (50%) of the control patients. These results suggested that low-dose radiation is beneficial for the management of subfoveal or juxtafoveal choroidal neovascularization in age-related macular degeneration. (author)

  6. Radiation therapy for small choroidal neovascularization in age-related macular degeneration

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the effects of radiation therapy on age-related macular degeneration with subfoveal or juxtafoveal choroidal neovascularization ≤1 disc area. Fourteen patients (14 eyes) received a total radiation dose of 10-20 Gy in 5-10 fractions. The mean follow-up time was 22 months. Ten patients (10 eyes) in a control group were followed up for an average of 16 months without treatment. At a 12-month posttreatment examination, funduscopic and angiographic findings showed improvement in 7 eyes (50%), no change in 1 eye (7%), and deterioration in 6 eyes (43%) among the treated patients. The same findings demonstrated improvement in 1 eye (10%), no change in 2 eyes (20%), and deterioration in 7 eyes (70%) among the control patients. This difference was determined to be statistically significant between the two groups by the Mann-Whitney U-test. Visual acuity had improved in 4 eyes (29%), was unchanged in 6 eyes (43%), and had declined in 4 eyes (29%), among the treated patients. Among the control patients, visual acuity had improved in none of the eyes (0%), was unchanged in 6 eyes (60%), and had declined in 4 eyes (40%). The difference in visual acuity between the two groups was not statistically significant. Radiation therapy inhibited small choroidal neovascularization, as seen by funduscopy and angiography, but its effectiveness in improving visual prognosis was not always evident. (author)

  7. Radiation therapy for small choroidal neovascularization in age-related macular degeneration

    International Nuclear Information System (INIS)

    Radiation therapy for age-related macular degeneration with subfoveal or juxtafoveal choroidal neovascularization smaller than or equal to 1 disc area was evaluated. Fourteen eyes received a total radiation dose of 10-20 Gy in 5-10 fractions. The mean follow-up time was 22 months. Ten eyes in a control group were followed for an average of 16 months without any treatment. At a 12-month follow-up examination, funduscopic and angiographic findings had improved in 7 eyes (50%), were unchanged in 1 eye (7%) and, had deteriorated in 6 eyes (43%) among the treated patients. The same findings had improved in 1 eye (10%), were unchanged in 2 eyes (20%), and had deteriorated in 7 eyes (70%) among the control patients. There was a statistically significant difference by Mann-Whitney U test between the two groups. Visual acuity had improved in 4 eyes (29%), was unchanged in 6 eyes (43%), and had declined in 4 eyes (29%) among the treated patients. Among the control patients visual acuity had improved in none of the eyes (0%), was unchanged in 6 eyes (60%), and had declined in 4 eyes (40%). The difference between the two groups was not statistically significant. Of the 7 cases whose fundus had improved by 12 months, 4 cases maintained a favorable status through the following 2 years. Radiation therapy had an inhibitory effect on small choroidal neovascularization when viewed by funduscopy and angiography, but, the efficacy for visual prognosis was not always identified. (author)

  8. Radioactive phosphorus uptake test: an in vitro analysis of choroidal melanoma and ocular tissues

    International Nuclear Information System (INIS)

    The concentration of radioactive phosphorus in uveal melanoma and normal parts of the eye was determined in vitro in 14 eyes. The eyes were enucleated after a positive 32P uptake test. Portions of the melanoma as well as normal choroid, retina, sclera, lens, and vitreous were analyzed. The 32P uptake test had been performed at various intervals after intravenous administration of 32P from 24 to 556 hr. The in vitro uptake of 32P was compared to cell type, tumor volume, time of testing, percent uptake measured clinically, and specific activity. The only positive correlation was between percent uptake measured clinically and 32P concentration (dpm/gm). A higher concentration of phosphorus in melanoma resulted when carrier-free 32P was used. A negative correlation existed between number of hours from injection to clinical measurement of percent uptake, although melanoma to normal choroid ratios did not change from 24 to 72 hr. No correlation was found between uptake and tumor volume. The sample was small; however, we saw no correlation between 32P uptake and degree of malignancy

  9. Choroidal metastasis from carcinoma of breast detected on 18F-FDG PET CT scan: a case report and review of literature

    International Nuclear Information System (INIS)

    Intraocular choroidal metastasis is a very rare cause of blindness. Choroidal hemangioma and melanoma are other causes that may mimic the condition. Carcinoma of breast is the most common primary malignancy that accounts for choroidal metastasis in females and carcinoma of lung is the most common cause in males. Other primary neoplasms which can uncommonly metastasize to the choroid are testis, gastrointestinal tract, kidney, thyroid, pancreas, and prostate. Metastatic neoplasm to the eye outnumbers the primary tumors such as retinoblastomas and malignant melanoma. Sonography is usually the initial investigation after fundus examination to look for the architecture of the lesion. However, it lacks in specificity. We present a case of carcinoma of breast that had visual disturbances and wholebody 18F-fluorodeoxyglucose, positron emission tomography-computerized tomography (FDG PET CT) revealed a choroidal lesion in addition to cerebral, pulmonary, and skeletal metastases. Choroidal metastasis from carcinoma of lung has been reported previously on FDG PET. To the best of our knowledge, this is the first case report of carcinoma of breast demonstrating choroid metastasis on 18F-FDG PET CT scan. (author)

  10. Indocyanine green angiography findings in patients with long-standing Vogt-Koyanagi-Harada disease: a cross-sectional study

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    da Silva Felipe T

    2012-08-01

    Full Text Available Abstract Background To investigate indocyanine green angiography (ICGA findings in patients with long-standing Vogt-Koyanagi-Harada (VKH disease and their correlation with disease activity on clinical examination as well as with systemic corticosteroid therapy. Methods Twenty-eight patients (51 eyes with long-standing (≥6 months from disease onset VKH disease whose treatment was tapered based only in clinical features were prospectively included at a single center in Brazil. All patients underwent standardized clinical evaluation, which included fundus photography, fluorescein angiography and ICGA. Clinical disease activity was determined based in the Standardization in Uveitis Nomenclature Working Group. Fisher exact test and logistic regression models were used for statistical analysis. Results Disease-related choroidal inflammation on ICGA was observed in 72.5% (31 of 51 eyes. Angiographic findings suggestive of (choroidal and/or retinal disease activity were not observed on FA. Clinically active disease based on clinical evaluation was observed in 41.2% (21 of 51 eyes. In these 21 eyes, disease-related choroidal inflammation on ICGA was observed in 76.2% (16 of 21 eyes; in the remaining eyes (without clinical active disease disease-related choroidal inflammation on ICGA was observed in 70.0% (21 of 30 eyes. In respect to systemic corticosteroid therapy, 10 patients (18 of 51 eyes were under treatment with prednisone. In these 10 (18 of 51 eyes patients, disease-related choroidal inflammation on ICGA was observed in 83.3% (15 of 18 eyes; in the remaining patients (33 of 51 eyes disease-related choroidal inflammation on ICGA was observed in 66.7% (22 of 33 eyes. Conclusion ICGA findings suggestive of disease-related choroidal inflammation were observed in a considerable proportion of patients with long-standing VKH disease, independent of the inflammatory status of the disease on clinical examination or current use of systemic

  11. Comparison of In Vivo Gene Expression Profiling of RPE/Choroid following Intravitreal Injection of Dexamethasone and Triamcinolone Acetonide.

    Science.gov (United States)

    Smit-McBride, Zeljka; Moisseiev, Elad; Modjtahedi, Sara P; Telander, David G; Hjelmeland, Leonard M; Morse, Lawrence S

    2016-01-01

    Purpose. To identify retinal pigment epithelium (RPE)/choroid genes and their relevant expression pathways affected by intravitreal injections of dexamethasone and triamcinolone acetonide in mice at clinically relevant time points for patient care. Methods. Differential gene expression of over 34,000 well-characterized mouse genes in the RPE/choroid of 6-week-old C57BL/6J mice was analyzed after intravitreal steroid injections at 1 week and 1 month postinjection, using Affymetrix Mouse Genome 430 2.0 microarrays. The data were analyzed using GeneSpring GX 12.5 and Ingenuity Pathway Analysis (IPA) microarray analysis software for biologically relevant changes. Results. Both triamcinolone and dexamethasone caused differential activation of genes involved in "Circadian Rhythm Signaling" pathway at both time points tested. Triamcinolone (TAA) uniquely induced significant changes in gene expression in "Calcium Signaling" (1 week) and "Glutamate Receptor Signaling" pathways (1 month). In contrast, dexamethasone (Dex) affected the "GABA Receptor Signaling" (1 week) and "Serotonin Receptor Signaling" (1 month) pathways. Understanding how intraocular steroids affect the gene expression of RPE/choroid is clinically relevant. Conclusions. This in vivo study has elucidated several genes and pathways that are potentially altering the circadian rhythms and several other neurotransmitter pathways in RPE/choroid during intravitreal steroid injections, which likely has consequences in the dysregulation of RPE function and neurodegeneration of the retina. PMID:27429799

  12. Comparison of In Vivo Gene Expression Profiling of RPE/Choroid following Intravitreal Injection of Dexamethasone and Triamcinolone Acetonide

    Directory of Open Access Journals (Sweden)

    Zeljka Smit-McBride

    2016-01-01

    Full Text Available Purpose. To identify retinal pigment epithelium (RPE/choroid genes and their relevant expression pathways affected by intravitreal injections of dexamethasone and triamcinolone acetonide in mice at clinically relevant time points for patient care. Methods. Differential gene expression of over 34,000 well-characterized mouse genes in the RPE/choroid of 6-week-old C57BL/6J mice was analyzed after intravitreal steroid injections at 1 week and 1 month postinjection, using Affymetrix Mouse Genome 430 2.0 microarrays. The data were analyzed using GeneSpring GX 12.5 and Ingenuity Pathway Analysis (IPA microarray analysis software for biologically relevant changes. Results. Both triamcinolone and dexamethasone caused differential activation of genes involved in “Circadian Rhythm Signaling” pathway at both time points tested. Triamcinolone (TAA uniquely induced significant changes in gene expression in “Calcium Signaling” (1 week and “Glutamate Receptor Signaling” pathways (1 month. In contrast, dexamethasone (Dex affected the “GABA Receptor Signaling” (1 week and “Serotonin Receptor Signaling” (1 month pathways. Understanding how intraocular steroids affect the gene expression of RPE/choroid is clinically relevant. Conclusions. This in vivo study has elucidated several genes and pathways that are potentially altering the circadian rhythms and several other neurotransmitter pathways in RPE/choroid during intravitreal steroid injections, which likely has consequences in the dysregulation of RPE function and neurodegeneration of the retina.

  13. Poor Uptake of Fluorodeoxyglucose in Positron Emission Tomography-Computed Tomography Scan for Intraocular Choroidal Melanoma in Asian Indian Eyes

    OpenAIRE

    Sharma, Rahul S.; Parag K Shah; Narendran, Venkatapathy

    2016-01-01

    Fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) scan is fast becoming a very useful tool in diagnosing and staging of several malignancies that affect the human body. We report three cases of ocular choroidal malignant melanoma, wherein FDG PET-CT scan did not show as good uptake as seen in other cancers.

  14. Discrepancy in compliance between the clinical and genetic diagnosis of choroidal hypoplasia in Danish Rough Collies and Shetland Sheepdogs

    DEFF Research Database (Denmark)

    Fredholm, Merete; Larsen, R. C.; Jönsson, M.; Söderlund, M. A.; Hardon, T.; Proschowsky, H. F.

    2016-01-01

    Collie eye anomaly (CEA) is a congenital, inherited ocular disorder which is widespread in herding breeds. Clinically, the two major lesions associated with CEA are choroidal hypoplasia (CH) and coloboma, and both lesions are diagnosed based on ophthalmological examination. A 7.8-kb intronic...

  15. Comparison of In Vivo Gene Expression Profiling of RPE/Choroid following Intravitreal Injection of Dexamethasone and Triamcinolone Acetonide

    Science.gov (United States)

    Smit-McBride, Zeljka; Moisseiev, Elad; Modjtahedi, Sara P.; Telander, David G.; Hjelmeland, Leonard M.; Morse, Lawrence S.

    2016-01-01

    Purpose. To identify retinal pigment epithelium (RPE)/choroid genes and their relevant expression pathways affected by intravitreal injections of dexamethasone and triamcinolone acetonide in mice at clinically relevant time points for patient care. Methods. Differential gene expression of over 34,000 well-characterized mouse genes in the RPE/choroid of 6-week-old C57BL/6J mice was analyzed after intravitreal steroid injections at 1 week and 1 month postinjection, using Affymetrix Mouse Genome 430 2.0 microarrays. The data were analyzed using GeneSpring GX 12.5 and Ingenuity Pathway Analysis (IPA) microarray analysis software for biologically relevant changes. Results. Both triamcinolone and dexamethasone caused differential activation of genes involved in “Circadian Rhythm Signaling” pathway at both time points tested. Triamcinolone (TAA) uniquely induced significant changes in gene expression in “Calcium Signaling” (1 week) and “Glutamate Receptor Signaling” pathways (1 month). In contrast, dexamethasone (Dex) affected the “GABA Receptor Signaling” (1 week) and “Serotonin Receptor Signaling” (1 month) pathways. Understanding how intraocular steroids affect the gene expression of RPE/choroid is clinically relevant. Conclusions. This in vivo study has elucidated several genes and pathways that are potentially altering the circadian rhythms and several other neurotransmitter pathways in RPE/choroid during intravitreal steroid injections, which likely has consequences in the dysregulation of RPE function and neurodegeneration of the retina.

  16. Na(+) dependent acid-base transporters in the choroid plexus; insights from slc4 and slc9 gene deletion studies

    DEFF Research Database (Denmark)

    Christensen, Henriette L; Nguyen, An T; Pedersen, Fredrik D;

    2013-01-01

    The choroid plexus epithelium (CPE) is located in the ventricular system of the brain, where it secretes the majority of the cerebrospinal fluid (CSF) that fills the ventricular system and surrounds the central nervous system. The CPE is a highly vascularized single layer of cuboidal cells with a...

  17. Retinal and choroidal TGF-beta in the tree shrew model of myopia: isoform expression, activation and effects on function.

    Science.gov (United States)

    Jobling, Andrew Ian; Wan, Ran; Gentle, Alex; Bui, Bang Viet; McBrien, Neville Anthony

    2009-03-01

    A visually evoked signalling cascade, which begins in the retina, transverses the choroid, and mediates scleral remodelling, is considered to control eye growth. The ubiquitous cytokine TGF-beta has been associated with alterations in ocular growth, where alterations in scleral TGF-beta isoforms mediate the scleral remodelling that results in myopia. However, while the TGF-beta isoforms have been implicated in the scleral change during myopia development, it is unclear whether alterations in retinal and choroidal isoforms constitute part of the retinoscleral cascade. This study characterised the retinal and choroidal TGF-beta isoform profiles and TGF-beta2 activation during different stages of myopia development, as induced by form deprivation, in a mammalian model of eye growth. Using quantitative real-time PCR, the mRNA for all three mammalian isoforms of TGF-beta was detected in tree shrew retina and choroid. Distinct tissue-specific isoform profiles were observed for the retina (TGF-beta1:TGF-beta2:TGF-beta3=20:2085:1) and choroid (TGF-beta1:TGF-beta2:TGF-beta3=16:23:1), which remained constant over the development period under investigation. The active and latent pools of retinal TGF-beta2 were quantified using ELISA with the majority (>94%) of total TGF-beta2 found in the latent form. Unlike previous scleral data showing early and continuous decreases in TGF-beta isoform expression during myopia development, the levels of the three isoforms remained within normal ranges for retinal (TGF-beta1, -14 to +14%; TGF-beta2, -2 to +20%; TGF-beta3, -10 to +26%) and choroidal (TGF-beta1, -19 to +21%; TGF-beta2, -26 to +8%; TGF-beta3, -11 to +28%) tissues during myopia development (induction times of 3h, 7h, 11h, 24h, and 5 days). A 40% decrease in retinal TGF-beta2 activation was observed after 5 days of myopia development, however, there was no functional correlate of altered TGF-beta2 activity, as assessed by the retinal ERG response. Overall, these data highlight

  18. PRIMARY CULTURE OF CHOROIDAL EPITHELIAL CELLS: CHARACTERIZATION OF AN IN VITRO MODEL OF BLOOD-CSF BARRIER

    Science.gov (United States)

    ZHENG, WEI; ZHAO, QIUQU; GRAZIANO, JOSEPH H.

    2016-01-01

    Summary 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 × 104 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. PMID:9542634

  19. T-Lymphocytes Traffic into the Brain across the Blood-CSF Barrier: Evidence Using a Reconstituted Choroid Plexus Epithelium.

    Science.gov (United States)

    Strazielle, Nathalie; Creidy, Rita; Malcus, Christophe; Boucraut, José; Ghersi-Egea, Jean-François

    2016-01-01

    An emerging concept of normal brain immune surveillance proposes that recently and moderately activated central memory T lymphocytes enter the central nervous system (CNS) directly into the cerebrospinal fluid (CSF) via the choroid plexus. Within the CSF space, T cells inspect the CNS environment for cognate antigens. This gate of entry into the CNS could also prevail at the initial stage of neuroinflammatory processes. To actually demonstrate T cell migration across the choroidal epithelium forming the blood-CSF barrier, an in vitro model of the rat blood-CSF barrier was established in an "inverse" configuration that enables cell transmigration studies in the basolateral to apical, i.e. blood/stroma to CSF direction. Structural barrier features were evaluated by immunocytochemical analysis of tight junction proteins, functional barrier properties were assessed by measuring the monolayer permeability to sucrose and the active efflux transport of organic anions. The migratory behaviour of activated T cells across the choroidal epithelium was analysed in the presence and absence of chemokines. The migration pathway was examined by confocal microscopy. The inverse rat BCSFB model reproduces the continuous distribution of tight junction proteins at cell margins, the restricted paracellular permeability, and polarized active transport mechanisms, which all contribute to the barrier phenotype in vivo. Using this model, we present experimental evidence of T cell migration across the choroidal epithelium. Cell migration appears to occur via a paracellular route without disrupting the restrictive barrier properties of the epithelial interface. Apical chemokine addition strongly stimulates T cell migration across the choroidal epithelium. The present data provide evidence for the controlled migration of T cells across the blood-CSF barrier into brain. They further indicate that this recruitment route is sensitive to CSF-borne chemokines, extending the relevance of this

  20. The heritability of glaucoma-related traits corneal hysteresis, central corneal thickness, intraocular pressure, and choroidal blood flow pulsatility.

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    Ellen E Freeman

    Full Text Available PURPOSE: The purpose of this work was to investigate the heritability of potential glaucoma endophenotypes. We estimated for the first time the heritability of the pulsatility of choroidal blood flow. We also sought to confirm the heritability of corneal hysteresis, central corneal thickness, and 3 ways of measuring intraocular pressure. METHODS: Measurements were performed on 96 first-degree relatives recruited from Maisonneuve-Rosemont Hospital in Montreal. Corneal hysteresis was determined using the Reichert Ocular Response Analyser. Central corneal thickness was measured with an ultrasound pachymeter. Three measures of intraocular pressure were obtained: Goldmann-correlated and corneal compensated intraocular pressure using the Ocular Response Analyser, and Pascal intraocular pressure using the Pascal Dynamic Contour Tonometer. The pulsatility of choroidal blood velocity and flow were measured in the sub-foveolar choroid using single-point laser Doppler flowmetry (Oculix. We estimated heritability using maximum-likelihood variance components methods implemented in the SOLAR software. RESULTS: No significant heritability was detected for the pulsatility of choroidal blood flow or velocity. The Goldman-correlated, corneal compensated, and Pascal measures of intraocular pressure measures were all significantly heritable at 0.94, 0.79, and 0.53 after age and sex adjustment (p = 0.0003, p = 0.0023, p = 0.0239. Central corneal thickness was significantly heritable at 0.68 (p = 0.0078. Corneal hysteresis was highly heritable but the estimate was at the upper boundary of 1.00 preventing us from giving a precise estimate. CONCLUSION: Corneal hysteresis, central corneal thickness, and intraocular pressure are all heritable and may be suitable as glaucoma endophenotypes. The pulsatility of choroidal blood flow and blood velocity were not significantly heritable in this sample.

  1. HIV infection of choroid plexus in AIDS and asymptomatic HIV-infected patients suggests that the choroid plexus may be a reservoir of productive infection.

    Science.gov (United States)

    Petito, C K; Chen, H; Mastri, A R; Torres-Munoz, J; Roberts, B; Wood, C

    1999-12-01

    The choroid plexus (CPx) may be an important site of viral dissemination since monocytes and dendritic cells in its stroma are infected with HIV in AIDS patients and since the ratio of CPx to brain infection is more than 2 : 1. In order to see if CPx infection also develops in asymptomatic (ASY) HIV-infected patients, we examined archival formalin-fixed brain and CPx from 14 AIDS and seven ASY cases, using routine histology, immunohistochemistry for HIV gp41, and DNA extraction and gene amplification for HIV DNA. Eight of 14 AIDS (57%) had HIV-positive cells in the CPx and four (29%) had HIV encephalitis. Two of seven ASY cases (29%) had HIV-positive cells in the CPx but none had HIV encephalitis. Extracted DNA from brain, CPx and systemic organs of five ASY cases was amplified by nested PCR with or without Southern blotting for HIV env gene. It was positive in systemic organs in five cases; in CPx in four cases; and in brain in one case. This study shows that the CPx is a site of HIV infection in ASY patients and that the frequency of CPx infection is higher than seen in brain in both AIDS and ASY cases. The results are consistent with the hypothesis that the CPx may be a site for hematogeneous spread and a reservoir for HIV infection during the period of clinical latency. PMID:10602407

  2. Long-Term Changes in Subfoveal Choroidal Thickness After Cataract Surgery.

    Science.gov (United States)

    Yılmaz, Tolga; Karci, Ayse Aslihan; Yilmaz, İhsan; Yılmaz, Ahu; Yıldırım, Yusuf; Sakalar, Yildirim Bayezit

    2016-01-01

    BACKGROUND Cataract surgery is associated with the development of late-onset age-related macular degeneration (AMD). The pathogenic mechanism is still not fully established. The purpose of this study was to evaluate the possible changes in central macula thickness (CMT) and subfoveal choroid thickness (SCT) after uneventful cataract surgery. MATERIAL AND METHODS A total of 65 eyes of 65 patients who underwent phacoemulsification and intracapsular lens implantation were included in this prospective study. Patients had not undergone previous ocular surgery and had no other ocular abnormality. CMT and SCT were measured at baseline and postoperatively at week 1 and months 1, 3, 6 and 12 via spectral domain optical cohorence tomography (SD-OCT). RESULTS CMT was 252.4±27.6 μm (mean ±SD) preoperatively, then 253.5±29.8, 256.1±28.7, 257.4±27.2, 253.18±23.7, and 252.8±21.7 μm at postoperative week 1 and postoperative months 1, 3, 6, and 12, respectively. There were insignificant changes in CMT, and it returned to baseline at six months after surgery (all p>0.05). SCT was 237.4±21.6 μm preoperatively, and 240.5±24.8, 241.2±25.7, 242.7±26.3, 243.1±24.2, and 244.2±21.4 μm at postoperative week 1 and postoperative months 1, 3, 6, and 12, respectively. Although there was an increase in SCT during follow-up, the difference between preoperative and postoperative values was not significant (p>0.05). CONCLUSIONS Uncomplicated phacoemulsification induces subclinical changes in CMT, probably due to the inflammatory insult of surgery, and CMT returns to baseline value. There were slight, insignificant increases in choroid thickness during follow-up, and this did not return to baseline during follow-up. Changes in the choroid after cataract surgery may provide clues to the development of late-onset AMD. PMID:27158971

  3. Choroid plexus epithelial monolayers – a cell culture model from porcine brain

    Directory of Open Access Journals (Sweden)

    Reichel Valeska

    2006-12-01

    Full Text Available Abstract Background The goal of the present study was to develop an in vitro choroid plexus (CP epithelial cell culture model for studying transport of protein-mediated drug secretion from blood to cerebrospinal fluid (CSF and vice versa. Methods Cells were isolated by mechanical and enzymatic treatment of freshly isolated porcine plexus tissue. Epithelial cell monolayers were grown and CSF secretion and transepithelial resistance were determined. The expression of f-actin as well as the choroid plexus marker protein transthyretin (TTR, were assessed. The expression of the export proteins p-glycoprotein (Pgp, Abcb1 and multidrug resistance protein 1 (Mrp1, Abcc1 was studied by RT-PCR, Western-blot and immunofluorescence techniques and their functional activity was assessed by transport and uptake experiments. Results Choroid plexus epithelial cells were isolated in high purity and grown to form confluent monolayers. Filter-grown monolayers displayed transendothelial resistance (TEER values in the range of 100 to 150 Ωcm2. Morphologically, the cells showed the typical net work of f-actin and expressed TTR at a high rate. The cultured cells were able to secrete CSF at a rate of 48.2 ± 4.6 μl/cm2/h over 2–3 hours. The ABC-export protein Mrp1 was expressed in the basolateral (blood-facing membranes of cell monolayers and intact tissue. P-glycoprotein showed only low expression within the apical (CSF directed membrane but was located more in sub-apical cell compartments. This finding was paralleled by the lack of directed excretion of p-glycoprotein substrates, verapamil and rhodamine 123. Conclusion It was demonstrated that CP epithelium can be isolated and cultured, with cells growing into intact monolayers, fully differentiating and with properties resembling the tissue in vivo. Thus, the established primary porcine CP model, allowing investigation of complex transport processes, can be used as a reliable tool for analysis of xenobiotic

  4. Melissa officinalis extract inhibits laser-induced choroidal neovascularization in a rat model.

    Directory of Open Access Journals (Sweden)

    Eun Kyoung Lee

    Full Text Available PURPOSE: This study investigated the effect of Melissa officinalis extract on laser-induced choroidal neovascularization (CNV in a rat model. The mechanism by which M. officinalis extract acted was also investigated. METHODS: Experimental CNV was induced by laser photocoagulation in Brown Norway rats. An active fraction of the Melissa leaf extract was orally administered (50 or 100 mg/kg/day beginning 3 days before laser photocoagulation and ending 14 days after laser photocoagulation. Optical coherence tomography and fluorescein angiography were performed in vivo to evaluate the thickness and leakage of CNV. Choroidal flat mount and histological analysis were conducted to observe the CNV in vitro. Vascular endothelial growth factor (VEGF, matrix metalloproteinase (MMP-2, and MMP-9 expression were measured in retinal and choroidal-scleral lysates 7 days after laser injury. Moreover, the effect of M. officinalis extract on tertiary-butylhydroperoxide (t-BH-induced VEGF secretion and mRNA levels of VEGF, MMP-2, and MMP-9 were evaluated in human retinal epithelial cells (ARPE-19 as well as in human umbilical vein endothelial cells (HUVECs. RESULTS: The CNV thickness in M. officinalis-treated rats was significantly lower than in vehicle-treated rats by histological analysis. The CNV thickness was 33.93±7.64 µm in the high-dose group (P<0.001, 44.09±12.01 µm in the low-dose group (P = 0.016, and 51.00±12.37 µm in the control group. The proportion of CNV lesions with clinically significant fluorescein leakage was 9.2% in rats treated with high-dose M. officinalis, which was significantly lower than in control rats (53.4%, P<0.001. The levels of VEGF, MMP-2, and MMP-9 were significantly lower in the high-dose group than in the control group. Meanwhile, M. officinalis extract suppressed t-BH-induced transcription of VEGF and MMP-9 in ARPE-19 cells and HUVECs. CONCLUSIONS: Systemic administration of M. officinalis extract suppressed laser

  5. Retinal Inhibition of CCR3 Induces Retinal Cell Death in a Murine Model of Choroidal Neovascularization.

    Science.gov (United States)

    Wang, Haibo; Han, Xiaokun; Gambhir, Deeksha; Becker, Silke; Kunz, Eric; Liu, Angelina Jingtong; Hartnett, M Elizabeth

    2016-01-01

    Inhibition of chemokine C-C motif receptor 3 (CCR3) signaling has been considered as treatment for neovascular age-related macular degeneration (AMD). However, CCR3 is expressed in neural retina from aged human donor eyes. Therefore, broad CCR3 inhibition may be harmful to the retina. We assessed the effects of CCR3 inhibition on retina and choroidal endothelial cells (CECs) that develop into choroidal neovascularization (CNV). In adult murine eyes, CCR3 colocalized with glutamine-synthetase labeled Műller cells. In a murine laser-induced CNV model, CCR3 immunolocalized not only to lectin-stained cells in CNV lesions but also to the retina. Compared to non-lasered controls, CCR3 mRNA was significantly increased in laser-treated retina. An intravitreal injection of a CCR3 inhibitor (CCR3i) significantly reduced CNV compared to DMSO or PBS controls. Both CCR3i and a neutralizing antibody to CCR3 increased TUNEL+ retinal cells overlying CNV, compared to controls. There was no difference in cleaved caspase-3 in laser-induced CNV lesions or in overlying retina between CCR3i- or control-treated eyes. Following CCR3i, apoptotic inducible factor (AIF) was significantly increased and anti-apoptotic factor BCL2 decreased in the retina; there were no differences in retinal vascular endothelial growth factor (VEGF). In cultured human Műller cells exposed to eotaxin (CCL11) and VEGF, CCR3i significantly increased TUNEL+ cells and AIF but decreased BCL2 and brain derived neurotrophic factor, without affecting caspase-3 activity or VEGF. CCR3i significantly decreased AIF in RPE/choroids and immunostaining of phosphorylated VEGF receptor 2 (p-VEGFR2) in CNV with a trend toward reduced VEGF. In cultured CECs treated with CCL11 and/or VEGF, CCR3i decreased p-VEGFR2 and increased BCL2 without increasing TUNEL+ cells and AIF. These findings suggest that inhibition of retinal CCR3 causes retinal cell death and that targeted inhibition of CCR3 in CECs may be a safer if CCR3 inhibition

  6. Long-term Results of the UCSF-LBNL Randomized Trial: Charged Particle With Helium Ion Versus Iodine-125 Plaque Therapy for Choroidal and Ciliary Body Melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Mishra, Kavita K., E-mail: Kavita.mishra@ucsf.edu [Department of Radiation Oncology, University of California-San Francisco, San Francisco, California (United States); Quivey, Jeanne M.; Daftari, Inder K. [Department of Radiation Oncology, University of California-San Francisco, San Francisco, California (United States); Lawrence Berkeley National Laboratory, Berkeley, California (United States); Weinberg, Vivian [Department of Radiation Oncology, University of California-San Francisco, San Francisco, California (United States); Cole, Tia B. [The Tumori Foundation, San Francisco, California (United States); Patel, Kishan [Department of Radiation Oncology, University of California-San Francisco, San Francisco, California (United States); Castro, Joseph R.; Phillips, Theodore L. [Department of Radiation Oncology, University of California-San Francisco, San Francisco, California (United States); Lawrence Berkeley National Laboratory, Berkeley, California (United States); Char, Devron H. [The Tumori Foundation, San Francisco, California (United States); Department of Ophthalmology, University of California-San Francisco, San Francisco, California (United States); Department of Ophthalmology, Stanford University, Palo Alto, California (United States)

    2015-06-01

    Purpose: Relevant clinical data are needed given the increasing national interest in charged particle radiation therapy (CPT) programs. Here we report long-term outcomes from the only randomized, stratified trial comparing CPT with iodine-125 plaque therapy for choroidal and ciliary body melanoma. Methods and Materials: From 1985 to 1991, 184 patients met eligibility criteria and were randomized to receive particle (86 patients) or plaque therapy (98 patients). Patients were stratified by tumor diameter, thickness, distance to disc/fovea, anterior extension, and visual acuity. Tumors close to the optic disc were included. Local tumor control, as well as eye preservation, metastases due to melanoma, and survival were evaluated. Results: Median follow-up times for particle and plaque arm patients were 14.6 years and 12.3 years, respectively (P=.22), and for those alive at last follow-up, 18.5 and 16.5 years, respectively (P=.81). Local control (LC) for particle versus plaque treatment was 100% versus 84% at 5 years, and 98% versus 79% at 12 years, respectively (log rank: P=.0006). If patients with tumors close to the disc (<2 mm) were excluded, CPT still resulted in significantly improved LC: 100% versus 90% at 5 years and 98% versus 86% at 12 years, respectively (log rank: P=.048). Enucleation rate was lower after CPT: 11% versus 22% at 5 years and 17% versus 37% at 12 years, respectively (log rank: P=.01). Using Cox regression model, likelihood ratio test, treatment was the most important predictor of LC (P=.0002) and eye preservation (P=.01). CPT was a significant predictor of prolonged disease-free survival (log rank: P=.001). Conclusions: Particle therapy resulted in significantly improved local control, eye preservation, and disease-free survival as confirmed by long-term outcomes from the only randomized study available to date comparing radiation modalities in choroidal and ciliary body melanoma.

  7. Infectious diseases

    International Nuclear Information System (INIS)

    Central nervous system infections represents a group of life-threatening diseases that present a formidable challenge to physicians. Despite the development of effective antimicrobial agents and modern surgical techniques, significant mortality and morbidity with CNS infections persist. Since the introduction of computed tomography, there is evidence of a marked decrease in mortality among patients with brain abscesses, although the morbidity has not changed significantly. CT correlation with pathology of the various CNS infections may aid in earlier diagnosis and bring about further disease in morbidity and mortality. Infections reach the brain or meninges mainly by two routes: (1) hematogenous dissemination from a distant infective focus to the meninges, corticomedullary junction, and choroid plexus; (2) direct extension by bony erosion for an adjacent focus of suppuration (otitis, mastoidits, sinusitis), by transmission along anaostomotic veins from the face, scalp, and orbits, and by transmission along cranial nerves following neurosurgery or traumatic craniocerebral wounds. Certain external factors serve to enhance the risk of intracranial infections, such as radiation; immunosuppressive or steroid therapy; cyanotic congenital heart disease; systemic illness such as diabetes mellitus, alcoholism, or cirrhosis; leukemia, lymphoma, or agammaglobulinemia; severe body stress; midline bony fusion defects; surgical or traumatic craniocerebral injury; and pulmonary or other systemic infections

  8. Transpupillary thermotherapy for choroidal neovascular membrane in age related macular degeneration

    Directory of Open Access Journals (Sweden)

    Agarwal Manisha

    2004-01-01

    Full Text Available Purpose: To evaluate the efficacy of transpupillary thermotherapy (TTT in choroidal neovasularisation (CNVM secondary to age related macular degeneration ( AMD. Material and methods: Retrospective, non-randomized study of 28 eyes of 28 patients with subfoveal CNVM (classic, occult or mixed secondary to AMD. Results: Fifteen patients (53.57% maintained their pre-treatment vision, 2 (7.14% patients showed improvement of more than 2 lines and 11(39.28% patients showed deterioration of vision by> 2 lines. Angiographic and clinical regression of CNVM was noted in 19 patients (67.8% on an average follow up of 15.32 ± 3.31 months. Conclusion: TTT leads to stabilisation of vision in 60% of treated eyes with CNVM due to AMD.

  9. Cellular Specificity of the Blood-CSF Barrier for Albumin Transfer across the Choroid Plexus Epithelium

    DEFF Research Database (Denmark)

    Liddelow, Shane A; Dzięgielewska, Katarzyna M; Møllgård, Kjeld;

    2014-01-01

    in albumin transport into developing brain, however the exact mechanism remains unknown. We postulate that SPARC is a docking site for albumin, mediating its uptake and transfer by choroid plexus epithelial cells from blood into cerebrospinal fluid (CSF). We used in vivo physiological measurements...... of transfer of endogenous (mouse) and exogenous (human) albumins, in situ Proximity Ligation Assay (in situ PLA), and qRT-PCR experiments to examine the cellular mechanism mediating protein transfer across the blood-CSF interface. We report that at all developmental stages mouse albumin and SPARC gave...... positive signals with in situ PLAs in plasma, CSF and within individual plexus cells suggesting a possible molecular interaction. In contrast, in situ PLA experiments in brain sections from mice injected with human albumin showed positive signals for human albumin in the vascular compartment that were only...

  10. Aging. Aging-induced type I interferon signaling at the choroid plexus negatively affects brain function

    Science.gov (United States)

    Baruch, Kuti; Deczkowska, Aleksandra; David, Eyal; Castellano, Joseph M.; Miller, Omer; Kertser, Alexander; Berkutzki, Tamara; Barnett-Itzhaki, Zohar; Bezalel, Dana; Wyss-Coray, Tony; Amit, Ido; Schwartz, Michal

    2016-01-01

    Age-associated cognitive decline is affected by factors produced inside and outside the brain. We found in aged mice and humans, that the choroid plexus (CP), an epithelial interface between the brain and the circulation, shows a type I interferon (IFN-I)-dependent expression profile, often associated with anti-viral responses. This signature was induced by brain-derived signals present in the cerebrospinal fluid of aged mice. Blocking IFN-I signaling within the brain of cognitively-impaired aged mice, using IFN-I receptor neutralizing antibody, led to partial restoration of cognitive function and hippocampal neurogenesis, and reestablished IFN-II-dependent CP activity, lost in aging. Our data identify an aging-induced IFN-I signature at the CP, and demonstrate its negative influence on brain function, thereby suggesting a potential target for therapeutic intervention for age-related cognitive decline. PMID:25147279

  11. Ranibizumab for choroidal neovascularization following atrophic involution of adult-onset foveomacular vitelliform dystrophy.

    Directory of Open Access Journals (Sweden)

    Sebastian Martinez-Castillo

    2013-10-01

    Full Text Available Purpose: We report a case of adult-onset foveomacular vitelliform dystrophy (AOFVD complicated with atrophic involution and subsequent choroidal neovascularization (CNV and treated with intravitreal ranibizumab. Design: Case Report Methods: A 71-year-old woman diagnosed with AOFVD experienced a progression of the vitelliform lesion to the atrophic stage in her left eye immediately after cataract surgery. Best corrected visual acuity (BCVA decreased from 0.5 to 0.16. Ten months later, the patient was referred with new worsening of her visual acuity (0.05 and metamorphopsia. The spectral-domain optical coherence tomography (SD-OCT confirmed the presence of type 2 CNV next to the atrophic area. The patient was treated with 2 monthly injections of ranibizumab. Results: SD-OCT images improved significantly and her BCVA increased to 0.20 associated with subjective improvement of metamorphopsia. Conclusion: Ranibizumab may be effective for CNV in patients with AOFVD.

  12. A multimodal approach to the treatment of bilateral choroidal metastases from thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Luca Cionini

    2009-07-01

    Full Text Available A 58-year old man, affected by metastatic thyroid carcinoma, experienced a progressive bilateral visual impairment. Ophthalmic examination revealed the presence of a choroidal mass with an associated exudative retinal detachment in both eyes. Twelve years before, a diagnosis of metastatic thyroid carcinoma had been established and the patient had been subject to several therapeutic procedures. In May 2007, he received a radiotherapy treatment to the left eye with an episcleral plaque and bilateral bulbar injection of bevacizumab. The patient had a rapid and stable visual acuity recovery. Twenty months after treatment, the lesion treated with radiotherapy was still stable whereas the contra-lateral lesion had evolved and determined a vitreal hemorrhage.

  13. Hemorrhagic choroidal detachment after use of anti-glaucomatous eye drops: case report

    Directory of Open Access Journals (Sweden)

    Deniz Turgut Coban

    2013-10-01

    Full Text Available Eighty-two-year-old patient with a pacemaker using warfarin due to arrhythmia and having an intraocular lens in the right eye, developed spontaneous hemorrhagic choroidal detachment one day after the use of combined preparation of 0.5% timolol maleate and 0.004% travoprost, due to primary open-angle glaucoma. Hemorrhagic detachment was detected by anterior and posterior segment examination, as well as B-scan ultrasonography. After the detachment, excessive increased intraocular pressure was controlled with oral carbonic anhydrase inhibitor, cycloplegic and steroid therapy. After four months, visual acuity was 20/20 and the intraocular pressure was under control with 0.5% timolol maleate and 1% brinzolamide. Controlled reduction of the intraocular pressure should be considered, particularly in older patients under anticoagulant therapy and that had undergone prior ocular surgery.

  14. Hemorrhagic choroidal detachment after use of anti-glaucomatous eye drops: case report.

    Science.gov (United States)

    Coban, Deniz Turgut; Erol, Muhammet Kazim; Yucel, Ozgur

    2013-10-01

    Eighty-two-year-old patient with a pacemaker using warfarin due to arrhythmia and having an intraocular lens in the right eye, developed spontaneous hemorrhagic choroidal detachment one day after the use of combined preparation of 0.5% timolol maleate and 0.004% travoprost, due to primary open-angle glaucoma. Hemorrhagic detachment was detected by anterior and posterior segment examination, as well as B-scan ultrasonography. After the detachment, excessive increased intraocular pressure was controlled with oral carbonic anhydrase inhibitor, cycloplegic and steroid therapy. After four months, visual acuity was 20/20 and the intraocular pressure was under control with 0.5% timolol maleate and 1% brinzolamide. Controlled reduction of the intraocular pressure should be considered, particularly in older patients under anticoagulant therapy and that had undergone prior ocular surgery. PMID:24232947

  15. Choroid Plexus

    Science.gov (United States)

    ... not known. Treatment Surgery may be the only treatment required if the tumor is completely removed. Tumor removal relieves the hydrocephalus (excess water in the brain) about half of the time. A shunt (drainage system) may be required for other patients. The role ...

  16. Three year results of stereotactic radiosurgery of large choroidal melanomas with the gamma-knife

    International Nuclear Information System (INIS)

    Eye preserving surgery in patients with large choroidal melanomas includes local resection or radiosurgery. Brachytherapy can only be applied to small tumors in adequate localisation while radiosurgery (charged particles or gamma-knife) can be applied to all other tumors. We report 3-year results of 100 patients treated with gamma-knife radiosurgery. All patients received a single fraction gamma-knife treatment with a retrobulbar block. The radiation dose was 50 Gy and all tumors were within the 50 % isodosis range. Tumors were inaccessible for Ru106 Brachy-therapy as they were either too large (max. height > 6.0 mm, basis diameter > 19 mm) or contact to optic disc exceeded 90o or infiltration into the ciliary body was present. Of the 100 patients, 73 were followed for 1 year, 33 for 2 years and 17 for 3 years. Local tumor control was 98 % (2 recurrences). Complications following radiosurgery were rubeosis iridis (12 % of patients after l year, 15 % after 2 years and 6 % after 3 years) and secondary glaucoma (14 % of patients after 1 year, 9 % after 2 years, 6 % after 3 years). Total enucleation rate was 6.3 % per year. The tumors were found at the posterior pole (61 %), middle periphery (21 %) or ciliary body (18 %). Functional results depended on tumor localisation in the eye: after a mean of 1.9 years follow-up visual acuity was stable (± 3 lines) in 71 % of patients with a tumor in the middle periphery while 19 % of tumors with infiltration into the ciliary body and 0 % of tumors at the posterior pole showed stable visual acuity. Gamma-knife-radiosurgery offers a well tolerated, eye preserving treatment for patients with large choroidal melanoma in the middle periphery. Comparing our method to other radiosurgery therapies we can offer a fast technique which only requires a single visit. (author)

  17. Neovascular Glaucoma After Stereotactic Radiotherapy for Juxtapapillary Choroidal Melanoma: Histopathologic and Dosimetric Findings

    International Nuclear Information System (INIS)

    Purpose: Enucleation after stereotactic radiotherapy (SRT) for juxtapapillary choroidal melanoma may be required because of tumor progression (TP) or the development of intractable radiation-induced neovascular glaucoma (NVG). We compare pathologic changes and dosimetric findings in those eyes enucleated secondary to NVG as opposed to TP to better understand potential mechanisms. Methods and Materials: Patients with juxtapapillary choroidal melanoma treated with SRT (70 Gy in 5 fractions, alternate days over a total of 10 days) at the Princess Margaret Hospital, Toronto, Ontario, Canada, who underwent enucleation between 1998 and 2006 were selected. We correlated dosimetric data based on the patient's original SRT treatment plan with histopathologic findings in the retina, optic nerve head, and anterior chamber. A dedicated ocular pathologist reviewed each case in a blinded fashion. Results: Ten eyes in ten patients were enucleated after SRT. Six were enucleated secondary to NVG and four secondary to because of TP. Aggressive tumor features such as invasion of the sclera and epithelioid cell type were observed predominantly in the TP group. Retinal damage was more predominant in the NVG group, as were findings of radiation-related retinal vascular changes of fibrinoid necrosis and hyalinization. No conclusive radiation-related effects were found in the anterior chamber. The maximum point dose and dose to 0.1 cc were lower for the anterior chamber as compared with the dose to the tumor, retina, and optic nerve head. The mean 0.1-cc doses to the retina were 69.4 Gy and 73.5 Gy and to the anterior chamber were 4.9 Gy and 17.3 Gy for the NVG group and tumor progression group, respectively. Conclusions: Our findings suggest that NVG is due to radiation damage to the posterior chamber of the eye rather than primary radiation damage to the anterior segment.

  18. DISEASES

    DEFF Research Database (Denmark)

    Pletscher-Frankild, Sune; Pallejà, Albert; Tsafou, Kalliopi;

    2015-01-01

    Text mining is a flexible technology that can be applied to numerous different tasks in biology and medicine. We present a system for extracting disease-gene associations from biomedical abstracts. The system consists of a highly efficient dictionary-based tagger for named entity recognition of...... human genes and diseases, which we combine with a scoring scheme that takes into account co-occurrences both within and between sentences. We show that this approach is able to extract half of all manually curated associations with a false positive rate of only 0.16%. Nonetheless, text mining should not...... stand alone, but be combined with other types of evidence. For this reason, we have developed the DISEASES resource, which integrates the results from text mining with manually curated disease-gene associations, cancer mutation data, and genome-wide association studies from existing databases. The...

  19. Choroid plexus papilloma and Aicardi syndrome: case report Papiloma do plexo coróideo e síndrome de Aicardi: relato de caso

    OpenAIRE

    Geraldo Pianetti Filho; Luiz Fernando Fonseca; Márcia Cristina da Silva

    2002-01-01

    A case of Aicardi syndrome associated with a choroid plexus papilloma of the third and both lateral ventricles in a 15 months old baby girl is repported. The tumor was completely removed via three craniotomies. Reports of the literature with the association of choroid plexus papilloma and Aicardi syndrome are rare. We suggest that children diagnosed with Aicardi syndrome should routinely undergo imaging studies of the brain, such as computed tomography or magnetic resonance.Relatamos o caso d...

  20. A Prospective Study of Treatment Patterns and 1-Year Outcome of Asian Age-Related Macular Degeneration and Polypoidal Choroidal Vasculopathy

    OpenAIRE

    Cheung, Chui Ming Gemmy; Xiang LI; Mathur, Ranjana; Lee, Shu Yen; Chan, Choi Mun; Yeo, Ian; Loh, Boon Kwang; Williams, Rachel; Wong, Edmund Yick-Mun; Wong, Doric; Wong, Tien Yin

    2014-01-01

    Objective To study the treatment patterns and visual outcome over one year in Asian patients with choroidal neovascular membrane secondary to age-related macular degeneration (AMD-CNV) and polypoidal choroidal vasculopathy (PCV). Design Prospective cohort, non-interventional study. Methods 132 treatment-naïve patients who received treatment for AMD-CNV and PCV were included. All patients underwent standardized examination procedures including retinal imaging at baseline and follow-up. AMD-CNV...

  1. Review of the Series "Disease of the Year 2011: Toxoplasmosis" Pathophysiology of Toxoplasmosis

    NARCIS (Netherlands)

    Subauste, C.S.; Ajzenberg, D.; Kijlstra, A.

    2011-01-01

    Toxoplasma gondii is a major cause of chronic parasitic infection in the world. This protozoan can cause retino-choroiditis in newborns and in adults, both immunocompetent and immunodeficient. This disease tends to be recurrent and can lead to severe visual impairment. The authors review current kno

  2. Clinical and histological findings after intravitreal injection of bevacizumab (Avastin) in a porcine model of choroidal neovascularization

    DEFF Research Database (Denmark)

    Lassota, Nathan; Prause, Jan Ulrik; Scherfig, Erik; Kiilgaard, Jens Folke; la Cour, Morten

    2010-01-01

    PURPOSE: To examine the effect of intravitreally injected bevacizumab (Avastin) on the histological and angiographic morphology of choroidal neovascularization (CNV) in a masked and placebo-controlled animal study. METHODS: Choroidal neovascularization was induced surgically in 11 porcine eyes by...... perforating Bruch's membrane with a retinal perforator. After closure of the ports used for the vitrectomy, which was performed to facilitate the Bruch's membrane rupture, 0.05 ml of either bevacizumab or Ringer-Lactat (placebo) was injected into the vitreous cavity. Eyes were enucleated after 14 days. Fundus...... photographs and fluorescein angiograms (FAs) were obtained immediately prior to enucleation. Sections of formalin- and paraffin-embedded eyes were examined by light microscopy and by immunohistochemical staining. RESULTS: Placebo-injected eyes exhibited the highest propensity to leak, with five of six eyes...

  3. Clinical and histological findings after intravitreal injection of bevacizumsb (Avastin®) in a porcine model of choroidal neovascularisation

    DEFF Research Database (Denmark)

    Lassota, Nathan; Prause, Jan Ulrik; Scherfig, Erik; Kiilgaard, Jens Folke; Dornonville de la Cour, Morten

    2010-01-01

    PURPOSE: To examine the effect of intravitreally injected bevacizumab (Avastin) on the histological and angiographic morphology of choroidal neovascularization (CNV) in a masked and placebo-controlled animal study. METHODS: Choroidal neovascularization was induced surgically in 11 porcine eyes by...... perforating Bruch's membrane with a retinal perforator. After closure of the ports used for the vitrectomy, which was performed to facilitate the Bruch's membrane rupture, 0.05 ml of either bevacizumab or Ringer-Lactat (placebo) was injected into the vitreous cavity. Eyes were enucleated after 14 days. Fundus...... photographs and fluorescein angiograms (FAs) were obtained immediately prior to enucleation. Sections of formalin- and paraffin-embedded eyes were examined by light microscopy and by immunohistochemical staining. RESULTS: Placebo-injected eyes exhibited the highest propensity to leak, with five of six eyes...

  4. THE PROBLEM OF SECONDARY DRY EYE SYNDROME IN THE CONTEXT OF ORGAN-SAVING RADIOTHERAPY FOR CHOROIDAL MELANOMA

    Directory of Open Access Journals (Sweden)

    Ye. I. Gyuntner

    2015-04-01

    Full Text Available After brachytherapy for choroidal melanoma, mild and moderate secondary dry eye syndrome was established in 87.2 and 12.8 % of the patients, respectively. Biomicroscopic changes in the ocular surface were seen in the postradiation period over time. Out of the functional studies, there was timing of precorneal tear film rupture, meniscometry using optical coherent tomography, which proved to be of the most informative value. The findings suggested that at 1 year of brachytherapy for choroidal melanoma, the secondary dry eye syndrome was accompanied by a significant reduction in the rupture time for the precorneal tear film and by a decrease in the height of the lower tear meniscus.

  5. Choroidal neovascularization is inhibited via an intraocular decrease of inflammatory cells in mice lacking complement component C3

    OpenAIRE

    Xue Tan; Katsuhito Fujiu; Ichiro Manabe; Junko Nishida; Reiko Yamagishi; Ryozo Nagai; Yasuo Yanagi

    2015-01-01

    In early age-related macular degeneration (AMD), complement component C3 can be observed in drusen, which is the accumulation of material beneath the retinal pigment epithelium. The complement pathways, via the activation of C3, can upregulate the expression of cytokines and their receptors and the recruitment of inflammatory leukocytes, both of which play an important role in the development of choroidal neovascularization (CNV) in exudative AMD. Laser-induced CNV lesions were found to be si...

  6. Posttreatment visual acuity in patients treated with episcleral plaque therapy for choroidal melanomas: dose and dose rate effects

    International Nuclear Information System (INIS)

    Purpose: To determine the relationship between the long-term visual function and the dose and dose rates delivered to critical ocular structures in patients with choroidal melanoma treated with 125I episcleral plaque radiotherapy. Methods and Materials: From 1987 to 1994, 63 patients underwent 125I episcleral plaque (Collaborative Ocular Melanoma Study [COMS] design) application for the treatment of choroidal melanoma. The mean tumor height was 4.5 mm (range 1.7-8.3). Doses and dose rates at the tumor apex, macula, and optic disc were calculated. Forty-three records were scored to assess whether a decrease in visual acuity of >2 lines on a standard Snellen eye chart had occurred. Patient age and the presence of hypertension or diabetes were noted. Statistical analysis was performed to assess both the rate at which visual decline had occurred and the presence of significant factors that had contributed to this decline. Results: With a median follow-up of 36 months, the 3-year actuarial survival rate was 93.6%. The 3-year actuarial local control rate was 86.9%. The median time to visual loss after therapy was 18.7 months. The 3-year actuarial rate of visual preservation was 40.5%. Multivariate analysis demonstrated higher macula dose rates (p=0.003) to forecast visual decline. Macula dose rates of 111±11.1 cGy/h were associated with a 50% risk of significant visual loss. Conclusion: Patients in our series treated with 125I plaque brachytherapy for choroidal melanoma experienced favorable tumor control, but with a measurable incidence of visual decline. Higher dose rates to the macula correlated strongly with poorer posttreatment visual outcome. This information may be valuable in selecting the optimal dose rates to treat choroidal melanomas and to predict the risk of visual decline

  7. An initiator codon mutation in ornithine-delta-aminotransferase causing gyrate atrophy of the choroid and retina.

    OpenAIRE

    Mitchell, G. A.; Brody, L C; Looney, J; Steel, G.; Suchanek, M.; Dowling, C; Der Kaloustian, V; Kaiser-Kupfer, M; Valle, D

    1988-01-01

    Gyrate atrophy of the choroid and retina (GA) is an autosomal recessive chorioretinal degeneration caused by deficiency of the mitochondrial matrix enzyme, ornithine-delta-aminotransferase (OAT). To study the molecular basis of the mutations causing GA, we cloned and sequenced the human OAT cDNA and determined the intron-exon arrangement of the structural gene. Using the cDNA template, we synthesized antisense RNA probes and performed RNase A protection experiments with RNA from four Lebanese...

  8. Adrenergic-induced enhancement of brain barrier system permeability to small nonelectrolytes: choroid plexus versus cerebral capillaries

    International Nuclear Information System (INIS)

    Acute hypertension induced by adrenergic agents opens up the blood-CSF barrier (choroid plexus) to nonelectrolyte and protein tracers. Sprague-Dawley adult rats anesthetized with ketamine were given an intravenous bolus of either epinephrine (10 micrograms/kg), phenylephrine (100 micrograms/kg), isoproterenol (10 micrograms/kg), or D,L-amphetamine (2 mg/kg). Tracers were injected simultaneously with test agents, and the animals killed 10 min later. Epinephrine raised MABP by 57 mm Hg, to a peak pressure of 160 mm Hg; and it increased the volume of distribution (Vd) of urea, mannitol, and 125I-bovine serum albumin in CSF by 1.5-, 2.7-, and 30-fold, respectively. There was enhanced uptake by lateral and fourth ventricle choroid plexuses, cerebral cortex, cerebellum, medulla, and thalamus. Phenylephrine also elevated MABP to 160 mm Hg, but it increased permeation of tracers into CSF (and several brain regions) to a lesser extent than epinephrine, attributable to protective vasoconstriction associated with alpha-agonist activity. Ratio analysis of Vd data provides evidence that augmented permeation of nonelectrolyte tracers in acute hypertension occurs predominantly by diffusion rather than vesicular transport. It is postulated that elevated MABP distends the central cores of choroid plexus villi and cerebral capillaries, with resultant stretching and opening of tight junctions in both barrier systems; with less hindrance to diffusion, urea and mannitol are cleared at rates closer to free diffusion. Neither isoproterenol (decreased MABP by 40 mm Hg) nor amphetamine (did not alter MABP) significantly opened the choroid plexus or blood-brain barrier to tracers

  9. Massive choroidal hemorrhage after intravitreal administration of bevacizumab (Avastin®) for AMD followed by controlateral sympathetic ophthalmia

    OpenAIRE

    Brouzas, Dimitrios; Koutsandrea, Chryssanthi; Moschos, Marilita; Papadimitriou, Spiros; Ladas, Ioannis; Apostolopoulos, Michael

    2009-01-01

    Purpose: To report a severe ocular complication initiated ten days after intravitreal administration of bevacizumab (Avastin®), in a patient with exudative age-related macular degeneration (AMD). Patients and method: Case report. Results: Ten days after intravitreal injection of 1.25 mg Avastin®, the patient manifested acute loss of vision with excruciating pain. An extensive choroidal detachment was evident in close contact with the lens, which necessitated an emergency sclerotomy with recon...

  10. Ethnic differences in the association of SERPING1 with age-related macular degeneration and polypoidal choroidal vasculopathy

    OpenAIRE

    Ke Liu; Lai, Timothy Y. Y.; Li Ma; Lai, Frank H. P.; Young, Alvin L.; Marten E. Brelen; Tam, Pancy O.S.; Chi Pui Pang; Li Jia Chen

    2015-01-01

    Neovascular age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV) are leading causes of irreversible blindness in developed countries. In this study, we investigated the association of single nucleotide polymorphisms (SNPs) in the serpin peptidase inhibitor, clade G, member 1 (SERPING1) gene with neovascular AMD and PCV. Two haplotype-tagging SNPs, rs1005510 and rs11603020, of SERPING1 were genotyped in 708 unrelated Chinese individuals: 200 neovascular AMD, 233 P...

  11. The Heritability of Glaucoma-Related Traits Corneal Hysteresis, Central Corneal Thickness, Intraocular Pressure, and Choroidal Blood Flow Pulsatility

    OpenAIRE

    Freeman, Ellen E.; Roy-Gagnon, Marie-Hélène; Descovich, Denise; Massé, Hugues; Mark R. Lesk

    2013-01-01

    Purpose The purpose of this work was to investigate the heritability of potential glaucoma endophenotypes. We estimated for the first time the heritability of the pulsatility of choroidal blood flow. We also sought to confirm the heritability of corneal hysteresis, central corneal thickness, and 3 ways of measuring intraocular pressure. Methods Measurements were performed on 96 first-degree relatives recruited from Maisonneuve-Rosemont Hospital in Montreal. Corneal hysteresis was determined u...

  12. Structural defects in cilia of the choroid plexus, subfornical organ and ventricular ependyma are associated with ventriculomegaly

    Directory of Open Access Journals (Sweden)

    Swiderski Ruth E

    2012-10-01

    Full Text Available Abstract Background Hydrocephalus is a heterogeneous disorder with multiple etiologies that are not yet fully understood. Animal models have implicated dysfunctional cilia of the ependyma and choroid plexus in the development of the disorder. In this report, we sought to determine the origin of the ventriculomegaly in four Bardet Biedl syndrome (BBS mutant mouse strains as models of a ciliopathy. Methods Evans Blue dye was injected into the lateral ventricle of wild- type and BBS mutant mice to determine whether obstruction of intra- or extra-ventricular CSF flow contributed to ventriculomegaly. Transmission electron microscopy (TEM was used to examine the ultrastructure of the choroid plexus, subfornical organ (SFO, subcommisural organ (SCO, and ventricular ependyma to evaluate their ultrastructure and the morphology of their primary and motile cilia. Results and discussion No obstruction of intra- or extra-ventricular CSF flow was observed, implying a communicating form of hydrocephalus in BBS mutant mice. TEM analyses of the mutants showed no evidence of choroidal papillomas or breakdown of the blood:CSF barrier. In contrast, structural defects were observed in a subpopulation of cilia lining the choroid plexus, SFO, and ventricular ependyma. These included disruptions of the microtubular structure of the axoneme and the presence of electron-dense vesicular-like material along the ciliary shaft and at the tips of cilia. Conclusions Abnormalities in cilia structure and function have the potential to influence ciliary intraflagellar transport (IFT, cilia maintenance, protein trafficking, and regulation of CSF production. Ciliary structural defects are the only consistent pathological features associated with CSF-related structures in BBS mutant mice. These defects are observed from an early age, and may contribute to the underlying pathophysiology of ventriculomegaly.

  13. An attempt to understand flicker vertigo: changes in pupil size and choroidal blood flow under flickering conditions

    Science.gov (United States)

    Masi, Maria Gabriella; Peretto, Lorenzo; Rovati, Luigi; Ansari, Rafat R.

    2010-02-01

    Light flickering at a rate of 4- 20 cycles per second can produce unpleasant reactions such as nausea and vertigo. In this paper, the possibility of achieving an objective evaluation/prediction of the physiological effects induced by flicker is investigated using a new imaging method based on the pupil size determination. This method is also compared with the blood flow analysis in the choroid.

  14. Choroidal Neovascularization Associated with Punctate Inner Choroidopathy: Combination of Intravitreal Anti-VEGF and Systemic Immunosuppressive Therapy

    OpenAIRE

    Hohberger, Bettina; Rudolph, Michael; Bergua, Antonio

    2015-01-01

    Purpose Choroidal neovascularization (CNV) associated with punctate inner choroidopathy (PIC) is a rare clinical entity, yet still a challenge for medical treatment. A case of a young myopic woman developing CNV secondary to unilateral PIC is presented. Clinical morphology, diagnostic procedure and follow-up are reported. Case Report A 29-year-old woman presented with multiple yellowish dots at the posterior pole. No other signs of inflammation could be seen. Angiography with fluorescein yiel...

  15. Therapeutic effect of intravitreal injections of ranibizumab for the treatment of macular choroidal neovascularization caused by pathological myopia

    OpenAIRE

    JI, LEIBING; Lv, Wenjuan; Xiao, Yun; Xu, Zhenghua; Zhang, Xiaoling; Zhang, Wei

    2015-01-01

    The aim of the present study was to evaluate the clinical efficacy and safety of intravitreal ranibizumab injections for the treatment of macular choroidal neovascularization (CNV) caused by pathological myopia. Between one and four intravitreal injections of ranibizumab were administered to 61 eyes from 61 patients who were diagnosed with macular CNV caused by pathological myopia. Following injection, the best-corrected visual acuity (BCVA), central macular thickness (CMT) and fundus fluores...

  16. Two years follow-up outcome of verteporfin therapy for subfoveal choroidal neovascularization in pathologic myopia in Indian eyes

    OpenAIRE

    Hussain Nazimul; Khanna Rohit; Das Taraprasad; Narayanan Raja; Sunday Oluleye; Bansal Azad; Reddy Rajeev

    2008-01-01

    Context: In India, refractive errors are a major cause of treatable blindness. Population surveys in southern India have shown prevalence of high myopia to be 4.32-4.54%. Photodynamic therapy (PDT) for choroidal neovascularization (CNV) caused by pathologic myopia is beneficial. Aims: To report the 24 months outcome of PDT with verteporfin for subfoveal CNV caused by pathologic myopia in Indian eyes Settings and Design: Prospective case series Materials and Methods: Review of pr...

  17. Immunoreactivity of glucose transporter 8 is localized in the epithelial cells of the choroid plexus and in ependymal cells.

    Science.gov (United States)

    Murakami, Ryuta; Chiba, Yoichi; Tsuboi, Kazuhito; Matsumoto, Koichi; Kawauchi, Machi; Fujihara, Ryuji; Mashima, Masato; Kanenishi, Kenji; Yamamoto, Tetsuji; Ueno, Masaki

    2016-08-01

    High fructose intake is known to be associated with increased plasma triglyceride concentration, impaired glucose tolerance, insulin resistance, and high blood pressure. In addition, excess fructose intake is also thought to be a risk factor for dementia. Previous immunohistochemical studies have shown the presence of glucose transporter 5 (GLUT5), a major transporter of fructose, in the epithelial cells of the choroid plexus and ependymal cells in the brains of humans, rats, and mice, while GLUT2, a minor transporter of fructose, was localized in the ependymal cells of rat brain. In this study, immunoreactivity for the fructose transporter GLUT8 was observed in the cytoplasm of the epithelial cells in the choroid plexus and in the ependymal cells of the brains of humans and mice. These structures were not immunoreactive for GLUT7, GLUT11, and GLUT12. Our findings support the hypothesis of the transport of intravascular fructose through the epithelial cells of the choroid plexus and the ependymal cells. PMID:27160096

  18. Massive choroidal hemorrhage after intravitreal administration of bevacizumab (Avastin® for AMD followed by controlateral sympathetic ophthalmia

    Directory of Open Access Journals (Sweden)

    Dimitrios Brouzas

    2009-08-01

    Full Text Available Dimitrios Brouzas, Chryssanthi Koutsandrea, Marilita Moschos, Spiros Papadimitriou, Ioannis Ladas, Michael Apostolopoulos1st Eye Department , University of Athens, Athens, GreecePurpose: To report a severe ocular complication initiated ten days after intravitreal administration of bevacizumab (Avastin®, in a patient with exudative age-related macular degeneration (AMD.Patients and method: Case report.Results: Ten days after intravitreal injection of 1.25 mg Avastin®, the patient manifested acute loss of vision with excruciating pain. An extensive choroidal detachment was evident in close contact with the lens, which necessitated an emergency sclerotomy with reconstruction of the anterior chamber. Four months later, the eye proceeded to phthisis bulbi. Five months after the injection, the patient complained of mild pain, photophobia, and visual acuity deterioration from the fellow eye. The diagnosis of sympathetic ophthalmia was suggested and treated with intravitreal injections of triamcinolone acetonide every three months with good response, complicated by elevation of intraocular pressure which we managed with Ahmet valve implantation.Conclusion: Serious ocular complications after intravitreal of Avastin® can not be excluded, including massive choroidal hemorrhage and sympathetic ophthalmia of the fellow eye.Keywords: Avastin® complication, intravitreal injection, choroidal detachment, Phthisis bulbi, sympathetic ophthalmia

  19. 脉络膜转移癌的最新研究进展%Current research progress of choroidal metastasis

    Institute of Scientific and Technical Information of China (English)

    袁琳慧; 陈晓隆

    2016-01-01

    Choroidal metastasis is one of the most common malignant tumors inside the eyes. It causes pain, hypopsia and some other related symptoms. It reduces the quality of the patients' life. It's significant for the patients to be detected and treated early, therefore they will have better vision and longer life. The treatments of choroidal metastasis are developing quickly. Both the vitreous cavity injection of targeted drug and gene therapy are hot topics of research. This paper summarizes the etiology, development, diagnosis and treatment of choroidal metastasis nowadays.%脉络膜转移癌是眼部最常见的恶性肿瘤之一。其症状表现为眼部疼痛、视力下降等,从而降低了患者的生活质量。早期发现和早期治疗可改善患者视力,延长患者寿命,意义重大。因此,脉络膜转移癌的治疗方式迅速发展。靶向药物和基因治疗的玻璃体腔注射是研究的热点。本文主要叙述了目前脉络膜转移癌的病因、发展、诊断和治疗方法。

  20. Long-term follow-up of choroidal neovascularization secondary to angioid streaks: case series and literature review

    Directory of Open Access Journals (Sweden)

    Al-Rashaed S

    2012-07-01

    Full Text Available Saba Al-Rashaed, J Fernando ArevaloKing Khaled Eye Specialist Hospital, Riyadh, Saudi ArabiaBackground: The purpose of this paper is to report the clinical course of choroidal neovascularization (CNV secondary to angioid streaks and the outcomes in response to different treatment modalities.Methods: This was a case series of two consecutive patients (four eyes with CNV secondary to angioid streaks. Visual acuity, ophthalmological examination, color photographs, fluorescein angiography, and optical coherence tomography were used to assess the outcomes of treatment.Results: Two eyes were treated with photodynamic therapy for subfoveal choroidal neovascular membrane, one eye underwent thermal laser photocoagulation for extrafoveal CNV followed by intravitreal bevacizumab for subfoveal CNV, and one eye underwent intravitreal bevacizumab for subfoveal CNV. The follow-up period was 4–6 years. The final visual acuities of all eyes were 20/300 or worse with large submacular fibrosis.Conclusion: CNV secondary to angioid streaks in these two patients had a poor prognosis despite undergoing different types of treatment. Poor outcome was likely related to frequent recurrence and newly developed CNV, which remained a clinical concern in these cases.Keywords: choroidal neovascular membrane, angioid streaks, intravitreal bevacizumab, photodynamic therapy

  1. Retrospective study of choroidal melanomas at the 1st Department of Ophthalmology, AHEPA hospital, Thessaloniki, from 2002 to 2011

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    A A Chranioti

    2016-01-01

    Full Text Available Aim: Retrospective study of cases of choroidal melanoma examined at the 1st Department of Ophthalmology, University Hospital American Hellenic Educational Progressive Association, during the 10-year period, from January 2002 to December 2011. Materials and Methods: The study group consists of 84 patients (84 eyes with newly diagnosed choroidal melanoma. The documentation of the location and the dimensions of the melanomas, based on B-Ultrasonography findings (apical height, diameter, were included. A total of 58 patients were referred to a specialized center abroad for conservative irradiation therapy. Twenty six eyes were enucleated due to large size of the tumor and the histopathological type was determined. Results: Of the 84 cases, 44 were located at the posterior pole while 40 anteriorly. Based on size, 6% (5/84 were small, 58% (49/84 were medium and 36% (30/84 large. Based on the histopathological analysis of 22 of the 26 eyes enucleated, 36% were mixed-cell, 32% were spindle cell and 27% were epithelioid cell melanomas. Conclusions: Our study is the first documentation and classification of newly diagnosed cases of choroidal melanomas. The large number of mandatory enucleations, due to large size, is surprising. Patients need to be better informed about preventive fundoscopy for diagnosis of asymptomatic melanoma at an earlier stage.

  2. Disease: H01295 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available across the blood brain barrier via the choroid plexus. It has been reported that mutations in FOLR1 cause this disease. Foli...acterized by severe developmental regression, movement disturbances, epilepsy, and leukodyst...rophy. Folate-receptor alpha (FOLR1) is of central importance for folate transport..., Kraetzner R, Dreha-Kulaczewski S, Helms G, Dechent P, Wevers R, Grosso S, Gartner J Folate receptor alpha defect causes cerebral... disorder associated with disturbed myelin metabolism. Am J Hum Genet 85:354-63 (2009) PMID:20018644 Cario H, Bode H, Deba

  3. Disease: H01114 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available H01114 Ocular coloboma, including: Coloboma of iris choroid and retina (COI); Coloboma of optic ... 1414-9 (2011) PMID:18408502 Gopal L A clinical and optical ... coherence tomography study of choroidal colobomas. ...

  4. Outcomes of Proton Radiation Therapy for Peripapillary Choroidal Melanoma at the BC Cancer Agency

    Energy Technology Data Exchange (ETDEWEB)

    Tran, Eric, E-mail: etran2@bccancer.bc.ca [Radiation Therapy Program, BC Cancer Agency and University of British Columbia, Vancouver, British Columbia (Canada); Ma, Roy [Radiation Therapy Program, BC Cancer Agency and University of British Columbia, Vancouver, British Columbia (Canada); Paton, Katherine [Department of Ophthalmology and Visual Sciences, Vancouver Hospital Eye Care Centre and University of British Columbia, Vancouver, British Columbia (Canada); Blackmore, Ewart [TRIUMF, Vancouver, British Columbia (Canada); Pickles, Tom [Radiation Therapy Program, BC Cancer Agency and University of British Columbia, Vancouver, British Columbia (Canada)

    2012-08-01

    Purpose: To report toxicity, local control, enucleation, and survival rates for patients with peripapillary choroidal melanoma treated with proton therapy in Canada. Methods and Materials: We performed a retrospective analysis of patients with peripapillary choroidal melanoma ({<=}2 mm from optic disc) treated between 1995 and 2007 at the only Canadian proton therapy facility. A prospective database was updated for follow-up information from a chart review. Descriptive and actuarial data are presented. Results: In total, 59 patients were treated. The median age was 59 years. According to the 2010 American Joint Committee on Cancer TNM classification, there were 20 T1 tumors (34%), 28 T2 tumors (48%), and 11 T3 tumors (19%). The median tumor diameter was 11.4 mm, and the median thickness was 3.5 mm. Median follow-up was 63 months. Nineteen patients received 54 cobalt gray equivalents (CGE) and forty patients received 60 CGE, each in 4 fractions. The 5-year actuarial local control rate was 91% (T1, 100%; T2, 93%; and T3, 59%) (p = 0.038). There was a suggestive relationship between local control and dose. The local control rate was 97% with 60 CGE and 83% with 54 CGE (p = 0.106). The metastasis-free survival rate was 82% and related to T stage (T1, 94%; T2, 84%; and T3, 47%) (p < 0.001). Twelve patients died, including eleven with metastases. The 5-year actuarial rate of neovascular glaucoma was 31% (23% for T1-T2 and 68% for T3, p < 0.001), and that of enucleation was 0% for T1, 14% for T2, and 72% for T3 (p < 0.001). Radiation retinopathy (74%) and optic neuropathy (64%) were common within-field effects. Conclusions: Proton therapy provides excellent local control with acceptable toxicity while conserving the globe in 80% of cases. These results are consistent with other single-institution series using proton radiotherapy, and toxicity rates were acceptable. T3 tumors carry a higher rate of both local recurrence and metastasis.

  5. Outcomes of Proton Radiation Therapy for Peripapillary Choroidal Melanoma at the BC Cancer Agency

    International Nuclear Information System (INIS)

    Purpose: To report toxicity, local control, enucleation, and survival rates for patients with peripapillary choroidal melanoma treated with proton therapy in Canada. Methods and Materials: We performed a retrospective analysis of patients with peripapillary choroidal melanoma (≤2 mm from optic disc) treated between 1995 and 2007 at the only Canadian proton therapy facility. A prospective database was updated for follow-up information from a chart review. Descriptive and actuarial data are presented. Results: In total, 59 patients were treated. The median age was 59 years. According to the 2010 American Joint Committee on Cancer TNM classification, there were 20 T1 tumors (34%), 28 T2 tumors (48%), and 11 T3 tumors (19%). The median tumor diameter was 11.4 mm, and the median thickness was 3.5 mm. Median follow-up was 63 months. Nineteen patients received 54 cobalt gray equivalents (CGE) and forty patients received 60 CGE, each in 4 fractions. The 5-year actuarial local control rate was 91% (T1, 100%; T2, 93%; and T3, 59%) (p = 0.038). There was a suggestive relationship between local control and dose. The local control rate was 97% with 60 CGE and 83% with 54 CGE (p = 0.106). The metastasis-free survival rate was 82% and related to T stage (T1, 94%; T2, 84%; and T3, 47%) (p < 0.001). Twelve patients died, including eleven with metastases. The 5-year actuarial rate of neovascular glaucoma was 31% (23% for T1–T2 and 68% for T3, p < 0.001), and that of enucleation was 0% for T1, 14% for T2, and 72% for T3 (p < 0.001). Radiation retinopathy (74%) and optic neuropathy (64%) were common within-field effects. Conclusions: Proton therapy provides excellent local control with acceptable toxicity while conserving the globe in 80% of cases. These results are consistent with other single-institution series using proton radiotherapy, and toxicity rates were acceptable. T3 tumors carry a higher rate of both local recurrence and metastasis.

  6. Pneumatic displacement with intravitreal bevacizumab for massive submacular hemorrhage due to polypoidal choroidal vasculopathy

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    Kitahashi M

    2014-03-01

    Full Text Available Masayasu Kitahashi,1 Takayuki Baba,1 Madoka Sakurai,1 Hirotaka Yokouchi,1 Mariko Kubota-Taniai,1 Yoshinori Mitamura,2 Shuichi Yamamoto1 1Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, 2Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan Background: The purpose of this study was to compare the effectiveness of pneumatic displacement combined with intravitreal bevacizumab (IVB with that of pneumatic displacement (PD alone to treat massive submacular hemorrhage (SMH secondary to polypoidal choroidal vasculopathy (PCV. Methods: Thirty-two eyes of 32 patients with massive SMH secondary to PCV were studied. Twenty-two eyes were treated with a combination of PD and 1.25 mg of intravitreal bevacizumab (PD + IVB group, and ten eyes with pneumatic displacement alone (PD group. Results: Pretreatment, the differences in best-corrected visual acuity and size of the SMH between the two groups were not significant (P=0.59 and P=0.72, respectively. Complete displacement of the hemorrhage from under the fovea was achieved in 19 of 22 eyes (86.4% in the PD + IVB group and in five of ten eyes (50% in the PD group. The best-corrected visual acuity in the PD + IVB group was significantly better than that in the PD group at one, 3, and 6 months after treatment (P<0.001, P<0.001, and P<0.001, respectively. Improvement in best-corrected visual acuity by >0.3 logMAR units was obtained in 18 eyes (81.8% in the PD + IVB group and two eyes (20% in the PD group (P<0.001. The number of eyes that required additional treatments was significantly fewer in the PD + IVB group than in the PD group (P=0.0001. Conclusion: The combination of PD and IVB may be a better therapeutic procedure for eyes with massive SMH due to PCV in the short term because of the better visual outcome and less need for additional treatments. Keywords: pneumatic displacement, intravitreal bevacizumab, submacular

  7. Clinical validation of a genetic model to estimate the risk of developing choroidal neovascular age-related macular degeneration

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    Hageman Gregory S

    2011-07-01

    Full Text Available Abstract Predictive tests for estimating the risk of developing late-stage neovascular age-related macular degeneration (AMD are subject to unique challenges. AMD prevalence increases with age, clinical phenotypes are heterogeneous and control collections are prone to high false-negative rates, as many control subjects are likely to develop disease with advancing age. Risk prediction tests have been presented previously, using up to ten genetic markers and a range of self-reported non-genetic variables such as body mass index (BMI and smoking history. In order to maximise the accuracy of prediction for mainstream genetic testing, we sought to derive a test comparable in performance to earlier testing models but based purely on genetic markers, which are static through life and not subject to misreporting. We report a multicentre assessment of a larger panel of single nucleotide polymorphisms (SNPs than previously analysed, to improve further the classification performance of a predictive test to estimate the risk of developing choroidal neovascular (CNV disease. We developed a predictive model based solely on genetic markers and avoided inclusion of self-reported variables (eg smoking history or non-static factors (BMI, education status that might otherwise introduce inaccuracies in calculating individual risk estimates. We describe the performance of a test panel comprising 13 SNPs genotyped across a consolidated collection of four patient cohorts obtained from academic centres deemed appropriate for pooling. We report on predictive effect sizes and their classification performance. By incorporating multiple cohorts of homogeneous ethnic origin, we obtained >80 per cent power to detect differences in genetic variants observed between cases and controls. We focused our study on CNV, a subtype of advanced AMD associated with a severe and potentially treatable form of the disease. Lastly, we followed a two-stage strategy involving both test model

  8. Basal and apical regulation of VEGF-A and placenta growth factor in the RPE/choroid and primary RPE

    Science.gov (United States)

    Kaya, Leyla; Flach, Janina; Lassen, Jens; Treumer, Felix; Roider, Johann

    2015-01-01

    Purpose Members of the vascular endothelial growth factor (VEGF) family are strongly involved in pathological processes in the retina, such as age-related macular degeneration and diabetic retinopathy. Cells of the retinal pigment epithelium (RPE) constitutively secrete VEGF-A, and the secretion of placental growth factor (PlGF) has also been described. RPE cells are strongly polarized cells with different secretome at the apical and basal side. In this study, we evaluated the basal and apical regulation of VEGF-A and PlGF secretion in RPE/choroid explants and primary RPE cells. Methods RPE/choroid tissue explants were prepared from porcine eyes and cultivated in modified Ussing chambers, separating apical (RPE) and basal (choroid) supernatant. Primary RPE cells were also prepared from porcine eyes and cultivated on Transwell plates. Explants and cells were treated with inhibitors for VEGFR-2 (SU1498), p38 (SB203580), and the transcription factors nuclear factor-kappa B (NF-κB) and SP-1 (mithramycin), respectively. VEGF-A and PlGF content was evaluated with enzyme-linked immunosorbent assay (ELISA). In addition, western blots were performed. Results In the RPE/choroid, VEGF-A can initially be found on the apical and basal sides with significantly more pronounced secretion on the basal side. VEGF-A secretion is differentially regulated on the apical and basal sides, with the inhibition of SP-1 and NF-κB showing strong effects apically and basally after 24 h and 48 h, the inhibition of p38 displaying its effect mainly on the basal side with some effect apically after 48 h, and the inhibition of VEGFR-2 reducing the secretion of VEGF only on the apical side at 24 h and 48 h. In the RPE cell culture, similar effects were found, with inhibition of NF-κB or SP-1 displaying a strong decrease in VEGF-A on both sides, and p38 inhibition displaying only an inhibitory effect on the basal side. In contrast, an apical effect of VEGFR-2 inhibition was not found. However, the

  9. Ultrastructural study of the lateral ventricle choroid plexus in experimental hydrocephalus in Wistar rats Estudo ultraestrutural dos plexos corióides dos ventrículos laterais de ratos Wistar submetidos a hidrocefalia experimental

    Directory of Open Access Journals (Sweden)

    Daniela Pretti da Cunha Tirapelli

    2007-12-01

    Full Text Available Hydrocephalus is one of the most frequent and complex neurological diseases characterized by the abnormal buildup of cerebrospinal fluid (CSF in the ventricles of the brain, due to an altered CSF dynamics. To detect possible ultrastructural alterations of the lateral ventricles choroid plexus (responsible for the CSF production, rats seven days after birth were submitted to an intracisternal injection of 20% kaolim (hydrated aluminum silicate for the hydrocephalus induction. Twenty-eight or 35 days after injection, injected animals and respective controls were processed for observation under a transmission electron microscopy. Alterations found: presence of concentric cell membrane fragments, larger number of primary and secondary lysossomes, vacuoles, and cytoplasmic vesicles, and an enlargement of the intercellular space and between the basolateral interdigitation of the choroid epithelium. The alterations observed are probably associated to an increase of the ventricular pressure, inducing morpho-functional effects on the choroid plexus integrity.A hidrocefalia é uma das mais freqüentes e complexas doenças neurológicas caracterizada pelo acúmulo de líquido cefalorraquidiano (LCR no interior dos ventrículos cerebrais e conseqüente alteração na dinâmica liquórica. Para detectar as possíveis alterações ultra-estruturais nos plexos corióides dos ventrículos laterais (responsáveis pela produção do LCR, ratos sete dias após o nascimento, foram submetidos à indução de hidrocefalia pela injeção intracisternal de caulim a 20%. Após 28 e 35 dias da injeção, estes animais e seus respectivos controles foram processados para observação em um microscópio eletrônico de transmissão. Alterações observadas: presença de membranas concêntricas, maior número de lisossomos primários e secundários, vacúolos e vesículas citoplasmáticas, aumento do espaço intercelular e entre as interdigitações basolaterais das c

  10. Choroid plexus carcinoma: clinical and radiological features of four cases and review of literature

    International Nuclear Information System (INIS)

    Choroid plexus carcinoma (CPC) is rare central nervous system (CNS) tumor that accounts for nearly 0.06% of all intracranial neoplasms, most frequently occurring in patients less than 3 years of age. The authors present a clinical and radiological study of four patients with the diagnosis of CPC. The research was undertaken in the archives of radiology in the University Hospital of Curitiba, Parana State, Brazil, in the period from 1990 to 1997. The exams related to the CNS were catalogued and the CPC cases were looked into. Three of the patients were male and the mean age was 13.7 months. The clinical symptoms reported were due to intracranial hypertension, and the most common location was the lateral ventricles. Computed tomography scans show hydrocephalus and a mass hyperdense to the brain parenchyma, with marked enhancement post-contrast. Surgical resection was attempted in all patients. One of them died during the procedures. All of the other underwent relapse and died within an average of 7 months after the diagnosis. (author)

  11. Motor recovery by anterior choroidal artery territory in a patient with middle cerebral artery infarct

    Institute of Scientific and Technical Information of China (English)

    Ji Heon Hong; Sung Ho Jang

    2010-01-01

    In this study,the uninjured periventricular area of a female patient who presented with complete paralysis of the left extremities following middle cerebral artery infarction was analyzed using diffusion tensor tractography,transcranial magnetic stimulation,and functional magnetic resonance imaging.Diffusion tensor tractography revealed interrupted corticospinal tract at the infarct lesion in the corona radiata at 2 weeks after onset,which descended through the spared periventricular area at 6 months after onset.Transcranial magnetic stimulation and functional magnetic resonance imaging revealed a motor pathway of the affected hand that was compatible with the lateral corticospinal tract.At 6 months after onset,motor function in the affected extremities recovered to normal levels,which suggested that motor function in the affected hand recovered by the corticospinal tract that passed through the spared periventricular area.The arterial territory of the spared periventricular area corresponded with the anterior choroidal artery.These results suggest that care should be taken in spared periventricular areas in patients with lesions at the corona radiata level.

  12. Retinal and Choroidal Damage from Long-Term Exposure to a Laser Pointer Beam

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    Heidari M H

    2004-01-01

    Full Text Available Introduction: Laser pointers are devices that produce a weak laser beam of 630-680 nmwavelength and 1-5 mW power (ClassII or III A laser. These devices generally emit a redbeam that is used by lecturers and teachers for presentations. Some children use pointers astoys and sometimes direct the beam to their own or others' eyes. Material and Methods: Following irradiation by a laser pointer beam for 8 secondsthe eyes of Chinchilla rabbits were examined by opthalmoscope, and fluorescein angiographywas performed 5, 10 and 15 min after the exposure. The rabbits were killed immediately or24h after exposure, the eyes were enucleated, and the histological features of sections fromfundus, retina and choroid were observed by transmission electron microscopy. Results: A fluorescein block was found in the irradiated area immediately after irradiationand it increased in size with increasing time after exposure. The ultrastructural study showedacute oedema shortly after exposure, and thick collagenic bundles after 24h. Conclusion: Laser pointers with labelled power of less than 1mW are capable of producing visible and ultrastructual lesions in pigmented rabbit eyes.

  13. Carcinoma de plexo coroideo: relato de um caso Carcinoma of the choroid plexus: a case report

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    Hans H. Japp

    1976-09-01

    Full Text Available É relatado um caso de carcinoma de plexo coróideo em paciente com 3 anos de idade, com hipertensão intracraniana. Sem um claro diagnóstico clínico, o paciente evoluiu para o óbito, em 8 dias. O exame neuropatológico do cérebro e estudo histopatológico do tecido removido, revelou um tumor maligno do plexo coróideo, de extrema raridade no sistema nervoso central.The case of a three-years-old male with intracranial hypertension is reported. Without a clear clinical diagnosis, a gradual deterioration ocurred before his death, 8 days later. The neuropathological examination of the brain revealed a tumor with indistint borders at the right lateral ventricle, with granulous surface, pink-gray colour, irregular necrotic and hemorragic areas, invading the adjacent brain tissue. The histopathological study revealed a malignant variant of the choroid plexus tumor, of extreme rarity in the central nervous system. The biological and histological criteria accepted by Lewis, Rubinstein and Polak for the correct diagnosis of this type of tumour are discussed.

  14. The path from the choroid plexus to the subventricular zone: go with the flow!

    Directory of Open Access Journals (Sweden)

    Ana Mendanha Falcao

    2012-08-01

    Full Text Available In adult mammals, under physiological conditions, neurogenesis, the process of generating new functional neurons from precursor cells, occurs mainly in two brain areas: the subgranular zone in the dentate gyrus of the hippocampus, and the subventricular zone (SVZ lining the walls of the brain lateral ventricles. Taking into account the location of the SVZ and the cytoarchitecture of this periventricular neural progenitor cell niche, namely the fact that the slow dividing primary progenitor cells (type B cells of the SVZ extend an apical primary cilium towards the brain ventricular space which is filled with cerebrospinal fluid (CSF, it becomes likely that the composition of the CSF can modulate both self-renewal, proliferation and differentiation of SVZ neural stem cells. The major site of CSF synthesis is the choroid plexus (CP; quite surprisingly, however, it is still largely unknown the contribution of molecules specifically secreted by the adult CP as modulators of the SVZ adult neurogenesis. This is even more relevant in light of recent evidence showing the ability of the CP to adapt its transcriptome and secretome to various physiologic and pathologic stimuli. By giving particular emphasizes to growth factors and axonal guidance molecules we will illustrate how CP-born molecules might play an important role in the SVZ niche cell population dynamics.

  15. Measurement of choroidal thickness and macular thickness during and after pregnancy

    Institute of Scientific and Technical Information of China (English)

    D?ndü; Melek; Ulusoy; Necati; Duru; Mustafa; Atas; Hasan; Altιnkaynak; Zeynep; Duru; G?khan; A?maz

    2015-01-01

    AIM: To investigate the effect of pregnancy on subfoveal choroidal thickness(SFCT) and macular thickness in both pregnant and not pregnant healthy women.METHODS: Twenty-nine healthy pregnant women in their third trimester and 36 age-matched healthy women were enrolled in a prospective, cross-sectional study.Foveal and parafoveal thickness in the four quadrants and SFCT were measured by optical coherence tomography(OCT) in the healthy pregnant women(i.e.study group) and healthy women(i.e. control group).OCT measurements were again measured 3mo after delivery in the study group.RESULTS: Mean SFCT measurements in the control group, pregnant women of the study group, and after delivery of the study group were 320.86 ±59.18 μm,387.97 ±59.91 μm, and 332.40 ±26.03 μm, respectively.There was a statistically significant difference in the mean SFCT values between pregnant women of the study group and the control group(P =0.000). Foveal and parafoveal thickness values were not statistically significant in either the study or control group.CONCLUSION: SFCT increases during pregnancy and returns to normal range in the three months after delivery. Macular thickness does not show any change during pregnancy.

  16. Minimizing projection artifacts for accurate presentation of choroidal neovascularization in OCT micro-angiography.

    Science.gov (United States)

    Zhang, Anqi; Zhang, Qinqin; Wang, Ruikang K

    2015-10-01

    Current optical coherence tomography (OCT) based micro-angiography is prone to a projection (or tailing) effect due to the high scattering property of blood within overlying patent vessels, creating artifacts that interfere with the interpretation of retinal angiographic results. In this work, the projection effect in OCT micro-angiography is examined and its causality is explained by strong light scattering and photon propagation within blood. A simple practical approach is then introduced to minimize these artifacts presented in the outer retinal avascular space, especially useful for examining clinical cases with choroidal neovascularization (CNV). Demonstrated through in-vivo human posterior eye imaging of healthy and CNV subjects, the proposed method is shown effective to eliminate the projection artifacts in outer retinal space of OCT micro-angiography, resulting in better visualization of the pathological neovascularization when compared with the current common approaches. In addition, it is also shown that the proposed method is applicable to minimize the projection artifacts appearing in deep retinal layers. PMID:26504660

  17. Visual function after strontium-90 plaque irradiation in patients with age-related subfoveal choroidal neovascularization

    International Nuclear Information System (INIS)

    Purpose: To report 2-year visual and angiographic results in eyes treated with strontium plaque irradiation for subfoveal choroidal neovascular membranes (CNVM) in age-related macular degeneration. Methods: Twenty eyes with recent subfoveal CNVM were treated with local irradiation. The impact of the treatment on visual function was evaluated by visual acuity, contrast sensitivity and reading speed testing. Results: At 12 months visual acuity had improved or remained the same in 9/20 eyes (45%). At 24 months visual acuity was stable in 5/18 eyes (28%). Eyes with signs of CNVM regression (13/18,72%) lost a mean of 3.3 lines, but eyes with recurrent CNVM lost a mean of 5.1 lines of vision. The mean contrast sensitivity was better in the irradiated eyes than in the fellow eyes with late age-related macular degeneration at 24 months. Six of 17 irradiated eyes (35%) could read at least some words at 24 months. Conclusion: Visual function decreases in patients treated with strontium irradiation, but less in eyes showing regression of the CNVM than in eyes with further growth of the CNVM. (au)

  18. Ciliary body and choroidal melanomas treated by proton beam irradiation. Histopathologic study of eyes

    International Nuclear Information System (INIS)

    Proton beam irradiation resulted in clinical and/or histopathological regression of large ciliary body and choroidal melanomas in three eyes. Enucleations were performed 6 1/2 weeks, five months, and 11 months after irradiation for angle-closure glaucoma from total retinal detachment, increase in retinal detachment, and neovascular glaucoma, respectively. A direct relationship was found between the length of the interval from irradiation to enucleation and the degree of histologic changes. Vascular changes in the tumors included endothelial cell swelling and decreased lumen size, basement membrane thickening, collapse of sinusoidal vessels, and thrombosis of vessels. Although apparently unaltered tumor cells remained, degenerative changes occurred in some melanoma cells, including lipid vacuoles in cytoplasm, pyknotic nuclei, and balloon cell formation. Patchy areas of necrosis and proteinaceous exudate were present. Pigment-laden macrophages were found near tumor vessels and all had a substantial chronic inflammatory infiltrate. The effect of proton beam irradiation on tumor vessels probably plays an important role in uveal melanoma regression

  19. Subfoveal choroidal thickness measured by Cirrus HD optical coherence tomography in myopia

    Directory of Open Access Journals (Sweden)

    Li-Li Chen

    2014-09-01

    Full Text Available ATM: To measure the subfoveal choroidal thickness(SFCTin myopia using Cirrus HD optical coherence tomography(OCT, and to explore the relationship between the SFCT, axial length and myopic refractive spherical equivalent.METHODS: One-hundred thirty-three eyes of 70 healthy volunteers were recruited, and were divided into emmetropia group, low-degree myopia, middle-degree myopia and high-degree myopia group. SFCT were measured by Cirrus HD OCT, and the relationship between the SFCT, axial length and myopic refractive spherical equivalent were evaluated.RESULTS: 1Average SFCT was(275.91±55.74μm in normals, that in emmetropia group, low-degree myopia, middle-degree myopia and high-degree myopia group were(290.03±34.82μm,(287.64±51.51μm,(274.95±56.83μm,(248.37±67.98μm; 2the SFCT of high-degree myopia group was significant thinner than that of emmetropia group(PPPCONCLUSION: the SFCT is inversely correlated with increasing axial length and myopic refractive error.

  20. Evaluation of Idiopathic Choroidal Neovascularization with Indocyanine Green Angiography in Patients Undergoing Bevacizumab Therapy

    Directory of Open Access Journals (Sweden)

    Ryan B. Rush

    2015-01-01

    Full Text Available Purpose. To examine the clinical implications of change in choroidal neovascularization (CNV size on indocyanine green (ICG angiography in subjects with idiopathic CNV undergoing bevacizumab therapy. Methods. The charts of subjects with an idiopathic CNV treated by a modified PRN regimen with intravitreal bevacizumab over a 12-month period were retrospectively reviewed. Results. There were 34 subjects included in the analysis. Baseline CNV sizes of less than 1.0 mm2 on ICG angiography correlated with complete CNV resolution (P=0.0404, fewer injections delivered (P=0.0002, and better Snellen visual acuity (P=0.0098 at 12 months. Subjects that experienced a 33% or more reduction in CNV size on ICG angiography at 2 months had complete CNV resolution (P=0.0047 and fewer injections (P<0.0001 at 12 months compared to subjects that did not experience a 33% or more reduction in CNV size on ICG angiography at 2 months. Conclusions. Smaller baseline CNV size on ICG angiography resulted in better visual acuity and fewer injections at 12 months, and a reduction of 33% or more in CNV size after 2 months may predict a better clinical course in subjects with idiopathic CNV undergoing bevacizumab therapy.

  1. Intravitreal avastin for choroidal neovascularization associated with stargardt-like retinal abnormalities in pseudoxanthoma elasticum

    Directory of Open Access Journals (Sweden)

    Querques Giuseppe

    2010-01-01

    Full Text Available The aim of the study was to describe a patient with pseudoxanthoma elasticum (PXE, showing Stargardt-like retinal abnormalities, who underwent treatment with intravitreal bevacizumab for subfoveal choroidal neovascularization (CNV of the right eye (RE. A 57-year-old woman with diagnosis of angioid streaks, retinal flecks, and chorioretinal Stargardt-like atrophy due to PXE was referred to our department for sudden decreased vision in her RE (20/160. Upon a complete ophthalmologic examination, including fluorescein angiography (FA, and optical coherence tomography (OCT, the patient was diagnosed with subfoveal CNV of the RE. Owing to the subfoveal localization of the CNV, the patient was submitted to intravitreal bevacizumab injection. At the 1-month follow-up, visual acuity (VA improved (20/40, and FA and OCT revealed the CNV closure. Twelve months after the treatment, the patient′s VA remained stable with no recurrence of active CNV. On the basis of our findings, a single intravitreal bevacizumab injection seems to induce total regression of CNV complicating PXE, in a patient showing Stargardt-like retinal abnormalities. Further investigations are required to confirm our results.

  2. Idiopathic Choroidal Neovascularisation as the Inaugural Sign of Multiple Evanescent White Dot Syndrome

    Science.gov (United States)

    Papadia, Marina; Herbort, Carl P

    2010-01-01

    We report a case of multiple evanescent white dot syndrome (MEWDS) that presented with putative idiopathic choroidal neovascularisation (ICNV) before showing angiographic signs typical of MEWDS. A 16-year-old male presented with unilateral metamorphopsias and visual loss in his left eye. ICNV with subretinal hemorrhage was diagnosed and treated with intravitreal Avastin®. Fifteen days later, regression of choriodal neovascularization (CNV) was documented together with the appearance of fluorescein angiography (FA) and indocyanine green angiography (ICGA) signs typical for MEWDS, that included faint mottled FA hyperfluorescence in the mid-peripheral fundus, irregularly shaped mid-peripheral ICGA dark areas in the intermediate angiographic phase that were clearly delineated in the late phase as well as peripapillary hypofluorescence. Fundus examination appeared completely normal during the follow-up except for the CNV hemorrhage noted at the initial visit. This case demonstrates the need to consider ICNV as a diagnosis of exclusion until inflammatory causes have been eliminated. In this case, the underlying occult inflammatory condition would have been missed without the ICGA data that clearly showed signs of MEWDS that was supported by FA findings. PMID:20844686

  3. Idiopathic choroidal neovascularisation as the inaugural sign of multiple evanescent white dot syndrome

    Directory of Open Access Journals (Sweden)

    Papadia Marina

    2010-01-01

    Full Text Available We report a case of multiple evanescent white dot syndrome (MEWDS that presented with putative idiopathic choroidal neovascularisation (ICNV before showing angiographic signs typical of MEWDS. A 16-year-old male presented with unilateral metamorphopsias and visual loss in his left eye. ICNV with subretinal hemorrhage was diagnosed and treated with intravitreal Avastin ® . Fifteen days later, regression of choriodal neovascularization (CNV was documented together with the appearance of fluorescein angiography (FA and indocyanine green angiography (ICGA signs typical for MEWDS, that included faint mottled FA hyperfluorescence in the mid-peripheral fundus, irregularly shaped mid-peripheral ICGA dark areas in the intermediate angiographic phase that were clearly delineated in the late phase as well as peripapillary hypofluorescence. Fundus examination appeared completely normal during the follow-up except for the CNV hemorrhage noted at the initial visit. This case demonstrates the need to consider ICNV as a diagnosis of exclusion until inflammatory causes have been eliminated. In this case, the underlying occult inflammatory condition would have been missed without the ICGA data that clearly showed signs of MEWDS that was supported by FA findings.

  4. Cd59a deficiency in mice leads to preferential innate immune activation in the retinal pigment epithelium-choroid with age.

    Science.gov (United States)

    Herrmann, Philipp; Cowing, Jill A; Cristante, Enrico; Liyanage, Sidath E; Ribeiro, Joana; Duran, Yanai; Abelleira Hervas, Laura; Carvalho, Livia S; Bainbridge, James W B; Luhmann, Ulrich F O; Ali, Robin R

    2015-09-01

    Dysregulation of the complement system has been implicated in the pathogenesis of age-related macular degeneration. To investigate consequences of altered complement regulation in the eye with age, we examined Cd59a complement regulator deficient (Cd59a(-/-)) mice between 4 and 15 months. In vivo imaging revealed an increased age-related accumulation of autofluorescent spots in Cd59a(-/-) mice, a feature that reflects accumulation of subretinal macrophages and/or microglia. Despite this activation of myeloid cells in the eye, Cd59a(-/-) mice showed normal retinal histology and function as well as normal choroidal microvasculature. With age, they revealed increased expression of activators of the alternative complement pathway (C3, Cfb, Cfd), in particular in the retinal pigment epithelium (RPE)-choroid but less in the retina. This molecular response was not altered by moderately-enhanced light exposure. Cd59a deficiency therefore leads to a preferential age-related dysregulation of the complement system in the RPE-choroid, that alone or in combination with light as a trigger, is not sufficient to cause choroidal vascular changes or retinal degeneration and dysfunction. This data emphasizes the particular vulnerability of the RPE-choroidal complex to dysregulation of the alternative complement pathway during aging. PMID:26234657

  5. An Evaluation of Effects of Different Mydriatics on Choroidal Thickness by Examining Anterior Chamber Parameters: The Scheimpflug Imaging and Enhanced Depth Imaging-OCT Study.

    Science.gov (United States)

    Yuvacı, İsa; Pangal, Emine; Yuvacı, Sümeyra; Bayram, Nurettin; Ataş, Mustafa; Başkan, Burhan; Demircan, Süleyman; Akal, Ali

    2015-01-01

    Aim. To assess the effects of mydriatics commonly used in clinical practice on choroidal thickness and anterior chamber change. Methods. This was a prospective, randomized, controlled, double-blinded study including a single eye of the participants. The subjects were assigned into 4 groups to receive tropicamide 1%, phenylephrine 2.5%, cyclopentolate 1%, and artificial tears. At the baseline, anterior chamber parameters were assessed using a Pentacam Scheimpflug camera system, and choroidal thickness (CT) was measured using a spectral-domain OCT with Enhanced Depth Imaging (EDI) modality. All measurements were repeated again after drug administration. Results. Increases in pupil diameter, volume, and depth of anterior chamber were found to be significant (p = 0.000, p = 0.000, and p = 0.000, resp.), while decreases in the choroidal thickness were found to be significant in subjects receiving mydriatics (p parameters. This study was registered with trial registration number 2014/357. PMID:26509080

  6. Radiogenic Side Effects After Hypofractionated Stereotactic Photon Radiotherapy of Choroidal Melanoma in 212 Patients Treated Between 1997 and 2007

    Energy Technology Data Exchange (ETDEWEB)

    Dunavoelgyi, Roman [Department of Ophthalmology, Medical University of Vienna, Vienna (Austria); Dieckmann, Karin [Department of Radiology, Medical University of Vienna, Vienna (Austria); Gleiss, Andreas [Section of Clinical Biometrics, Medical University of Vienna, Vienna (Austria); Sacu, Stefan; Kircher, Karl; Georgopoulos, Michael [Department of Ophthalmology, Medical University of Vienna, Vienna (Austria); Georg, Dietmar [Department of Radiology, Medical University of Vienna, Vienna (Austria); Zehetmayer, Martin, E-mail: martin.zehetmayer@meduniwien.ac.at [Department of Ophthalmology, Medical University of Vienna, Vienna (Austria); Poetter, Richard [Department of Radiology, Medical University of Vienna, Vienna (Austria)

    2012-05-01

    Purpose: To evaluate side effects of hypofractionated stereotactic photon radiotherapy for patients with choroidal melanoma. Patients and Methods: Two hundred and twelve patients with choroidal melanoma unsuitable for ruthenium-106 brachytherapy or local resection were treated stereotactically at the Medical University of Vienna between 1997 and 2007 with a Linac with 6-MV photon beams in five fractions with 10, 12, or 14 Gy per fraction. Examinations for radiogenic side effects were performed at baseline and every 3 months in the first 2 years, then every 6 months until 5 years and then once a year thereafter until 10 years after radiotherapy. Adverse side effects were assessed using slit-lamp examination, funduscopy, gonioscopy, tonometry, and, if necessary, fundus photography and fluorescein angiography. Evaluations of incidence of side effects are based on an actuarial analysis. Results: One hundred and eighty-nine (89.2%) and 168 (79.2%) of the tumors were within 3 mm of the macula and the optic disc, respectively. The five most common radiotherapy side effects were retinopathy and optic neuropathy (114 cases and 107 cases, respectively), cataract development (87 cases), neovascular glaucoma (46 cases), and corneal epithelium defects (41 cases). In total, 33.6%, 38.5%, 51.2%, 75.5%, and 77.6% of the patients were free of any radiation retinopathy, optic neuropathy, cataract, neovascular glaucoma, or corneal epithelium defects 5 years after radiotherapy, respectively. Conclusion: In centrally located choroidal melanoma hypofractionated stereotactic photon radiotherapy shows a low to moderate rate of adverse long-term side effects comparable with those after proton beam radiotherapy. Future fractionation schemes should seek to further reduce adverse side effects rate while maintaining excellent local tumor control.

  7. Radiogenic Side Effects After Hypofractionated Stereotactic Photon Radiotherapy of Choroidal Melanoma in 212 Patients Treated Between 1997 and 2007

    International Nuclear Information System (INIS)

    Purpose: To evaluate side effects of hypofractionated stereotactic photon radiotherapy for patients with choroidal melanoma. Patients and Methods: Two hundred and twelve patients with choroidal melanoma unsuitable for ruthenium-106 brachytherapy or local resection were treated stereotactically at the Medical University of Vienna between 1997 and 2007 with a Linac with 6-MV photon beams in five fractions with 10, 12, or 14 Gy per fraction. Examinations for radiogenic side effects were performed at baseline and every 3 months in the first 2 years, then every 6 months until 5 years and then once a year thereafter until 10 years after radiotherapy. Adverse side effects were assessed using slit-lamp examination, funduscopy, gonioscopy, tonometry, and, if necessary, fundus photography and fluorescein angiography. Evaluations of incidence of side effects are based on an actuarial analysis. Results: One hundred and eighty-nine (89.2%) and 168 (79.2%) of the tumors were within 3 mm of the macula and the optic disc, respectively. The five most common radiotherapy side effects were retinopathy and optic neuropathy (114 cases and 107 cases, respectively), cataract development (87 cases), neovascular glaucoma (46 cases), and corneal epithelium defects (41 cases). In total, 33.6%, 38.5%, 51.2%, 75.5%, and 77.6% of the patients were free of any radiation retinopathy, optic neuropathy, cataract, neovascular glaucoma, or corneal epithelium defects 5 years after radiotherapy, respectively. Conclusion: In centrally located choroidal melanoma hypofractionated stereotactic photon radiotherapy shows a low to moderate rate of adverse long-term side effects comparable with those after proton beam radiotherapy. Future fractionation schemes should seek to further reduce adverse side effects rate while maintaining excellent local tumor control.

  8. Treatment of age-related subfoveal choroidal neovascularization by low-dose external radiation. A preliminary study

    International Nuclear Information System (INIS)

    We applied low dose external beam radiation (6MV) to 17 eyes of 17 patients (Mean age 70.9 years, range 58-85) who had subfoveal choroidal neovascularization associated with age-related macular degeneration. None of the cases were suitable for photocoagulation according to the Macular Photo-coagulation Study protocol, and no feeding vessels underlying choroidal neovascular membrane could be detected. Corrected visual acuity ranged from 0.02 to 0.6 before treatment. The patients were divided into two groups. One group of 11 eyes was treated with 10 Gy and the other group of 6 eyes with 21 Gy. Mean follow up period was 347±89 (mean±standard deviation) days in the 10 Gy group and 312±100 days in the 21 Gy group. We evaluated the outcome as 'effective' if no progression in neovascular membrane was found by ophthalmoscopic and angiographic examination. Only 3 eyes (21%) of patients in the 10 Gy group and 2 eyes (33%) in 21 Gy group showed any effect. Although the rate of progression in choroidal neovascular membrane was significantly smaller in the 10 and 21 Gy group than in the controls, the corrected visual acuity in the treated group was not improved over that of the controls. No serious complications were seen. Only one case showed a stabilized neovascular membrane in the control group of 7 patients. Although the present results seem to be worse than those in previous reports, the efficacy of this treatment still needs to be evaluated because no beneficial strategies in the treatment of subfoveal neovascularization have been established. (author)

  9. In vivo bioluminescence imaging of hyperglycemia exacerbating stem cells on choroidal neovascularization in mice

    Science.gov (United States)

    Gao, Xiang; Wang, Yu; Hou, Hui-Yuan; Lyu, Yang; Wang, Hai-Yan; Yao, Li-Bo; Zhang, Jian; Cao, Feng; Wang, Yu-Sheng

    2016-01-01

    AIM To investigate the influence of hyperglycemia on the severity of choroidal neovascularization (CNV), especially the involvement of bone marrow-derived cells (BMCs) and underlying mechanisms. METHODS BMCs from firefly luciferase (Fluc)/green fluorescent protein (GFP) double transgenic mice were transplanted into C57BL/6J wide-type mice. The recipient mice were injected intraperitoneally with streptozotocin (STZ) daily for 5 consecutive days to induce diabetes mellitus (DM), followed by CNV laser photocoagulation. The BMCs recruitment in CNV exposed to hyperglycemia was firstly examined in Fluc/GFP chimeric mice by in vivo optical bioluminescence imaging (BLI) and in vitro Fluc assays. The CNV severity was evaluated by H&E staining and choroidal flatmount. The expression of vascular endothelial growth factor (VEGF) and stromal cell derived factor-1 (SDF-1) was detected by Western Blot. RESULTS BLI showed that the BMCs exerted dynamic effects in CNV model in Fluc/GFP chimeric mice exposed to hyperglycemia. The signal intensity of transplanted Fluc+GFP+ BMCs in the DM chimeric mice was significantly higher than that in the control chimeric mice with CNV induction at days 5, 7, 14 and 21 (121861.67±9948.81 vs 144998.33±13787.13 photons/second/cm2/sr for control and DM mice, P5d<0.05; 178791.67±30350.8 vs 240166.67±22605.3, P7d<0.05; 124176.67±16253.52 vs 196376.67±18556.79, P14d<0.05; 97951.60±10343.09 vs 119510.00±14383.76, P21d<0.05), which was consistent with in vitro Fluc assay at day 7 [relative light units of Fluc (RLU1)], 215.00±52.05 vs 707.33±88.65, P<0.05; RLU1/ relative light units of renilla luciferase (RLU2), 0.90±0.17 vs 1.83±0.17, P<0.05]. The CNVs in the DM mice were wider than those in the control group at days 5, 7, 14 and 21 (147.83±17.36 vs 220.33±20.17 µm, P5d<0.05; 212.17±24.63 vs 326.83±19.49, P7d<0.05; 163.17±18.24 vs 265.17±20.55, P14d<0.05; 132.00±10.88 vs 205.33±12.98, P21d<0.05). The average area of CNV in the DM

  10. Disease: H01007 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available H01007 Choroid plexus papilloma Choroid plexus tumors (CPTs) are rare intraventricu...lar papillary neoplasms of neuroectodermal origin, accounting for less than 1% of all intracranial tumors an...d 2-4% of pediatric brain tumors. CPTs are categorized by three distinct histologies; choroid plexus papillo...905-9 (2012) PMID:21970783 (description) Ogiwara H, Dipatri AJ, Alden TD, Bowman RM, Tomita T Choroid plexus tumors...nlay JL Choroid plexus tumors; management, outcome, and association with the Li-F

  11. Digital Photography in the Diagnosis and Follow-up of Ocular Diseases

    OpenAIRE

    Saari, Jukka

    2007-01-01

    Purpose: The aim of the present study was to develop and test new digital imaging equipment and methods for diagnosis and follow-up of ocular diseases. Methods: The whole material comprised 398 subjects (469 examined eyes), including 241 patients with melanocytic choroidal tumours, 56 patients with melanocytic iris tumours, 42 patients with diabetes, a 52-year old patient with chronic phase of VKH disease, a 30-year old patient with an old blunt eye injury, and 57 normal healthy subjects...

  12. Organic anion and cation transport in vitro by dog choroid plexus: Effects of neuroleptics and tricyclic antidepressants

    International Nuclear Information System (INIS)

    Dog lateral choroid plexus accumulates the cation 14C-emepronium and the divalent anion 125I-iodipamide in vitro. At 10 μM, high potency neuroleptics with a substituted piperazine side chain and also haloperidol depress only the uptake of the cation and even stimulate the uptake of the anion. In contrast, at 1-10μM, the accumulation of both test substances is inhibited by neuroleptics and tricyclic antidepresssants with an aliphatic side chain. Such unspecific effects on seemingly unrelated transport systems at concentrations reached clinically in the CSF might explain some side actions of low potency neuroleptics and antidepressants. (author)

  13. The antimigraine drugs ergotamine and dihydroergotamine are potent 5-HT1C receptor agonists in piglet choroid plexus.

    OpenAIRE

    Brown, A. M.; Patch, T. L.; Kaumann, A. J.

    1991-01-01

    1. Fozard & Gray (1989) proposed that migraine is mediated by stimulation of 5-HT1C receptors. We have examined the interaction of two effective anti-migraine agents, ergotamine and dihydroergotamine (DHE), with these receptors. Binding (inhibition of labelling by [3H]-mesulergine) and agonist activity (phosphoinositide hydrolysis) were measured in piglet choroid plexus, a tissue rich in 5-HT1C receptors. 2. The pKD for [3H]-mesulergine binding was 8.4. Ergotamine and DHE both inhibited [3H]-...

  14. Photodynamic monotherapy or combination treatment with intravitreal triamcinolone acetonide, bevacizumab or ranibizumab for choroidal neovascularization associated with pathological myopia

    OpenAIRE

    Pukhraj Rishi; Ekta Rishi; Anusha Venkataraman; Lingam Gopal; Tarun Sharma(Department of Theoretical Physics, Tata Institute of Fundamental Research, Homi Bhabha Road, Colaba-400005, India); Muna Bhende; Dhanashree Ratra; Pratik Ranjan Sen; Parveen Sen

    2011-01-01

    This retrospective, interventional case series analyses treatment outcomes in eyes with choroidal neovascularization (CNV) secondary to pathological myopia, managed with photodynamic therapy, (PDT), (Group 1, N = 11), PDT and intravitreal triamcinolone acetonide (4 mg/0.1ml) (Group 2, N = 3), PDT and intravitreal anti-vascular endothelial growth factor (anti-VEGF) bevacizumab 1.25 mg/0.05 ml, ranibizumab 0.5 mg/0.05 ml and reduced-fluence PDT and intravitreal ranibizumab 0.5 mg/0.05 ml (Group...

  15. Insulin signaling inhibits the 5-HT2C receptor in choroid plexus via MAP kinase

    Directory of Open Access Journals (Sweden)

    Guan Kunliang

    2003-06-01

    Full Text Available Abstract Background G protein-coupled receptors (GPCRs interact with heterotrimeric GTP-binding proteins (G proteins to modulate acute changes in intracellular messenger levels and ion channel activity. In contrast, long-term changes in cellular growth, proliferation and differentiation are often mediated by tyrosine kinase receptors and certain GPCRs by activation of mitogen-activated protein (MAP kinases. Complex interactions occur between these signaling pathways, but the specific mechanisms of such regulatory events are not well-understood. In particular it is not clear whether GPCRs are modulated by tyrosine kinase receptor-MAP kinase pathways. Results Here we describe tyrosine kinase receptor regulation of a GPCR via MAP kinase. Insulin reduced the activity of the 5-HT2C receptor in choroid plexus cells which was blocked by the MAP kinase kinase (MEK inhibitor, PD 098059. We demonstrate that the inhibitory effect of insulin and insulin-like growth factor type 1 (IGF-1 on the 5-HT2C receptor is dependent on tyrosine kinase, RAS and MAP kinase. The effect may be receptor-specific: insulin had no effect on another GPCR that shares the same G protein signaling pathway as the 5-HT2C receptor. This effect is also direct: activated MAP kinase mimicked the effect of insulin, and removing a putative MAP kinase site from the 5-HT2C receptor abolished the effect of insulin. Conclusion These results show that insulin signaling can inhibit 5-HT2C receptor activity and suggest that MAP kinase may play a direct role in regulating the function of a specific GPCR.

  16. Ocular Response of Choroidal Melanoma With Monosomy 3 Versus Disomy 3 After Iodine-125 Brachytherapy

    International Nuclear Information System (INIS)

    Purpose: To report the ocular response of choroidal melanoma with monosomy 3 vs. disomy 3 after 125I brachytherapy. Methods and Materials: We evaluated patients with ciliochoroidal melanoma managed with fine needle aspiration biopsy immediately before plaque application for 125I brachytherapy between January 1, 2005 and December 31, 2008. Patients with (1) cytopathologic diagnosis of melanoma, (2) melanoma chromosome 3 status identified by fluorescence in situ hybridization, and (3) 6 or more months of follow-up after brachytherapy were sorted by monosomy 3 vs. disomy 3 and compared by Kruskal-Wallis test. Results: Among 40 ciliochoroidal melanomas (40 patients), 15 had monosomy 3 and 25 had disomy 3. Monosomy 3 melanomas had a median greatest basal diameter of 12.00 mm and a median tumor thickness of 6.69 mm before brachytherapy; at a median of 1.75 years after brachytherapy, median thickness was 3.10 mm. Median percentage decrease in tumor thickness was 48.3%. Disomy 3 melanomas had a median greatest basal diameter of 10.00 mm and median tumor thickness of 3.19 mm before brachytherapy; at a median of 2.00 years after brachytherapy, median tumor thickness was 2.37 mm. The median percentage decrease in tumor thickness was 22.7%. Monosomy 3 melanomas were statistically greater in size than disomy 3 melanomas (p < 0.001) and showed a greater decrease in tumor thickness after brachytherapy (p = 0.006). Conclusion: In this study, ciliochoroidal melanomas with monosomy 3 were significantly greater in size than disomy 3 melanoma and showed a significantly greater decrease in thickness at a median of 1.75 years after brachytherapy. The greater decrease in monosomy 3 melanoma thickness after brachytherapy is consistent with other malignancies in which more aggressive pathology has been shown to be associated with a greater initial response to radiotherapy.

  17. Novel 3D conformal technique for treament of choroidal melanoma with external beam photon radiotherapy

    International Nuclear Information System (INIS)

    To report a 3D conformal radiotherapy (3D-CRT) technique that utilises a specific eye immobilisation and treatment set-up method as an alternative to stereotactic radiotherapy (SRT), for treatment of juxtapapillary choroidal melanoma (CM) and report early treatment outcomes of this technique. A contact lens and rod system was designed to provide eye immobilisation and a treatment reference point for 3D-CRT. The technique is described in detail in the body of the paper. A retrospective chart review was conducted to report freedom from local progression (FFLP) and radiation toxicity in a cohort of patients treated with a dose of 50Gy in five fractions. Eleven eligible patients with juxtapapillary CM were treated between 2003 and 2009. The median follow-up was 3.2 years (range 1.2–5.3). The FFLP was 100% (95% confidence interval 71.5–100). The reproducibility of the set-up and eye immobilisation for fractionation was excellent. The mean dose to the planning target volume was 51.4Gy (interquartilic range 51.0–51.9). Normal tissue dose constraints were achieved; however, the quality of the 3D-CRT plan was variable. The highest acute radiation toxicity score was Common Toxicity Criteria version 3 grade 1. Vision outcomes were poor. n this small series, a novel non-stereotactic technique was found to be an accurate method for the treatment of CM with a high rate of freedom from tumour progression, in keeping with the SRT series. The quality of the conformal plan was variable. Investigation of the optimal dose-fractionation schedule to minimise late radiation toxicity without compromise of tumour control is the focus of ongoing clinical research at our centre.

  18. Choroidal thickness changes after dynamic exercise as measured by spectral-domain optical coherence tomography

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    Nihat Sayin

    2015-01-01

    Full Text Available Purpose: To measure the choroidal thickness (CT after dynamic exercise by using enhanced depth imaging optical coherence tomography (EDI-OCT. Materials and Methods: A total of 19 healthy participants performed 10 min of low-impact, moderate-intensity exercise (i.e., riding a bicycle ergometer and were examined with EDI-OCT. Each participant was scanned before exercise and afterward at 5 min and 15 min. CT measurement was taken at the fovea and 1000 μ away from the fovea in the nasal, temporal, superior, and inferior regions. Retinal thickness, intraocular pressure, ocular perfusion pressure (OPP, heart rate, and mean blood pressure (mBP were also measured. Results: A significant increase occurred in OPP and mBP at 5 min and 15 min following exercise (P ˂ 0.05. The mean subfoveal CT at baseline was 344.00 ± 64.71 μm compared to 370.63 ± 66.87 μm at 5 min and 345.31 ± 63.58 μm at 15 min after exercise. CT measurements at all locations significantly increased at 5 min following exercise compared to the baseline (P ˂ 0.001, while measurements at 15 min following exercise did not significant differ compared to the baseline (P ˃ 0.05. There was no significant difference in retinal thickness at any location before and at 5 min and 15 min following exercise (P ˃ 0.05. Conclusion: Findings revealed that dynamic exercise causes a significant increase in CT for at least 5 min following exercise.

  19. Association between hyperacuity defects and retinal microstructure in polypoidal choroidal vasculopathy

    Directory of Open Access Journals (Sweden)

    Moosang Kim

    2014-01-01

    Full Text Available Purpose: To improve our understanding of hyperacuity defects measured with preferential hyperacuity perimetry (PHP by correlating PHP findings with the retinal microstructural changes visible on spectral-domain optical coherence tomography (OCT in patients with polypoidal choroidal vasculopathy (PCV. Materials and Methods: Twenty-eight eyes of 28 patients with PCV were retrospectively reviewed. All patients underwent a complete ophthalmologic examination, including best-corrected visual acuity (logMAR testing, PHP, and OCT. The functional ′PHP test score′ and ′total volume of hyperacuity defect zone′ were also analyzed. Results: Patients were classified based on the hyperacuity defect by PHP, as follows: Hyperacuity defect (n = 17 eyes group and hyperacuity intact (n = 11 eyes group. The mean best-corrected visual acuity in the hyperacuity intact group (0.46 ± 0.39 was better than that in the hyperacuity defect group (0.82 ± 0.37 (P = 0.014. The presence of serous retinal detachment and retinal pigment epithelial detachment did not differ significantly between groups (P = 0.120 and P = 0.689, respectively. A disrupted photoreceptor layer was more common in the hyperacuity defect group compared with the hyperacuity intact group (P = 0.0001. Among 17 eyes with a hyperacuity defect, 9 eyes showing intra-retinal pathology (intra-retinal cyst or hard exudates and had a significantly higher PHP test score and larger total volume of the hyperacuity defect zone than 8 eyes without intra-retinal pathology (P = 0.006 and P = 0.021, respectively. Conclusion: A hyperacuity defect in PCV was associated with photoreceptor disarrangement. Furthermore, PCV lesions on the inner retina that invaded the photoreceptor layer were associated with a more severe hyperacuity defect.

  20. Evidence of a novel gene HERPUD1 in polypoidal choroidal vasculopathy.

    Science.gov (United States)

    Jin, Enzhong; Bai, Yujing; Huang, Lvzhen; Zhao, Min; Zhang, Chunfang; Zhao, Mingwei; Li, Xiaoxin

    2015-01-01

    Polypoidal choroidal vasculopathy (PCV) is an exudative maculopathy, with clinical features distinct from neovascular age-related macular degeneration (nAMD) which is the leading cause of irreversible blindness in the elderly. Our studies focused on the genetic background and function of a novel gene HERPUD1 in PCV. HERPUD1 has been reported to increase the level of amyloid β (Aβ), which is a component of drusen deposits underlying the retinal pigment epithelium (RPE) layer. To verify the genetic functional associations of HERPUD1 with PCV, exome sequencing of HERPUD1 was performed in unrelated Chinese individuals, including nAMD patients, PCV patients and control subjects. Immunohistochemistry assays for HERPUD1 were performed in the subretinal membranes of PCV patients. The relationship between HERPUD1 and amyloid beta precursor was determined using real-time PCR in HERPUD1-overexpressing RPE cells. The gene expression patterns of angiogenesis cytokines and chemokines in both Aβ-treated RPE cells and in Brown Norway rats that received Aβ subretinal injections were determined. We showed that HERPUD1 rs2217332 is significant associated with Chinese PCV, and HERPUD1 was expressed in PCV subretinal membranes. Besides, Plasma Aβ42 protein was significantly higher in PCV patients compared to nAMD and control subjects. Aβ could upregulate angiogenic factors, chemokines and matrix metalloproteinases both in RPE cells and in a rat model of subretinal Aβ injection. The imbalance of the cytokines may be one of the mechanisms for the formation and development of PCV. Our results strongly suggest that HERPUD1 is highly associated with PCV patients. PMID:26823705

  1. Surgical removal of subfoveal choroidal neovascularization in pathologic myopia: a 12-year follow-up study.

    Science.gov (United States)

    Hera, R; Chiquet, C; Romanet, J P

    2013-12-01

    The purpose of this study was to review the 12-year visual outcomes of patients who underwent surgical removal for subfoveal choroidal neovascularization (CNV) attributable to pathologic myopia. This retrospective study included 14 patients, with a mean age of 45.8 years, high myopia (>6 D) and classic subfoveal CNV. They were treated with pars plana vitrectomy and surgical removal of CNV. All patients were followed up every 3 months for 2 years, with visual acuity (VA), fundus examination, and fluorescein angiography and then every year for 5 years. Ten patients underwent a final visit with VA and fundus examination after a minimum 12-year follow-up. The main outcome measurement was VA and the secondary outcome measurement was the lesion size. After 12 years of follow-up, the mean VA did not significantly change over time, with a mean gain of 0.22 logMAR at 1 year, and 0.18, 0.12 and 0.05 at 2, 5 and 12 years, respectively. The anatomical evolution was characterized by a significant enlargement of the lesion size at 5 years. This study showed that final VA after surgical treatment with 12 years of follow-up was poor, due to the significant CNV scar enlargement over time. These results should prompt a prospective randomized study of other medical treatments, particularly anti-vascular endothelial growth factor therapy. PMID:23539478

  2. Comparison of intravitreal bevacizumab to photodynamic therapy for polypoidal choroidal vasculopathy: Short-term results

    Directory of Open Access Journals (Sweden)

    Mitamura Yoshinori

    2010-01-01

    Full Text Available Aims: To compare the short-term therapeutic effects of intravitreal bevacizumab (IVB to those of photodynamic therapy (PDT for polypoidal choroidal vasculopathy (PCV. Materials and Methods: Retrospective interventional case study. Eighty-nine eyes of 89 patients with symptomatic PCV were treated by IVB or PDT. Eighteen eyes were treated with a single injection of IVB (s-IVB group, 22 eyes with three consecutive monthly IVB injections (m-IVB group, and 49 eyes with PDT alone (PDT group. The best-corrected visual acuity (BCVA and OCT-determined central foveal thickness (CFT were evaluated before, and one and three months after the treatment. For statistical analyses, one-factor ANOVA and Chi-square test were used. Results: The differences in the BCVA and CFT among the three groups at the baseline were not significant (P=0.992, P=0.981, respectively. Three months after the treatment, the BCVA improved by> 0.2 logMAR units in two out of 18 eyes (11% in the s-IVB group, three out of 22 eyes (14% in the m-IVB group, and 15 out of 49 eyes (31% in the PDT group (P=0.124. A decrease in the CFT by> 20% was achieved in six out of 18 eyes in the s-IVB group, ten eyes (46% in the m-IVB group, and 35 eyes (71% in the PDT group (P=0.009. The resolution of polyps was achieved in three out of 18 eyes in the s-IVB group, one eye (5% in the m-IVB group and 35 eyes (71% in the PDT group (P < 0.001. Conclusion: The better short-term therapeutic outcomes in the PDT group than in the s-IVB and m-IVB groups indicate that PDT may be more effective than IVB in short term after treatment for PCV.

  3. RANIBIZUMAB (LUCENTIS® INJECTION BY ANTERIOR CHAMBER IN APHAKIC EYES WITH MYOPIC CHOROIDAL NEOVASCULARIZATION

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    F. Petrarchini

    2012-05-01

    Full Text Available Purpose. macular choroidal neovascularization (CNV is one of the most vision-threatening complications of myopia, which can lead to severe vision loss. Our purpose was to evaluate the safety and efficacy of trans-corneal injection of ranibizumab in the treatment of myopic CNV in aphakic patients. Materials and Methods. ten eyes of 10 aphakic patients with CNV secondary to pathologic myopia treated with three trans- corneal injection of ranibizumab were evaluated. A complete ophthalmologic examination including best-corrected visual acuity (BCVA and fundus biomicroscopy, specular microscopy, fundus optical coherence tomography (OCT, fluorescein an- giography (FA were performed at baseline and monthly for all patients. Mean time of follow-up was 6 months. results. The mean axial length was 27,6 mm (range, 25.7-31.3 mm. The mean initial visual acuity (VA was 0.19 (decimal equivalent. A statistically significant improvement to a mean VA of 0.33 decimal equivalent (log-MAR:0.48 was demon- strated at the final follow-up. VA improved by a mean of 2.86 lines. Mean central macular thickness (CMT measured with OCT was 340 μm (range, 179-663 μm at the baseline, and was reduced significantly at the final follow-up to 212μm (range, 125-455 μm. No injection complications or drug-related side effects were noted during the follow-up period. Conclusions. in this small series of aphakic eyes with limited follow-up, ranibizumab by anterior chamber administration seems to be a safe and effective treatment for CNV secondary to pathologic myopia (PM, without any complications. Further studies to evaluate the safety and efficacy are justified.

  4. Fractionated stereotactic irradiation by Cyberknife of choroid melanomas: repositioning validation, closed eyelids; Irradiation stereotaxique fractionnee par Cyberknife des melanomes choroidiens: validation du repositionnement, paupieres fermees

    Energy Technology Data Exchange (ETDEWEB)

    Horn, S.; Rezvoy, N.; Lacornerie, T.; Mirabel, X.; Labalette, P.; Lartigau, E. [Centre Oscar-Lambret, Service de Radiotherapie, 59 - Lille (France)

    2009-10-15

    The fractionated stereotactic radiotherapy by Cyberknife is an option in the treatment of eyes tumors. The advantages of the Cyberknife in the choroid melanomas are in its infra-millimetric precision, to the automated repositioning on the skull bones and to the conformity brought by the stereotaxy. The objective of this study was to validate the quality of repositioning and the immobility of the eyes with closed eyelids. Conclusion: the reproducibility of the eye positioning with closed eyelids seems enough to consider the conservative treatment of choroid melanomas by fractionated stereotactic radiotherapy by Cyberknife without implementation of fiducials nor retrobulbar anaesthesia. (N.C.)

  5. Long-term outcome after radiation therapy for subfoveal choroidal neovascularization associated with age-related macular degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Mandai, Michiko; Takahashi, Masayo; Miyamoto, Hideki; Hiroshiba, Naoko; Kimura, Hideya; Ogura, Yuichiro; Honda, Yoshihito; Sasai, Keisuke [Kyoto Univ. (Japan). Graduate School of Medicine

    2000-10-01

    The purpose of this study was to investigate the long-term effect of low-dose radiation therapy on subfoveal choroidal neovascularization associated with age-related macular degeneration. The clinical course and visual outcome were compared retrospectively among two treated groups and a control group; 15 patients (15 eyes) received 10 Gy, another 15 patients (15 eyes) received 20 Gy. The control group consisted of 15 patients (15 eyes) without treatment. All patients were followed up for at least 18 months, and most were followed up for 3 years. The macula was irradiated with either 10 Gy in 5 fractions or with 20 Gy in 10 fractions after computed tomography (CT) simulation enabled real-time treatment planning from multiple CT slices. During the 3 years of follow-up, the lesions became better in 5 eyes, unchanged in 1, and worse in 9 with 10 Gy radiation; better in 7 eyes, unchanged in 1, and worse in 7 eyes with 20 Gy; and better in 1 eye and worse in 14 with no treatment. The difference between the groups treated with radiation and the control was statistically significant (P<.05). Visual acuity was also significantly better in the group receiving 20 Gy than in the control group up to 2 years after radiation (P<.01). Radiation may extend the period of good visual function substantially by reducing subfoveal choroidal neovascularization activity. (author)

  6. Management of peripheral polypoidal choroidal vasculopathy with intravitreal bevacizumab and indocyanine green angiography-guided laser photocoagulation

    Directory of Open Access Journals (Sweden)

    Pukhraj Rishi

    2012-01-01

    Full Text Available A 69-year-old lady presented with complaints of decreased vision in left eye since one month. Best Corrected Visual Acuity (BCVA was 6/18 in that eye. Fundus examination revealed non-central geographic atrophy and soft drusens at macula in both eyes. Temporal periphery of left eye revealed subretinal exudates with altered sub-RPE hemorrhage mimicking peripheral exudative hemorrhagic chorioretinopathy (PEHCR. Fundus Fluorescein Angiogram showed window defects at macula and blocked fluorescence at temporal periphery in left eye. However, Indocyanine green angiography (ICGA revealed active peripheral choroidal polyps. The patient was successfully treated with intravitreal bevacizumab and ICGA-guided laser photocoagulation. 27 months after laser treatment, BCVA improved to 6/9. Rationale of consecutive anti-vascular endothelial growth factor (VEGF treatment followed by more definitive laser photocoagulation is that anti-VEGF aids in resolution of subretinal fluid, thus making the polyp more amenable to focal laser photocoagulation which stabilizes the choroidal vasculature and prevents further leakage.

  7. Bacterial endotoxin-induced gene expression in the choroid plexus and paraventricular and supraoptic hypothalamic nuclei of the sheep.

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    Vellucci, S V; Parrott, R F

    1996-12-31

    The febrile and neuroendocrine responses to circulating endotoxin are effected, at least in part, by a central action of prostaglandins with interleukins serving as intermediaries. Data from rodents suggest that prostaglandin and interleukin (IL-1 beta) synthesis in response to endotoxin challenge may occur within the circumventricular organs of the brain, especially the choroid plexus; the present study investigated this possibility using the sheep as an experimental model. A pyretic dose of bacterial endotoxin (40 micrograms lipopolysaccharide) was given intravenously to sheep (n = 5) and the effect on gene expression in the choroid plexus after a 40 min interval was compared with that observed in vehicle-treated animals (n = 5) using in situ hybridisation histochemistry. Evidence of activational and synthetic events following endotoxin administration was provided by significant increases in c-fos (P gene expression. The results showed that c-fos mRNA increased in the paraventricular (P gene expression although oxytocin mRNA was enhanced throughout the paraventricular nucleus (P sheep to immunological challenge: (2) endotoxin-induced changes in gene expression in the ovine hypothalamus similar in those caused by other stressors: and (3) possible changes in oxytocin synthesis concomitant with fever in the sheep. PMID:9037517

  8. Long-term outcome after radiation therapy for subfoveal choroidal neovascularization associated with age-related macular degeneration

    International Nuclear Information System (INIS)

    The purpose of this study was to investigate the long-term effect of low-dose radiation therapy on subfoveal choroidal neovascularization associated with age-related macular degeneration. The clinical course and visual outcome were compared retrospectively among two treated groups and a control group; 15 patients (15 eyes) received 10 Gy, another 15 patients (15 eyes) received 20 Gy. The control group consisted of 15 patients (15 eyes) without treatment. All patients were followed up for at least 18 months, and most were followed up for 3 years. The macula was irradiated with either 10 Gy in 5 fractions or with 20 Gy in 10 fractions after computed tomography (CT) simulation enabled real-time treatment planning from multiple CT slices. During the 3 years of follow-up, the lesions became better in 5 eyes, unchanged in 1, and worse in 9 with 10 Gy radiation; better in 7 eyes, unchanged in 1, and worse in 7 eyes with 20 Gy; and better in 1 eye and worse in 14 with no treatment. The difference between the groups treated with radiation and the control was statistically significant (P<.05). Visual acuity was also significantly better in the group receiving 20 Gy than in the control group up to 2 years after radiation (P<.01). Radiation may extend the period of good visual function substantially by reducing subfoveal choroidal neovascularization activity. (author)

  9. Risk factors for neovascular glaucoma after carbon ion radiotherapy of choroidal melanoma using dose-volume histogram analysis

    International Nuclear Information System (INIS)

    Purpose: To determine the risk factors for neovascular glaucoma (NVG) after carbon ion radiotherapy (C-ion RT) of choroidal melanoma. Methods and Materials: A total of 55 patients with choroidal melanoma were treated between 2001 and 2005 with C-ion RT based on computed tomography treatment planning. All patients had a tumor of large size or one located close to the optic disk. Univariate and multivariate analyses were performed to identify the risk factors of NVG for the following parameters; gender, age, dose-volumes of the iris-ciliary body and the wall of eyeball, and irradiation of the optic disk (ODI). Results: Neovascular glaucoma occurred in 23 patients and the 3-year cumulative NVG rate was 42.6 ± 6.8% (standard error), but enucleation from NVG was performed in only three eyes. Multivariate analysis revealed that the significant risk factors for NVG were V50IC (volume irradiated ≥50 GyE to iris-ciliary body) (p = 0.002) and ODI (p = 0.036). The 3-year NVG rate for patients with V50IC ≥0.127 mL and those with V50IC IC and ODI were independent risk factors for NVG. An irradiation system that can reduce the dose to both the anterior segment and the optic disk might be worth adopting to investigate whether or not incidence of NVG can be decreased with it

  10. Insulin-like growth factor II messenger ribonucleic acids are synthesized in the choroid plexus of the rat brain

    International Nuclear Information System (INIS)

    Previous studies demonstrating the presence of immunoreactive insulin-like growth factors (IGFs) and their receptors in the brain suggest a role of the IGFs in the central nervous system. IGF-II has been implicated as the predominant IGF in brain of mature animals based on studies of immunoreactive peptide and of IGF-II mRNAs. To obtain information about the sites of synthesis of IGF-II in adult rat brain, a 32P-labeled 31 base long synthetic oligodeoxyribonucleotide complementary in sequence to trailer peptide coding sequences in rat IGF-II mRNA (IGF-II 31 mer) was hybridized with coronal sections of fixed rat brain. The IGF-II 31 mer showed specific hybridization with the choroid plexus throughout rat brain, whereas in other brain regions, structures or cells, hybridization was not discernibly above background. These findings suggest that the choroid plexus is a primary site of synthesis of IGF-II, a probable source of IGF-II in cerebrospinal fluid, and a potential source of IGF-II for actions on target cells within the adult rat brain

  11. Is Reticular Macular Disease a Choriocapillaris Perfusion Problem?

    Science.gov (United States)

    A. Martillo, Miguel; Marsiglia, Marcela; D. Lee, Michele; Pumariega, Nicole; Bearelly, Srilaxmi; Smith, R. Theodore

    2012-01-01

    The etiology of reticular macular disease (RMD), a sub-phenotype of age-related macular degeneration (AMD), is controversial and has not been clarified. RMD is suspected to be a multifactorial, complex disease with genetic, environmental, and systemic factors playing an important role in its origin. Findings from combinations of different imaging modalities suggest that the pattern that characterizes this condition is associated with an alteration of the choriocapillaris blood flow. If the choroid is indeed affected in RMD, the possible linkage with inflammatory or other systemic diseases could be better supported. PMID:24600618

  12. Effects of three consecutive monthly intravitreal injection of ranibizumab for polypoidal choroidal vasculopathy in Korea

    Institute of Scientific and Technical Information of China (English)

    Young; Gun; Park; Seungbum; Kang; Young; Jung; Roh

    2015-01-01

    AIM: To evaluate the efficacy and safety of three consecutive monthly injections of intravitreal ranibizumab for the treatment of polypoidal choroidal vasculopathy(PCV) in Korea.METHODS: A retrospective chart review of 25 patients(27 eyes) with PCV was conducted. Patients received three initial monthly intravitreal injections(0.5 mg) of ranibizumab and were monitored monthly for 12 mo from January 2010 to October 2011. Reinjection of ranibizumab after three initial monthly loading was administered on an as-needed basis, guided by the optical coherence tomography(OCT), fluorescein angiography(FA) and indocyanine green angiography(ICGA). The main outcomes were the changes of the mean best corrected Snellen visual acuity(VA), central macular thickness(CMT) by OCT, the changes of polyps and branching vascular network by FA and ICGA, and total number of injections received by patients during the 12 mo.RESULTS: The mean best corrected Snellen visual acuities at baseline, 1, 3, 6 and 12 mo after primary injection were 0.77 ±0.59, 0.76 ±0.53, 0.70 ±0.47, 0.63 ±0.43,0.61 ±0.43, 0.62 ±0.42 log MAR, respectively, and showed significant improvement at 3, 6, 12mo(P =0.003, P =0.002,P =0.018, Wilcoxon signed-rank test). The mean CMT at baseline, 1, 2, 3, 6, and 12 mo was 312.41 ±66.38 μm,244.59 ±71.47 μm, 232.32 ±69.41 μm, 226.69 ±69.03 μm,228.62 ±37.07 μm, 227.59 ±51.01 μm respectively, and showed significant reduction(all P <0.001, Wilcoxon signed-rank test). Polypoidal lesions resolved on ICGA in 3 eyes(11.1%) and a branching vascular network remained in all 24 eyes(88.9%). A total of 106 injections were given in the 12-month period, which equaled to a mean of 3.92(range, 3-6) times. Sixteen of the 27 treatedeyes had additional 1.56 ±0.91 injections. The others(11eyes) had just 3 consecutive injections.CONCLUSION: An initial loading dose of three monthly ranibizumab injections is a safe and effective method in treating PCV, with visual and anatomical

  13. Ultra–Short-Term Reproducibility of Speckle-Noise Freed Fluid and Tissue Compartmentalization of the Choroid Analyzed by Standard OCT

    Science.gov (United States)

    Maloca, Peter; Gyger, Cyrill; Schoetzau, Andreas; Hasler, Pascal W.

    2015-01-01

    Purpose We measured reproducibility of speckle-noise freed fluid and tissue compartmentalization of the choroid (choroidal angiography and tissue characterization). Methods This study included 26 eyes of 13 healthy females: 13 were used for repeated measurements and 13 were used for side comparison. A semiautomated algorithm removed speckle-noise with structure preservation. Results Intraclass correlation (ICC), with respect to reproducibility of the method, showed an ICC for choroidal fluid inner space analysis (FISA) of 95.15% (90.01–98.24). The ICC of tissue inner space analysis (TISA) was 99.75% (99.47–99.91). The total choroid ratio (TCR), calculated from volumes of tissue to vessels, showed an ICC of 88.84% (78.28–95.82). Comparison of eyes (left to right) showed a difference for FISA of 0.033 (95% confidence interval [CI] −0.0018–0.0680, P = 0.063), TISA −0.118 (CI −0.2373–0.0023, P = 0.055), and TCR −0.590 (CI −0.9047 to −0.2754, P = 0.004). The ICC for FISA and TISA showed a trend in the difference comparing left and right eyes; however, TCR showed a significant difference between the eyes in the measured area (P TISA was 3.45 mm3 (range, 2.38–5.0 mm3, SD 0.072). Mean TCR was 6.13 (overall range, 3.93–10.2, SD = 1.34). Conclusions Differences in choroidal layers between subjects were found mainly due to alterations in choroidal tissue. Reproducibility of speckle-noise freed choroidal angiography appeared excellent. Translational Relevance Speckle noise is a granular “noise” that appears in a wide range of medical imaging methods as ultrasonography, magnetic resonance, computer tomography, or optical coherence tomography (OCT). Findings from basic science about speckle noise were translated into a novel, medical image postprocessing application that can separate signal from speckle noise with structure preservation with high reproducibility and enhance medical imaging. PMID:26629399

  14. Human cerebrospinal fluid central memory CD4+ T cells: Evidence for trafficking through choroid plexus and meninges via P-selectin

    Science.gov (United States)

    Kivisäkk, Pia; Mahad, Don J.; Callahan, Melissa K.; Trebst, Corinna; Tucky, Barbara; Wei, Tao; Wu, Lijun; Baekkevold, Espen S.; Lassmann, Hans; Staugaitis, Susan M.; Campbell, James J.; Ransohoff, Richard M.

    2003-01-01

    Cerebrospinal fluid (CSF) from healthy individuals contains between 1,000 and 3,000 leukocytes per ml. Little is known about trafficking patterns of leukocytes between the systemic circulation and the noninflamed CNS. In the current study, we characterized the surface phenotype of CSF cells and defined the expression of selected adhesion molecules on vasculature in the choroid plexus, the subarachnoid space surrounding the cerebral cortex, and the cerebral parenchyma. Using multicolor flow cytometry, we found that CSF cells predominantly consisted of CD4+/CD45RA-/CD27+/CD69+-activated central memory T cells expressing high levels of CCR7 and L-selectin. CD3+ T cells were present in the choroid plexus stroma in autopsy CNS tissue sections from individuals who died without known neurological disorders. P- and E-selectin immunoreactivity was detected in large venules in the choroid plexus and subarachnoid space, but not in parenchymal microvessels. CD4+ T cells in the CSF expressed high levels of P-selectin glycoprotein ligand 1, and a subpopulation of circulating CD4+ T cells displayed P-selectin binding activity. Intercellular adhesion molecule 1, but not vascular cell adhesion molecule 1 or mucosal addressin cell adhesion molecule 1, was expressed in choroid plexus and subarachnoid space vessels. Based on these findings, we propose that T cells are recruited to the CSF through interactions between P-selectin/P-selectin ligands and intercellular adhesion molecule 1/lymphocyte function-associated antigen 1 in choroid plexus and subarachnoid space venules. These results support the overall hypothesis that activated memory T cells enter CSF directly from the systemic circulation and monitor the subarachnoid space, retaining the capacity to either initiate local immune reactions or return to secondary lymphoid organs. PMID:12829791

  15. Aflibercept: a review of its use in the treatment of choroidal neovascularization due to age-related macular degeneration

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    Balaratnasingam C

    2015-12-01

    Full Text Available Chandrakumar Balaratnasingam,1–3 Elona Dhrami-Gavazi,1,2,4 Jesse T McCann,1,2,4,5 Quraish Ghadiali,1,2 K Bailey Freund1,2,4,5 1Vitreous-Retina-Macula Consultants of New York, NY, USA; 2LuEsther T Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, NY, USA; 3Centre for Ophthalmology and Visual Sciences, Lions Eye Institute, University of Western Australia, Perth, WA, Australia; 4Department of Ophthalmology, Edward S Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, NY, USA; 5Department of Ophthalmology, New York University School of Medicine, New York, NY, USA Abstract: Choroidal neovascularization (CNV due to age-related macular degeneration (AMD is an important cause of visual morbidity globally. Modern treatment strategies for neovascular AMD achieve regression of CNV by suppressing the activity of key growth factors that mediate angiogenesis. Vascular endothelial growth factor (VEGF has been the major target of neovascular AMD therapy for almost two decades, and there have been several intravitreally-administered agents that have enabled anatomical restitution and improvement in visual function with continual dosing. Aflibercept (EYLEA®, initially named VEGF Trap-eye, is the most recent anti-VEGF agent to be granted US Food and Drug Administration approval for the treatment of neovascular AMD. Biologic advantages of aflibercept include its greater binding affinity for VEGF, a longer intravitreal half-life relative to other anti-VEGF agents, and the capacity to antagonize growth factors other than VEGF. This paper provides an up-to-date summary of the molecular mechanisms mediating CNV. The structural, pharmacodynamic, and pharmacokinetic advantages of aflibercept are also reviewed to rationalize the utility of this agent for treating CNV. Results of landmark clinical investigations, including VIEW 1 and 2 trials, and other important studies are then summarized and used to

  16. Topical application of PPADS inhibits complement activation and choroidal neovascularization in a model of age-related macular degeneration.

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    Kerstin Birke

    Full Text Available Age-related macular degeneration (AMD is the most common cause of blindness among the elderly. AMD patients have elevated levels of membrane attack complex (MAC in their choroidal blood vessels and retinal pigment epithelium (RPE. MAC forms pores in cell membranes. Low levels of MAC result in an elevation of cytokine release such as vascular endothelial growth factor (VEGF that promotes the formation of choroidal neovascularization (CNV. High levels of MAC result in cell lysis and RPE degeneration is a hallmark of advanced AMD. The current standard of care for CNV associated with wet AMD is intravitreal injection of anti-VEGF molecules every 4 to 12 weeks. Such injections have significant side effects. Recently, it has been found that membrane pore-forming proteins such as α-haemolysin can mediate their toxic effects through auto- and paracrine signaling and that complement-induced lysis is amplified through ATP release followed by P2X receptor activation. We hypothesized that attenuation of P2X receptor activation may lead to a reduction in MAC deposition and consequent formation of CNV. Hence, in this study we investigated topical application of the purinergic P2X antagonist Pyridoxalphosphate-6-azophenyl-2',4'-disulphonic acid (PPADS as a potential treatment for AMD. We found that 4.17 µM PPADS inhibited formation of HUVEC master junctions and master segments by 74.7%. In a human complement mediated cell lysis assay, 104 µM PPADS enabled almost complete protection of Hepa1c1c7 cells from 1% normal human serum mediated cell lysis. Daily topical application of 4.17 mM PPADS for 3 days attenuated the progression of laser induced CNV in mice by 41.8% and attenuated the deposition of MAC at the site of the laser injury by 19.7%. Our data have implications for the future treatment of AMD and potentially other ocular disorders involving CNV such as angioid streaks, choroidal rupture and high myopia.

  17. Small laser spot versus standard laser spot photodynamic therapy for idiopathic choroidal neovascularization: a randomized controlled study

    Institute of Scientific and Technical Information of China (English)

    LI Xiao-xin; TAO Yong

    2012-01-01

    Backcround Idiopathic choroidal neovascularization (ICNV) affects young patients and thus may have a significant impact on vision and life quality over a patient's lifespan.This study was designed to compare the visual outcome and retinal pigment epithelium (RPE) damage after photodynamic therapy (PDT) with small laser spot and PDT with standard laser spot for idiopathic choroidal neovascularization (ICNV).Methods This was a randomized controlled study.Fifty-two patients with ICNV were enrolled and randomly divided into a study group (small laser spot PDT,n=27) and a control group (standard laser spot PDT,n=25).Best corrected visual acuity (BCVA),optic coherence tomography (OCT) and fluorescein angiography (FA) findings were the main measurements.The patients were followed up 1 week,1,3,6,9 months and 1 year after PDT.Results BCVA improvement was statistically significantly higher in the study group than the control group at 6-month ((25.53±15.01) letters vs.(14.71±11.66) letters,P=0.025) and 9-month follow-ups ((27.53±17.78) letters vs.(15.59±12.21) letters,P=0.039).At 3-and 6-month follow-ups,the quadrants of RPE damage between the two groups varied significantly (P <0.001 and P=0.023,respectively).In each follow-up,the number of cases with decreased or unchanged leakage of choroidal neovascularization by FA and reduced subretinal fluid by OCT did not vary significantly between the two groups.Ten cases (37.0%) in the study group and eight cases (32.0%) in the control group suffered from recurrent CNV (P=0.703).Conclusions Better visual improvements,less RPE damage,a similar recurrent rate of CNV and change of subretinal fluid were observed in the small laser spot PDT group than in the standard laser spot PDT group for ICNV.

  18. Inhibition of development of laser-induced choroidal neovascularization with suppression of infiltration of macrophages in Smad3-null mice.

    Science.gov (United States)

    Iwanishi, Hiroki; Fujita, Norihito; Tomoyose, Katsuo; Okada, Yuka; Yamanaka, Osamu; Flanders, Kathleen C; Saika, Shizuya

    2016-06-01

    We evaluated the effects of the loss of Smad3 on the development of experimental argon laser-induced choroidal neovascularization (CNV) in mice. An in vitro angiogenesis model was also used to examine the role of transforming growth factor-β1 (TGFβ1)/Smad3 signaling in vessel-like tube formation by human umbilical vein endothelial cells (HUVECs). CNV was induced in eyes of 8-12-week-old B6.129-background Smad3-deficient (KO) mice (n=47) and wild-type (WT) mice (n=47) by argon laser irradiation. Results showed that the size of the CNV induced was significantly smaller in KO mice as compared with WT mice at day 14 as revealed by high-resolution angiography with fluorescein isothiocyanate-dextran. Immunohistochemistry and real-time reverse transcription-polymerase chain reaction of RNA extracted from laser-irradiated choroidal tissues were conducted on specimens at specific timepoints. Invasion of macrophages (F4/80+), but not neutrophils (myeloperoxidase+), and appearance of myofibroblasts (α-smooth muscle actin+) were suppressed in laser-irradiated KO tissues. mRNA expression of inflammation-related factors, that is, vascular endothelial growth factor (VEGF), macrophage-chemoattractant protein-1 (MCP-1), interleukin-6 (IL-6) and TGFβ1 in choroidal tissues was suppressed by the loss of Smad3. We then examined the effects of adding a Smad3 inhibitor, SIS3, or an ALK5 inhibitor, SB431542, on tube formation promoted by TGFβ1 or VEGF in HUVECs cocultured with fibroblast feeder. Further addition of SIS3 or SB431542 augmented vessel-like tube formation by HUVECs in the presence of TGFβ1 or VEGF. In conclusion, lack of Smad3 attenuated the growth of laser-induced CNV with suppression of inflammation by macrophages in mice. Because blocking TGFβ1/Smad3 signal stimulated the activity of angiogenesis of HUVECs in vitro, the reduction of CNV in vivo in KO mice is attributed to a decrease in growth factor levels in the tissue by the loss of Smad3. PMID:26950486

  19. Angiographic results of retinal-retinal anastomosis and retinal-choroidal anastomosis after treatments in eyes with retinal angiomatous proliferation

    Directory of Open Access Journals (Sweden)

    Saito M

    2012-08-01

    Full Text Available Masaaki Saito,1 Tomohiro Iida,1,2 Mariko Kano,1 Kanako Itagaki11Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, 2Department of Ophthalmology, Tokyo Women's Medical University School of Medicine, Tokyo, JapanBackground: The purpose of this study was to evaluate the angiographic results of retinal-retinal anastomosis (RRA and retinal-choroidal anastomosis (RCA for eyes with retinal angiomatous proliferation (RAP after treatment with intravitreal bevacizumab injections as monotherapy or intravitreal bevacizumab combined with photodynamic therapy.Methods: In this interventional, consecutive case series, we retrospectively reviewed five naïve eyes from four patients (mean age 80 years treated with three consecutive monthly intravitreal bevacizumab (1.25 mg/0.05 mL injections as initial treatment, and followed up for at least 3 months. In cases with over 3 months of follow-up and having recurrence of RAP or leakage by fluorescein angiography, retreatment was performed with a single intravitreal bevacizumab injection and photodynamic therapy.Results: Indocyanine green angiography showed RRA in three eyes with subretinal neovascularization and RCA in two eyes with choroidal neovascularization at baseline. At 3 months after baseline (month 3, neither the RRA nor RCA was occluded in any eye on indocyanine green angiography. Retreatment with intravitreal bevacizumab plus photodynamic therapy was performed in three eyes at months 3 (persistent leakage on fluorescein angiography, 6, and 7 (recurrence of RAP lesion, which achieved obvious occlusion of the RRA and RCA. Mean best-corrected visual acuity improved from 0.13 to 0.21 at month 3 (P = 0.066. No complications or systemic adverse events were noted.Conclusion: Although intravitreal bevacizumab for RAP was effective in improving visual acuity during short-term follow-up, intravitreal bevacizumab could not achieve complete occlusion of RRA and RCA, which could

  20. Estudo comparativo da flarefotometria em pacientes com melanoma maligno e nevo de coróide Comparative study of flare photometry in patients with choroidal malignant melanoma and choroidal nevus

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    Priscilla Luppi Ballalai

    2002-01-01

    Full Text Available Introdução: Os tumores malignos intra-oculares estão associados com um aumento do "flare" na câmara anterior, causado por uma quebra na barreira hemato-aquosa, que pode ocorrer por vários mecanismos. Estudos utilizando a flarefotometria confirmam o aumento do "flare" em olhos com tumores intra-oculares malignos e benignos. Objetivo: Avaliar a flarefotometria como auxiliar no diagnóstico diferencial de melanoma maligno e nevo de coróide, comparando-se com olhos contralaterais normais. Métodos: Foram avaliados olhos com melanoma maligno e olhos com nevo de coróide diagnosticados por meio de oftalmoscopia indireta e/ou ultra-sonografia. Os olhos normais contralaterais foram utilizados como controles. A flarefotometria foi realizada em todos os pacientes, sob midríase bilateral, utilizando equipamento Laser Flare Meter (FC 500, Kowa. Foram aplicados os testes de Wilcoxon, Mann-Whitney, e Spearman para análise estatística. Resultados: A média da flarefotometria nos olhos com melanoma maligno de coróide foi 17,1 ph/ms e nos olhos normais contralaterais foi 4,06 ph/ms. Nos olhos com nevo de coróide o valor da flarefotometria foi 6,12 ph/ms e nos olhos contralaterais normais foi 4,47 ph/ms. O valor da flarefotometria foi maior nos olhos com melanoma maligno e nevo quando comparado com os olhos contralaterais normais (pIntroduction: Malignant intraocular tumors are associated with an increase in the aqueous flare, caused by alterations of the blood-ocular barriers through various mechanisms. Several studies have demonstrated an ocular flare increase using flare photometry in eyes with benign and malignant tumors. Purpose: To evaluate flare photometry as an adjunct method in the differential diagnosis of choroidal malignant melanoma and choroidal nevus comparing to normal control eyes. Methods: Eyes with melanoma and nevus were diagnosed by indirect binocular ophthalmoscopy and/or ultrasound were evaluated. The fellow normal eyes were used

  1. A laser-spectroscopy system for fluorescent diagnostics and photodynamic therapy of diseases of eye retina and choroid

    International Nuclear Information System (INIS)

    A laser-spectroscopy system for the fluorescent diagnostics and photodynamic therapy of pathologic eye-fundus changes combined with the use of the Photosens compound is developed. The system is tested on experimental animals (mice and rabbits). (laser biology and medicine)

  2. Inhibition of visna virus replication and cytopathic effect in sheep choroid plexus cell cultures by selected anti-HIV agents.

    Science.gov (United States)

    Thormar, H; Balzarini, J; Debyser, Z; Witvrouw, M; Desmyter, J; De Clercq, E

    1995-05-01

    Several anti-HIV agents were tested against visna virus replication and cytopathic effect (CPE) in sheep choroid plexus cell cultures. Sulphated polysaccharides (i.e., dextran sulphate, pentosan polysulphate and heparin) and plant lectins, which inhibit viral adsorption and fusion, were found to be 10- to 40-fold less active against visna virus than against HIV. Bicyclam derivatives were at least 250-fold less active against visna virus and the highly HIV-1 specific TIBO derivatives were without a significant inhibitory effect on visna virus at subtoxic concentrations. In contrast, several 2',3'-dideoxynucleosides and acyclic nucleoside phosphonate analogues, which inhibit reverse transcription, were found to be very effective inhibitors of visna virus replication and viral CPE in cell culture. PMID:7486958

  3. Pneumatic displacement and intravitreal bevacizumab: A new approach for management of submacular hemorrhage in choroidal neovascular membrane

    Directory of Open Access Journals (Sweden)

    Chawla Shobhit

    2009-01-01

    Full Text Available Choroidal neovascular membrane (CNVM is one of the most common causes of submacular hemorrhage (SMH. Conventional treatment involves management of the SMH with pneumatic displacement with or without tissue plasminogen activator (TPA followed by intravitreal injection of bevacizumab in a second sitting. We decided to assess the efficacy of treating SMH secondary to CNVM with pneumatic displacement using sulphur hexafluoride (SF6 gas and intravitreal bevacizumab. Four patients with SMH secondary to CNVM were included in this study. Intravitreal bevacizumab, 0.05 ml, along with 0.5 ml of SF6 was injected through the pars plana into the vitreous cavity. Postoperative best corrected visual acuity improved in all eyes with complete or partial displacement of SMH out of the foveal area.

  4. Age-related alterations in the diffusional transport of amino acids across the human Bruch's-choroid complex

    Science.gov (United States)

    Hussain, Ali A.; Rowe, Lisa; Marshall, John

    2002-01-01

    Photoreceptor maintenance is dependent on effective delivery of nutrients from the choroidal circulation by way of the acellular Bruch's membrane and the retinal pigment epithelium. Aging of Bruch's membrane is associated with thickening, increased cross linking of fibers, and deposition of debris culminating in reduced porosity. The present study has investigated the effects of aging on the diffusional transport of eight amino acids across Bruch's membrane in 19 human donors. Diffusion studies were carried out in Ussing chambers, and the amount of time-dependent transfer of amino acids across the preparation was quantified by reverse-phase high-performance liquid chromatography. Diffusion rates for all amino acids showed a significant linear decline with aging of donor. The importance of this reduction in delivery of amino acids is discussed with reference to both normal physiology and age-related macular degeneration.

  5. Gold nanoparticles-based brachytherapy enhancement in choroidal melanoma using a full Monte Carlo modelling of human eye

    CERN Document Server

    Asadi, Somayeh; Masoudi, S Farhad; Rahmani, Faezeh

    2014-01-01

    Materials of high atomic number such as gold, can provide a high probability for photon interaction by photoelectric effects during radiation therapy. In cancer therapy, the object of brachytherapy as a kind of radiotherapy is to deliver adequate radiation dose to tumor while sparing surrounding healthy tissue. Several studies demonstrated that the preferential accumulation of gold nanoparticles within the tumor can enhance the absorbed dose by the tumor without increasing the radiation dose delivered externally. Accordingly, the required time for tumor irradiation decreases as the estimated adequate radiation dose for tumor is provided following this method. The dose delivered to healthy tissue is reduced when the time of irradiation is decreased. Hear, GNPs effects on choroidal Melanoma dosimetry is discussed by Monte Carlo study. Monte Carlo Ophthalmic brachytherapy dosimetry usually, is studied by simulation of water phantom. Considering the composition and density of eye material instead of water in thes...

  6. En face projection imaging of the human choroidal layers with tracking SLO and swept source OCT angiography methods

    Science.gov (United States)

    Gorczynska, Iwona; Migacz, Justin; Zawadzki, Robert J.; Sudheendran, Narendran; Jian, Yifan; Tiruveedhula, Pavan K.; Roorda, Austin; Werner, John S.

    2015-07-01

    We tested and compared the capability of multiple optical coherence tomography (OCT) angiography methods: phase variance, amplitude decorrelation and speckle variance, with application of the split spectrum technique, to image the choroiretinal complex of the human eye. To test the possibility of OCT imaging stability improvement we utilized a real-time tracking scanning laser ophthalmoscopy (TSLO) system combined with a swept source OCT setup. In addition, we implemented a post- processing volume averaging method for improved angiographic image quality and reduction of motion artifacts. The OCT system operated at the central wavelength of 1040nm to enable sufficient depth penetration into the choroid. Imaging was performed in the eyes of healthy volunteers and patients diagnosed with age-related macular degeneration.

  7. Malignant melanoma of the choroid: treatment with episcleral /sup 198/Au plaque and xenon-arc photocoagulation

    Energy Technology Data Exchange (ETDEWEB)

    Moura, R.A.; McPherson, A.R.; Easley, J.

    1985-02-01

    A method of treatment for posteriorly located malignant melanomas of the choroid is reviewed. Twenty-six patients have been treated either by radioactive gold (/sup 198/Au) seed radiation plaque, alone or in combination with postradiation xenon-arc photocoagulation. Success, defined as the preservation of the globe with tumor ablated or regressed, was achieved in 92.3% of the treated eyes. These patients have been followed from 1 to 8.5 years, with an average follow-up of 44.84 months. Fifteen out of 26 patients (57.69%) had a final visual acuity of 20/50 or better. The main complications were radiation retinopathy (19.2%) and cystoid macular edema (19.2%). There were two enucleations, one after 29 months and one after 24 months following treatment.

  8. Dosimetric and Late Radiation Toxicity Comparison Between Iodine-125 Brachytherapy and Stereotactic Radiation Therapy for Juxtapapillary Choroidal Melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Krema, Hatem, E-mail: htmkrm19@yahoo.com [Department of Ocular Oncology, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto, Ontario (Canada); Heydarian, Mostafa [Department of Radiation Medicine, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto, Ontario (Canada); Beiki-Ardakani, Akbar [Department of Radiation Oncology, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto, Ontario (Canada); Weisbrod, Daniel [Department of Ocular Oncology, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto, Ontario (Canada); Xu, Wei [Department of Biostatistics, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto, Ontario (Canada); Laperriere, Normand J.; Sahgal, Arjun [Department of Radiation Oncology, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto, Ontario (Canada)

    2013-07-01

    Purpose: To compare the dose distributions and late radiation toxicities for {sup 125}I brachytherapy (IBT) and stereotactic radiation therapy (SRT) in the treatment of juxtapapillary choroidal melanoma. Methods: Ninety-four consecutive patients with juxtapapillary melanoma were reviewed: 30 have been treated with IBT and 64 with SRT. Iodine-125 brachytherapy cases were modeled with plaque simulator software for dosimetric analysis. The SRT dosimetric data were obtained from the Radionics XKnife RT3 software. Mean doses at predetermined intraocular points were calculated. Kaplan-Meier estimates determined the actuarial rates of late toxicities, and the log–rank test compared the estimates. Results: The median follow-up was 46 months in both cohorts. The 2 cohorts were balanced with respect to pretreatment clinical and tumor characteristics. Comparisons of radiation toxicity rates between the IBT and SRT cohorts yielded actuarial rates at 50 months for cataracts of 62% and 75% (P=.1), for neovascular glaucoma 8% and 47% (P=.002), for radiation retinopathy 59% and 89% (P=.0001), and for radiation papillopathy 39% and 74% (P=.003), respectively. Dosimetric comparisons between the IBT and SRT cohorts yielded mean doses of 12.8 and 14.1 Gy (P=.56) for the lens center, 17.6 and 19.7 Gy (P=.44) for the lens posterior pole, 13.9 and 10.8 Gy (P=.30) for the ciliary body, 61.9 and 69.7 Gy (P=.03) for optic disc center, and 48.9 and 60.1 Gy (P<.0001) for retina at 5-mm distance from tumor margin, respectively. Conclusions: Late radiation-induced toxicities were greater with SRT, which is secondary to the high-dose exposure inherent to the technique as compared with IBT. When technically feasible, IBT is preferred to treat juxtapapillary choroidal melanoma.

  9. Dosimetric and Late Radiation Toxicity Comparison Between Iodine-125 Brachytherapy and Stereotactic Radiation Therapy for Juxtapapillary Choroidal Melanoma

    International Nuclear Information System (INIS)

    Purpose: To compare the dose distributions and late radiation toxicities for 125I brachytherapy (IBT) and stereotactic radiation therapy (SRT) in the treatment of juxtapapillary choroidal melanoma. Methods: Ninety-four consecutive patients with juxtapapillary melanoma were reviewed: 30 have been treated with IBT and 64 with SRT. Iodine-125 brachytherapy cases were modeled with plaque simulator software for dosimetric analysis. The SRT dosimetric data were obtained from the Radionics XKnife RT3 software. Mean doses at predetermined intraocular points were calculated. Kaplan-Meier estimates determined the actuarial rates of late toxicities, and the log–rank test compared the estimates. Results: The median follow-up was 46 months in both cohorts. The 2 cohorts were balanced with respect to pretreatment clinical and tumor characteristics. Comparisons of radiation toxicity rates between the IBT and SRT cohorts yielded actuarial rates at 50 months for cataracts of 62% and 75% (P=.1), for neovascular glaucoma 8% and 47% (P=.002), for radiation retinopathy 59% and 89% (P=.0001), and for radiation papillopathy 39% and 74% (P=.003), respectively. Dosimetric comparisons between the IBT and SRT cohorts yielded mean doses of 12.8 and 14.1 Gy (P=.56) for the lens center, 17.6 and 19.7 Gy (P=.44) for the lens posterior pole, 13.9 and 10.8 Gy (P=.30) for the ciliary body, 61.9 and 69.7 Gy (P=.03) for optic disc center, and 48.9 and 60.1 Gy (P<.0001) for retina at 5-mm distance from tumor margin, respectively. Conclusions: Late radiation-induced toxicities were greater with SRT, which is secondary to the high-dose exposure inherent to the technique as compared with IBT. When technically feasible, IBT is preferred to treat juxtapapillary choroidal melanoma

  10. Combined photodynamic therapy and intravitreal bevacizumab for idiopathic polypoidal choroidal vasculopathy: one-year follow-up

    Directory of Open Access Journals (Sweden)

    Mario R Romano

    2010-10-01

    Full Text Available Mario R Romano1, Ugo Cipollone2, Francesco Semeraro3, Michele Rinaldi4, Ciro Costagliola11Dipartimento di Scienze per la Salute, Università degli Studi del Molise, Campobasso; 2Dipartimento di Oftalmologia, Ospedale G Vietri, Larino, Campobasso; 3Clinica Oculistica, Università degli Studi di Brescia, Brescia; 4Clinica Oculistica, II Università degli Studi di Napoli, Napoli, ItalyObjective: To report the efficacy and safety of combined photodynamic therapy (PDT and intravitreal bevacizumab (IVB injection in the treatment of idiopathic polypoidal choroidal vasculopathy (IPCV.Material and methods: A prospective case series of 10 eyes of 10 consecutive patients affected by IPCV with subfoveal involvement. PDT plus IVB (1.25 mg/0.05 mL injection two weeks later was performed in all patients. Two adjunctive injections of bevacizumab were scheduled at four and eight weeks after the initial treatment. Best-corrected visual acuity (BCVA, fluorescein and indocyanine green angiographies, and optical coherence tomography were obtained at baseline, and at one, three, six, nine, and 12 months.Results: The combined treatment led to an improvement of both neurosensory detachment and pigmented epithelial detachment in all eyes, with a decrease of exudation and regression of macular thickness, which remained stable to the end of follow-up. However, BCVA remained stable over the 12 months of follow-up.Conclusion: These findings demonstrate that PDT/IVB combined therapy is able to achieve morphologic stabilization of the IPCV lesion, through a rapid decrease of macular thickness and regression of the size of polypoidal vascular lesion.Keywords: combined treatment, idiopathic polypoidal choroidal vasculopathy, age-related macular degeneration, intravitreal bevacizumab, photodynamic therapy

  11. Indocyanine Green Angiography Guided Management of Vogt-Koyanagi-Harada Disease

    OpenAIRE

    Nadia Bouchenaki; Herbort, Carl P.

    2011-01-01

    Purpose: To report the management of Vogt-Koyanagi-Harada (VKH) disease based on indocyanine green angiography (ICGA). Methods: VKH patients with acute episodes of inflammation (inaugural or recurrent) who had received standard ICGA-guided care were studied retrospectively. Standard of care included high dose systemic corticosteroids at presentation and close ICGA follow-up with addition of immunosuppressive agents and/or intensification of ongoing therapy when recurrent choroidal lesions wer...

  12. Duplicated middle cerebral artery arising from the origin of the hyperplastic anterior choroidal artery that mimicked aneurysm on routine MR angiography.

    Science.gov (United States)

    Uchino, Akira; Ito, Sayaka; Kurita, Hiroki; Tanaka, Masahiko

    2016-04-01

    We report a case of duplicated right middle cerebral artery that arose from the origin of the right hyperplastic anterior choroidal artery diagnosed by magnetic resonance angiography. To our knowledge, this is the first case of such a variation reported with magnetic resonance angiographic images. The internal carotid artery-hyperplastic anterior choroidal artery-duplicated middle cerebral artery junction was dilated and mimicking aneurysm. Partial maximum intensity projection images and volume-rendering images showed that it was not a saccular aneurysm but an infundibular dilatation. Careful observation of magnetic resonance angiographic images including its source images is important for detecting rare arterial variations. To identify an anomalous artery on magnetic resonance angiography, creation of partial maximum intensity projection images and volume-rendering images is valuable. PMID:26915899

  13. Human cerebrospinal fluid central memory CD4+ T cells: Evidence for trafficking through choroid plexus and meninges via P-selectin

    OpenAIRE

    Kivisäkk, Pia; Mahad, Don J.; Callahan, Melissa K.; Trebst, Corinna; Tucky, Barbara; Wei, Tao; Wu, Lijun; Baekkevold, Espen S; Lassmann, Hans; Staugaitis, Susan M.; Campbell, James J.; Ransohoff, Richard M.

    2003-01-01

    Cerebrospinal fluid (CSF) from healthy individuals contains between 1,000 and 3,000 leukocytes per ml. Little is known about trafficking patterns of leukocytes between the systemic circulation and the noninflamed CNS. In the current study, we characterized the surface phenotype of CSF cells and defined the expression of selected adhesion molecules on vasculature in the choroid plexus, the subarachnoid space surrounding the cerebral cortex, and the cerebral parenchyma. ...

  14. Intravitreal ranibizumab and bevacizumab therapy for choroidal neovascularization in age-related macular degeneration with extensive pre-existing geographic atrophy

    OpenAIRE

    Miguel Hage Amaro; Aaron Brock Roller

    2012-01-01

    PURPOSE: To report the response of choroidal neovascularization to intravitreal ranibizumab or bevacizumab treatment in the setting of age-related macular degeneration with extensive pre-existing geographic atrophy of the retinal pigment epithelium. METHODS: This is a retrospective case series of 11 eyes in ten consecutive patients retrieved from a photographic database. The patients were treated with ranibizumab or bevacizumab for neovascular age-related macular degeneration with pre-existin...

  15. Ultrahigh field magnetic resonance and colour Doppler real-time fusion imaging of the orbit - a hybrid tool for assessment of choroidal melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Walter, Uwe [University of Rostock, Department of Neurology, Rostock (Germany); Niendorf, Thoralf; Rieger, Jan [Berlin Ultrahigh Field Facility, Max-Delbrueck-Center for Molecular Medicine, Berlin (Germany); MRI.TOOLS GmbH, Berlin (Germany); Graessl, Andreas [Berlin Ultrahigh Field Facility, Max-Delbrueck-Center for Molecular Medicine, Berlin (Germany); Krueger, Paul-Christian; Langner, Soenke [University of Greifswald, Institute for Diagnostic Radiology and Neuroradiology, Greifswald (Germany); Guthoff, Rudolf F.; Stachs, Oliver [University of Rostock, Department of Ophthalmology, Rostock (Germany)

    2014-05-15

    A combination of magnetic resonance images with real-time high-resolution ultrasound known as fusion imaging may improve ophthalmologic examination. This study was undertaken to evaluate the feasibility of orbital high-field magnetic resonance and real-time colour Doppler ultrasound image fusion and navigation. This case study, performed between April and June 2013, included one healthy man (age, 47 years) and two patients (one woman, 57 years; one man, 67 years) with choroidal melanomas. All cases underwent 7.0-T magnetic resonance imaging using a custom-made ocular imaging surface coil. The Digital Imaging and Communications in Medicine volume data set was then loaded into the ultrasound system for manual registration of the live ultrasound image and fusion imaging examination. Data registration, matching and then volume navigation were feasible in all cases. Fusion imaging provided real-time imaging capabilities and high tissue contrast of choroidal tumour and optic nerve. It also allowed adding a real-time colour Doppler signal on magnetic resonance images for assessment of vasculature of tumour and retrobulbar structures. The combination of orbital high-field magnetic resonance and colour Doppler ultrasound image fusion and navigation is feasible. Multimodal fusion imaging promises to foster assessment and monitoring of choroidal melanoma and optic nerve disorders. (orig.)

  16. Radiation Macular Edema after Ru-106 Plaque Brachytherapy for Choroidal Melanoma Resolved by an Intravitreal Dexamethasone 0.7-mg Implant

    Directory of Open Access Journals (Sweden)

    Andrea Russo

    2012-02-01

    Full Text Available Purpose: To report the effective treatment of radiation macular edema following ruthenium-106 plaque brachytherapy for a choroidal melanoma with a dexamethasone 0.7-mg (Ozurdex® intravitreal implant. Methods: An interventional case report with optical coherence tomography (OCT scans. Results: A 65-year-old Caucasian woman was suffering from radiation macular edema following ruthenium-106 plaque brachytherapy for a choroidal melanoma on her left eye. She had undergone one intravitreal injection of 0.5 mg bevacizumab (Avastin®, Genentech/Roche in the following months without functional or anatomical improvement. Seven months after the development of radiation macular edema, she received a single intravitreal injection of dexamethasone 0.7 mg (Ozurdex. Four weeks following the injection, her best-corrected visual acuity improved from 0.3 to 0.5. Radiation macular edema resolved with a reduction of central retinal thickness from 498 µm before Ozurdex injection to 224 µm after Ozurdex injection, as measured by OCT scan. Conclusion: Dexamethasone 0.7 mg (Ozurdex has proven to be an effective treatment option in retinal vein occlusion and noninfectious uveitis. It can also be considered as off-label treatment in radiation macular edema following ruthenium-106 plaque brachytherapy for a choroidal melanoma.

  17. Ultrahigh field magnetic resonance and colour Doppler real-time fusion imaging of the orbit - a hybrid tool for assessment of choroidal melanoma

    International Nuclear Information System (INIS)

    A combination of magnetic resonance images with real-time high-resolution ultrasound known as fusion imaging may improve ophthalmologic examination. This study was undertaken to evaluate the feasibility of orbital high-field magnetic resonance and real-time colour Doppler ultrasound image fusion and navigation. This case study, performed between April and June 2013, included one healthy man (age, 47 years) and two patients (one woman, 57 years; one man, 67 years) with choroidal melanomas. All cases underwent 7.0-T magnetic resonance imaging using a custom-made ocular imaging surface coil. The Digital Imaging and Communications in Medicine volume data set was then loaded into the ultrasound system for manual registration of the live ultrasound image and fusion imaging examination. Data registration, matching and then volume navigation were feasible in all cases. Fusion imaging provided real-time imaging capabilities and high tissue contrast of choroidal tumour and optic nerve. It also allowed adding a real-time colour Doppler signal on magnetic resonance images for assessment of vasculature of tumour and retrobulbar structures. The combination of orbital high-field magnetic resonance and colour Doppler ultrasound image fusion and navigation is feasible. Multimodal fusion imaging promises to foster assessment and monitoring of choroidal melanoma and optic nerve disorders. (orig.)

  18. Comparison of amplitude-decorrelation, speckle-variance and phase-variance OCT angiography methods for imaging the human retina and choroid.

    Science.gov (United States)

    Gorczynska, Iwona; Migacz, Justin V; Zawadzki, Robert J; Capps, Arlie G; Werner, John S

    2016-03-01

    We compared the performance of three OCT angiography (OCTA) methods: speckle variance, amplitude decorrelation and phase variance for imaging of the human retina and choroid. Two averaging methods, split spectrum and volume averaging, were compared to assess the quality of the OCTA vascular images. All data were acquired using a swept-source OCT system at 1040 nm central wavelength, operating at 100,000 A-scans/s. We performed a quantitative comparison using a contrast-to-noise (CNR) metric to assess the capability of the three methods to visualize the choriocapillaris layer. For evaluation of the static tissue noise suppression in OCTA images we proposed to calculate CNR between the photoreceptor/RPE complex and the choriocapillaris layer. Finally, we demonstrated that implementation of intensity-based OCT imaging and OCT angiography methods allows for visualization of retinal and choroidal vascular layers known from anatomic studies in retinal preparations. OCT projection imaging of data flattened to selected retinal layers was implemented to visualize retinal and choroidal vasculature. User guided vessel tracing was applied to segment the retinal vasculature. The results were visualized in a form of a skeletonized 3D model. PMID:27231598

  19. A Quantitative and Standardized Method for the Evaluation of Choroidal Neovascularization Using MICRON III Fluorescein Angiograms in Rats.

    Directory of Open Access Journals (Sweden)

    Jonathan P Wigg

    Full Text Available In-vivo imaging of choroidal neovascularization (CNV has been increasingly recognized as a valuable tool in the investigation of age-related macular degeneration (AMD in both clinical and basic research applications. Arguably the most widely utilised model replicating AMD is laser generated CNV by rupture of Bruch's membrane in rodents. Heretofore CNV evaluation via in-vivo imaging techniques has been hamstrung by a lack of appropriate rodent fundus camera and a non-standardised analysis method. The aim of this study was to establish a simple, quantifiable method of fluorescein fundus angiogram (FFA image analysis for CNV lesions.Laser was applied to 32 Brown Norway Rats; FFA images were taken using a rodent specific fundus camera (Micron III, Phoenix Laboratories over 3 weeks and compared to conventional ex-vivo CNV assessment. FFA images acquired with fluorescein administered by intraperitoneal injection and intravenous injection were compared and shown to greatly influence lesion properties. Utilising commonly used software packages, FFA images were assessed for CNV and chorioretinal burns lesion area by manually outlining the maximum border of each lesion and normalising against the optic nerve head. Net fluorescence above background and derived value of area corrected lesion intensity were calculated.CNV lesions of rats treated with anti-VEGF antibody were significantly smaller in normalised lesion area (p < 0.001 and fluorescent intensity (p < 0.001 than the PBS treated control two weeks post laser. The calculated area corrected lesion intensity was significantly smaller (p < 0.001 in anti-VEGF treated animals at 2 and 3 weeks post laser. The results obtained using FFA correlated with, and were confirmed by conventional lesion area measurements from isolectin stained choroidal flatmounts, where lesions of anti-VEGF treated rats were significantly smaller at 2 weeks (p = 0.049 and 3 weeks (p < 0.001 post laser.The presented method of in

  20. Age-Dependent Increase of Brain Copper Levels and Expressions of Copper Regulatory Proteins in the Subventricular Zone and Choroid Plexus

    Directory of Open Access Journals (Sweden)

    Sherleen eFu

    2015-06-01

    Full Text Available Our recent data suggest a high accumulation of Cu in the subventricular zone (SVZ along the wall of brain ventricles. Anatomically, SVZ is in direct contact with cerebrospinal fluid (CSF, which is secreted by a neighboring tissue choroid plexus. Changes in Cu regulatory gene expressions in the SVZ and choroid plexus as the function of aging may determine Cu levels in the CSF and SVZ. This study was designed to investigate associations between age, Cu levels, and Cu regulatory genes in SVZ and plexus. The SVZ and choroid plexus were dissected from brains of 3-week, 10-week or 9-month old male rats. Analyses by atomic absorption spectroscopy revealed that the SVZ of adult and old animals contained the highest Cu level compared with other tested brain regions. Significant positive correlations between age and Cu levels in SVZ and plexus were observed; the SVZ Cu level of old animals was 7.5- and 5.8-fold higher than those of young and adult rats (p<0.01, respectively. Quantitation by qPCR of the transcriptional expressions of Cu regulatory proteins showed that the SVZ expressed the highest level of Cu storage protein MTs, while the choroid plexus expressed the high level of Cu transporter protein Ctr1. Noticeably, Cu levels in the SVZ were positively associated with type B slow proliferating cell marker Gfap (p<0.05, but inversely associated with type A proliferating neuroblast marker Dcx (p<0.05 and type C transit amplifying progenitor marker Nestin (p<0.01. Dmt1 had significant positive correlations with age and Cu levels in the plexus (p<0.01. These findings suggest that Cu levels in all tested brain regions are increased as the function of age. The SVZ shows a different expression pattern of Cu-regulatory genes from the choroid plexus. The age-related increase of MTs and decrease of Ctr1 may contribute to the high Cu level in this neurogenesis active brain region.

  1. Film dosimetry analyses on the effect of gold shielding for Iodine-125 eye plaque therapy for choroidal melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Wu, A. (Department of Radiation Oncology, University of Pittsburgh, School of Medicine, Joint Radiation Oncology Center and Pittsburgh Cancer Institute, Pittsburgh, PA (USA)); Krasin, F. (Department of Radiation Oncology, Tufts University School of Medicine, New England Medical Center, Boston, MA (USA))

    1990-09-01

    One of the methods currently being used to treat choroidal melanoma employs an episcleral plaque containing I-125 radioactive seeds. However, comprehensive dosimetry studies on the plaque are scarce and controversial. For this work, we use film to study the dosimetry outside the lip of the gold shield of the eye plaque. This lip around the gold shield was made to protect the critical structures behind and adjacent to the lesion. Since the changes of energy spectrum of I-125 in tissue are negligible, film dosimetry seems to be a logical choice because of high spatial resolution required around the lip of the gold plaque. For this study, we first established an H and D curve with dose expressed in a unit of specific dose rate constant. This avoids absolute dose measurements. All film density measurements are made with a 1-mm aperture scan, normalized to the density at the prescription point for tumor of 3--5-mm apical height, i.e., 5 mm from the interior surface of sclera, and converted to percentage isodose curves. With a gold shield, it is found that when the plaque is placed against the optical nerve, the optical disk and macula, located at 2 mm outside the lip, on the exterior surface of sclera, may receive 85% of the prescription dose for a 12-mm plaque and 58% for a 16-mm plaque. For tumors of 8-mm apical height, the optical nerve would receive more than the prescription dose.

  2. Discrepancy in compliance between the clinical and genetic diagnosis of choroidal hypoplasia in Danish Rough Collies and Shetland Sheepdogs.

    Science.gov (United States)

    Fredholm, M; Larsen, R C; Jönsson, M; Söderlund, M A; Hardon, T; Proschowsky, H F

    2016-04-01

    Collie eye anomaly (CEA) is a congenital, inherited ocular disorder which is widespread in herding breeds. Clinically, the two major lesions associated with CEA are choroidal hypoplasia (CH) and coloboma, and both lesions are diagnosed based on ophthalmological examination. A 7.8-kb intronic deletion in the gene encoding non-homologous end-joining factor 1 (NHEJ1) has been reported to be the causative mutation underlying CH when present in the homozygous state. In this study, we have investigated the compliance between the clinical and genetic diagnosis of CH in the Danish Rough Collie and Shetland Sheepdog populations. Our results show that the deletion in NHEJ1 is not predictive for CH in the Danish Rough Collie population, whereas the clinical and genetic diagnosis is in accordance with each other in the Shetland Sheepdog population. Based on these results, it can be concluded that the intronic deletion in NHEJ1 is not the causative mutation but, rather, a marker linked to the locus underlying the trait in some populations but linked to both the wild-type and CH-causing locus in most dogs in the Danish Rough Collie population. PMID:26732749

  3. Photodynamic monotherapy or combination treatment with intravitreal triamcinolone acetonide, bevacizumab or ranibizumab for choroidal neovascularization associated with pathological myopia

    Directory of Open Access Journals (Sweden)

    Pukhraj Rishi

    2011-01-01

    Full Text Available This retrospective, interventional case series analyses treatment outcomes in eyes with choroidal neovascularization (CNV secondary to pathological myopia, managed with photodynamic therapy, (PDT, (Group 1, N = 11, PDT and intravitreal triamcinolone acetonide (4 mg/0.1ml (Group 2, N = 3, PDT and intravitreal anti-vascular endothelial growth factor (anti-VEGF bevacizumab 1.25 mg/0.05 ml, ranibizumab 0.5 mg/0.05 ml and reduced-fluence PDT and intravitreal ranibizumab 0.5 mg/0.05 ml (Group 3, N=12. All the patients underwent PDT. Intravitreal injections were repeated as required. SPSS 14 software was used to evaluate the data. Wilcoxon signed ranks test was used to evaluate pre- and post-treatment vision. The Kruskal-Wallis test was used for comparison between the groups. All the groups were statistically comparable. All the eyes showed complete regression of CNV, with a minimum follow-up of six months. All groups had visual improvement; significantly in Group 3 ( p = 0.003. Combination PDT with anti-VEGF agents appeared to be efficacious in eyes with myopic CNV. However, a larger study with a longer follow-up is required to validate these results.

  4. Different treatment modalities for choroidal neovascularization in two eyes of one patient with bilateral type 2A parafoveal telangiectasia

    Directory of Open Access Journals (Sweden)

    Vivek Dave

    2013-01-01

    Full Text Available A 60-year-old diabetic man presented with a history of decrease in vision in both eyes since 2 weeks. At presentation, best corrected visual acuity (BCVA in the right eye (RE was 20/30 and that in the left eye (LE was 20/80. The right fundus revealed a grayish reflex, yellowish crystalline deposits and retinal pigment epithelial hyperplasia at the macula. The left fundus showed subretinal fluid and temporal subretinal hemorrhage near a grayish reflex at the macula. A diagnosis in both eyes of idiopathic macular telangiectasia (IMT type 2A with RE stage 4 and LE stage 5, choroidal neovascularization (CNVM was made. The patient was treated with photodynamic therapy (PDT in LE. The visual acuity improved to 20/40 over the next 6 months. At a 4-year follow-up, he developed decreased vision in RE diagnosed as IMT with CNV and was treated with intravitreal ranibizumab. At 6-month follow-up post injection, the vision was 20/40p.

  5. Identification of the novel localization of tenascinX in the monkey choroid plexus and comparison with the mouse

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    K. Imura

    2009-12-01

    Full Text Available Tenascin-X (Tn-X belongs to the tenascin family of glycoproteins and has been reported to be significantly associated with schizophrenia in a single nucleotide polymorphism analysis in humans. This finding indicates an important role of Tn-X in the central nervous system (CNS. However, details of Tn-X localization are not clear in the primate CNS. Using immunohistochemical techniques, we found novel localizations of Tn-X in the interstitial connective tissue and around blood vessels in the choroid plexus (CP in macaque monkeys. To verify the reliability of Tn-X localization, we compared the Tn-X localization with the tenascin-C (Tn-C localization in corresponding regions using neighbouring sections. Localization of Tn-C was not observed in CP. This result indicated consistently restricted localization of Tn-X in CP. Comparative investigations using mouse tissues showed equivalent results. Our observations provide possible insight into specific roles of Tn-X in CP for mammalian CNS function.

  6. Two years follow-up outcome of verteporfin therapy for subfoveal choroidal neovascularization in pathologic myopia in Indian eyes

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    Hussain Nazimul

    2008-01-01

    Full Text Available Context: In India, refractive errors are a major cause of treatable blindness. Population surveys in southern India have shown prevalence of high myopia to be 4.32-4.54%. Photodynamic therapy (PDT for choroidal neovascularization (CNV caused by pathologic myopia is beneficial. Aims: To report the 24 months outcome of PDT with verteporfin for subfoveal CNV caused by pathologic myopia in Indian eyes Settings and Design: Prospective case series Materials and Methods: Review of prospectively collected data of Indian patients with pathologic myopia and subfoveal CNV treated with verteporfin therapy between 2001 and 2005 using standard regimen for PDT. Statistical Analysis Used: Wilcoxon signed rank test was used to see the difference in the mean letter acuity at intervals compared to baseline. Kaplan Meier Survival analysis was done to estimate the success rate of verteporfin therapy for CNV caused by pathologic myopia. Results: Fifteen patients (15 eyes treated with standard fluence PDT and who had completed 24 months follow-up were analyzed. The mean spherical equivalent was -13.36 ± 5.88 diopter. Five out of 15 eyes in six months, three out of 15 eyes at 12 months and four eyes out of 15 at 24 months had improved vision by > 10 letters. The mean number of treatment session was 2.2 in two years. Conclusions: PDT with verteporfin for subfoveal CNV caused by pathologic myopia in Indian eyes is effective.

  7. Dose–response of critical structures in the posterior eye segment to hypofractioned stereotactic photon radiotherapy of choroidal melanoma

    International Nuclear Information System (INIS)

    Purpose: To identify modifying factors and dose–/volume–response relationships for the retina and optic nerve related to highly conformal hypofractionated radiotherapy. Patients and methods: Seventy-three patients undergoing hypofractionated stereotactic photon radiotherapy of choroidal melanoma were included in this retrospective study. The volumes of the optic nerve receiving doses of more than 7.5 or 12 Gy, respectively, were defined. Optic nerve circumference included in the 30%, 40%, 50%, or 80% isodose (ON%) and retina included in 30% or 40% were determined as quantal effects. Univariate and multivariate analyses were performed for clinical variables as well as probit analysis to define EDx (doses where a positive response is expected in x% of the cases). Results: Median follow-up was 90.0 (interquartile range 69.0–98.0) months. Fifty-two (71%) and 49 (67%) patients developed radiation retinopathy and optic neuropathy (any grade). Age, length of follow-up and diabetes were significant parameters regarding retinopathy. Optic neuropathy was significantly influenced by age, length of follow-up, and ON30. The probability of optic neuropathy (any grade and grade ⩾2) significantly increases with the dose (p ranges from 0.0126 to 0.0211). Conclusion: Treatment planning should aim at minimizing encompassing isodoses particularly in the low dose region, without compromising PTV coverage

  8. Aβ immunization worsens iron deposits in the choroid plexus and cerebral microbleeds

    OpenAIRE

    Joseph-Mathurin, Nelly; Dorieux, Olène; Trouche, Stéphanie G.; Boutajangout, Allal; Kraska, Audrey; Fontès, Pascaline; Verdier, Jean-Michel; Sigurdsson, Einar M.; Mestre-Francés, Nadine; Dhenain, Marc

    2013-01-01

    Anti-Aβ immunotherapy provides potential benefits in Alzheimer’s disease patients. Nevertheless, strategies based on Aβ1-42 peptide induced encephalomyelitis and possible microhemorrhages. These outcomes were not expected from studies performed in rodents. It is critical to determine if other animal models better predict side effects of immunotherapies. Mouse lemur primates can develop amyloidosis with aging. Here we used old lemurs to study immunotherapy based on Aβ1-42 or Aβ-derivative (K6A...

  9. Preliminary results of proton therapy in choroidal melanoma at the centre de proton therapy d`Orsay (C.P.O.): 464 initial cases; Resultats preliminaires de la protontherapie du melanome de la choroide au centre de protontherapie d`Orsay (CPO): les 464 premiers cas

    Energy Technology Data Exchange (ETDEWEB)

    Desjardins, L.; Levy, C.; D`hermies, F.; Frau, E.; Schlienger, P.; Habrand, J.L.; Mammar, H.; Schwartz, L.; Mazal, A.; Delacroix, S.; Nauraye, C.; Ferrand, R.; Asselain, B. [Centre de protontherapie d`Orsay, 91 - Orsay (France)

    1997-06-01

    Retrospective analysis of the treatment of choroidal melanoma with proton-therapy at the Centre de protontherapie d`Orsay, France. Between September 1991 and September 1995, 612 patients presenting with choroidal melanoma were treated by proton-therapy in Orsay. Following initial management of the first 464 patients, results were analyzed, as were results after a 1-year follow up for 305 patients, a 2-year follow-up for 169 patients, and a 3-year follow-up for 59 patients. Univariate analysis showed that the actuarial local recurrence rate was 5 %, the 3-year survival rate 88 %, and the overall metastatic rate 5%. The initial tumor volume was the most significant predictive factor for visual results and metastases. Multivariate analysis revealed that visual results were significantly related to the initial tumor volume, initial retinal detachment, and total dose delivered to the optic nerve and macula. Proton-therapy of choroidal melanoma allows in most cases conservation of the eye without modification of survival. Visual results mainly depend on the site and size of the tumor. (author) 16 refs.

  10. Multiple isoforms of the tumor protein p73 are expressed in the adult human telencephalon and choroid plexus and present in the cerebrospinal fluid.

    Science.gov (United States)

    Cabrera-Socorro, Alfredo; Pueyo Morlans, Mercedes; Suarez Sola, Maria Luisa; Gonzalez Delgado, Francisco J; Castañeyra-Perdomo, Agustin; Marin, Maria C; Meyer, Gundela

    2006-04-01

    p73, a homolog of the p53 tumor suppressor, codes for full-length transactivating (TA) and N-terminally truncated (DeltaN) isoforms, with pro- and anti-apoptotic activities, respectively. We examined the expression of the main p73 isoforms in adult human and mouse telencephalon and choroid plexus by immunohistochemistry on paraffin sections, and immunoblotting (IB) of tissue extracts and cerebrospinal fluid (CSF), using antibodies against different protein domains. Cortical neurons expressed TAp73 predominantly in the cytoplasm and DeltaNp73 mainly in the nucleus, with partial overlap in the cytoplasm. Highest expression was found in the hippocampus. IB showed an array of TAp73 variants in adult human cortex and hippocampus. IB of human choroid plexus and CSF using TAp73-specific antibodies revealed the presence of a approximately 90-kDa protein whose molecular weight was reduced after N-deglycosylation, suggesting that glycosylated TAp73 is exported into the CSF. In the mouse, high expression of TAp73 was also detected in the subcommissural organ (SCO), an ependymal gland absent in adult humans. TAp73 colocalized with anti-fibra-Reissner-antibody (AFRU), which is a marker of Reissner's fiber, the secreted SCO product. p73-deficient mice had generalized cortical hypoplasia and hydrocephalus; in addition, we observed a dramatic size reduction of the choroid plexus. However, the SCOs were apparently unaltered and continued to secrete Reissner's fiber. Our findings point to complex and widespread p73 activities in the maintenance of adult cortical neurons and in brain homeostasis. TAp73 in the CSF may play important roles in the maintenance of the adult ventricular wall as well as in the development of the proliferating neuroepithelium. PMID:16630058

  11. Cellular gene expression in papillomas of the choroid plexus from transgenic mice that express the simian virus 40 large T antigen.

    OpenAIRE

    Marks, J R; J. Lin; Hinds, P; MILLER, D; Levine, A J

    1989-01-01

    Transgenic mice that contain the simian virus 40 (SV40) enhancer-promoter and large tumor (T) antigen gene develop papillomas of the choroid plexus. The tumors remain well differentiated on histological examination and express normal levels of tissue-specific mRNAs for transthyretin (TTR) and the 5-HT1C serotonin receptor, two differentiated cell markers. Both Northern (RNA) blot analysis and in situ cytohybridization have been used to monitor the steady-state levels of the mRNAs from the vir...

  12. Surgery with radioguided location of a liver metastasis of melanoma choroid: case report; Cirurgia com localizacao radioguiada de uma metastase hepatica de melanoma de coroide: relato de caso

    Energy Technology Data Exchange (ETDEWEB)

    Moreno, Marcelo; Miranda, Mario Henrique Furlanetto, E-mail: mmoreno@unochapeco.edu.br, E-mail: mirandamario@unochapeco.edu.br [Universidade Comunitaria da Regiao de Chapeco (UNOCHAPECO), SC (Brazil)

    2015-04-15

    Introduction: The use of radioguided occult lesion localization prior to surgical excision is increasing, mainly due to the development of new probes and the use of PET-CT. Case report: A 70-year-old male who presented with a metastatic lesion in his liver from a choroidal melanoma. This was located using PET-CT and subsequently located with a low-energy intraoperative gamma probe during the laparotomy. Conclusion: The present case shows that it is possible to excise a hepatic metastasis utilizing the principles of radioguided surgery, even in centers without access to high energy probes. (author)

  13. Intravitreal ranibizumab and bevacizumab therapy for choroidal neovascularization in age-related macular degeneration with extensive pre-existing geographic atrophy

    Directory of Open Access Journals (Sweden)

    Miguel Hage Amaro

    2012-08-01

    Full Text Available PURPOSE: To report the response of choroidal neovascularization to intravitreal ranibizumab or bevacizumab treatment in the setting of age-related macular degeneration with extensive pre-existing geographic atrophy of the retinal pigment epithelium. METHODS: This is a retrospective case series of 11 eyes in ten consecutive patients retrieved from a photographic database. The patients were treated with ranibizumab or bevacizumab for neovascular age-related macular degeneration with pre-existing geographic atrophy. Patients were included if they had geographic atrophy at or adjacent to the foveal center of at least 1 disc area in size that was present before the development of choroidal neovascularization. The best corrected visual acuity and optical coherence tomography analysis of the central macular thickness were recorded for each visit. Serial injections of ranibizumab or bevacizumab were administered until there was complete resolution of subretinal fluid on optical coherence tomography. Data over the entire follow-up period were analyzed for overall visual and optical coherence tomography changes. RESULTS: The patients received an average of 7 ± 3 intravitreal injections over the treatment period. Seven of 11 eyes had reduced retinal thickening on optical coherence tomography. On average, the central macular thickness was reduced by 72 ± 115 µm. Six of these 7 eyes had improvement of one or more lines of vision and one had no change. The average acuity change for all patients was -0.04 ± 0.46 logMAR units, which corresponded to a gain of 0.2 ± 4.4 lines of Snellen acuity. The treatment resulted in a good anatomic response with resolution of the subretinal fluid and overall stable visual acuity. CONCLUSIONS: The results of this case series suggest that the use of an intravitreal anti-vascular endothelial growth factor (VEGF agent (ranibizumab or bevacizumab for choroidal neovascularization in age-related macular degeneration with pre

  14. Melanoma de corpo ciliar e coróide: relato de caso Choroidal and ciliary body melanoma: case report

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    Aline Amaral Fulgêncio da Cunha

    2010-04-01

    Full Text Available Melanomas oculares correspondem a 5% de todos os melanomas e 85% deles têm origem no trato uveal. Melanoma uveal é o tumor maligno intraocular primário mais comum no adulto. Relatamos neste artigo um caso de melanoma uveal em paciente, sexo feminino, 31 anos, com quadro de fotopsia, hiperemia e baixa da acuidade visual no olho esquerdo com evolução de quatro meses. Apresentava ao exame oftalmológico acuidade visual menor que 20/400, grande massa tumoral na região nasal retroiriana, com deslocamento anterior do cristalino, estreitamento da câmara anterior e descolamento seroso da retina. A ecografia sugeriu tratar-se de grande massa tumoral suspeita de melanoma de coróide com invasão do corpo ciliar. A confirmação diagnóstica foi possível por meio do exame anatomopatológico.Ocular melanomas correspond to 5% of all melanomas and 85% of them have its origin in the uveal tract. Uveal melanoma is the most commom primary intraocular malignant tumor in the adult. In this article, a case of uveal melanoma in a 31 year-old female patient, with photopsia, hyperemia and low visual acuity in the left eye with evolution of 4 months is presented. In the ophthalmologic examination, visual acuity was lower than 20/400, a large tumoral mass was noted at the nasal region behind the iris with anterior lens displacement, anterior chamber narrowing and serous retinal detachment. The ocular echography suggested a large tumoral mass as a choroidal melanoma extending to the ciliary body. The confirmation diagnosis was possible through the histopathologic examination.

  15. Genetic and functional dissection of ARMS2 in age-related macular degeneration and polypoidal choroidal vasculopathy.

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    Yong Cheng

    Full Text Available Age-related maculopathy susceptibility 2(ARMS2 was suggested to be associated with neovascular age-related macular degeneration (nAMD and polypoidal choroidal vasculopathy (PCV in multiple genetic studies in Caucasians and Japanese. To date, no biological properties have been attributed to the putative protein in nAMD and PCV. The complete genes of ARMS2 and HTRA1 including all exons and the promoter region were assessed using direct sequencing technology in 284 unrelated mainland northern Chinese individuals: 96 nAMD patients, 92 PCV patients and 96 controls. Significant associations with both nAMD and PCV were observed in 2 polymorphisms of ARMS2 and HTRA1 rs11200638, with different genotypic distributions between nAMD and PCV (p<0.001. After adjusting for rs11200638, ARMS2 rs10490924 remained significantly associated with nAMD and PCV (p<0.001. Then we overexpressed wild-type ARMS2 and ARMS2 A69S mutation (rs10490924 in RF/6A cells and RPE cells as in vitro study model. Cell proliferation, attachment, migration and tube formation were analyzed for the first time. Compare with wild-type ARMS2, A69S mutation resulted in a significant increase in proliferation and attachment but inhibited cell migration. Moreover, neither wild-type ARMS2 nor A69S mutation affected tube formation of RF/6A cells. There is a strong and consistent association of the ARMS2/HTRA1 locus with both nAMD and PCV, suggesting the two disorders share, at least partially, similar molecular mechanisms. Neither wild-type ARMS2 nor A69S mutation had direct association with neovascularisation in the pathogenesis of AMD.

  16. Intravitreal Anti-vascular Endothelial Growth Factor for Treating Polypoidal Choroidal Vasculopathy with Grape-like Polyp Clusters

    Science.gov (United States)

    Chang, Young Suk; Kim, Jong Woo; Lee, Tae Gon; Kim, Chul Gu

    2016-01-01

    Purpose To evaluate 12-month outcomes of anti-vascular endothelial growth factor (VEGF) therapy for polypoidal choroidal vasculopathy (PCV) with grape-like polyp clusters. Methods This retrospective observational study included 23 eyes of 23 patients who were newly diagnosed with PCV with grape-like polyp clusters, and who were subsequently treated with anti-VEGF monotherapy. The study compares the best-corrected visual acuity (BCVA) of the patients at diagnosis, at 3 months, and at 12 months after diagnosis. In addition, 12-month changes in BCVA values were compared between cases with subfoveal or juxtafoveal polyps and cases with extrafoveal polyps. Results The baseline, 3-month, and 12-month logarithm of the minimal angle of resolution BCVA was 0.62 ± 0.35, 0.50 ± 0.43, and 0.58 ± 0.48, respectively. Compared to the baseline, patient BCVA was not significantly different at 12 months after diagnosis (p = 0.764). Six eyes (26.1%) gained ≥0.2 logarithm of the minimal angle of resolution BCVA. In cases with subfoveal or juxtafoveal polyps, BCVA values at baseline and at 12 months after diagnosis were 0.66 ± 0.37 and 0.69 ± 0.53, respectively. In cases with extrafoveal polyps, the values were 0.54 ± 0.33 and 0.37 ± 0.31, respectively. Changes in BCVA values were significantly different between the two groups (p = 0.023). Conclusions Although anti-VEGF therapy has favorable short-term efficacy for treating PCV with grape-like polyp clusters, long-term visual improvements are generally limited in the majority of afflicted eyes. The presence of subfoveal or juxtafoveal polyps may suggest unfavorable treatment outcomes. PMID:27478354

  17. Malária ocular: estudo histopatológico experimental das alterações coriorretinianas Ocular malaria: experimental histopathological study of choroidal and retinal changes

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    Paulo Roberto de Magalhães Silva

    2003-06-01

    findings in the target organ such as the brain. METHODS: We used mice of isogenic lineage (CBA/J for they develop malaria, actually the neurological form (cerebral malaria when inoculated with Plasmodium berghei (ANKA. We performed an intraperitoneal inoculation and parasitemia was obtained daily. To correlate the changes with malaria development, the mice were sacrificed on the 3th, 7th and 9 th day of infection. After the enucleation, the eyeball was fixed in Bouin solution for later inclusion in paraffin. The obtained sections were stained with hematoxylin and eosin, Gomori's trichrome and Giemsa. RESULTS: Malarial pigments (hemozoyn were observed in several ocular structures in the initial phase of the disease, also endothelial changes in retinal vessels, monocyte adhesion and parasitized erythrocyte clogging of retinal and choroid vessels (sequestration in the latest stage of infection. Parasitemia levels showed an ascending and critical curve by the seventh day. In this model we observed similar changes that occur in other organs, such as the brain. CONCLUSION: The malaria murine model permits correlation of the ocular features with those other of target organs. The sequestration of late stage parasitized red cells accounts for most ocular changes in malaria, probably on the basis of obstructive phenomena, similar to the process which involves the central nervous system.

  18. Intraoperative Localization of Tantalum Markers for Proton Beam Radiation of Choroidal Melanoma by an Opto-Electronic Navigation System: A Novel Technique

    International Nuclear Information System (INIS)

    Purpose: External beam proton radiation therapy has been used since 1975 to treat choroidal melanoma. For tumor location determination during proton radiation treatment, surgical tantalum clips are registered with image data. This report introduces the intraoperative application of an opto-electronic navigation system to determine with high precision the position of the tantalum markers and their spatial relationship to the tumor and anatomical landmarks. The application of the technique in the first 4 patients is described. Methods and Materials: A navigated reference base was attached noninvasively to the eye, and a navigated pointer device was used to record the spatial position of the tantalum markers, the tumor, and anatomical landmarks. Measurement accuracy was assessed on ex vivo porcine eye specimen by repetitive recording of the tantalum marker positions. The method was applied intraoperatively on 4 patients undergoing routine tantalum clip surgery. The spatial position information delivered by the navigation system was compared to the geometric data generated by the EYEPLAN software. Results: In the ex vivo experiments, the maximum repetition error was 0.34 mm. For the intraoperative application, the root mean square error of paired-points matching of the marker positions from the navigation system and from the EYEPLAN software was 0.701–1.25 mm. Conclusions: Navigation systems are a feasible tool for accurate localization of tantalum markers and anatomic landmarks. They can provide additional geometric information, and therefore have the potential to increase the reliability and accuracy of external beam proton radiation therapy for choroidal melanoma.

  19. Effect of Oral Morphine Consumption in Female Rats on Development of Brain Cavities, Central Canal and Choroid Plexus of Their Embryos

    Directory of Open Access Journals (Sweden)

    Masoomeh Kazemi

    2011-01-01

    Full Text Available Objective: Previous studies have shown that morphine consumption during pregnancymay delay embryo development or cause abnormal nervous system function. The presentstudy focused on the effects of maternal morphine consumption on brain cavities andcentral canal development in Wistar rats.Materials and Methods: In this study Wistar rats (average weight: 170-200 g were used.The experimental group, after pregnancy, received 0.05 mg/ml of morphine by tap waterwhile the control group received water. On the 17th day of pregnancy, the pregnant animalswere anesthetized by chloroform and embryos were surgically removed. The sampleswere fixed in 10% formalin for four weeks. Then, tissues were processed and sectioned.Sections were stained with hematoxylin and eosin (H&E and examined for ventricle, centralcanal and choroid plexus development by light microscopy and MOTIC software.Results: Severe reductions of the third and lateral ventricles were observed in the experimentalgroup. In addition, an increase in the choroid plexus (CP area in the experimentalgroup with regards to the control group was identified.Conclusion: The study showed that oral morphine consumption lead to reduction in thethird and lateral brain cavities and an increase in the CP area. This defect may cause behavioralchanges observed in the F1 generation from addicted pregnant animals.

  20. Topical application of a G-Quartet aptamer targeting nucleolin attenuates choroidal neovascularization in a model of age-related macular degeneration.

    Science.gov (United States)

    Leaderer, Derek; Cashman, Siobhan M; Kumar-Singh, Rajendra

    2015-11-01

    Choroidal neovascularization (CNV) associated with the 'wet' form of age related macular degeneration (AMD) is one of the most common causes of central vision loss among the elderly. The 'wet' form of AMD is currently treated by intravitreal delivery of anti-VEGF agents. However, intravitreal injections are associated with complications and long-term inhibition of VEGF leads to macular atrophy. Thus, there is currently an unmet need for the development of therapies for CNV that target molecules other than VEGF. Here, we describe nucleolin as a novel target for the 'wet' form of AMD. Nucleolin was found on the surface of endothelial cells that migrate from the choroid into the subretinal space in the laser-induced model of 'wet' AMD. AS1411 is a previously described G-quartet oligonucleotide that has been shown to bind nucleolin. We found that AS1411 inhibited the formation of tubes by human umbilical vein endothelial cells (HUVECs) by approximately 27.4% in vitro. AS1411 co-localized with the site of laser induced CNV in vivo. Intravitreally injected AS1411 inhibited laser-induced CNV by 37.6% and attenuated infiltration of macrophages by 40.3%. Finally, topical application of AS1411 led to a 43.4% reduction in CNV. Our observations have potential implications for the development of therapies for CNV and specifically for the 'wet' form of AMD. PMID:26368850

  1. Management of recurrent inflammatory choroidal neovascular membrane secondary to Vogt-Koyanagi-Harada syndrome, using combined intravitreal injection of bevacizumab and triamcinolone acetate

    Directory of Open Access Journals (Sweden)

    Sivakami A Pai

    2012-01-01

    Full Text Available The purpose of this report is to evaluate the efficacy and safety of combined intravitreal injection of bevacizumab and intravitreal triamcinolone acetonide (IVTA for recurrent inflammatory choroidal neovascular membrane (CNVM. It was a prospective interventional study of a young female, who was a known case of Vogt-Koyanagi-Harada syndrome. She presented with an inflammatory choroidal neovascualar membrane and signs of panuveitis in the right eye. She underwent a complete ophthalmic examination. She was given intravitreal injection of bevacizumab and IVTA at different sites. There was complete regression of CNVM and ocular inflammation within a week. After six months, she had recurrence of CNVM in the same eye, which was treated similarly. There was a complete resolution of CNVM and ocular inflammation after the combination therapy and systemic steroids, until one year of follow-up. No serious systemic or ocular adverse events were noted. Combination therapy appears to be an effective and safe method in the management of recurrent inflammatory CNVM.

  2. Choroid plexus papilloma and Aicardi syndrome: case report Papiloma do plexo coróideo e síndrome de Aicardi: relato de caso

    Directory of Open Access Journals (Sweden)

    Geraldo Pianetti Filho

    2002-12-01

    Full Text Available A case of Aicardi syndrome associated with a choroid plexus papilloma of the third and both lateral ventricles in a 15 months old baby girl is repported. The tumor was completely removed via three craniotomies. Reports of the literature with the association of choroid plexus papilloma and Aicardi syndrome are rare. We suggest that children diagnosed with Aicardi syndrome should routinely undergo imaging studies of the brain, such as computed tomography or magnetic resonance.Relatamos o caso de uma criança com 15 meses de idade, portadora da síndrome de Aicardi associada a tumores nos ventrículos laterais e terceiro ventrículo (papilomas que foram retirados cirurgicamente através de três craniotomias. A ocorrência de papiloma do plexo coróideo associada à sindrome de Aicardi é raramente descrita na literatura. Sugerimos que as crianças portadoras da síndrome de Aicardi sejam rotineiramente submetidas a estudo radiológico do encéfalo através da tomografia computadorizada ou ressonância nuclear.

  3. Intraoperative Localization of Tantalum Markers for Proton Beam Radiation of Choroidal Melanoma by an Opto-Electronic Navigation System: A Novel Technique

    Energy Technology Data Exchange (ETDEWEB)

    Amstutz, Christoph A., E-mail: christoph.amstutz@usz.ch [Department of Ophthalmology, University Hospital Zurich, Frauenklinikstrasse 24, 8091 Zurich (Switzerland); Bechrakis, Nikolaos E. [Department of Ophthalmology, Medical University of Innsbruck, Innsbruck (Austria); Foerster, Michael H. [Department of Ophthalmology, DRK Kliniken Berlin - Westend, Berlin (Germany); Heufelder, Jens [Charite - BerlinProtonen, HZB Helmholtz Zentrum Berlin, Berlin (Germany); Kowal, Jens H. [ARTORG Ophthalmic Technology Group, University Hospital Berne, Inselspital, Berne (Switzerland)

    2012-03-15

    Purpose: External beam proton radiation therapy has been used since 1975 to treat choroidal melanoma. For tumor location determination during proton radiation treatment, surgical tantalum clips are registered with image data. This report introduces the intraoperative application of an opto-electronic navigation system to determine with high precision the position of the tantalum markers and their spatial relationship to the tumor and anatomical landmarks. The application of the technique in the first 4 patients is described. Methods and Materials: A navigated reference base was attached noninvasively to the eye, and a navigated pointer device was used to record the spatial position of the tantalum markers, the tumor, and anatomical landmarks. Measurement accuracy was assessed on ex vivo porcine eye specimen by repetitive recording of the tantalum marker positions. The method was applied intraoperatively on 4 patients undergoing routine tantalum clip surgery. The spatial position information delivered by the navigation system was compared to the geometric data generated by the EYEPLAN software. Results: In the ex vivo experiments, the maximum repetition error was 0.34 mm. For the intraoperative application, the root mean square error of paired-points matching of the marker positions from the navigation system and from the EYEPLAN software was 0.701-1.25 mm. Conclusions: Navigation systems are a feasible tool for accurate localization of tantalum markers and anatomic landmarks. They can provide additional geometric information, and therefore have the potential to increase the reliability and accuracy of external beam proton radiation therapy for choroidal melanoma.

  4. Assessment of Open-Angle Glaucoma Peripapillary and Macular Choroidal Thickness Using Swept-Source Optical Coherence Tomography (SS-OCT.

    Directory of Open Access Journals (Sweden)

    Yong Ju Song

    Full Text Available To compare peripapillary and macular choroidal thickness (PCT and MCT between open-angle glaucoma (OAG and normal controls using swept-source optical coherence tomography (SS-OCT, and to evaluate global and localized relationships between choroidal thickness and various factors in OAG, also using SS-OCT.In this cross-sectional comparative study, 134 OAG patients and 73 normal controls were examined. PCT (global, 12 clock-hour sectors, MCT (global, six sectors were measured by SS-OCT. The difference in choroidal thickness between the OAG patients and the normal controls was analyzed. The relationships between choroidal thickness and various factors including age, sex, spherical equivalent (SE, axial length (AXL, central corneal thickness (CCT, intraocular pressure (IOP, peripapillary retinal nerve fiber layer thickness (pRNFLT, visual field mean deviation (MD, ganglion cell-inner plexiform layer thickness (GCIPLT, and disc area were analyzed by univariate and multivariate linear regression. Global and regional analyses were performed in 12 segments of the peripapillary circle and in six sectors of the macula.There were significant differences in global PCT and MCT between the OAG patients and the normal controls (115.22±41.17 vs. 138.89±44.70, P<0.001, (184.36±57.15 vs. 209.25±61.11, P = 0.004. The difference in global PCT remained, both after adjusting for age, AXL (117.08±3.45 vs. 135.47±4.70, P = 0.002 and also after adjusting for age, AXL, disc area (117.46±3.46 vs. 135.67±4.67, P = 0.002. But the difference in global MCT did not remain after adjusting for age, AXL, SE (188.18±4.46 vs. 202.25±6.08, P = 0.066. PCT showed significant differences between the groups in all of the 12 clock-hour sectors. These differences remained after adjusting for age, AXL and for age, AXL, disc area, with the exception of the 10 o'clock (o/c sector. MCT in six sectors showed differences between the two groups, but they did not remain after adjusting

  5. Major single nucleotide polymorphisms in polypoidal choroidal vasculopathy: a comparative analysis between Thai and other Asian populations

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    Chantaren P

    2012-03-01

    Full Text Available Patchima Chantaren1, Paisan Ruamviboonsuk1, Mathurose Ponglikitmongkol2, Montip Tiensuwan3, Somying Promso41Department of Ophthalmology, Rajavithi Hospital, Bangkok, 2Department of Biochemistry, Faculty of Science, Mahidol University, Bangkok, 3Department of Mathematics, Faculty of Science, Mahidol University, Bangkok, 4Virology and Molecular Microbiology Unit, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandPurpose: To investigate the association in a Thai population between the major age-related macular degeneration (AMD susceptibility loci, Y402H and I62V in the complement factor H (CFH and A69S in the age-related maculopathy susceptibility 2 (ARMS2 genes, and polypoidal choroidal vasculopathy (PCV.Methods: A case-control study included 97 PCV cases and 102 age- and gender-matched controls without any retinopathy. The genotypic profiles of the three polymorphisms were obtained using a real-time polymerase chain reaction assay. The allelic and genotypic association between the polymorphisms and PCV were compared with those from the compiled data of other Asian populations reported previously.Results: Strong associations between the Y402H, I62V, and A69S polymorphisms and PCV were observed in the present study (P = 0.002, 0.003, and 0.0008 respectively and in the compiled data (P < 0.0001 for all three polymorphisms. The risk allele frequencies of the polymorphisms in PCVs and in controls from the present study (15.0% and 5.4% for Y402H, 71.7% and 57.4% for I62V, and 54.1% and 37.3% for A69S respectively were also comparable with the frequencies from the compiled data (10.3% and 6.4% for Y402H, 75.2% and 58.3% for I62V, and 56.8% and 36.8% for A69S respectively. The genotype distribution for each polymorphism was also comparable in both datasets.Conclusion: The findings of this study support a significant genetic association between the major AMD susceptibility genes and PCV across Asian

  6. Indocyanine Green Angiography Guided Management of Vogt-Koyanagi-Harada Disease

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    Nadia Bouchenaki

    2011-01-01

    Full Text Available Purpose: To report the management of Vogt-Koyanagi-Harada (VKH disease based on indocyanine green angiography (ICGA. Methods: VKH patients with acute episodes of inflammation (inaugural or recurrent who had received standard ICGA-guided care were studied retrospectively. Standard of care included high dose systemic corticosteroids at presentation and close ICGA follow-up with addition of immunosuppressive agents and/or intensification of ongoing therapy when recurrent choroidal lesions were detected by ICGA. Visual acuity, number of subclinical recurrences, type and duration of therapy, proportion of quiescent patients after therapy, and ICGA findings were recorded. Results: Nine patients including 8 female and one male subject were studied. Five patients had inaugural disease and 4 presented with recurrent acute episodes. Visual acuity increased from 0.86±0.36 to 1.14±0.34 in the right eyes, and from 0.77±0.34 to 1.05±0.33 in the left eyes. The number of ICGA-detected occult choroidal recurrences amounted to 13. Mean duration of treatment was 30.1±34.6 months leading to recurrence-free status after discontinuation of therapy in 6 cases with mean duration of 29.5 months. Conclusion: Continuous monitoring and aggressive therapy guided by ICGA in VKH disease prolongs treatment as compared to textbook guidelines but offers the prospect of reaching inflammation-free status after discontinuation of therapy. Zero tolerance to subclinical choroidal inflammation avoids irremediable evolution towards sunset glow fundus in patients treated early after the initial acute inflammatory attack.

  7. Asymmetry of disciform scarring in bilateral disease when one eye is treated with radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Hart, P.M.; Archer, D.B.; Chakravarthy, U. [Queen`s Univ., Belfast, Northern Ireland (United Kingdom)

    1995-06-01

    A previous study has shown that in age-related macular degeneration a high degree of concordance of disciform scar size occurs in the two eyes of any one patient. In a study of 35 patients with choroidal neovascular membrane who were treated with low dose ionising radiation to the macula of the affected eye, 11 were found to have bilateral disease. The visual outcome and scar size and morphology in the two eyes of each of these patients were compared. This study has provided evidence in support of reduced scarring and maintenance of better central visual function in radiotherapy treated eyes when compared with untreated fellow eyes. (author).

  8. Asymmetry of disciform scarring in bilateral disease when one eye is treated with radiotherapy

    International Nuclear Information System (INIS)

    A previous study has shown that in age-related macular degeneration a high degree of concordance of disciform scar size occurs in the two eyes of any one patient. In a study of 35 patients with choroidal neovascular membrane who were treated with low dose ionising radiation to the macula of the affected eye, 11 were found to have bilateral disease. The visual outcome and scar size and morphology in the two eyes of each of these patients were compared. This study has provided evidence in support of reduced scarring and maintenance of better central visual function in radiotherapy treated eyes when compared with untreated fellow eyes. (author)

  9. Targeting Cells With MR Imaging Probes: Cellular Interaction And Intracellular Magnetic Iron Oxide Nanoparticles Uptake In Brain Capillary Endothelial and Choroidal Plexus Epithelial Cells

    Science.gov (United States)

    Cambianica, I.; Bossi, M.; Gasco, P.; Gonzalez, W.; Idee, J. M.; Miserocchi, G.; Rigolio, R.; Chanana, M.; Morjan, I.; Wang, D.; Sancini, G.

    2010-10-01

    Magnetic iron oxide nanoparticles (NPs) are considered for various diagnostic and therapeutic applications in brain including their use as contrast agent for magnetic resonance imaging. In delivery application, the critical step is the transport across cell layers and the internalization of NPs into specific cells, a process often limited by poor targeting specificity and low internalization efficiency. The development of the models of brain endothelial cells and choroidal plexus epithelial cells in culture has allowed us to investigate into these mechanisms. Our strategy is aimed at exploring different routes to the entrapment of iron oxide NPs in these brain related cells. Here we demonstrated that not only cells endowed with a good phagocytic activity like activated macrophages but also endothelial brain capillary and choroidal plexus epithelial cells do internalize iron oxide NPs. Our study of the intracellular trafficking of NPs by TEM, and confocal microscopy revealed that NPs are mainly internalized by the endocytic pathway. Iron oxide NPs were dispersed in water and coated with 3,4-dihydroxyl-L-phenylalanine (L-DOPA) using standard procedures. Magnetic lipid NPs were prepared by NANOVECTOR: water in oil in water (W/O/W) microemulsion process has been applied to directly coat different iron based NPs by lipid layer or to encapsulate them into Solid Lipid Nanoparticles (SLNs). By these coating/loading the colloidal stability was improved without strong alteration of the particle size distribution. Magnetic lipid NPs could be reconstituted after freeze drying without appreciable changes in stability. L-DOPA coated NPs are stable in PBS and in MEM (Modified Eagle Medium) medium. The magnetic properties of these NPs were not altered by the coating processes. We investigated the cellular uptake, cytotoxicity, and interaction of these NPs with rat brain capillary endothelial (REB4) and choroidal plexus epithelial (Z310) cells. By means of widefield, confocal

  10. Combined Transpupillary Thermotherapy with Subtenon Triamcinolone Injection in Treatment of Choroidal Neovascularization Secondary to Exudative Age Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    M Naseripour

    2008-04-01

    Full Text Available ABSTRACT: Introduction & Objective: In spite of several treatment methods which are being used to treat exudative age-related macular degeneration (ARMD like laser therapy, Intravitreal steroids injections or anti-vascular endothelial growth factors (VEGF, no method has been yet presented as the best treatment way. This study aimed to assess the effectiveness of combined transpupillary thermotherapy (TTT with subtenon triamcinolone acetonide (TA injection in treatment of choroidal neovascularization (CNV in patients with ARMD. Materials & Methods: In this clinical trial, 63 eyes of 57 patients with CNV secondary to exudative age-related macular degeneration (ARMD were studied. All CNVs (including 20 predominantly classic and 43 predominantly occult lesions were treated with diode laser (810nm. In 20 eyes with predominantly classic CNVs, 20 mg and 40 mg subtenon triamcinolone was injected in 12 and 8 eyes respectively. The patients were followed for a mean of 9.1 months (ranging from 5.5 to 16 months. The average number of treatment sessions was 1.25. In 43 eyes with occult CNV, 20 mg and 40 mg subtenon triamcinolone was injected in 31 eyes and in 12 eyes respectively. Mean follow up time was 12 months (4.5 to 23 months. Mean treatment times was 1.17. A variable spot size of 0.8, 1.2, 2 and 3 mm was used depending on the size of CNV and treatment was given in one area for 1 minute. Thermotherapy was adminstered through a contact lens at a power range between 120-560 mw. At the end of treatment, each patient randomly received 20 mg or 40 mg subtenon triamcinolone acetonide injection in superotemporal quadrant. Outcome was assessed with clinical and angiographic examination.collected data were analyzed by one-sample and paired –sample T test, using SPSS software. Results: At the end of the study in first group, visual acuity remained stable (0 to ± one line in 14 out of 20 (70 % of eyes, improved (> one line in 2 of 20 (10 % eyes and showed a

  11. Enucleaton of the right eye due to large choroidal melanoma with simultaneous penetrating cornea transplantation from OD to OS (Case report.

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    E. A. Korchuganova

    2013-01-01

    Full Text Available There is presentation case report of 75‑year old woman with choroidal melanoma (T3N0M0 on the right eye and failed graft on the left pseudophakic eye with far advanced glaucoma and ARMD. No treatment was given to the leading eye with VA 0,2. VA of OS = 1 / ∞ pr.l.certa; PKP OS in 2008 for pseudophakic bullous keratopathy on the eye with far advanced glaucoma. IOP was normal after previous filtering surgery. After PKP VA = 0,04; clear graft during 2 years; then gradually opacification and vascularization occurred. VA dropped to light perception. Echography OD — tumor h 8,29 mm, d 21,77 mm. No ingrowth of tumor into anterior segment of the eye; VA OD = 0 (no light perception. Concerning the need to enucleate the right eye with large choroidal melanoma, the advantage of using corneal autograft from OD to OS, location of tumor in the posterior pole with no ingrowth in anterior segment, the decision was made to perform the following operation — to enucleate the right eye and transplant simultaneously corneal graft from OD on OS. Patient was discharged from the Ophthalmology Hospital with VA OS = 0,01, during next week VA improved to 0,02. 8,0 mm graft isclear, fixed with 8 interruptured and continious suture 10 / 0‑nylon. Anterior chamber — normal depth, atrophic iris, stable position of PC IOL. Optic nerve head is pale with subtotal deep glaucomatous excavation. Conclusion: presented case report demonstrates the rarepossibility to use cornea after enucleation the eye with large malignant tumor (located in the posterior pole for grafting in the only eye with failed vascularised graft. It was the only possibility for this patient to restore some vision.

  12. Enucleaton of the right eye due to large choroidal melanoma with simultaneous penetrating cornea transplantation from OD to OS (Case report.

    Directory of Open Access Journals (Sweden)

    E. A. Korchuganova

    2014-07-01

    Full Text Available There is presentation case report of 75‑year old woman with choroidal melanoma (T3N0M0 on the right eye and failed graft on the left pseudophakic eye with far advanced glaucoma and ARMD. No treatment was given to the leading eye with VA 0,2. VA of OS = 1 / ∞ pr.l.certa; PKP OS in 2008 for pseudophakic bullous keratopathy on the eye with far advanced glaucoma. IOP was normal after previous filtering surgery. After PKP VA = 0,04; clear graft during 2 years; then gradually opacification and vascularization occurred. VA dropped to light perception. Echography OD — tumor h 8,29 mm, d 21,77 mm. No ingrowth of tumor into anterior segment of the eye; VA OD = 0 (no light perception. Concerning the need to enucleate the right eye with large choroidal melanoma, the advantage of using corneal autograft from OD to OS, location of tumor in the posterior pole with no ingrowth in anterior segment, the decision was made to perform the following operation — to enucleate the right eye and transplant simultaneously corneal graft from OD on OS. Patient was discharged from the Ophthalmology Hospital with VA OS = 0,01, during next week VA improved to 0,02. 8,0 mm graft isclear, fixed with 8 interruptured and continious suture 10 / 0‑nylon. Anterior chamber — normal depth, atrophic iris, stable position of PC IOL. Optic nerve head is pale with subtotal deep glaucomatous excavation. Conclusion: presented case report demonstrates the rarepossibility to use cornea after enucleation the eye with large malignant tumor (located in the posterior pole for grafting in the only eye with failed vascularised graft. It was the only possibility for this patient to restore some vision.

  13. [18F]Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (PET/CT) Physiologic Imaging of Choroidal Melanoma: Before and After Ophthalmic Plaque Radiation Therapy

    International Nuclear Information System (INIS)

    Purpose: To evaluate changes in [18F]fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) standardized uptake values (SUV) in uveal melanoma before and after plaque brachytherapy. Methods and Materials: A cohort of 217 patients diagnosed with uveal melanoma and eligible for ophthalmic plaque brachytherapy underwent preoperative PET/CT to evaluate their intraocular tumor and screen for metastasis. Subsequent to undergoing plaque brachytherapy, patients' PET/CT SUV were periodically reevaluated over 42 months. Results: In this series, 37 (17%) choroidal melanoma patients were found to have an SUV of >2.0. Of these, 18 patients were able to undergo interval follow-up PET/CT scanning. There were 3 patients with T2, 11 patients with T3, and 4 patients with T4 melanomas according to 7th edition AJCC-UICC criteria. Mean apical thickness was 8.8 mm (range, 3-12.3 mm), and the largest mean tumor diameter was 15.1 mm (range, 12-19.9 mm). The mean initial SUV was 3.7 (range, 2.1-7.3). Patients were followed for a median 16 months (range, 6-42 months). The median time to a tumor SUV of 0 was 8.0 months (range, 6-18 months). There was one case of one interval increase in SUV that diminished after circumferential laser treatment. Conclusions: Intraocular PET/CT imaging provides a physiological assessment of tumor metabolism that can be used to evaluate changes after treatment. In this study, ophthalmic plaque radiation therapy was associated with extinguished tumor PET/CT SUV over time. PET/CT imaging can be used to assess choroidal melanomas for their response to treatment.

  14. Intravitreal bevacizumab in choroidal neovascularization secondary to Grönblad-Strandberg syndrome: case report Uso de bevacizumab intravítreo em neovascularização coroidiana secundária a síndrome de Grönblad-Strandberg: relato de caso

    OpenAIRE

    Ricardo Miguel Japiassú; Maria Augusta Castro Farias Japiassú; Mariana Gomes Pecego

    2008-01-01

    Angioid streaks are commonly related to Grönblad-Strandberg syndrome, that often shows dermatological characteristics, such as pseudoxanthoma elasticum. Choroidal neovascularization is uncommon, often occurring after ocular trauma. This is a case report of the successful use of intravitreal bevacizumab for the treatment of choroidal neovascularization secondary to Grönblad-Strandberg syndrome.As estrias angióides estão comumente relacionadas à síndrome de Grönblad-Strandberg, que se caracteri...

  15. 脉络丛乳头状瘤术后椎管内种植二例%Diffuse craniospinal seeding following the operation of choroid plexus papilloma: report of two cases

    Institute of Scientific and Technical Information of China (English)

    翟卫东; 马振宇; 袁俊; 钟建卫; 王涛; 孙永锋; 尚传强

    2005-01-01

    脉络丛乳头状瘤(choroid plexus papillomas,CPP)是临床少见的颅内良性肿瘤,约占颅内肿瘤0.4%-0.6%,手术后椎管内播散种植更为罕见。本文报道CPP术后椎管内播散种植2例并进行临床分析。

  16. Radiotherapy for refractory choroidal hemangioma%放射疗法治疗难治性脉络膜血管瘤的疗效观察

    Institute of Scientific and Technical Information of China (English)

    李骥; 王胜资; 徐格致; 王文吉

    2014-01-01

    Objective To observe the effectiveness of radiotherapy for refractory choroidal hemangioma.Methods Eight patients (8 eyes) with choroidal hemangioma were enrolled in this retrospective study.All the patients had received laser or photodynamic therapy before without effectiveness.The patients included 7 males and 1 females.The age was ranged from 11 to 54 years old,with an average of (27.50± 15.18) years.All the patients were affected unilaterally,including 3 right eyes and 5 left eyes.There were 5 eyes with circumscribed choroidal hemangioma,3 eyes with diffused choroidal hemangioma.All eyes had extensively exudative retinal detachment.The vision was from light sensation to 0.01.The volume of the tumors was ranged from 1.96 to 5.35 cm3,with a mean of (3.37±1.06) cm3.All the patients were treated with X rays by conventional fractional radiotherapy.Four of 8 patients were applied 24Gy totally in 8 fractions,while the other 4 patients were applied 46Gy in 23 fractions.Follow-up period ranged from 7 to 95 months,with medium of 42 months.Results Retinas reattached in all the eyes while exudation being absorbed.No retinal detachment happened again.To the last follow-up,the vision was from light sensation to 0.6.Visual activity improved in 6 eyes while 2 eyes improved obviously.Visual acuity was stable in remaining 2 eyes.The volume of the tumors decreased to 1.24-2.16 cm3,with a mean of (1.68±0.30) cm3.The percentage of the tumor decreased by 14.6-72.7,with an average of (44.89±21.30) %.No radiotherapy-associated complication occurred.Conclusion Radiotherapy is an efficient and safe treatment for refractory choroidal hemangioma.%目的 观察放射疗法(放疗)对难治性脉络膜血管瘤的临床效果.方法 回顾性研究.经氩激光光凝或光动力疗法多次治疗无效的脉络膜血管瘤患者8例8只眼纳入研究.其中,男性7例,女性1例;年龄11~54岁,平均年龄(27.50±15.18)岁.均为单眼发病,右眼3只,左眼5

  17. Ocular Involvement in Systemic Autoimmune Diseases.

    Science.gov (United States)

    Generali, Elena; Cantarini, Luca; Selmi, Carlo

    2015-12-01

    Eye involvement represents a common finding in patients with systemic autoimmune diseases, particularly rheumatoid arthritis, Sjogren syndrome, seronegative spondyloarthropathy, and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. The eye is a privileged immune site but commensal bacteria are found on the ocular surface. The eye injury may be inflammatory, vascular or infectious, as well as iatrogenic, as in the case of hydroxychloroquine, chloroquine, corticosteroids, and bisphosphonates. Manifestations may affect different components of the eye, with episcleritis involving the episclera, a thin layer of tissue covering the sclera; scleritis being an inflammation of the sclera potentially leading to blindness; keratitis, referring to corneal inflammation frequently associated with scleritis; and uveitis as the inflammation of the uvea, including the iris, ciliary body, and choroid, subdivided into anterior, posterior, or panuveitis. As blindness may result from the eye involvement, clinicians should be aware of the possible manifestations and their management also independent of the ophthalmologist opinion as the therapeutic approach generally points to the underlying diseases. In some cases, the eye involvement may have a diagnostic implication, as for episcleritis in rheumatoid arthritis, or acute anterior uveitis in seronegative spondyloarthritis. Nonetheless, some conditions lack specificity, as in the case of dry eye which affects nearly 30 % of the general population. The aim of this review is to elucidate to non-ophthalmologists the major ocular complications of rheumatic diseases and their specific management and treatment options. PMID:26494481

  18. A prospective study of treatment patterns and 1-year outcome of Asian age-related macular degeneration and polypoidal choroidal vasculopathy.

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    Chui Ming Gemmy Cheung

    Full Text Available OBJECTIVE: To study the treatment patterns and visual outcome over one year in Asian patients with choroidal neovascular membrane secondary to age-related macular degeneration (AMD-CNV and polypoidal choroidal vasculopathy (PCV. DESIGN: Prospective cohort, non-interventional study. METHODS: 132 treatment-naïve patients who received treatment for AMD-CNV and PCV were included. All patients underwent standardized examination procedures including retinal imaging at baseline and follow-up. AMD-CNV and PCV were defined on fundus fluorescein angiography and indocyanine green angiography at baseline. Patients were treated according to standard of care.We report the visual acuity (VA and optical coherence tomography (OCT measurements at baseline, month 3 and month 12 The factors influencing month 12 outcomes were analyzed. MAIN OUTCOME MEASURE: Type of treatment, number of Anti-vascular endothelial growth factor (VEGF treatments, visual outcome over one year. RESULTS: Anti-VEGF monotherapy was the initial treatment in 89.1% of AMD-CNV, but only 15.1% of PCV. The mean number of anti-VEGF injections up to month 12 was 3.97 (4.51 AMD-CNV, 3.43 PCV, p = 0.021. Baseline OCT, month 3 OCT and month 3 VA were significant in determining continuation of treatment after month 3. At month 12, mean VA improved from 0.82 (∼20/132 at baseline to 0.68 (∼20/96 at month 12 (mean gain 6.5 ETDRS letters, p = 0.002. 34.2% of eyes (38/113 eyes gained ≥15 ETDRS letters and 14.4% (16/113 eyes lost ≥15 ETDRS letters. There were no significant differences in visual outcome between AMD-CNV and PCV (p = 0.51. Factors predictive of month 12 visual outcome were baseline VA, baseline OCT central macular thickness, month 3 VA and age. CONCLUSIONS: There is significant variation in treatment patterns in Asian eyes with exudative maculopathy. There is significant visual improvement in all treatment groups at one year. These data highlight the need for high quality

  19. Descolamento seroso tardio e recorrente da coróide após trabeculectomia: relato de caso Late and recurrent serous choroidal detachment after trabeculectomy: case report

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    Nikias Alves da Silva

    2009-08-01

    Full Text Available O presente caso refere-se a um paciente do sexo masculino, de 85 anos de idade, com catarata senil e glaucoma primário de ângulo aberto avançado nos dois olhos, não controlado com medicação máxima, hialose asteróide no OD e degeneração macular relacionada à idade no OE, submetido a facotrabeculectomia em ambos os olhos com mitomicina C. Diante da falência da cirurgia nos dois olhos, mesmo após lise de suturas com laser de argônio, uso de 5-fluorouracil e agulhamento, foi necessário prescrever novamente hipotensores oculares. Com a combinação fixa timolol 0,5% + dorzolamida 2%, o paciente apresentou descolamento seroso coroidiano bilateral com marcante hipotonia; e com brinzolamida 1% o quadro ocorreu apenas no olho esquerdo. Suspensos os colírios, a pressão intraocular se elevava e o descolamento da coróide regredia completamente. O agulhamento associado às aplicações de 5-fluorouracil resolveu a hipertensão ocular.A case of an 85 year-old white man with bilateral senile cataract and advanced primary open-angle glaucoma uncontrolled with maximal medical therapy, asteroid hyalosis in OD and age-related macular degeneration in OS, submitted to a phacotrabeculectomy OU with mitomycin-C is reported. Because the surgery failed in both eyes, even after laser suture lysis, 5-FU injections and needling, it was necessary to reintroduce hypotensive agents. With the fixed combination of 0.5% timolol + 2% dorzolamide, a serous choroidal detachment with marked hypotony developed in both eyes; with 1% brinzolamide it only occurred in the OS. The IOP raised and the choroidal detachment resolved completely after discontinuation of the medications. The dilemma was finally solved through repeat needling with subconjunctival 5-FU injections.

  20. Basic Technology and Clinical Applications of the Updated Model of Laser Speckle Flowgraphy to Ocular Diseases

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    Tetsuya Sugiyama

    2014-08-01

    Full Text Available Laser speckle flowgraphy (LSFG allows for quantitative estimation of blood flow in the optic nerve head (ONH, choroid and retina, utilizing the laser speckle phenomenon. The basic technology and clinical applications of LSFG-NAVI, the updated model of LSFG, are summarized in this review. For developing a commercial version of LSFG, the special area sensor was replaced by the ordinary charge-coupled device camera. In LSFG-NAVI, the mean blur rate (MBR has been introduced as a new parameter. Compared to the original LSFG model, LSFG-NAVI demonstrates a better spatial resolution of the blood flow map of human ocular fundus. The observation area is 24 times larger than the original system. The analysis software can separately calculate MBRs in the blood vessels and tissues (capillaries of an entire ONH and the measurements have good reproducibility. The absolute values of MBR in the ONH have been shown to linearly correlate with the capillary blood flow. The Analysis of MBR pulse waveform provides parameters including skew, blowout score, blowout time, rising and falling rates, flow acceleration index, acceleration time index, and resistivity index for comparing different eyes. Recently, there have been an increasing number of reports on the clinical applications of LSFG-NAVI to ocular diseases, including glaucoma, retinal and choroidal diseases.