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Sample records for lateral ventricle choroid

  1. Ultrastructural study of the lateral ventricle choroid plexus in experimental hydrocephalus in Wistar rats

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    Daniela Pretti da Cunha Tirapelli; Luiza da Silva Lopes; João José Lachat; Benedicto Oscar Colli; Luís Fernando Tirapelli

    2007-01-01

    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 o...

  2. Choroid plexus of the fourth ventricle: Review and anatomic study highlighting anatomical variations.

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    Tubbs, R Shane; Shoja, Mohammadali M; Aggarwal, Anjali; Gupta, Tulika; Loukas, Marios; Sahni, Daisy; Ansari, Shaheryar F; Cohen-Gadol, Aaron A

    2016-04-01

    Relatively few studies have been performed that analyze the morphology of the choroid plexus of the fourth ventricle. Due to the importance of this tissue as a landmark on imaging and during surgical intervention of the fourth ventricle, the authors performed a cadaveric study to better characterize this important structure. The choroid plexus of the fourth ventricle of 60 formalin fixed adult human brains was examined and measured. The horizontal distance from the midline to the lateral most point of the protruding tip of the horizontal limbs was measured. In the majority of the 60 brain specimens, right and left horizontal limbs of the choroid plexus were seen extending from the midline and protruding out of their respective lateral apertures of the fourth ventricle and into the subarachnoid space. However, on 3.3% of sides, there was absence of an extension into the foramen of Luschka and in one specimen, this lack of extension into the foramen of Luschka was bilateral. On two sides, there was discontinuity between the midline choroid plexus and the tuft of choroid just outside the foramen of Luschka. For specimens in which the choroid plexus did protrude through the foramen of Luschka (96.7%), these tufts were located anterior to the flocculus and inferolateral to the facial/vestibulocochlear nerve complex and posterosuperior to the glossopharyngeal/vagal/accessory complex. A thorough understanding of the normal and variant anatomy of the fourth ventricular choroid plexus is necessary for those who operate in, or interpret imaging of, this region.

  3. Surgery and clinical analysis of 6 children with lateral ventricle choroid plexus cysts%儿童侧脑室脉络丛囊肿6例手术治疗及临床分析

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    廖毓芝; 张保中; 于永; 李珊; 杜军; 王志超

    2011-01-01

    Objective: To investigate the pathogenesis, clinical manifestations and treatment principles of lateral ventncle choroid plexus cysts in children. Methods: Retrospective analysis of the clinical data of 6 childrcn with laleral ventricle choroid plexus cysts who were admitted to our department. Results: 6 paticnts were confirmed by surgery and pathology,aged between 5 months and 7 years old, whose course of disease were betwecn 1 month and 5 years. In the 6 cases, the 8Uthors resected the cystic wall by craniotomy under the microscope, while establishing bilateral veniricle traffic. There was good efficaey and postoperative follow-up satisfaction. Conclusion: Lateral ventricle choroid plexus cyst is a kind of benign congenital neuroepithelial cyst and it's rare. The diagnosis is primarily based on clinical manifestations, imaging and pathology. Choroid plexus cyst in adults without obvious symploms can be followed up. But for children, once it is found having mass effect or significantly enlarging, thc surgical treatmetnt should be operated as soon as possible to avoid impeding the development of brain and its functions.%目的:探讨儿童侧脑室脉络丛囊肿的发病机制、临床表现和治疗手段.方法:回顾性分析我科收治的6例儿童侧脑室脉络丛囊肿临床资料.结果:本组6例,年龄5个月~7岁,病程1个月~5年,均经手术和病理证实.6例均采用开颅显微下手术切除囊壁,同时建立侧脑室交通方法,疗效好,术后随访满意.结论:侧脑室脉络丛囊肿属良性先天性神经上皮性囊肿,临床少见,诊断主要根据临床表现、影像学和病理学检查.脉络丛囊肿在成人如无明显症状可随访观察,但对于儿童,主张一旦发现其具有占位效应或明显增大应尽快手术治疗,以防阻碍脑及其功能的发育.

  4. 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

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    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

  5. Reversible transinsular herniation of the lateral ventricle

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    Holodny, Andrei I. [UMDNJ-New Jersey Medical School, Department of Radiology, Newark, NJ (United States); Memorial Sloan Kettering Cancer Center, The Department of Radiology, New York, NY (United States); Gor, Devang M.; Thaver, Hussain; Millian, Brian R. [UMDNJ-New Jersey Medical School, Department of Radiology, Newark, NJ (United States)

    2004-11-01

    We present a 7-year-old boy, with a history of neonatal intraventricular hemorrhage, leading to hydrocephalus with multiple shunt revisions. The current presentation of shunt failure and resultant hydrocephalus was complicated by herniation of the trigone of the lateral ventricle into the posterior fossa. Despite the dramatic radiological appearance, this herniation of the lateral ventricle was not accompanied by any additional clinical signs or symptoms other than those usually attributed to hydrocephalus. Following successful shunt revision, the patient returned to his baseline clinically with the trigone reverting back to its normal position. We also present a second companion case. (orig.)

  6. Liponeurocytoma of the Left Lateral Ventricle

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    Ahmet BEKAR

    2009-09-01

    Full Text Available Liponeurocytoma has been recognized recently as a distinct clinicopathological entity by the World Health Organization. Although there are few cases described in the literature it has been accepted as a benign lesion. Here we present a 55-year-old woman with a supratentorial intraventricular liponeurocytoma of the left lateral ventricle.

  7. Flow induced by ependymal cilia dominates near-wall cerebrospinal fluid dynamics in the lateral ventricles.

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    Siyahhan, Bercan; Knobloch, Verena; de Zélicourt, Diane; Asgari, Mahdi; Schmid Daners, Marianne; Poulikakos, Dimos; Kurtcuoglu, Vartan

    2014-05-06

    While there is growing experimental evidence that cerebrospinal fluid (CSF) flow induced by the beating of ependymal cilia is an important factor for neuronal guidance, the respective contribution of vascular pulsation-driven macroscale oscillatory CSF flow remains unclear. This work uses computational fluid dynamics to elucidate the interplay between macroscale and cilia-induced CSF flows and their relative impact on near-wall dynamics. Physiological macroscale CSF dynamics are simulated in the ventricular space using subject-specific anatomy, wall motion and choroid plexus pulsations derived from magnetic resonance imaging. Near-wall flow is quantified in two subdomains selected from the right lateral ventricle, for which dynamic boundary conditions are extracted from the macroscale simulations. When cilia are neglected, CSF pulsation leads to periodic flow reversals along the ventricular surface, resulting in close to zero time-averaged force on the ventricle wall. The cilia promote more aligned wall shear stresses that are on average two orders of magnitude larger compared with those produced by macroscopic pulsatile flow. These findings indicate that CSF flow-mediated neuronal guidance is likely to be dominated by the action of the ependymal cilia in the lateral ventricles, whereas CSF dynamics in the centre regions of the ventricles is driven predominantly by wall motion and choroid plexus pulsation.

  8. Endoscopic endonasal transplanum transtuberculum resection of a large solid choroid plexus papilloma of the third ventricle.

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    Kulwin, Charles; Chan, David; Ting, Jonathan; Hattab, Eyas M; Cohen-Gadol, Aaron A

    2014-07-01

    Choroid plexus papilloma (CPP) is a highly vascular solid or mixed solid-cystic tumor. Previously described resection techniques for the more common solid CPP in the third ventricle have all been through the transcranial route. The authors review the literature and describe a patient who, to their knowledge, is the first successful resection of a large, completely solid CPP of the third ventricle through an entirely endoscopic, extended transphenoidal approach. Using modern neuroendoscopic methods and closure techniques, a gross total resection was accomplished and a successful closure without postoperative cerebrospinal fluid leak was achieved despite the presence of preoperative hydrocephalus. For appropriately selected lesions, an extended endonasal skull base resection can be performed successfully for vascular tumors despite the presence of preoperative hydrocephalus.

  9. Ultrastructural alterations of choroid plexuses of lateral ventricles of rats (Rattus norvegicus submitted to experimental chronic alcoholism Alterações ultraestruturais dos plexos coróides dos ventrículos laterais de ratos (Rattus norvegicus submetidos a alcoolismo crônico experimental

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    LUÍS FERNANDO TIRAPELLI

    2000-03-01

    Full Text Available Adult male rats (Wistar lineage were alcoholized with sugar cane liquor diluted at 30(0 GL during 300 days and sacrificed every 60 days in 5 stages. Samples of choroid plexuses of lateral ventricles were collected and examined at transmission electronic microscope to detect possible ultrastructural alterations and to raise possible pathological correlations. Gradual changes were observed in these animals during all the experiment: dilatation and enlargement of cisternae of Golgi complex, dilatation of RER, presence of digestive vacuoles and a large amount of pinocytic vesicles as well as vesicles with electronlucent content throughout cytoplasm, as well as an enlargement of intercellular space between basolateral interdigitation of the cells and of the connective tissue. The changes observed in the epithelium and connective tissue of choroid plexuses specially in 240 and 300 days of treatment are presumably due to a disturbance in hydroelectrolitic homeostasis, contributing to several morpho-functional disturbs of central nervous system. No changes were observed in the control group animals.Ratos machos adultos (linhagem Wistar foram alcoolizados com aguardente de cana diluída a 30(0 GL durante 300 dias e sacrificados a cada 60 dias em 5 etapas. Amostras dos plexos coróides dos ventrículos laterais foram coletadas e examinadas ao microscópio eletrônico de transmissão para detectar possíveis alterações ultraestruturais e suas correlações patológicas. Alterações graduais foram observadas nestes animais durante todo o experimento: dilatação e aumento das cisternas de complexo de Golgi, dilatação do retículo endoplasmático rugoso, presença de vacúolos digestivos e grande quantidade de vesículas pinocíticas assim como de vesículas de conteúdo elétron-lúcido por todo o citoplasma, além de aumento do espaço intercelular, entre as interdigitações das células assim como no tecido conjuntivo. As alterações observadas no

  10. Brainstem mediates diazepam enhancement of palatability and feeding: microinjections into fourth ventricle versus lateral ventricle.

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    Peciña, S; Berridge, K C

    1996-07-15

    The hypothesis that benzodiazepine-induced hyperphagia is due to a specific enhancement of the palatability of foods has been supported by previous 'taste reactivity' studies of affective (hedonic and aversive) reactions to taste palatability. Diazepam and chlordiazepoxide enhance hedonic reactions of rats (rhythmic tongue protrusions, etc.) to sweet tastes in a receptor-specific fashion. A role for brainstem circuits has been indicated by a previous demonstration of the persistence of the taste reactivity enhancement by diazepam after midbrain decerebration. The present study examined whether benzodiazepine brainstem receptors are the chief substrates for palatability enhancement even in intact brains. We compared the effectiveness of benzodiazepine microinjections to elicit feeding and enhance hedonic reactions when delivered into either the lateral ventricle (forebrain) or the fourth ventricle (brainstem) of rats. The results show diazepam is reliably more effective at eliciting feeding and enhancing positive hedonic reactions to oral sucrose when microinjections are made in the fourth ventricle than in the lateral ventricle. We conclude that brainstem neural systems containing benzodiazepine-GABA receptors are likely to be the chief substrates for benzodiazepine-induced palatability enhancement.

  11. Dysarthria and dysphagia following treatment for a fourth ventricle choroid plexus papilloma.

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    Cornwell, P L; Murdoch, B E; Ward, E C; Morgan, A

    2003-07-01

    The present case report describes the presence of a persistent dysarthria and dysphagia as a consequence of surgical intervention for a choroid plexus papilloma (CPP). WM was a nine year ten month old male who at the time of the present study was seven years post-surgery. A comprehensive perceptual and instrumental test battery was used to document the nature of the dysarthria incorporating all components of speech production including respiration, phonation, resonance, articulation, and prosody. The nature of the dysphagia was evaluated through the use of videofluoroscopic evaluation of swallowing (VFS). Assessments confirmed the presence of a LMN dysarthria, marked by deficits in phonation, respiration, and prosody. Dysphagia assessment revealed deficits in oral preparatory, oral and pharyngeal stages of the swallow. The presence of persistent dysarthria and dysphagia in this case has a number of important implications for the management of children undergoing surgery for fourth ventricle CPPs, in particular the need for appropriate treatment, as well as counselling prior to surgery of the possible negative outcomes related to speech and swallowing.

  12. Atypical teratoid rhabdoid tumor of the lateral ventricle

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    Mehdi Darmoul

    2015-01-01

    Full Text Available Atypical teratoid/rhabdoid tumors (AT/RTs are rare and highly malignant embryonal central nervous system neoplasms, usually seen in very young children with rapid fatal outcome despite aggressive treatment. They are most commonly located in the posterior fossa. Intraventricular location is extremely rare. To the best of our knowledge, only 4 cases of lateral ventricle location were reported in the literature. We report the fifth case of lateral ventricle AT/RT in a 2-month-old male who presented with rapid increase of his head circumference. Brain computed tomography scan and magnetic resonance imaging showed heterogeneous huge mass within the left lateral ventricle extending to the parieto-occipital parenchyma and markedly enhancing by contrast. The baby underwent left transparietal approach with complete removal of the tumor. Histological examination confirmed the diagnosis of AT/RT. An aggressive chemotherapy was administrated postoperatively. The outcome is good without neurological deficit or recurrence after 3 years and half of follow-up.

  13. Cholesterol granuloma of the lateral ventricle. Case report.

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    Grossi, Peter M; Ellis, Michael J; Cummings, Thomas J; Gray, Linda L; Fukushima, Takanori; Sampson, John H

    2008-02-01

    Cholesterol granulomas (CGs) are benign lesions resulting from an inflammatory reaction to cholesterol and hemosiderin. These masses most often arise within the temporal bone or nasal sinuses; intracerebral CGs are extremely rare. In this report the authors present an unusual case of a CG arising within the lateral ventricle. The patient presented with transient hemiparesis and numbness. Computed tomography and magnetic resonance imaging demonstrated a cystic partially enhancing midline mass within the right lateral ventricle, expanding the ventricle and displacing the septum pellucidum. The patient underwent an interhemispheric, transcallosal resection of the lesion. Microscopic examination revealed a granulomatous inflammatory lesion containing cholesterol clefts, macrophages, and hemosiderin. Embedded within the granulomatous response were foci of tiny cystlike structures lined by nonciliated flattened cuboidal epithelium, consistent with the diagnosis of CG. To the authors' knowledge this is the first reported case of CG presenting as an intraventricular mass. The origin of this lesion is unclear, but it may relate to prior traumatic brain injury. The authors describe the presentation, imaging findings, histopathological characteristics, and surgical treatment of this rare lesion and related pathological entities.

  14. Meningiomas of the lateral ventricle - a report of 15 cases.

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    Menon, G; Nair, S; Sudhir, J; Rao, R; Easwer, H V; Krishnakumar, K

    2009-06-01

    Lateral ventricular meningiomas are rare tumours that pose considerable surgical challenge. This study attempts to analyse some of the important clinical features of these tumours and review technical considerations in surgery for lateral ventricular meningiomas. A retrospective analysis of the case records of patients with lateral ventricular meningiomas operated in our institute since 1998 with a minimum of one year follow up was done. The variables analysed included age, sex, clinical presentation, imaging characteristics, histopathology and operative details. Outcome was analysed using the Glasgow outcome score (GOS). Fifteen patients with a mean age of 40.6 years formed the study group. A female preponderance was observed (M:F 5:10). Raised intracranial pressure was the predominant symptom at presentation (10/15; 66%) followed by visual field deficits (6/15; 40%) and contralateral motor deficits (5/15; 33.3%). One patient presented with evidence of intratumoural bleed. The tumour was on the right side in 7 patients and on the left side in 8 patients. The lesion was located in the trigone of the lateral ventricle in 13 patients and in the body of the ventricle in two. The tumours were excised through a parietooccipital approach in 11 (73.33%) patients and through a middle temporal gyrus approach in 4 (26.66%).The tumour recurred in 2 patients, both tumours being histologically fibroblastic variants. Fresh operative complications included motor deficits in 3, contralateral homonymous hemianopia in 2, dysphasia in 1, refractory seizures in 2 and loculated hydrocephalus in one. We had no operative mortality. At last follow-up for 10 patients were in GOS 5, two were in GOS 4 and three in GOS 3. Lateral ventricular meningiomas are difficult tumours to operate. Total surgical excision through a superior parietal lobule or middle temporal gyrus approach is possible in most cases with minimal morbidity.

  15. Dopamine stimulation via infusion in the lateral ventricle.

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    Biagioni, Francesca; Busceti, Carla L; Molinaro, Gemma; Battaglia, Giuseppe; Giorgi, Filippo S; Ruggieri, Stefano; Fornai, Francesco

    2006-08-01

    Continuous dopamine (DA) stimulation is a therapeutic approach that applies to the treatment of motor fluctuations due to pulsatile DA stimulation in Parkinson's disease (PD), to cure the abuse of drugs, such as cocaine or amphetamine (which produce short-lasting peaks of extracellular DA), and as a safe therapeutic approach to avoid hedonistic homeostatic dysregulation (which sometime develops as an abuse pattern in PD patients receiving a pulsatile DA replacement therapy). However, systemic continuous delivery of DA agonists leads to a variety of side effects. In search for an alterative approach, in the present study we evaluated the possibility of delivering intracerebroventricularly (i.c.v.), a DA agonist: lisuride that was already shown to be effective when administered continuously subcutaneously (s.c.). In particular, we were interested in examining whether lisuride infused within the lateral ventricle was still able to stimulate DA receptor by inducing contralateral turning behavior in hemiparkinsonian rats. We found that lisuride, when infused in the lateral ventricle was effective in reducing the threshold for stimulating DA receptors. These results offer a more reliable and safe therapeutic approach to deliver continuous DA selectively in the brain.

  16. The ependyma of goat. II. Ependymal lining of the lateral ventricles, mesencephalic canal, and fourth ventricle: scanning electron microscopic study.

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    Rajtová, V

    1990-01-01

    The ependymal surface of the lateral cerebral ventricle, mesencephalic canal, and IVth ventricle of 13 male and female goats were studied by means of scanning electron microscopy. The lateral cerebral ventricle was covered mostly with thin cilia that might have club-like terminations on nucleus caudatus, the wide "naked" places with bleb-like protrusions occurred in the transition to cornu temporale during anestrous cycle. The ependymal surface of mesencephalic canal of female goats during anestrus was covered with abundant spherical protrusions. No other changes that could be related to the sexual differences were found.

  17. A Rare Case of Pericallosal Lipoma Associated with Bilaterally Symmetrical Lateral Ventricular Choroid Plexus Lipomas without Corpus Callosal Anomalies

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    Parag Suresh Mahajan

    2013-01-01

    Full Text Available Lipomas constitute less than 5% of primary brain tumors. Pericallosal lipomas (PCLp constitute almost half of all intracranial lipomas. Corpus callosal anomalies commonly occur in cases with PCLps. Although PCLp is often described as corpus callosal lipoma, it is most often pericallosal in location. PCLps may have calcification in the periphery and may continue into lateral ventricles, which is a very rare presentation. We observed a case of PCLp with peripheral calcifications associated with PCLp continuing as bilaterally symmetrical lateral ventricular choroid plexus lipomas (CPLp without any corpus callosal or other central nervous system anomalies, and as this is not been previously reported, we are presenting it. The appearance of PCLp in this case does not correspond to the descriptions of any of the existing morphological types (anterior and posterior of classification of PCLps; it is rather mixed, where PCLp occupies both anterior and posterior locations around the corpus callosum.

  18. In situ staining of the primo vascular system in the ventricles and subarachnoid space of the brain by trypan blue injection into the lateral ventricle

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    Jingxing Dai; Byung-Cheon Lee; Ping An; Zhendong Su; Rongmei Qu; Ki Hoon Eom; Kwang-Sup Soh

    2011-01-01

    We examined a new method for visualization of the primo vascular system in the rat brain in-volving lateral ventricle injection of trypan blue. Results showed that the primo vascular system in the lateral ventricles and arachnoid mater of the brain were preferentially stained relative to blood vessels and fascia. The primo-vessels along blood vessels in the brain were clearly ex-hibited. In addition, the primo vascular system was evident between the fourth ventricle and the quadrigeminal cistern. Our experimental findings indicate that this new technique of lateral ventricle injection of trypan blue can visualize the primo vascular system in lateral ventricles and arachnoid mater of rats in situ.

  19. In vivo validation of a 3D ultrasound system for imaging the lateral ventricles of neonates

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    Kishimoto, J.; Fenster, A.; Chen, N.; Lee, D.; de Ribaupierre, S.

    2014-03-01

    Dilated lateral ventricles in neonates can be due to many different causes, such as brain loss, or congenital malformation; however, the main cause is hydrocephalus, which is the accumulation of fluid within the ventricular system. Hydrocephalus can raise intracranial pressure resulting in secondary brain damage, and up to 25% of patients with severely enlarged ventricles have epilepsy in later life. Ventricle enlargement is clinically monitored using 2D US through the fontanels. The sensitivity of 2D US to dilation is poor because it cannot provide accurate measurements of irregular volumes such as the ventricles, so most clinical evaluations are of a qualitative nature. We developed a 3D US system to image the cerebral ventricles of neonates within the confines of incubators that can be easily translated to more open environments. Ventricle volumes can be segmented from these images giving a quantitative volumetric measurement of ventricle enlargement without moving the patient into an imaging facility. In this paper, we report on in vivo validation studies: 1) comparing 3D US ventricle volumes before and after clinically necessary interventions removing CSF, and 2) comparing 3D US ventricle volumes to those from MRI. Post-intervention ventricle volumes were less than pre-intervention measurements for all patients and all interventions. We found high correlations (R = 0.97) between the difference in ventricle volume and the reported removed CSF with the slope not significantly different than 1 (p < 0.05). Comparisons between ventricle volumes from 3D US and MR images taken 4 (±3.8) days of each other did not show significant difference (p=0.44) between 3D US and MRI through paired t-test.

  20. Massive symptomatic subependymoma of the lateral ventricles: case report and review of the literature

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    Rath, T.J.; Sundgren, P.C.; Gebarski, S.S. [University of Michigan Health Systems, Department of Radiology, Ann Arbor, MI (United States); Brahma, B.; Chandler, W.F. [University of Michigan Health Systems, Department of Neurosurgery, Ann Arbor, MI (United States); Lieberman, A.P. [University of Michigan Health Systems, Department of Pathology, Ann Arbor, MI (United States)

    2005-03-01

    Subependymomas are benign intraventricular tumors with an indolent growth pattern, which are usually asymptomatic, and most commonly occur in the fourth and lateral ventricles. When symptomatic, subependymomas often obstruct critical portions of the cerebrospinal fluid (CSF) pathway, causing hydrocephalus, and range from 3 cm to 5 cm in size. We report a case of an unusually massive subependymoma of the lateral ventricles treated with subtotal resection, ventriculoperitoneal shunt, and post-surgical radiation. The clinical course, radiographic and pathologic characteristics of this massive intraventricular subependymoma are discussed, as well as the differential diagnosis of lateral ventricular masses and a review of the literature concerning subependymomas. (orig.)

  1. Stereological Volumetry of Cere-bral Hemispheres and Lateral Ventricles Using MRI in Schizophrenia Subtypes

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    H. Haghir

    2004-06-01

    Full Text Available Background/Objectives: The structural changes of brain (cerebral and lateral ventricles volumes in schizophrenia are controversial. This is partly due to the heterogenicity of the schizophrenia subtypes. In this study we compared the changes in the volumes of cerebral hemispheres and lateral ventricles in 3 subtypes of schizophrenia (paranoid, undifferentiated and residual with normal controls. Materials and Methods: 29 schizophrenia patients (21 men, 8 women of 3 subtypes of paranoid, undifferentiated, and residual (according to DMS-IV criteria were compared with 29 age- and gender-matched normal controls. All cases and controls underwent 3-D brain MRI of full coronal series, 1.5 mm slices without interslice gaps. The hemispheres and lateral ventricles were outlined and their volumes were calculated using Cavalieri’s Principle. The results were statistically analyzed. Results: The brain was slightly but insignificantly smaller in the schizophrenia patients. Only the residual subtype showed a significant reduction in cerebral and hemispheric volumes than controls (p<0.05. The volumes of right and left ventricle, separately and together were larger than controls (p<0.03. The ventricle-to-brain ratios (VBRs were greater in the cases (p<0.05. The paranoid subtype patients had larger ventricles and VBRs than controls (p<0.05. The lateral ventricle volumes and VBRs in the undifferentiated subtype were similar to the controls. In the residual subtypes, the ventricular volumes were similar to and the VBRs were larger than controls (p<0.05. Conclusion: Schizophrenia is a heterogeneous disorder regarding its symptoms and neuropathological changes. The patterns of change in the cerebral and ventricular volumes differed in the studied 3 subtypes.

  2. Development of the lateral ventricular choroid plexus in a marsupial, Monodelphis domestica

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    VandeBerg John L

    2010-10-01

    Full Text Available Abstract Background Choroid plexus epithelial cells are the site of blood/cerebrospinal fluid (CSF barrier and regulate molecular transfer between the two compartments. Their mitotic activity in the adult is low. During development, the pattern of growth and timing of acquisition of functional properties of plexus epithelium are not known. Methods Numbers and size of choroid plexus epithelial cells and their nuclei were counted and measured in the lateral ventricular plexus from the first day of its appearance until adulthood. Newborn Monodelphis pups were injected with 5-bromo-2-deoxyuridine (BrdU at postnatal day 3 (P3, P4 and P5. Additional animals were injected at P63, P64 and P65. BrdU-immunopositive nuclei were counted and their position mapped in the plexus structure at different ages after injections. Double-labelling immunocytochemistry with antibodies to plasma protein identified post-mitotic cells involved in protein transfer. Results Numbers of choroid plexus epithelial cells increased 10-fold between the time of birth and adulthood. In newborn pups each consecutive injection of BrdU labelled 20-40 of epithelial cells counted. After 3 injections, numbers of BrdU positive cells remained constant for at least 2 months. BrdU injections at an older age (P63, P64, P65 resulted in a smaller number of labelled plexus cells. Numbers of plexus cells immunopositive for both BrdU and plasma protein increased with age indicating that protein transferring properties are acquired post mitotically. Labelled nuclei were only detected on the dorsal arm of the plexus as it grows from the neuroependyma, moving along the structure in a 'conveyor belt' like fashion. Conclusions The present study established that lateral ventricular choroid plexus epithelial cells are born on the dorsal side of the structure only. Cells born in the first few days after choroid plexus differentiation from the neuroependyma remain present even two months later. Protein

  3. Evaluation of Radioactivity in the Bladder after Injection of 131I Hippurate into Lateral Ventricles of Hydrocephalic Patients

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    DIJKSTRA, J.; H.W.M. Baars

    1972-01-01

    textabstractThis correlative study sought an explanation for the appearance in the bladder of 131I hippurate injected into the lateral ventricle. Part of the excretion seemed to depend upon a ventricular process. High disappearance constants and early onset times were related to small ventricles, an

  4. Evaluation of Radioactivity in the Bladder after Injection of 131I Hippurate into Lateral Ventricles of Hydrocephalic Patients

    NARCIS (Netherlands)

    DIJKSTRA, J.; H.W.M. Baars

    1972-01-01

    textabstractThis correlative study sought an explanation for the appearance in the bladder of 131I hippurate injected into the lateral ventricle. Part of the excretion seemed to depend upon a ventricular process. High disappearance constants and early onset times were related to small ventricles,

  5. Lateral ventricle segmentation of 3D pre-term neonates US using convex optimization.

    Science.gov (United States)

    Qiu, Wu; Yuan, Jing; Kishimoto, Jessica; Ukwatta, Eranga; Fenster, Aaron

    2013-01-01

    Intraventricular hemorrhage (IVH) is a common disease among preterm infants with an occurrence of 12-20% in those born at less than 35 weeks gestational age. Neonates at risk of IVH are monitored by conventional 2D ultrasound (US) for hemorrhage and potential ventricular dilation. Compared to 2D US relying on linear measurements from a single slice and visually estimates to determine ventricular dilation, 3D US can provide volumetric ventricle measurements, more sensitive to longitudinal changes in ventricular volume. In this work, we propose a global optimization-based surface evolution approach to the segmentation of the lateral ventricles in preterm neonates with IVH. The proposed segmentation approach makes use of convex optimization technique in combination with a subject-specific shape model. We show that the introduced challenging combinatorial optimization problem can be solved globally by means of convex relaxation. In this regard, we propose a coupled continuous max-flow model, which derives a new and efficient dual based algorithm, that can be implemented on GPUs to achieve a high-performance in numerics. Experiments demonstrate the advantages of our approach in both accuracy and efficiency. To the best of our knowledge, this paper reports the first study on semi-automatic segmentation of lateral ventricles in neonates with IVH from 3D US images.

  6. Ultrastructural study of the lateral ventricle choroid plexus in experimental hydrocephalus in Wistar rats

    National Research Council Canada - National Science Library

    Daniela Pretti da Cunha Tirapelli; Luiza da Silva Lopes; João José Lachat; Benedicto Oscar Colli; Luís Fernando Tirapelli

    2007-01-01

    ...: 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...

  7. Rupture of the lateral ventricle secondary to a fourth ventricle tumour resulting in an indirect nontraumatic cerebrospinal fluid fistula

    Energy Technology Data Exchange (ETDEWEB)

    Tan, S.P.; Liew, W.F. [Department of Radiology, Hospital Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur (Malaysia); Abdullah, B.J.J. [Department of Radiology, University Malaya Medical Centre (Malaysia); Waran, V. [Department of Neurosurgery, University Malaya Medical Centre (Malaysia)

    2003-01-01

    We present a rare indirect nontraumatic cerebrospinal fluid (CSF) fistula secondary to a fourth ventricle ependymoma. The fistula resulted from rupture of the left temporal horn, distant from the tumour. The fistula was well demonstrated by MRI. High-resolution CT demonstrated a defect in the roof of the sphenoid sinus, but no leakage of CSF was seen on CT cisternography. (orig.)

  8. Ultrasound guided neural stem cell transplantation through the lateral ventricle for treatment of cerebral palsy in children.

    Science.gov (United States)

    He, Sheng; Luan, Zuo; Qu, Suqing; Qiu, Xuan; Xin, Daqing; Jia, Wenkai; Shen, Yanhua; Yu, Zehui; Xu, Tao

    2012-11-15

    A total of 24 children with cerebral palsy were enrolled in this study and underwent ultrasound guided transplantation of neural stem cells through the lateral ventricle. Neural stem cells (3.8 × 10(6)-7.3 × 10(7)) were injected into the lateral ventricles. Mild injury of lateral ventricular blood vessels occurred in only two cases (8.3%). Seven cases (29.2%) experienced a fever. Clinical manifestations were improved to varying degrees in eight cases (28.0%) within 3 months after transplantation. Patient condition did not worsen, and no patient experienced severe adverse reactions.

  9. Ultrasound guided neural stem cell transplantation through the lateral ventricle for treatment of cerebral palsy in children☆

    Institute of Scientific and Technical Information of China (English)

    Sheng He; Zuo Luan; Suqing Qu; Xuan Qiu; Daqing Xin; Wenkai Jia; Yanhua Shen; Zehui Yu; Tao Xu

    2012-01-01

    A total of 24 children with cerebral palsy were enrolled in this study and underwent ultrasound guided transplantation of neural stem cells through the lateral ventricle. Neural stem cells (3.8 × 106–7.3 × 107) were injected into the lateral ventricles. Mild injury of lateral ventricular blood vessels occurred in only two cases (8.3%). Seven cases (29.2%) experienced a fever. Clinical manifestations were improved to varying degrees in eight cases (28.0%) within 3 months after transplantation. Patient condition did not worsen, and no patient experienced severe adverse reactions.

  10. Correlation between formation of the calcarine sulcus and morphological maturation of the lateral ventricle in cynomolgus monkey fetuses.

    Science.gov (United States)

    Fukunishi, Katsuhiro; Sawada, Kazuhiko; Kashima, Masatoshi; Saito, Shigeyoshi; Sakata-Haga, Hiromi; Sukamoto, Takayuki; Aoki, Ichio; Fukui, Yoshihiro

    2011-01-01

    In the present study developmental changes in the cerebral sulci and volumes of subcortical and archicortical structures of the cerebrum in cynomolgus monkey fetuses were examined with T(1)-weighted magnetic resonance (MR) images in 3D. On the embryonic day (ED) 90, the lateral ventricle had still an immature vesicular shape in the occipital region of the cerebrum, and it dramatically closed its lumen by ED 100. In that period the calcarine sulcus progressively infolded from the medial surface of the cerebral hemisphere narrowing the lumen of the lateral ventricle in the occipital region. Volume of the lateral ventricle decreased in the period ED 90-100, increasing afterwards in spite of increasing volumes of subcortical and archicortical structures such as the caudate nucleus, putamen, globus pallidus, amygdala and hippocampal formation. During the same time, the volume of the germinal matrix around lateral ventricles decreased to disappear completely by ED 120. These results suggest that the morphological maturation of lateral ventricle is linked to the development of calcarine sulcus in cynomolgus monkey fetuses. The degree of infolding of calcarine sulcus on ED 100 would be useful as a gross anatomical landmark for evaluating the cerebral maturation in cynomolgus monkey fetuses.

  11. The benefit of image guidance for the contralateral interhemispheric approach to the lateral ventricle.

    Science.gov (United States)

    Fronda, Chiara; Miller, Dorothea; Kappus, Christoph; Bertalanffy, Helmut; Sure, Ulrich

    2008-06-01

    Recently, neurosurgeons have increasingly faced small intracerebral lesions in asymptomatic or minimally symptomatic patients. Here, we evaluated a series of four patients with nearly asymptomatic intraventricular tumors close to the corpus callosum that had been treated with the aid of an image-guided transcallosal approach. Four consecutive patients suffering from left intra- and paraventricular tumors were operated on via a contralateral interhemispheric transcallosal approach with the aid of neuronavigation. Our image-guided system directed: (1) the skin incision, (2) the interhemispheric dissection, and (3) the incision of the corpus callosum. Using the image-guided contralateral interhemispheric transcallosal approach to the left ventricle all lesions have been completely resected without the risk of damage to the dominant hemisphere. The callosal incision was kept as limited as possible (1.2-2.1cm) depending on the size of the tumor. No postoperative neurological or neuropsychological deficit was observed in our series. Neuronavigation facilitates a safe and targeted contralateral interhemispheric transcallosal approach to the dominant hemisphere's lateral ventricle. Our technique minimizes the risk of damage to the dominant hemisphere and requires only a limited opening of the corpus callosum, which might decrease the risk of neuropsychological morbidity.

  12. Choroid plexus papilloma of the posterior third ventricle during infancy & childhood: Report of two cases with management morbidities

    Directory of Open Access Journals (Sweden)

    Pawar S

    2003-07-01

    Full Text Available We report two cases of posterior third ventricular choroid plexus papilloma, one in an 8-month-old infant and another in a two-year-old child. These cases presented with features of obstructive hydrocephalus. Both these patients underwent a ventriculo-peritoneal (VP shunt surgery prior to the tumor excision. Following the VP shunt surgery both patients developed ascitis requiring exteriorization of the abdominal end of the shunt. There was a clear proof of CSF overproduction: 1400-1500 ml/ day in the eight-month-old infant and 900-1200 ml / day in the two-year-old child. In the former it was transient and could be treated with revision of the VP shunt whereas in the second case a ventriculo-arterial shunt had to be done. In the second case a staged reduction cranioplasty was also performed for an enormously enlarged head (head circumference—74 cm. Interesting clinical and radiological findings and useful management strategies are described.

  13. Coronal MRI in the diagnosis of corona radiata infarcts adjacent to the lateral ventricles

    Energy Technology Data Exchange (ETDEWEB)

    Iwamoto, Toshihiko; Abe, Shin-e; Kanaya, Kiyoshi; Kubo, Hideki; Takasaki, Masaru (Tokyo Medical Coll. (Japan))

    1992-04-01

    To clarify pathophysiology of vascular lesions in corona radiata infarcts adjacent to the body of the lateral ventricle (CRILV), 17 patients with CRILV were studied by using magnetic resonance (MR) imaging. Based on the coronal MR images obtained between the anterior and posterior commissures, the patients were divided into two groups: (I) the group having infarcts below a line extending from the upper edge of the insular cistern to the external angle of the lateral ventricle adjacent to the corpus callosum (n=11); and (II) the group having lesions above the line towards the centrum semiovale (n=6). Most of the patients in both groups were male and had hypertension. Symptoms were gradually deteriorated and stroke in the morning was frequent in both groups, althrough the time from onset to completion was longer in Group II than Group I. In comparing clinical manifestations in Groups I and II, pure motor hemiparesis was found in 5 and 3 patients, and sensorimotor stroke in 2 and one patients, respectively. Drowsiness was found in 2 for Group I, while aphasia occurred in 2 for Group II. In addition, pseudobular and asymptomatic palsy occurred in each one patient for Group I. Prognosis was favorable in both groups, except for 2 who died of aspiration pneumonia. In Group I, 11 infarcts were well-defined, less than 15 mm in diameter on CT scans and were sclerotic in the main arteries without obstruction on angiograms. In contrast, Group II had ill-defined, larger low-density areas on CT scans and trunk obstruction of the internal carotid or middle cerebral arteries on angiograms. SPECT scans showed diffuse defect in Group II, in contrast to normal to diffuse or multiple defects in Group I. In Group I, lacunar lesions seemed to be caused by ischemia of the perforators, and in Group II, terminal zone infarcts in the territory of the cortical branches or watershed infarcts seemd to be caused by main trunk obstruction. (N.K.).

  14. Controversial neuroendoscopic Monro foraminoplasty in the management of isolated lateral ventricle in an adult

    Directory of Open Access Journals (Sweden)

    Max O. Krucoff

    2015-06-01

    Full Text Available This report describes the clinical presentation, differential diagnosis, imaging characteristics, and current literature regarding the minimally invasive neuroendoscopic treatment of a rare condition: idiopathic unilateral hydrocephalus presenting late in adulthood. This paper also addresses the current controversy regarding septum pellucidotomy and/or Monro foraminoplasty as mono- or dual therapies for UH. A 63 year old African American female presented with headaches, blurry vision, and gait instability for six months. She was referred for neurosurgical consultation after an MRI demonstrated enlargement of the right lateral ventricle with left septal deviation. The patient underwent endoscopic transventricular fenestration of an idiopathic membrane occluding the foramen of Monro, as well as foraminoplasty of the foramen of Monro and septum pellucidotomy. Postoperatively the patient had transient difficulty with short term recall that improved rapidly, and she was discharged home on postoperative day 2. Follow-up one month later demonstrated complete resolution of her headache, blurry vision, and imbalance, as well as continued improvement of her memory. At six months, she had durable resolution of hydrocephalus and no short term memory complaints.

  15. Morphological study of surgical approach by superior temporal sulcus-temporal horn of lateral ventricle approach using volume rendering.

    Science.gov (United States)

    Sun, Wei; Jia, Linpei; Dong, Yidian; Zhao, Hang; Liu, Haoyuan; Yang, Kerong; Li, Youqiong

    2014-03-01

    In this research, we acquired the length of the superior temporal sulcus, the shortest distance from the superior temporal sulcus to the temporal horn of the lateral ventricle, and the approach angle between the median sagittal plane and the shortest segment from the superior temporal sulcus to the temporal horn of the lateral ventricle measuring 98 specimens by magnetic resonance imaging volume rendering. At the same time, we preliminarily oriented the point of the superior temporal sulcus, which is closest to the temporal horn of the lateral ventricle, aimed at finding out the best entrance point of surgical approach through the superior temporal sulcus to the temporal horn of the lateral ventricle and reducing the damage to optic radiation as well as other nerve fibers during the operation. The results indicate that the point at the front side 3/5 of the superior temporal sulcus may be the ideal surgical approach entrance point, and there is no difference between 2 cerebral hemispheres (P < 0.05).

  16. Estimation of the Lateral Ventricles Volumes from a 2D Image and Its Relationship with Cerebrospinal Fluid Flow

    Directory of Open Access Journals (Sweden)

    Chaarani Bader

    2013-01-01

    Full Text Available Purpose. This work suggests a fast estimation method of the lateral ventricles volume from a 2D image and then determines if this volume is correlated with the cerebrospinal fluid flow at the aqueductal and cerebral levels in neurodegenerative diseases. Materials and Methods. FForty-five elderly patients suffering from Alzheimer’s disease (19, normal pressure hydrocephalus (13, and vascular dementia (13 were involved and underwent anatomical and phase contrast MRI scans. Lateral ventricles and stroke volumes were assessed on anatomical and phase contrast scans, respectively. A common reference plane was used to calculate the lateral ventricles’ area on 2D images. Results. The largest volumes were observed in hydrocephalus patients. The linear regression between volumes and areas was computed, and a strong positive correlation was detected (R2=0.9. A derived equation was determined to represent the volumes for any given area. On the other hand, no significant correlations were detected between ventricles and stroke volumes (R2≤0.15. Conclusion. Lateral ventricles volumes are significantly proportional to the 2D reference section area and could be used for patients’ follow-up even if 3D images are unavailable. The cerebrospinal fluid fluctuations in brain disorders may depend on many physiological parameters other than the ventricular morphology.

  17. Preterm neonatal lateral ventricle volume from three-dimensional ultrasound is not strongly correlated to two-dimensional ultrasound measurements.

    Science.gov (United States)

    Kishimoto, Jessica; de Ribaupierre, Sandrine; Salehi, Fateme; Romano, Walter; Lee, David S C; Fenster, Aaron

    2016-10-01

    The aim of this study is to compare longitudinal two-dimensional (2-D) and three-dimensional (3-D) ultrasound (US) estimates of ventricle size in preterm neonates with posthemorrhagic ventricular dilatation (PHVD) using quantitative measurements of the lateral ventricles. Cranial 2-D US and 3-D US images were acquired from neonatal patients with diagnosed PHVD within 10 min of each other one to two times per week and analyzed offline. Ventricle index, anterior horn width, third ventricle width, and thalamo-occipital distance were measured on the 2-D images and ventricle volume (VV) was measured from 3-D US images. Changes in the measurements between successive image sets were also recorded. No strong correlations were found between VV and 2-D US measurements ([Formula: see text] between 0.69 and 0.36). Additionally, weak correlations were found between changes in 2-D US measurements and 3-D US VV ([Formula: see text] between 0.13 and 0.02). A trend was found between increasing 2-D US measurements and 3-D US-based VV, but this was not the case when comparing changes between 3-D US VV and 2-D US measurements. If 3-D US-based VV provides a more accurate estimate of ventricle size than 2-D US measurements, moderate-weak correlations with 3-D US suggest that monitoring preterm patients with PHVD using 2-D US measurements alone might not accurately represent whether the ventricles are progressively dilating. A volumetric measure (3-D US or MRI) could be used instead to more accurately represent changes.

  18. Lateral Ventricle Volume Asymmetry Predicts Midline Shift in Severe Traumatic Brain Injury

    Science.gov (United States)

    Schmalfuss, Ilona; Heaton, Shelley C.; Gabrielli, Andrea; Hannay, H. Julia; Papa, Linda; Brophy, Gretchen M.; Wang, Kevin K.W.; Büki, András; Schwarcz, Attila; Hayes, Ronald L.; Robertson, Claudia S.; Robicsek, Steven A.

    2015-01-01

    Abstract Midline shift following severe traumatic brain injury (sTBI) detected on computed tomography (CT) scans is an established predictor of poor outcome. We hypothesized that lateral ventricular volume (LVV) asymmetry is an earlier sign of developing asymmetric intracranial pathology than midline shift. This retrospective analysis was performed on data from 84 adults with blunt sTBI requiring a ventriculostomy who presented to a Level I trauma center. Seventy-six patients underwent serial CTs within 3 h and an average of three scans within the first 10 d of sTBI. Left and right LVVs were quantified by computer-assisted manual volumetric measurements. LVV ratios (LVR) were determined on the admission CT to evaluate ventricular asymmetry. The relationship between the admission LVR value and subsequent midline shift development was tested using receiver operating characteristic (ROC) analysis, and odds ratio (OR) and relative risk tests. Sixty patients had no >5 mm midline shift on the initial admission scan. Of these, 15 patients developed it subsequently (16 patients already had >5 mm midline shift on admission scans). For >5 mm midline shift development, admission LVR of >1.67 was shown to have a sensitivity of 73.3% and a specificity of 73.3% (area under the curve=0.782; p1.67 as exposure yielded an OR of 7.56 (p<0.01), and a risk ratio of 4.42 (p<0.01) for midline shift development as unfavorable outcome. We propose that LVR captures LVV asymmetry and is not only related to, but also predicts the development of midline shift already at admission CT examination. Lateral ventricles may have a higher “compliance” than midline structures to developing asymmetric brain pathology. LVR analysis is simple, rapidly accomplished and may allow earlier interventions to attenuate midline shift and potentially improve ultimate outcomes. PMID:25752227

  19. Lateral Ventricle Volume Asymmetry Predicts Midline Shift in Severe Traumatic Brain Injury.

    Science.gov (United States)

    Tóth, Arnold; Schmalfuss, Ilona; Heaton, Shelley C; Gabrielli, Andrea; Hannay, H Julia; Papa, Linda; Brophy, Gretchen M; Wang, Kevin K W; Büki, András; Schwarcz, Attila; Hayes, Ronald L; Robertson, Claudia S; Robicsek, Steven A

    2015-09-01

    Midline shift following severe traumatic brain injury (sTBI) detected on computed tomography (CT) scans is an established predictor of poor outcome. We hypothesized that lateral ventricular volume (LVV) asymmetry is an earlier sign of developing asymmetric intracranial pathology than midline shift. This retrospective analysis was performed on data from 84 adults with blunt sTBI requiring a ventriculostomy who presented to a Level I trauma center. Seventy-six patients underwent serial CTs within 3 h and an average of three scans within the first 10 d of sTBI. Left and right LVVs were quantified by computer-assisted manual volumetric measurements. LVV ratios (LVR) were determined on the admission CT to evaluate ventricular asymmetry. The relationship between the admission LVR value and subsequent midline shift development was tested using receiver operating characteristic (ROC) analysis, and odds ratio (OR) and relative risk tests. Sixty patients had no >5 mm midline shift on the initial admission scan. Of these, 15 patients developed it subsequently (16 patients already had >5 mm midline shift on admission scans). For >5 mm midline shift development, admission LVR of >1.67 was shown to have a sensitivity of 73.3% and a specificity of 73.3% (area under the curve=0.782; p1.67 as exposure yielded an OR of 7.56 (pasymmetry and is not only related to, but also predicts the development of midline shift already at admission CT examination. Lateral ventricles may have a higher "compliance" than midline structures to developing asymmetric brain pathology. LVR analysis is simple, rapidly accomplished and may allow earlier interventions to attenuate midline shift and potentially improve ultimate outcomes.

  20. Pleomorphic xanthoastrocytoma in the lateral ventricle with extensive subarachnoid dissemination: report of a case and review of the literature

    Institute of Scientific and Technical Information of China (English)

    YANG Wan-qun; HUANG Biao; LIANG Chang-hong

    2012-01-01

    Pleomorphic xanthoastrocytoma (PXA) is a rare benign tumor that is usually located in the superficial cerebral hemisphere.Most reports of PXAs have included only a single case or small series.Therefore,the data with respect to the natural history of this tumor are fragmentary.We report a case of a PXA in the unusual location of the right lateral ventricle with extensive subarachnoid dissemination.To our knowledge,this is a rare case of PXA in the lateral ventricle.In addition,extensive subarachnoid space dissemination of this distinctly benign type of glioma is exceedingly rare.In our case,there was meningeal dissemination and metastases to the bilateral trigeminal nerves and oculomotor nerves.The neuroradiographic features,tumor location,and dissemination were reviewed.

  1. Prevalence of lateral ventricle asymmetry in brain MRI studies of neurologically normal dogs and dogs with idiopathic epilepsy.

    Science.gov (United States)

    Pivetta, Mauro; De Risio, Luisa; Newton, Richard; Dennis, Ruth

    2013-01-01

    Asymmetry of the cerebral lateral ventricles is a common finding in cross-sectional imaging of otherwise normal canine brains and has been assumed to be incidental. The purpose of this retrospective study was to compare the prevalence of ventricular asymmetry in brain MRI studies of normal dogs and dogs with idiopathic epilepsy. Brain MRI archives were searched for 100 neurologically normal dogs (Group 1) and 100 dogs with idiopathic epilepsy (Group 2). For each dog, asymmetry of the lateral ventricles was subjectively classified as absent, mild, moderate, and severe based on a consensus of two observers who were unaware of group status. Ventricular areas were measured from transverse T1W images at the level of the interthalamic adhesion. An asymmetry ratio was calculated as the ratio of the larger to smaller ventricular transverse area. There was excellent agreement between subjective assessments of ventricular asymmetry and quantitative assessments using asymmetry ratios (k = 0.995). The prevalence of asymmetry was 38% in Group 1 dogs and 44% in Group 2 dogs. Assymmetry was scored as mild in the majority of Group 2 dogs. There was no significant association between presence/absence and degree of ventricular asymmetry vs. dog group, age, gender, or skull conformation. Findings from the current study supported previously published assumptions that asymmetry of the lateral cerebral ventricles is an incidental finding in MRI studies of the canine brain.

  2. Therapeutic effect of human amniotic epithelial cell transplantation into the lateral ventricle of hemiparkinsonian rats

    Institute of Scientific and Technical Information of China (English)

    YANG Xin-xin; XUE Shou-ru; DONG Wan-li; Kong Yan

    2009-01-01

    Background Human amniotic epithelial cells (HAECs) are able to secrete biologically active neurotrophins such as brain-derived neurotrophic factor and neurotrophin-3, both of which exhibit trophic activities on dopamine neurons.Previous study showed that when human amniotic epithelial cells were transplanted into the striatum of 6-hydroxydopamine (6-OHDA)-induced Parkinson disease rats, the cells could survive and exert functional effects. The purpose of this study was to investigate the survival and the differentiation of human amniotic epithelial cells after being transplanted into the lateral ventricle of Parkinson's disease (PD) rats, and to investigate the effects of grafts on healing PD in models.Methods The Parkinson's model was made with stereotactic microinjection of 6-hydroxydopamine (6-OHDA) into the striatum of a rat. The PD models were divided into two groups: the HAECs group and the normal saline (NS) group.Some untreated rats were taken as the control. The rotational asymmetry induced by apomorphine of the HAECs group and the NS group were measured post cell transplantation. The expression of nestin and vimentin in grafts were determined by immunohistology. Ten weeks after transplantation the density of tyrosine hydroxylase positive cells in the substantia nigra of the HAECs group, NS group and the untreated group was determined. The differentiation of grafts was determined by TH immunohistology. High performance liquid chromatography (HPLC) was used to determine monoamine neurotransmitter levels in the striatum.Results The rotational asymmetry induced by apomorphine of the HAECs group was ameliorated significantly compared to the NS group two weeks after transplantation (P <0.01). The grafts expressed nestin and vimentin five weeks after transplantation. TH immunohistochemistry indicated that the TH positive cells in the substantia nigra of the HAECs group increased significantly compared to the NS group (P<0.01). Tyrosine hydroxylase (TH) positive

  3. Injecting erythropoietin into lateral ventricle and abdominal subcutaneous tissue improves the learning and memory ability of rats with vascular dementia

    Institute of Scientific and Technical Information of China (English)

    Shuqi Huang; Fuyuan Shao

    2006-01-01

    BACKGROUND: It is found in recent studies that erythropoietin (EPO) has protective effect on ischemic/hypoxic injury in central nervous system (CNS). Most of neuroprotective studies of EPO are aimed at nerve cells cultured in vitro, and whether or not EPO can improve cognitive function of rats with vascular dementia (VaD) induced by ischemic and hypoxic injury is still unclear.OBJECTIVE: To observe the effect of injecting EPO into lateral ventricle and abdominal subcutaneous tissue on learning and memory ability of rats with VaD.DESIGN: Randomized and controlled experiment.SETTING: Department of Neurology, Changzheng Hospital, Second Military Medical University of Chinese PLA.MATERIALS: Eight-six Wistar rats, aged > 16 months, weighing (300±41) g, of either gender, were provided by the Experimental Animal Center of the Second Military Medical University of Chinese PLA. Y-maze (type MG-3)was purchased from Zhangjiagang Biomedical Instrument Factory. EPO was produced by Shenyang Sunshine Pharmaceutical Co., Ltd. (No. S19980074).METHODS: This experiment was carried out in the laboratory of Department of Neurology, Changzheng Hospital, Second Military Medical University of Chinese PLA between July 2003 and December 2005. Animal models of VaD were developed by the method of permanent ligation of bilateral common carotid artery.Eighty-six rats were randomly divided into 4 groups: ① Sham-operation group (n =18): Bilateral common carotid artery was isolated. Suture was buried without ligation. ② Model group (n =21): Rat models of vascular dementia were developed. ③Lateral cerebral ventricle injection group (n =26): Following a cannula was buried in lateral cerebral ventricle for one week, rat models of vascular dementia were developed and injected with 200 U/kg recombinant human EPO (rhEPO) via lateral cerebral ventricle, 3 times a week. ④ Intraperitoneal injection group (n =21 ): After rat models of VaD were developed, they were intraperitoneally injected with

  4. Expansion of the lateral ventricles and ependymal deficits underlie the hydrocephalus evident in mice lacking the transcription factor NFIX.

    Science.gov (United States)

    Vidovic, Diana; Harris, Lachlan; Harvey, Tracey J; Evelyn Heng, Yee Hsieh; Smith, Aaron G; Osinski, Jason; Hughes, James; Thomas, Paul; Gronostajski, Richard M; Bailey, Timothy L; Piper, Michael

    2015-08-01

    Nuclear factor one X (NFIX) has been shown to play a pivotal role during the development of many regions of the brain, including the neocortex, the hippocampus and the cerebellum. Mechanistically, NFIX has been shown to promote neural stem cell differentiation through the activation of astrocyte-specific genes and via the repression of genes central to progenitor cell self-renewal. Interestingly, mice lacking Nfix also exhibit other phenotypes with respect to development of the central nervous system, and whose underlying causes have yet to be determined. Here we examine one of the phenotypes displayed by Nfix(-/-) mice, namely hydrocephalus. Through the examination of embryonic and postnatal Nfix(-/-) mice we reveal that hydrocephalus is first seen at around postnatal day (P) 10 in mice lacking Nfix, and is fully penetrant by P20. Furthermore, we examined the subcommissural organ (SCO), the Sylvian aqueduct and the ependymal layer of the lateral ventricles, regions that when malformed and functionally perturbed have previously been implicated in the development of hydrocephalus. SOX3 is a factor known to regulate SCO development. Although we revealed that NFIX could repress Sox3-promoter-driven transcriptional activity in vitro, SOX3 expression within the SCO was normal within Nfix(-/-) mice, and Nfix mutant mice showed no abnormalities in the structure or function of the SCO. Moreover, these mutant mice exhibited no overt blockage of the Sylvian aqueduct. However, the ependymal layer of the lateral ventricles was frequently absent in Nfix(-/-) mice, suggesting that this phenotype may underlie the development of hydrocephalus within these knockout mice.

  5. Choroidal OCT

    Science.gov (United States)

    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.

  6. [Lymphocytic primary angiitis of the central nervous system with fan-shaped linear enhancement converging to the lateral ventricles: a case report].

    Science.gov (United States)

    Okunomiya, Taro; Kageyama, Takashi; Tanaka, Kanta; Kambe, Daisuke; Shinde, Akiyo; Suenaga, Toshihiko

    2014-01-01

    We report a case of lymphocytic primary angiitis of the central nervous system (PACNS) with a characteristic gadolinium-enhancement pattern on magnetic resonance imaging (MRI). A 48-year-old, right-handed man presented with a 3-month history of tremor and progressing dementia. Neurologic examination revealed cognitive decline with anterograde amnesia and postural tremor of the fingers. Except for the positive result of serum antinuclear antibody, intense investigations for infectious, rheumatic and neoplastic diseases were negative. Analysis of cerebrospinal fluid showed mild pleocytosis (14 cells/μl). Brain MRI revealed diffuse hyperintense areas in the deep cerebral white matter on T2-weighted images. Gadolinium-enhanced T1-weighted images demonstrated fan-shaped multiple linear enhancements converging to the body of the lateral ventricles. Brain biopsy showed intense infiltration of small lymphocytes without atypia or granuloma mainly within the vessel walls and perivascular spaces. The diagnosis of lymphocytic PACNS was made. Administration of corticosteroid markedly improved the tremor and cognitive dysfunction. MRI after the treatment showed resolution of the abnormal fan-shaped linear enhancement. He returned to his previous occupation. PACNS should be included in the differential diagnosis for fan-shaped linear enhancement converging to the lateral ventricles on MRI in patients with unexplained progressing dementia.

  7. Hydrocephalus-lateral ventricle peritoneal shunt therapy clinical analysis%侧脑室-腹腔分流术治疗脑积水临床分析

    Institute of Scientific and Technical Information of China (English)

    赵德彬

    2013-01-01

      目的分析对脑积水患者行侧脑室-腹腔分流术治疗的效果。方法回顾分析112例脑积水患者采用侧脑室-腹腔分流手术进行治疗临床资料。结果术后复查,其中102例脑积水症状完全缓解,占91.1%。对术后正常出院108例进行随访,时间在6~12个月,平均(8.0±1.1)个月;24例轻型脑积水症状完全缓解;在74例中、重型脑积水患者中,4例患者由于原发病而死亡、6例重型患者缓解症状不明显;在14例极重型脑积水患者中,4例症状无明显缓解。结论对脑积水患者行侧脑室-腹腔分流术治疗,时间越早效果越好,术后有效改善了患者症状,值得推广。%objective to analyze patients with hydrocephalus line-lateral ventricle peritoneal shunt surgery effect. Methods retrospective analysis 112 cases of patients with hydrocephalus-lateral ventricle peritoneal shunt surgery for treatment of clinical data. Results postoperative review, of which 102 cases with hydrocephalus symptomatic palliation was complete, accounted for 91.1%. Time to normal hospital, 108 cases of postoperative follow-up, in 6 ~ 12 months, the average (8.0+1.1) months;24 cases of light hydrocephalus symptomatic palliation was complete;And heavy hydrocephalus in 74 cases of patients, 4 patients died due to the primary disease, 6 cases of severe patients relieve symptoms not obvious;In 14 cases of extremely heavy hydrocephalus patients, 4 cases have no obvious symptoms. Conclusion for hydrocephalus patients for the treatment of lateral ventricle peritoneal shunt, time the sooner the better the results, effectively improve the postoperative symptoms, is worth promoting.

  8. Immunoreactivity for GABA, GAD65, GAD67 and Bestrophin-1 in the meninges and the choroid plexus: implications for non-neuronal sources for GABA in the developing mouse brain.

    Directory of Open Access Journals (Sweden)

    Shiro Tochitani

    Full Text Available Neural progenitors in the developing neocortex, neuroepithelial cells and radial glial cells, have a bipolar shape with a basal process contacting the basal membrane of the meninge and an apical plasma membrane facing the lateral ventricle, which the cerebrospinal fluid is filled with. Recent studies revealed that the meninges and the cerebrospinal fluid have certain roles to regulate brain development. γ-aminobutyric acid (GABA is a neurotransmitter which appears first during development and works as a diffusible factor to regulate the properties of neural progenitors. In this study, we examined whether GABA can be released from the meninges and the choroid plexus in the developing mouse brain. Immunohistochemical analyses showed that glutamic acid decarboxylase 65 and 67 (GAD65 and GAD67, both of which are GABA-synthesizing enzymes, are expressed in the meninges. The epithelial cells in the choroid plexus express GAD65. GABA immunoreactivity could be observed beneath the basal membrane of the meninge and in the epithelial cells of the choroid plexus. Expression analyses on Bestrophin-1, which is known as a GABA-permeable channel in differentiated glial cells, suggested that the cells in the meninges and the epithelial cells in the choroid plexus have the channels able to permeate non-synaptic GABA into the extracellular space. Further studies showed that GAD65/67-expressing meningeal cells appear in a manner with rostral to caudal and lateral to dorsal gradient to cover the entire neocortex by E14.5 during development, while the cells in the choroid plexus in the lateral ventricle start to express GAD65 on E11-E12, the time when the choroid plexus starts to develop in the developing brain. These results totally suggest that the meninges and the choroid plexus can work as non-neuronal sources for ambient GABA which can modulate the properties of neural progenitors during neocortical development.

  9. Immunoreactivity for GABA, GAD65, GAD67 and Bestrophin-1 in the meninges and the choroid plexus: implications for non-neuronal sources for GABA in the developing mouse brain.

    Science.gov (United States)

    Tochitani, Shiro; Kondo, Shigeaki

    2013-01-01

    Neural progenitors in the developing neocortex, neuroepithelial cells and radial glial cells, have a bipolar shape with a basal process contacting the basal membrane of the meninge and an apical plasma membrane facing the lateral ventricle, which the cerebrospinal fluid is filled with. Recent studies revealed that the meninges and the cerebrospinal fluid have certain roles to regulate brain development. γ-aminobutyric acid (GABA) is a neurotransmitter which appears first during development and works as a diffusible factor to regulate the properties of neural progenitors. In this study, we examined whether GABA can be released from the meninges and the choroid plexus in the developing mouse brain. Immunohistochemical analyses showed that glutamic acid decarboxylase 65 and 67 (GAD65 and GAD67), both of which are GABA-synthesizing enzymes, are expressed in the meninges. The epithelial cells in the choroid plexus express GAD65. GABA immunoreactivity could be observed beneath the basal membrane of the meninge and in the epithelial cells of the choroid plexus. Expression analyses on Bestrophin-1, which is known as a GABA-permeable channel in differentiated glial cells, suggested that the cells in the meninges and the epithelial cells in the choroid plexus have the channels able to permeate non-synaptic GABA into the extracellular space. Further studies showed that GAD65/67-expressing meningeal cells appear in a manner with rostral to caudal and lateral to dorsal gradient to cover the entire neocortex by E14.5 during development, while the cells in the choroid plexus in the lateral ventricle start to express GAD65 on E11-E12, the time when the choroid plexus starts to develop in the developing brain. These results totally suggest that the meninges and the choroid plexus can work as non-neuronal sources for ambient GABA which can modulate the properties of neural progenitors during neocortical development.

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

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    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

  11. Effects of injection of anti-corticotropin release hormone serum in the lateral ventricles and electroacupuncture analgesia on pain threshold in rats with adjuvant arthritis

    Institute of Scientific and Technical Information of China (English)

    Yunying Qiao; Fudong Wu; Jian Wang; Xiaolu Cui; Congcong Liu; Xinlong Zhu

    2012-01-01

    Rat models of adjuvant arthritis were established, and anti-corticotropin release hormone serum injection in the lateral ventricles and electroacupuncture at right Jiaji (EX-B2) were performed. The pain threshold was decreased at 45 and 60 minutes after injection of the anti-corticotropin release hormone serum. Electroacupuncture at Jiaji can resist this effect. Immunohistochemical staining results showed that the expression of corticotropin release hormone in the hypothalamic paraven-tricular nucleus was greater in the electroacupuncture + anti-corticotropin release hormone serum group compared with the anti-corticotropin release hormone serum group. The expression of corti-cotropin release hormone was correlated with the pain threshold. The effect of endogenous corti-cotropin release hormone in pain modulation can be obstructed by anti-corticotropin release hor-mone serum. The analgesia of electroacupuncture can partially resist the depressed pain threshold caused by injection of anti-corticotropin release hormone serum. The analgesic effect of elec-troacupuncture is associated with the corticotropin release hormone content in the hypothalamus.

  12. Acute triventricular hydrocephalus caused by choroid plexus cysts: a diagnostic and neurosurgical challenge.

    Science.gov (United States)

    Spennato, Pietro; Chiaramonte, Carmela; Cicala, Domenico; Donofrio, Vittoria; Barbarisi, Manlio; Nastro, Anna; Mirone, Giuseppe; Trischitta, Vincenzo; Cinalli, Giuseppe

    2016-11-01

    OBJECTIVE Intraventricular choroid plexus cysts are unusual causes of acute hydrocephalus in children. Radiological diagnosis of intraventricular choroid plexus cysts is difficult because they have very thin walls and fluid contents similar to CSF and can go undetected on routine CT studies. METHODS This study reports the authors' experience with 5 patients affected by intraventricular cysts originating from the choroid plexus. All patients experienced acute presentation with rapid neurological deterioration, sometimes associated with hypothalamic dysfunction, and required urgent surgery. In 2 cases the symptoms were intermittent, with spontaneous remission and sudden clinical deteriorations, reflecting an intermittent obstruction of the CSF pathway. RESULTS Radiological diagnosis was difficult in these cases because a nonenhanced CT scan revealed only triventricular hydrocephalus, with slight lateral ventricle asymmetry in all cases. MRI with driven-equilibrium sequences and CT ventriculography (in 1 case) allowed the authors to accurately diagnose the intraventricular cysts that typically occupied the posterior part of the third ventricle, occluding the aqueduct and at least 1 foramen of Monro. The patients were managed by urgent implantation of an external ventricular drain in 1 case (followed by endoscopic surgery, after completing a diagnostic workup) and by urgent endoscopic surgery in 4 cases. Endoscopic surgery allowed the shrinkage and near-complete removal of the cysts in all cases. Use of neuronavigation and a laser were indispensable. All procedures were uneventful, resulting in restoration of normal neurological conditions. Long-term follow-up (> 2 years) was available for 2 patients, and no complications or recurrences occurred. CONCLUSIONS This case series emphasizes the necessity of an accurate and precise identification of the possible causes of triventricular hydrocephalus. Endoscopic surgery can be considered the ideal treatment of choroid plexus

  13. De novo Evolution of a Small Choroidal Melanoma

    Science.gov (United States)

    Aleksidze, Nino; Medina, Carlos A.; Singh, Arun D.

    2015-01-01

    Aim To report the evolution of a de novo choroidal melanoma. Method This is a case report of a 22-year-old white male patient who has been undergoing periodic examination for a choroidal ‘freckle’ since 10 years of age. Results In 2007, a fundus photograph of the left eye showed a nondescript area of choroidal hyperpigmentation temporal to the fovea. Progressive growth was observed and, by 2012, the lesion had become well circumscribed and raised. One year later, a 4.5 × 4.5 × 1.5 mm, dome-shaped, pigmented, choroidal mass with subretinal fluid and orange pigmentation was evident. The lesion was classified as a small choroidal melanoma. Six months after plaque radiotherapy, tumor regression with total resolution of the subretinal fluid was documented. Conclusion The distinction between small choroidal melanoma and choroidal nevus is not absolute; therefore, some choroidal melanomas may initially be mislabeled as choroidal nevi because of their small size until continued growth identifies them to be small choroidal melanomas. In our case, the documented growth of the choroidal lesion on each consecutive visit and its high-risk features strongly suggest that it had been a melanoma from the beginning. To our knowledge, this is only the second documented case of a de novo evolution of a small choroidal melanoma. PMID:27231689

  14. Isolation of locally derived stem/progenitor cells from the peri-infarct area that do not migrate from the lateral ventricle after cortical stroke.

    Science.gov (United States)

    Shimada, Issei S; Peterson, Brittni M; Spees, Jeffrey L

    2010-09-01

    Neurogenesis can arise from neural stem/progenitor cells of the subventricular zone after strokes involving both the cortex and striatum. However, it is controversial whether all types of stroke and strokes of different sizes activate neurogenesis from the subventricular zone niche. In contrast with cortical/striatal strokes, repair and remodeling after mild cortical strokes may involve to a greater extent local cortical stem/progenitor cells and cells from nonneurogenic niches. We compared stem/progenitor cell responses after focal cortical strokes produced by distal middle cerebral artery occlusion and cortical/striatal strokes produced by the intraluminal suture model. To label migrating neuroblasts from the subventricular zone, we injected DiI to the lateral ventricle after distal middle cerebral artery occlusion. By immunohistochemistry, we characterized cells expressing stem/progenitor cell markers in the peri-infarct area. We isolated cortical stem/progenitor cells from the peri-infarct area after distal middle cerebral artery occlusion and assayed their self-renewal and differentiation capacity. In contrast with cortical/striatal strokes, focal cortical strokes did not induce neuroblast migration from the subventricular zone to the infarct zone after distal middle cerebral artery occlusion. By immunohistochemistry, we observed subpopulations of reactive astrocytes in the peri-infarct area that coexpressed radial glial cell markers such as Sox2, Nestin, and RC2. Clonal neural spheres isolated from the peri-infarct area after distal middle cerebral artery occlusion differentiated into neurons, astrocytes, oligodendrocytes, and smooth muscle cells. Notably, neural spheres isolated from the peri-infarct area also expressed RC2 before differentiation. Mild cortical strokes that do not penetrate the striatum activate local cortical stem/progenitor cells but do not induce neuroblast migration from the subventricular zone niche.

  15. Z-score-based semi-quantitative analysis of the volume of the temporal horn of the lateral ventricle on brain CT images.

    Science.gov (United States)

    Takahashi, Noriyuki; Kinoshita, Toshibumi; Ohmura, Tomomi; Lee, Yongbum; Matsuyama, Eri; Toyoshima, Hideto; Tsai, Du-Yih

    2016-01-01

    The volume of the temporal horn of the lateral ventricle (THLV) on brain computed tomography (CT) images is important for neurologic diagnosis. Our purpose in this study was to develop a z-score-based semi-quantitative analysis for estimation of the THLV volume by using voxel-based morphometry. The THLV volume was estimated by use of a z-score mapping method that consisted of four main steps: anatomic standardization, construction of a normal reference database, calculation of the z score, and calculation of the mean z score in a volume of interest (VOI). A mean z score of the CT value obtained from a VOI around the THLV was used as an index for the THLV volume. CT scans from 50 subjects were evaluated. For evaluation of the accuracy of this method for estimating the THLV volume, the THLV volume was determined manually by neuroradiologists (serving as the reference volume). A mean z score was calculated from the VOI for each THLV of the 50 subjects by use of the proposed method. The accuracy of this method was evaluated by use of the relationship between the mean z score and the reference volume. The quadratic polynomial regression equation demonstrated a statistically significant correlation between the mean z score and the reference volume of the THLV (R (2) = 0.94; P z score captured the reference volume of the THLV. The z-score-based semi-quantitative analysis has the potential quantitatively to estimate the THLV volume on CT images.

  16. Choroidal osteoma with choroidal neovascular membrane: Successful treatment with intravitreal bevacizumab

    Directory of Open Access Journals (Sweden)

    Neeraj Pandey

    2010-09-01

    Full Text Available Neeraj Pandey, Ayachit GuruprasadMM Joshi Eye Institute, Hubli, Karnataka, IndiaAbstract: An otherwise healthy 27-year-old woman presented with complaints of sudden painless blurred vision in the right eye for one week. On examination, visual acuity was 20/30 in the right eye and 20/20 in left eye. Fundus examination OS was normal, but OD demonstrated an elevated, opaque, yellowish parapapillary choroidal lesion with grayish membrane associated with minimal subretinal fluid, suggestive of a choroidal neovascular membrane in the center. B-scan ultrasonography revealed findings consistent with a choroidal osteoma. Fundus fluorescein angiography of the right eye revealed a relatively well defined area of hyperfluorescence that increased in size and intensity in the later phases, suggestive of active extrafoveal choroidal neovascular membrane. Optical coherence tomography confirmed the extrafoveal choroidal neovascular membrane with subfoveal fluid. She was treated with intravitreal bevacizumab OD. At the two-week visit, vision OD improved to 20/20. Fluorescein angiography and optical coherence tomography revealed a resolved choroidal neovascular membrane. Intravitreal bevacizumab may be an effective alternative in the management of choroidal neovascular membrane secondary to choroidal osteoma.Keywords: osteoma, choroidal neovascular membrane, optical coherence tomography, bevacizumab

  17. The value of diagnosis of ultrasound with the width of the lateral ventricles 6-10mm%超声对侧脑室宽度6~10mm胎儿的诊断价值研究

    Institute of Scientific and Technical Information of China (English)

    李帆; 吴丹

    2014-01-01

    Objective To investigate the clinical significance of of ultrasound with the width of the lateral ventricles 6-10mm.Methods Pregnant women with 20 to 24 weeks of pregnancy were checked by ultrasound and the clinical data of varying degrees of lateral ventricle of the fetus was analyzed. Results 112 subjects were found ventriculomegaly 11-15mm(2.97%); 73 subjects were found ventriculomegaly 6-10mm(1.94%). After about 10 weeks of follow-up, side lateral ventricle mildly group improved better than that of the critical group(P<0.05); abortion rates of the side lateral ventricle mildly widened group and side lateral ventricle critically group was significantly higher than that of the control group(P<0.05). When the lateral ventricle width was 10.03mm, the sensitivity was 80.006% and a specificity was 86.976%.Conclusion The side lateral ventricle critically has a greater risk of abnormity, clinical and family members should be highly valued.%目的:探讨B超诊断胎儿临界侧脑室增宽的临床意义。方法采用B超对妊娠20~24周的孕妇进行检查,回顾分析不同程度侧脑室增宽的的胎儿及其母亲的临床资料,比较妊娠相关的结局。结果本研究共发现112例胎儿侧脑室增宽11~15mm(2.97%);73例胎儿侧脑室在6~10mm,为临界侧脑扩张(1.94%);经过约10周的随访,轻度侧脑室增宽组改善优于临界侧脑室增宽组(P<0.05);轻度侧脑室增宽组、临界侧脑室增宽组的引产率及新生儿异常率均明显高于正常组(P<0.05),侧脑室宽度=10.03mm时,灵敏度为80.006%,特异度为86.976%。结论临界值侧脑室增宽胎儿相对于正常组胎儿仍然存在较大的异常风险,临床上及家属应予以高度重视。

  18. The Treatment Experience of Hydrocephalus Patients with Lateral Ventricle-Peritoneal Shunt%脑积水患者侧脑室-腹腔分流术治疗体会

    Institute of Scientific and Technical Information of China (English)

    杜海军

    2014-01-01

    Objective The treatment effect of hydrocephalus patients with lateral ventricle-peritoneal shunt to be investigated.Methods Making an analysis of treatment data selected from 23 cases of hydrocephalus patients with lateral ventricle-peritoneal shunt.Results With being treated,there are 20 cases of patients having recovered the ventricle shape,and 3 cases of patients are ventricle shape.And with 6 months to a year folowing-up observation,12 cases of patients have improved the health state to a great extent and 9 cases of patients show a sign of improvement,while,there are 2 cases are ineffective,and one case of patient gets inflammatory,but the patient gets better after being cured.ConclusionLateral ventricle-peritoneal shunt can be applied to the obstruction or communicating hydrocephalus caused by any reason.The surgical method is easy and simple;however,the complications of the ilness relapse easily which should be noticed.%目的:探讨脑积水患者脑室-腹腔分流术治疗方法效果。方法选取23例脑积水患者行侧脑室-腹腔分流术治疗方法资料进行分析。结果经治疗脑室形态恢复20例,脑室形态3例。随访6个月至1年,症状明显好转12例,好转9例,无效2例。感染1体,经治疗后好转。结论脑室-腹腔分流术适应证于对各种原因引起的梗阻性或交通性脑积水均适用。手术方法简单,术后易发生并发症,应引起注意。

  19. Choroidal neovascularization secondary to choroidal nevus simulating an inflammatory lesion

    Directory of Open Access Journals (Sweden)

    Samuray Tuncer

    2013-01-01

    Full Text Available Choroidal nevi are the most common benign pigmented lesions of the fundus. Choroidal neovascularization is a rare complication of choroidal nevi. We report herein a young patient managed successfully with intravitreal bevacizumab injections for juxtapapillary choroidal neovascularization secondary to choroidal nevus simulating an inflammatory lesion.

  20. The choroid in glaucoma.

    Science.gov (United States)

    Banitt, Michael

    2013-03-01

    Prior studies have not conclusively established a relationship between the choroid and glaucoma. The development of an enhanced imaging technique for spectral domain optical coherence tomography (SD-OCT) has allowed for measurements of choroidal thickness that are more accurate than previously possible. Therefore, the SD-OCT may be capable of documenting the changes in the choroid as they relate to glaucoma. When applied to the SD-OCT, the technique of enhanced depth imaging allows for reproducible measurements of choroidal thickness. Nine reports have been published about choroidal thickness within the macula, as measured by OCT, in eyes with glaucoma. In six publications, there was no significant difference between the macular choroidal thicknesses of patients with glaucoma compared with those without glaucoma. Additional five studies have reported on peripapillary choroidal thickness in glaucoma patients. Although three of the studies determined that the peripapillary choroid is thinner in glaucoma patients, two others failed to establish this relationship. The SD-OCT is capable of reproducibly measuring choroidal thickness in the peripapillary and macular areas. In those with glaucoma, choroidal thickness does not change within the macula. In a few subsets of glaucoma, the peripapillary choroid is thinner when compared with normals.

  1. 儿童脉络丛乳头状瘤的影像分析%The Image Analysis of Choroid Plexus Papillomas in Children

    Institute of Scientific and Technical Information of China (English)

    刘本刚

    2011-01-01

    Objective To explore the imaging features of choroid plexus papillomas in children so that it can be diagnosed and differentiated well. Methods The full clinical data and imaging features of 11 cases of choroid plexus papillomas in children were retrospectively reviewed. All cases were underwent by CT and 6 cases by MRI. All cases were confirmed by surgical pathology. Results In 11 cases, 3 cases of choroid plexus papillomas were found in the posterior horn of left lateral ventricle; 4 cases in the triangle of left lateral ventricle; 1 cases in the anterior horn of the left lateral ventricle;3 cases in the triangle of righe lateral ventricle. The tabulated or cauliflower-like and equidensity or high density could be seen on the images. The image strengthened obviously after being enhanced with different degree hydronephalus. Pointlike calcification coule be seen in 3 cases. Conclusion The typical imaging characteristics of choroid plexus papillomas in children was great useful for preoperative positional and qualitative diagnosis.%目的 探讨小儿脉络丛乳头状瘤的影像特点,旨在提高对其诊断及鉴别能力.方法 回顾性分析11例小儿脉络丛乳头状瘤病例的完整临床资料及影像特点,全部病例均经过C僧强检查,6例同时行MRI检查,均经随访手术病理证实.结果 11例病例中,发生于左侧侧脑室后角内3例、左侧侧脑室三角区4例、左侧侧脑室前角l例、右侧侧脑室三角区3例.影像表现呈分叶状或菜花样等密度或高密度;增强后明显强化,均伴有不同程度的脑积水,3例伴有点状钙化.结论 儿童脉络丛乳头状瘤的CT及MRI表现均有典型影像学特征,对术前定位、定性诊断有很大帮助.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. A study of ultrasound diagnosis in clinical prognosis of fetal lateral ventricle dilatation%超声诊断胎儿侧脑室扩张的临床预后研究

    Institute of Scientific and Technical Information of China (English)

    叶菀华; 徐婉芳; 林洋洋

    2015-01-01

    Objective To observe and investigate the clinical prognosis and significance of ultrasonic diagnosis in fetal lateral ventricle expansion.Methods 156 cases with lateral ventricle dilation in our hospital from July 2010 to September 2013 were randomly selected, and divided into a critical expansion group with 116 cases (lateral ventricle dilatation 8 to 10mm), mild dilatation group with 34 patients (11 to 15mm), severe dilatation group with 6 patients (>15mm, pregnant women with termination of pregnancy by automatic abortion); pregnant women of the mild dilation and critical group received the dynamic ultrasound fetal monitoring by the right person, the lateral ventricle size (narrow, stability, progress), note the fetus and abnormal conditions, until delivery were observe; and the relevant data was recorded, analyzed and studied.Results 55 cases (47.41%) in critical narrow expansion group was higher than that of progress one case (0.86%), while was lower than the control group(P<0.05); abortion rate of group critical expansion was 5.17% and the rate of neonatal abnormality was 9.48%, malformation rate was 3.45%, slightly lower than the expansion group(P<0.05).ConclusionUltrasound diagnostic and prognostic evaluation of fetal lateral ventricle dilation effect is significant, it is worth promoting.%目的:观察和研究超声诊断胎儿侧脑室扩张的临床预后与意义。方法于2010年7月~2013年9月在本院随机抽取156例侧脑室扩张患者,分为临界扩张组116例(侧脑室扩张8~10mm)、轻度扩张组34例(11~15mm)、重度扩张组6例(>15mm,重度扩张组孕妇自动引产终止妊娠),由专人负责对临界扩张组和轻度扩张组孕妇给予超声动态监测以观察胎儿侧脑室大小(缩小、稳定、进展)、注意胎儿及异常状况,直至分娩;同时记录相关数据加以分析与研究。结果临界扩张组缩小55例(47.41%),高于轻度扩张组,进展1例(0.86%

  4. THE MULTIFUNCTIONAL CHOROID

    Science.gov (United States)

    Nickla, Debora L.; Wallman, Josh

    2010-01-01

    The choroid of the eye is primarily a vascular structure supplying the outer retina. It has several unusual features: It contains large membrane-lined lacunae, which, at least in birds, function as part of the lymphatic drainage of the eye and which can change their volume dramatically, thereby changing the thickness of the choroid as much as four-fold over a few days (much less in primates). It contains non-vascular smooth muscle cells, especially behind the fovea, the contraction of which may thin the choroid, thereby opposing the thickening caused by expansion of the lacunae. It has intrinsic choroidal neurons, also mostly behind the central retina, which may control these muscles and may modulate choroidal blood-flow as well. These neurons receive sympathetic, parasympathetic and nitrergic innervation. The choroid has several functions: Its vasculature is the major supply for the outer retina; impairment of the flow of oxygen from choroid to retina may cause Age-Related Macular Degeneration. The choroidal blood flow, which is as great as in any other organ, may also cool and warm the retina. In addition to its vascular functions, the choroid contains secretory cells, probably involved in modulation of vascularization and in growth of the sclera. Finally, the dramatic changes in choroidal thickness move the retina forward and back, bringing the photoreceptors into the plane of focus, a function demonstrated by the thinning of the choroid that occurs when the focal plane is moved back by the wearing of negative lenses, and, conversely, by the thickening that occurs when positive lenses are worn. In addition to focusing the eye, more slowly than accommodation and more quickly than emmetropization, we argue that the choroidal thickness changes also are correlated with changes in the growth of the sclera, and hence of the eye. Because transient increases in choroidal thickness are followed by a prolonged decrease in synthesis of extracellular matrix molecules and a

  5. Double outlet right ventricle

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007328.htm Double outlet right ventricle To use the sharing features on this page, please enable JavaScript. Double outlet right ventricle (DORV) is a heart disease that is ...

  6. A “Pseudo-cavernoma” – an encapsulated Hematoma of the Choroid Plexus

    Science.gov (United States)

    Dey, Mahua; Turner, Michael S.; Pytel, Peter; Awad, Issam A.

    2011-01-01

    We present the first report of an intraventricular encapsulated hematoma, mimicking cavernous malformation on imaging and gross lesion appearance. A 47-year-old female on anticoagulation therapy for atrial fibrillation presented with left upper extremity apraxia, neglect, and mild gait imbalance. Her brain CT scan and MRI revealed multilobulated lesions involving the choroid plexus in the atria of both lateral ventricles. The intraoperative appearance was that of encapsulated mass, with blood clots at different stages of liquefaction and organization, all consistent with the gross appearance of a cavernous malformation. However, histopathologic examination demonstrated hematoma with components at different ages, and normal vessel infiltration without any hint of cavernous malformation histology, or underlying neoplasia. Encapsulated hematoma should be considered in the differential diagnosis of hemorrhagic intraventricular masses. PMID:21435884

  7. A "pseudo-cavernoma" - an encapsulated hematoma of the choroid plexus.

    Science.gov (United States)

    Dey, Mahua; Turner, Michael S; Pytel, Peter; Awad, Issam A

    2011-06-01

    We present the first report of an intraventricular encapsulated hematoma, mimicking cavernous malformation on imaging and gross lesion appearance. A 47-year-old female on anticoagulation therapy for atrial fibrillation presented with left upper extremity apraxia, neglect, and mild gait imbalance. Her brain CT scan and MRI revealed multilobulated lesions involving the choroid plexus in the atria of both lateral ventricles. The intraoperative appearance was that of encapsulated mass, with blood clots at different stages of liquefaction and organization, all consistent with the gross appearance of a cavernous malformation. However, histopathologic examination demonstrated hematoma with components at different ages, and normal vessel infiltration without any hint of cavernous malformation histology, or underlying neoplasia. Encapsulated hematoma should be considered in the differential diagnosis of hemorrhagic intraventricular masses.

  8. 侧脑室内胶质瘤与脑膜瘤的碰撞瘤一例并文献复习%Cocurrent meningioma after recurrent astrocytoma in the lateral ventricle: one case report of collision tumors and review of the literature

    Institute of Scientific and Technical Information of China (English)

    于金录; 曲丽梅; 许冰; 黄海燕

    2012-01-01

    Objective To report one case of a collision tumor composed of intraventricular meningioma and astrocytoma and explore the cause.Methods A 39 - year - old male patient previously underwent excision of astrocytoma in the triangle area of the lateral ventricle and had good postsurgery recovery.The astrocytoma recurred in situ 6 years after the surgery,and it was also complicated with another lesion. The pathological results confirmed a collision tumor composed of intraventricular malignant meningioma and glioma In addition to reporting this case,we also performed a literature review of collision tumors.Results The patient recovered well after surgery to treat the recurrence and was given radiotherapy after discharge.Based on this literature review,we proposed several hypotheses on the formation of collision tumors.Conclusions We conclude that one possible reason of the collision tumor formed between the intracranial meningioma and the astrocytoma was the recurrence of astrocytoma - induced malignancy of arachnoid cells in the choroid plexus.%目的 报告1例罕见的侧脑室内胶质瘤与脑膜瘤的碰撞瘤,并探讨其发生原因.方法 39岁男性,6年前曾行侧脑室内胶质瘤切除术;此次以头痛及头晕发病,MRI示胶质瘤原位复发,且同时合并另一占位性病变,予以手术切除.术后病理证实为胶质瘤与脑膜瘤的碰撞瘤;本文同时也对这种碰撞瘤进行文献复习.结果 术后患者恢复满意,并行伽玛刀放射治疗,随访1年时患者状态良好.本文在复习侧脑室内胶质瘤与脑膜瘤的碰撞瘤发生原因后,总结了几种假设.结论 复发的胶质瘤诱发脉络丛内的蛛网膜细胞恶性转化可能是导致脑膜瘤的原因,同时胶质瘤的刺激也可能诱导了脑膜瘤的生长.

  9. 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.

  10. Choroid plexus potassium cotransport: modulation by osmotic stress and external potassium.

    Science.gov (United States)

    Keep, R F; Xiang, J

    1995-06-01

    The choroid plexuses are involved in CSF secretion and CSF K homeostasis. This study examines the potential role of K cotransport in these two processes using isolated rat lateral ventricle choroid plexuses. Bumetanide-sensitive 86Rb influx and efflux were measured to assess the response of K cotransport to changes in media osmolality and K concentration. Alterations in osmolality had no effect on K uptake (in the presence or absence of bumetanide). However, the efflux rate constant for K was 0.29 +/- 0.02, 0.44 +/- 0.04, and 0.84 +/- 0.06 min-1 in 240, 300, and 424 mOsm/kg solutions, respectively (p brain shrinkage during hyperosmotic stress if the cotransporter is present on the apical membrane. The rate of bumetanide-sensitive efflux was unaffected by changes in external [K]. However, the rate of K uptake (measured on return to normal [K] media) was reduced gradually by exposure to low [K]. It was 21 +/- 1, 19 +/- 3, 13 +/- 2, and 6 +/- 1 nmol/mg/min after 0, 10, 30, and 60-min exposure to 1 mM K. Sixty minutes of exposure to 1 mM [K] abolished the bumetanide-sensitive K uptake present in plexuses exposed continually to normal media. This modulation of K cotransport by external [K] may be important in CSF K homeostasis by limiting K loss from the CSF if CSF [K] is low.

  11. 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.

  12. A visual description of the dissection of the cerebral surface vasculature and associated meninges and the choroid plexus from rat brain.

    Science.gov (United States)

    Bowyer, John F; Thomas, Monzy; Patterson, Tucker A; George, Nysia I; Runnells, Jeffrey A; Levi, Mark S

    2012-11-14

    This video presentation was created to show a method of harvesting the two most important highly vascular structures, not residing within the brain proper, that support forebrain function. They are the cerebral surface (superficial) vasculature along with associated meninges (MAV) and the choroid plexus which are necessary for cerebral blood flow and cerebrospinal fluid (CSF) homeostasis. The tissue harvested is suitable for biochemical and physiological analysis, and the MAV has been shown to be sensitive to damage produced by amphetamine and hyperthermia. As well, the major and minor cerebral vasculatures harvested in MAV are of potentially high interest when investigating concussive types of head trauma. The MAV dissected in this presentation consists of the pial and some of the arachnoid membrane (less dura) of the meninges and the major and minor cerebral surface vasculature. The choroid plexus dissected is the structure that resides in the lateral ventricles as described by Oldfield and McKinley. The methods used for harvesting these two tissues also facilitate the harvesting of regional cortical tissue devoid of meninges and larger cerebral surface vasculature, and is compatible with harvesting other brain tissues such as striatum, hypothalamus, hippocampus, etc. The dissection of the two tissues takes from 5 to 10 min total. The gene expression levels for the dissected MAV and choroid plexus, as shown and described in this presentation can be found at GSE23093 (MAV) and GSE29733 (choroid plexus) at the NCBI GEO repository. This data has been, and is being, used to help further understand the functioning of the MAV and choroid plexus and how neurotoxic events such as severe hyperthermia and AMPH adversely affect their function.

  13. The distribution of the anti-HIV drug, tenofovir (PMPA, into the brain, CSF and choroid plexuses

    Directory of Open Access Journals (Sweden)

    Gibbs Julie E

    2006-01-01

    Full Text Available Abstract Background Tenofovir disoproxil fumarate, a prodrug of the nucleotide reverse transcriptase inhibitor, tenofovir (9-[9(R-2-(phosphonomethoxypropyl]adenine; PMPA, was recently approved for use in the combination therapy of human immunodeficiency virus (HIV-1 infection. This study was undertaken to understand PMPA distribution to the virus sanctuary sites located in the brain, CSF and choroid plexuses and to clarify its possible role in reducing the neurological problems associated with HIV infection. Methods The methods used included an established bilateral carotid artery perfusion of [3H]PMPA and a vascular marker, D-[14C]mannitol, in anaesthetised guinea-pigs followed by scintillation counting, HPLC and capillary depletion analyses. Movement of [3H]PMPA into the brain, cisternal CSF and lateral ventricle choroid plexus was also examined in the absence and presence of additional anti-HIV drugs and a transport inhibitor. Control and test groups were compared by ANOVA or Student's t-test, as appropriate. Results The distribution of [3H]PMPA in the cerebrum, cerebellum, pituitary gland and cerebral capillary endothelial cells was not significantly different to that measured for D-[14C]mannitol. However, [3H]PMPA accumulation was significantly higher than that of D-[14C]mannitol in the choroid plexus and CSF. Further experiments revealed no cross-competition for transport of [3H]PMPA by probenecid, a non-specific inhibitor of organic anion transport, or the nucleoside reverse transcriptase inhibitors into any of the CNS regions studied. The octanol-saline partition coefficient measurement for [3H]PMPA was 0.0134 ± 0.00003, which is higher that the 0.002 ± 0.0004 measured for D-[14C]mannitol in an earlier study. Conclusion There is negligible transport of [3H]PMPA across the blood-brain barrier, but it can cross the blood-CSF barrier. This is a reflection of the differing physiological and functional characteristics of the blood

  14. Circumscribed choroidal hemangioma

    Directory of Open Access Journals (Sweden)

    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.

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

    DEFF Research Database (Denmark)

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

    1997-01-01

    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...

  16. 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

  17. [Claudio Galeno and the lateral ventricles].

    Science.gov (United States)

    Martínez, F; Decuadro-Sáenz, G

    2008-02-01

    Galen of Pergamon is considered one of the fathers of occidental medicine. Because of cultural and religious precepts at his time, many authors hypothesize that the anatomical concepts of Galen were derived from dissection of monkeys. In this paper, the authors analyzed the ventricular system, according to the anatomic and functional concepts described by Galen's early work. Knowing that his work was derived and or influenced from other preceding anatomists and physicians (specially Hipocrates of Cos), we present our investigation in two parts. In the first part, we present the influences of previous religious, philosophic, medical and anatomical theories over the galenic work. The "pregalenic era" can be divided in three periods: 1) the pretecnic era (ending in VI BC) in which the man have only a rudimentary knowledge of human anatomy, 2) the hellenistic science (from VI to III BC) and 3) the period comprised between III BC to Galenic period. In each of the three periods, we analyzed the neuroanatomic knowledge of the most important cultures.

  18. 3D真人侧脑室模型的设计与构建%Design and construction of a three-dimensional lateral ventricle model based on MRI data

    Institute of Scientific and Technical Information of China (English)

    杨治荣; 施巍; 沈晨; 郭智霖

    2012-01-01

    Objective To construct a three-dimensional (3D) anatomic model of the lateral ventricles for teaching microneurosurgical anatomy and clinical surgery planning. Methods The 3D model was constructed with a series of 176 MRIT2 head sections of a healthy male volunteer (36 years old) using software Matlab, Geomagic, Maya, etc. The 176 sections were subjected to management with software Matlab for image preprocessing and contour extracting; the acquired contours were subjected to software geomagic for 3D model constructing,3D-model and image connecting and other processings. Results The 3D model of the lateral ventricles and related structures were successfully constructed using more than 240,000 remodeled polygons, and the contour of the model consisted well with the images. The model had a even better visual effect after combining the 3D-model and image. The model could be viewed from any angle and could be rotated by 360 degrees in any plane using any structure as the focal point of rotation. Moreover, the model could be reduced or enlarged using the zoom function. Conclusion The constructed 3D model can be observed and studied repeatedly at any time, with no stress from surgery. The model may be used for interactive surgical exercises, paving a way for subsequent clinical practice.%目的 构建3D真人侧脑室解剖模型,用于显微神经解剖教学和临床手术计划.方法 以1例36岁健康成年志愿者176张头颅MRI T2加权二维断层图像图片为原始数据,联合应用Matlab、Geomagic和Maya等软件对原始图像进行预处理,轮廓线提取,三维重建形成3D模型,然后对模型和影像进行关联.结果 根据176张原始图像数据成功完成了人侧脑室三维模型的重建,计算证实模型轮廓线与原始图像边缘吻合较好,经过3D模型与MRI数据场关联后所得模型具有更好的视觉效果.所建模型可任意旋转、放缩,从各个角度观察.结论 成功构建的模型能够重复观察和研究

  19. Artificial Left Ventricle

    CERN Document Server

    Ranjbar, Saeed; Meybodi, Mahmood Emami

    2014-01-01

    This Artificial left ventricle is based on a simple conic assumption shape for left ventricle where its motion is made by attached compressed elastic tubes to its walls which are regarded to electrical points at each nodal .This compressed tubes are playing the role of myofibers in the myocardium of the left ventricle. These elastic tubes have helical shapes and are transacting on these helical bands dynamically. At this invention we give an algorithm of this artificial left ventricle construction that of course the effect of the blood flow in LV is observed with making beneficiary used of sensors to obtain this effecting, something like to lifegates problem. The main problem is to evaluate powers that are interacted between elastic body (left ventricle) and fluid (blood). The main goal of this invention is to show that artificial heart is not just a pump, but mechanical modeling of LV wall and its interaction with blood in it (blood movement modeling) can introduce an artificial heart closed to natural heart...

  20. Choroid plexus dysfunction impairs beta-amyloid clearance in a triple transgenic mouse model of Alzheimer’s disease

    Directory of Open Access Journals (Sweden)

    Ibrahim eGonzález Marrero

    2015-02-01

    Full Text Available Compromised secretory function of choroid plexus (CP and defective cerebrospinal fluid (CSF production, along with accumulation of beta-amyloid (Aβ peptides at the blood-CSF barrier (BCSFB, likely contribute to complications of Alzheimer’s disease (AD. The AD triple transgenic mouse model (3xTg-AD at 16 month-old mimics several critical hallmarks of the human disease. In brain, the 3xTg-AD progressively develops β-amyloid (Aβ plaques and neurofibrillary tangles with a temporal- and regional- specific profile resembling their development in human AD. Currently, little is known about transport and metabolic responses by CP to the disrupted homeostasis of CNS Aβ in AD. This study analyzed the effects of highly-expressed AD-linked human transgenes (APP, PS1 and tau on lateral ventricle CP function. Confocal imaging and immunohistochemistry revealed an increase in Aβ42 (but not Aβ40 in epithelial cytosol and in stroma surrounding choroidal capillaries; the buildup in insoluble Aβ42 may reflect insufficient clearance transport from CSF to blood. Still, there was increased expression, presumably compensatory, of the choroidal Aβ transporters: the low density lipoprotein receptor-related protein 1 (LRP1 and the receptor for advanced glycation end product (RAGE. A thickening of the epithelial basal membrane and greater collagen IV deposition occurred around capillaries in CP of 3xTg-AD mice, probably curtailing solute exchanges. Moreover, there was attenuated expression of epithelial aquaporin-1 and transthyretin protein compared to non-Tg controls. Collectively these findings indicate CP dysfunction (hypothetically linked to increasing Aβ burden resulting in less efficient ion transport, concurrently with reduced production of cerebrospinal fluid (less sink action on brain Aβ and diminished secretion of transthyretin (less neuroprotection against cortical Aβ toxicity. The putative effects of a disabled CP-CSF system on CNS f

  1. Immunohistochemical and morphometric analysis of immunoglobulin light-chain immunoreactive amyloid in psammoma bodies of the human choroid plexus.

    Science.gov (United States)

    Jovanović, Ivan; Ugrenović, Sladjana; Vasović, Ljiljana; Stojanović, Ivan

    2014-03-01

    The aim of this research was to establish the presence of amyloid and to quantify immunohistochemical reactions of kappa and lambda light chains of psammoma bodies of the choroid plexus. Choroid plexus tissue obtained from 14 right lateral ventricles postmortem was processed histologically and stained with Congo red, thioflavin T, and monoclonal antibodies for kappa and lambda light chains. Morphological analysis was performed with a light microscope at lens magnifications of 4×, 10×, 20×, 25×, and 40×. The morphometric characteristics of psammoma bodies that were kappa and lambda positive and negative were analyzed with ImageJ. Histological analysis showed that the psammoma bodies, stromal blood vessel walls, and some epithelial cells reacted positively with Congo red and thioflavin T. Psammoma bodies were predominantly positive for lambda light chains. Lambda positivity was detected inside some stromal blood vessels, which pointed to a probable systemic origin for these light chains. Morphometric analysis showed that the mean optical densities of lambda- and kappa-positive psammoma bodies were significantly higher than those that gave a negative reaction. The percentage of lambda-positive psammoma bodies was significantly higher than the percentage of lambda-negative psammoma bodies in 80% of the cases, while the reaction with kappa light chains was negative in the majority of the cases. Linear regression analysis showed a significant increase in the percentage of lambda-positive psammoma bodies and their mean optical density with age. Finally, it can be concluded that the positive reaction of psammoma bodies in the choroid plexus with respect to amyloid and lambda light chains may point to the presence of light-chain amyloid in their structures.

  2. Choroid plexus dysfunction impairs beta-amyloid clearance in a triple transgenic mouse model of Alzheimer’s disease

    Science.gov (United States)

    González-Marrero, Ibrahim; Giménez-Llort, Lydia; Johanson, Conrad E.; Carmona-Calero, Emilia María; Castañeyra-Ruiz, Leandro; Brito-Armas, José Miguel; Castañeyra-Perdomo, Agustín; Castro-Fuentes, Rafael

    2015-01-01

    Compromised secretory function of choroid plexus (CP) and defective cerebrospinal fluid (CSF) production, along with accumulation of beta-amyloid (Aβ) peptides at the blood-CSF barrier (BCSFB), contribute to complications of Alzheimer’s disease (AD). The AD triple transgenic mouse model (3xTg-AD) at 16 month-old mimics critical hallmarks of the human disease: β-amyloid (Aβ) plaques and neurofibrillary tangles (NFT) with a temporal- and regional- specific profile. Currently, little is known about transport and metabolic responses by CP to the disrupted homeostasis of CNS Aβ in AD. This study analyzed the effects of highly-expressed AD-linked human transgenes (APP, PS1 and tau) on lateral ventricle CP function. Confocal imaging and immunohistochemistry revealed an increase only of Aβ42 isoform in epithelial cytosol and in stroma surrounding choroidal capillaries; this buildup may reflect insufficient clearance transport from CSF to blood. Still, there was increased expression, presumably compensatory, of the choroidal Aβ transporters: the low density lipoprotein receptor-related protein 1 (LRP1) and the receptor for advanced glycation end product (RAGE). A thickening of the epithelial basal membrane and greater collagen-IV deposition occurred around capillaries in CP, probably curtailing solute exchanges. Moreover, there was attenuated expression of epithelial aquaporin-1 and transthyretin (TTR) protein compared to Non-Tg mice. Collectively these findings indicate CP dysfunction hypothetically linked to increasing Aβ burden resulting in less efficient ion transport, concurrently with reduced production of CSF (less sink action on brain Aβ) and diminished secretion of TTR (less neuroprotection against cortical Aβ toxicity). The putative effects of a disabled CP-CSF system on CNS functions are discussed in the context of AD. PMID:25705176

  3. Choroidal osteoma - case reports.

    Science.gov (United States)

    Khan, N; Rahman, N A; Uddin, M S

    2014-07-01

    Choroidal osteoma is a rare disease. In this article four case histories were described. All were female and young patient. One patient had bilateral and other three had unilateral involvement. They had no family history. One patient reported at eye department in Bangabandhu Sheikh Mujib Medical University (BSMMU) and the other three patients reported in Bangladesh Eye Hospital. Choroidal osteoma is a benign tumor. It is diagnosed by fundoscopy, ocular B-scan ultrasonography, x-ray orbit, FFA, OCT and CT-scan of orbit. Most patients do not require treatment. Hemorrhage on the lesion suggests the presence of sub-retinal neovascularization which are typically treated with laser or intra-vitreal anti-VEGF.

  4. 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.

  5. 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.

  6. Fuchs' adenoma of the choroid simulating a choroidal hemangioma.

    NARCIS (Netherlands)

    Razzaq, L.; Marinkovic, M.; Swart, W.; Duinen, S.G. van; Keunen, J.E.E.; Luyten, G.P.M.

    2012-01-01

    We report the case of a 54-year-old female who was referred to us with an amelanotic mass on the posterior pole of the left eye involving the macula. Fundus fluorescein angiography revealed a hyperfluorescent choroidal mass. Indocyanine green chorioangiography revealed a hypofluorescent choroidal

  7. CHOROIDAL MORPHOLOGY IN EYES WITH POLYPOIDAL CHOROIDAL VASCULOPATHY AND NORMAL OR SUBNORMAL SUBFOVEAL CHOROIDAL THICKNESS.

    Science.gov (United States)

    Lee, Won Ki; Baek, Jiwon; Dansingani, Kunal K; Lee, Jae Hyung; Freund, K Bailey

    2016-12-01

    To subsegment the choroid in patients with polypoidal choroidal vasculopathy and to determine whether the ratio of choriocapillaris/Sattler layer thickness to total choroidal thickness is decreased at sites of polypoidal pathology. Retrospective, observational, cross-sectional study. A total of 320 eyes of 305 patients with polypoidal choroidal vasculopathy were studied with optical coherence tomography and dye angiography. The ratio of choriocapillaris/Sattler layer thickness to total choroidal thickness was calculated at polypoidal lesion sites in eyes with subfoveal choroidal thickness (SFCT) ≤200 μm. Mean SFCT was 267.7 ± 118.5 μm for the entire cohort. Mean SFCT was 151.2 ± 35.0 μm in eyes with SFCT ≤200 μm (n = 124, 39%). In this subgroup, dilated Haller vessels (pachyvessels) were identified under the site of neovascular ingrowth in 117 eyes (94%). Choroidal thickness in the pachyvessel zone was greater (213.3 ± 52.2 μm) than SFCT (P thickness ratio (P choroidal thickening at sites of polypoidal disease. The choriocapillaris and Sattler layers were attenuated at these locations, but Haller vessels were markedly dilated. These changes were topographically associated with sites of neovascular ingrowth and support the classification of polypoidal choroidal vasculopathy as a pachychoroid disorder.

  8. Choroidal thickness after intravitreal ranibizumab injections for choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    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

  9. Treatment of choroid metastases.

    Science.gov (United States)

    Dobrowsky, W

    1988-02-01

    Sixteen patients with choroid secondary tumours were treated with irradiation consisting of 40-50 Gy in 3-5 weeks. There were 14 female patients with breast cancer, one male patient with prostatic cancer and one male patient with cancer of unknown origin. In four cases bilateral ocular metastases were seen. Ten out of 20 treated eyes showed complete response to treatment, seven out of 20 showed partial response and three out of 20 were not influenced by irradiation. Survival of patients, all having widespread metastatic disease, was 3-48 months (median 20 months). All patients responding to treatment showed increased quality of life.

  10. 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...

  11. 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 choroid (mean 77 ± 16 μm) and the outermost annulus, the thickest choroid (191 ± 52 μm). The choroid was thinnest inferior to the optic nerve head (139 ± 38 μm) and was thickest in the superior temporal sector (157 ± 40 μm). Significant differences in the distribution of choroidal thickness were also associated with myopia, with myopic children having significantly thinner choroids in the inner and outer annuli of the nasal and temporal sectors respectively (p thickness also varied significantly with annulus location and sector (p 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

  12. Claudin-1, -2 and -3 are selectively expressed in the epithelia of the choroid plexus of the mouse from early development and into adulthood while claudin-5 is restricted to endothelial cells

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    Alexandra eSteinemann

    2016-02-01

    Full Text Available A primary function of epithelial and endothelial monolayers is the formation of barriers that separate tissues into functional compartments. Tight junctions (TJs seal the intercellular space between the single cells of a monolayer. TJs thus contribute importantly to the homeostasis of the cerebrospinal fluid as they help in maintaining the blood-brain-barrier (BBB and the blood-cerebrospinal fluid barrier. The composition of TJs differs by its localization as well as the stage of development according to its respective function. Claudin-3 is typically present in the epithelia and has been claimed to be a constituent of the BBB. It is, however, notoriously difficult to demonstrate its expression in endothelial cells of the brain vasculature at the morphological level by means of immunohistochemical techniques. Using an improved fixation strategy (4 % paraformaldehyde at pH 11, in the presence of EDTA and the sensitive alkaline phosphatase as a detection system, we show that claudin-3 is present in mouse epithelia from embryonic day 14 onwards. In brain, it is restricted to the anlage of choroid plexus in the ventricles, together with claudin-1 and -2. In adult mice, it is clearly delineating the epithelium of the choroid plexus in the lateral and fourth ventricles. In contrast, in cerebral blood vessels claudin-3 as well as claudin-1 and -2 are absent in cerebral blood vessels during all developmental stages up to adulthood. Rather, the BBB is characterized by the presence of claudin-5, ZO-1 and occludin. Thus, in mice claudin-3 is an important constituent of TJ in the embryonic and in the adult choroid plexus.

  13. Peripheral Exudative Hemorrhagic Chorioretinopathy: A Variant of Polypoidal Choroidal Vasculopathy?

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    Arman Mashayekhi

    2013-01-01

    Full Text Available Purpose: To report a case of peripheral exudative hemorrhagic chorioretinopathy (PEHCR in an elderly patient. Case Report: A 74-year-old Caucasian woman, with a 20-year history of a stable choroidal nevus in her right eye, was referred for evaluation of two small hemorrhagic pigment epithelial detachments (PEDs affecting the temporal peripheral fundus of the same eye. Nine months later, the lesions became larger and indocyanine green angiography revealed polypoidal choroidal vascular changes corresponding to the location of the ophthalmoscopically visible PEDs. Despite one session of verteporfin photodynamic therapy, the lesions continued to enlarge eventually resulting in the development of a large hemorrhagic PED, which failed to respond to two subsequent injections of intravitreal bevacizumab. The final ophthalmoscopic appearance of the large hemorrhagic PED was typical of PEHCR. Conclusion: This case suggests that polypoidal choroidal vascular changes similar to that seen in our patient may underlie the development of PEHCR in some cases.

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

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    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.

  15. Recurrent Annular Peripheral Choroidal Detachment after Trabeculectomy

    Science.gov (United States)

    Liu, Shaohui; Sun, Lisa L.; Kavanaugh, A. Scott; Langford, Marlyn P.; Liang, Chanping

    2013-01-01

    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. PMID:24348402

  16. 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.

  17. DIFFUSE PERIPAPILLARY CHOROIDAL MELANOMA THAT EVOLVED FROM A SMALL PRESUMED CHOROIDAL NEVUS SUCCESSFULLY TREATED WITH GAMMA KNIFE RADIOTHERAPY.

    Science.gov (United States)

    Duker, Jacob S; Duker, Jay S

    2016-01-01

    To report a case of diffuse peripapillary choroidal melanoma which began as a small choroidal nevus and was successfully treated with gamma knife radiotherapy. Observational case report. A 31-year-old visually asymptomatic man presented for a routine eye examination and was noted to have a small choroidal nevus. Six years later, the lesion had become a diffuse juxtapapillary choroidal melanoma with a thickness of 1.9 mm. Given the peripapillary location of the tumor with involvement of about 6 clock hours of the disk, Leksell Gamma Knife radiotherapy was performed. At 5.5 years after radiation therapy, visual acuity remained 20/20. The lesion thickness had decreased to 1.5 mm, and there was no interval growth of any margins. Small choroidal nevi carry low malignant potential but still deserve photographic documentation when possible with regular follow intervals. Gamma knife radiotherapy can be considered for tumors abutting the optic nerve, especially when plaque radiotherapy may be technically difficult.

  18. The path from the choroid plexus to the subventricular zone: go with the flow!

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    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.

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

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    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.

  20. Expulsive choroidal haemorrhage

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    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.

  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. Membrane-bound proteases of the gerbil subfornical organ and choroid plexus: an enzyme histochemical study.

    Science.gov (United States)

    Mitro, A; De Bault, L E

    1994-03-01

    Using enzyme-histochemical methods, the membrane-bound peptidases, gamma-glutamyl transpeptidase (gamma-GTP), microsomal alanyl aminopeptidase (mAAP), glutamyl aminopeptidase (EAP), and dipeptidyl peptidase IV (DPP IV), were studied in microvessels of the gerbil subfornical organ (SFO), choroid plexus adjacent to the SFO, and the ependyma of brain ventricle walls in the vicinity of the SFO. Vessels and microvessels of gerbil SFO and choroid plexus were positive for gamma-GTP, mAAP, and EAP, but negative for DPP IV. Blood-brain barrier (BBB) microvessels in the surrounding brain tissue also showed positive reactions for gamma-GTP, mAAP, and EAP but a negative reaction for DPP IV. Both epithelial cells of the choroid plexus and ependymal cells of the ventricle walls were negative for all four studied enzymes. It is suggested that blood-borne peptide hormones which can be substrates for these membrane-bound proteases can be modulated by gamma-GTP, mAAP, and EAP, but not by DPP IV, when they come in contact with the plasma membrane of the endothelial cells of the vessels in gerbil SFO, choroid plexus, and surrounding brain tissue.

  3. [Choroidal melanoma - evolution and prognosis].

    Science.gov (United States)

    Chiruţa, Daria; Stan, Cristina

    2014-01-01

    Choroidal melanoma is the most common primary intraocular malignant tumor. We present the case of a 62 year old patient who was diagnosed with intraocular tumor in his right eye, for about three years. Regarding the fact that the patient refused any kind of treatment during this period, we just had the opportunity to monitor this case. Finally, the diagnosis was choroidal melanoma, confirmed by the histopathological exam.

  4. Retinal pigment epithelium tear formation following intravitreal ranibizumab injection in choroidal neovascularization secondary to choroidal osteoma.

    Science.gov (United States)

    Erol, Muhammet K; Coban, Deniz Turgut; Ceran, Basak Bostanci; Bulut, Mehmet

    2014-09-01

    Choroidal osteoma is an extremely rare osseous tumor of the choroid where choroidal neovascularization (CNV) is the major cause of visual loss. We report the case of a 28-year-old female with CNV secondary to choroidal osteoma, who developed RPE tear after intravitreal ranibizumab treatment.

  5. Microsurgical anatomy from atrial portion of choroid fissure to quadrigeminal cistern%经脉络膜裂房部至四叠体池的显微解剖

    Institute of Scientific and Technical Information of China (English)

    王永恒; 唐阔海; 魏绍武; 韩志光; 马智慧; 冯继

    2015-01-01

    adult cadaveric heads (20 sides) fixed with 10%formaldehyde were enrolled in the study.The neurovascular structures around atrial portion of choroid fissure were observed,then the simulated surgical approach from atrial portion of choroid fissure to quadrigeminal cistern was performed under microscope.Results The atrial portion of choroid fissure was a strip of natural fissure that located between fimbria fornicis and pulvinar,in the medial wall of atrial portion of lateral ventricle.The pulvinar was posterior border of atrial portion of the fissure.The distance from pulvinar to trailing edge of trigone of lateral ventricles and central line was (15.9 ±3.3) mm and (21.6 ±2.8)mm,respectively.Moreover,the length of the fissure from pulvinar to the starting point locating behind foramen of monro was (31.4 ±3.5) mm.The quadrigeminal cistern could be accessed through choroid fissure in atrial portion.The anterior medial wall of the cistern was pineal body and quadrigeminum,and the distance from posterior border of the fissure to pineal body was (10.8 ±2.1) mm.The lateral posterior choroidal artery distributed to the choroid plexus locating in temporal horn,atrial portion and body portion of lateral ventricle via choroid fissure.The medial posterior choroidal artery distributed to the choroid plexus locating in interpositum of hanging wall of the third ventricle via quadrigeminal cistern.The medial atrial vein was a group of veins locating in the medial wall of atrial portion and occipital horn of lateral ventricle.This group of veins aggregated in choroid fissure and entered into internal cerebral vein or Galen's vein in quadrigeminal cistern via medial portion of fornix to form a simulated transchoroidal approach, with exposure range including quadrigeminal cistern and posterior part of ipsilateral ambient cistern.The most of blood vessels passing through quadrigeminal cistern could be well exposed, including P2 and P3 segment of posterior cerebral artery and basilar

  6. Choroidal thickness profile in healthy Indian children.

    Science.gov (United States)

    Chhablani, Jay Kumar; Deshpande, Riddhima; Sachdeva, Virender; Vidya, Sagar; Rao, P Srinivasa; Panigati, Anand; Mahat, Birendra; Pappuru, Rajeev Reddy; Pehere, Niranjan; Pathengay, Avinash

    2015-06-01

    The purpose was to study choroidal thickness and its profile based on location in healthy Indian children using enhanced depth spectral-domain-optical coherence tomography (SD-OCT). In this cross-sectional observational study 255 eyes of 136 children with no retinal or choroidal disease were consecutively scanned using enhanced depth SD-OCT. Eyes with any ocular disease or axial length (AXL) >25 mm or choroidal thickness from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction at 500-microns intervals up to 2500 microns temporal and nasal to the fovea. Generalized estimating equations were used to evaluate the correlation between choroidal thickness at various locations and age, AXL, gender and spherical equivalent (SEq). Mean age of the subjects was 11.9 ± 3.4 years (range: 5-18 years). There were 62 Females and 74 males. The mean AXL was 23.55 ± 0.74 mm. Mean subfoveal choroidal thickness was 312.1 ± 45.40 μm. Choroid was found to be thickest subfoveally, then temporally. Age, AXL and SEq showed a significant correlation with choroidal thickness, whereas gender did not affect choroidal thickness. Our study provides a valid normative database of choroidal thickness in healthy Indian children. This database could be useful for further studies evaluating choroidal changes in various chorioretinal disorders. Age and AXL are critical factors, which negatively correlated with choroidal thickness.

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

    Energy Technology Data Exchange (ETDEWEB)

    Meyers, Steven P. [University of Rochester School of Medicine, Strong Memorial Hospital, Department of Radiology, Rochester, NY (United States); University of Rochester Medical Center, Department of Radiology, 601 Elmwood Avenue, P.O. Box 648, Rochester, NY (United States); Khademian, Zarir P.; Zimmerman, Robert A. [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Chuang, Sylvester H. [Hospital for Sick Children, Department of Radiology, Toronto, ON (Canada); Pollack, Ian F. [Children' s Hospital of Pittsburgh, Department of Pediatric Neurosurgery, Pittsburgh, PA (United States); Korones, David N. [University of Rochester School of Medicine, Strong Memorial Hospital, Department of Pediatrics, Rochester, NY (United States)

    2004-09-01

    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

  8. 经皮层侧脑室后锁孔入路的显微解剖研究%Microscopic anatomy study of transcortical-posterior lateral ventricular key-hole approach

    Institute of Scientific and Technical Information of China (English)

    杨麟; 严正村; 张恒柱

    2015-01-01

    Objective To observe anatomical structures of the atrium of the lateral ventricle under microscope through the transcortical-posterior lateral ventricular keyhole approach and explore the feasibility of this method, so as to provide anatomical evidence for clinical application. Methods Both sides of ten adult cadaveric specimens were studied from September 2009 to May 2011. The transcortical-posterior lateral ventricular keyhole approach was performed into the atrium of the lateral ventricle. Ventricular system was exposed and internal structures were observed under microscope. The distance from the intersection of intraparietal sulcus and postcentral sulcus to cerebral longitudinal fissure, the depth of intraparietal sulcus and the distance from the bottom of intraparietal sulcus to lateral ventricle were measured. Results Several important structures were clearly observed through the transintraparietal-sulcus-posterior lateral ventricular keyhole approach. The floor was formed by the collateral trigone. Medial part of the anterior wall was formed by the crus of the fornix and the lateral part of the anterior wall was formed by the pulvinar of the thalamus. The medial wall was formed by two prominences that were located one above the other, the upper prominence called the bulb of the corpus callosum, and the lower prominence called the calcar avis. The lateral wall was formed by the caudate nucleus wrapping around the pulvinar. The choroid plexus of the the atrium of the lateral ventricle had one obvious prominence, the bulb of the choroid plexus. The choroid plexus extended laterally into the temporal horn of lateral ventricle and extends forward into the body of the lateral ventricles. The choroid plexus didn’t expand to the occipital horn of lateral ventricle. Distance from the intersection of intraparietal sulcus and postcentral sulcus to cerebral longitudinal fissure was (35. 36 ± 1. 06) mm, the depth of intraparietal sulcus was (19. 16 ± 1. 03) mm, and

  9. Scanning electron microscopy study of the choroid plexus in the monkey (Cebus apella apella Estudo do plexo coróide no macaco (Cebus apella apella ao microscópio eletrônico de varredura

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    OISENYL JOSÉ TAMEGA

    2000-09-01

    Full Text Available The cells of the choroid plexus of the lateral ventricles of the monkey Cebus apella apella were examined through scanning electron microscopy at contributing to the description of such structures in primates. The animals were anesthetized previously with 3% hypnol intraperitoneally and after perfusion with 2.5% glutaraldehyde, samples of the choroid plexus were collected after exhibition of the central portion and inferior horn of the lateral ventricles. The ventricular surface of those cells presents globose form as well as fine interlaced protrusions named microvilli. Among those, it is observed the presence of some cilia. Resting on the choroid epithelial cells there is a variable number of free cells, with fine prolongations which extend from them. They are probably macrophages and have been compared to Kolmer cells or epiplexus cells, located on choroid epithelium. The choroid plexus of the encephalic lateral ventricles of the monkey Cebus apella apella at scanning electron microscopy is similar to that of other primates, as well as to that of other species of mammals mainly cats and rats, and also humans.As células do plexo coróide dos ventrículos laterais do macaco-prego (Cebus apella apella foram examinadas ao microscópio eletrônico de varredura com o objetivo de melhor descrever e comparar este órgão ao de outras espécies de mamíferos, principalmente o homem. Inicialmente, os animais foram previamente anestesiados com hipnol a 3% intraperitonealmente e após perfusão com glutaraldeído 2,5%, amostras dos plexos coróides foram coletadas após exibição da porção central e corno inferior dos ventrículos laterais. A superfície ventricular dessas células apresenta forma globosa e a presença de finas protrusões entrelaçadas denominadas microvilosidades. Entre estas, observam-se alguns cílios. Repousando sobre as células epiteliais coróides está presente um número variável de células livres com finos prolongamentos

  10. Choroidal osteoma: US and CT findings

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    Kim, Dong Hun; Park, Sang Woo [Armed Forces Kwangju Hospital, Kwangju (Korea, Republic of); Kim, Jeong Hun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2003-02-01

    The purpose of this study was to evaluate US and CT features of choroidal osteoma. US and CT scans of seven cases of choroidal osteoma occurring in six patients were retrospectively analyzed. We analysed US and CT findings with particular attention to the location, size, and shape of calcification associated with choroidal osteoma, and sought the possible cause of the tumor, if any. None of six patients had any possible cause related to choroidal osteoma. All of seven cases of choroidal osteoma were manifested as calcified mass which were located in the posterior wall of the eyeball near the juxtapapillary region. Calcification ranged in size from 1 to 2 cm and had curvilinear shape. Both US and CT were equally useful to evaluate choroidal osteoma. By depicting the characteristic calcification, US and CT are useful imaging modalities in evaluating choroidal osteoma.

  11. Choroidal Mapping; a Novel Approach for Evaluating Choroidal Thickness and Volume

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    Jila Noori

    2012-01-01

    Full Text Available There are a limited number of non-invasive imaging techniques available for assessing the choroid, a structure that may be affected by a variety of retinal disorders or become primarily involved in conditions such as polypoidal choroidal vasculopathy and choroidal tumors. The introduction of enhanced depth imaging optical coherence tomography (EDI-OCT has provided the advantage of in vivo cross-sectional imaging of the choroid, similar to the retina, with standard commercially available spectraldomain OCT machines. In this article, we review this imaging technique and introduce choroidal mapping as a novel approach for obtaining accurate topographic and volumetric information on the choroid in normal and diseased states.

  12. False aneurysm of the left ventricle due to a penetrating chest wound.

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    Badui, E; Madrid, R; Ayala, F; Enciso, R; Verdin, R

    1991-11-01

    A 24-year-old white man had a knife chest wound, and four months after this event, manifested progressive dyspnea. A false aneurysm of the left ventricle was diagnosed by 2D echocardiogram. Surgical resection of the aneurysmal sac with closure of the orifice of the lateral wall of the left ventricle was performed successfully.

  13. The Choroid and Optical Coherence Tomography

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    Taha Sezer

    2016-01-01

    Full Text Available The choroid is the most vascular tissue in the eye and it plays an important role in the pathophysiology of various common chorioretinal diseases such as central serous retinopathy, age-related macular degeneration and degenerative myopia. Quantitative assessment of the choroid has been quite challenging with traditional imaging modalities such as indocyanine green angiography and ultrasonography due to limited resolution and repeatability. With the advent of optical coherence tomography (OCT technology, detailed visualization of the choroid in vivo is now possible. Measurements of choroidal thickness have also enabled new directions in research to study normal and pathological processes within the choroid. The aim of the present study is to review the current literature on choroidal imaging using OCT

  14. The Choroid and Optical Coherence Tomography

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    Sezer, Taha; Altınışık, Muhammet; Koytak, İbrahim Arif; Özdemir, Mehmet Hakan

    2016-01-01

    The choroid is the most vascular tissue in the eye and it plays an important role in the pathophysiology of various common chorioretinal diseases such as central serous retinopathy, age-related macular degeneration and degenerative myopia. Quantitative assessment of the choroid has been quite challenging with traditional imaging modalities such as indocyanine green angiography and ultrasonography due to limited resolution and repeatability. With the advent of optical coherence tomography (OCT) technology, detailed visualization of the choroid in vivo is now possible. Measurements of choroidal thickness have also enabled new directions in research to study normal and pathological processes within the choroid. The aim of the present study is to review the current literature on choroidal imaging using OCT. PMID:27800255

  15. Choroidal thickness profile in healthy Indian children

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    Jay Kumar Chhablani

    2015-01-01

    Full Text Available Purpose: The purpose was to study choroidal thickness and its profile based on location in healthy Indian children using enhanced depth spectral-domain-optical coherence tomography (SD-OCT. Methods: In this cross-sectional observational study 255 eyes of 136 children with no retinal or choroidal disease were consecutively scanned using enhanced depth SD-OCT. Eyes with any ocular disease or axial length (AXL >25 mm or < 20 mm were excluded. A single observer measured choroidal thickness from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction at 500-microns intervals up to 2500 microns temporal and nasal to the fovea. Generalized estimating equations were used to evaluate the correlation between choroidal thickness at various locations and age, AXL, gender and spherical equivalent (SEq. Results: Mean age of the subjects was 11.9 ± 3.4 years (range: 5-18 years. There were 62 Females and 74 males. The mean AXL was 23.55 ± 0.74 mm. Mean subfoveal choroidal thickness was 312.1 ± 45.40 μm. Choroid was found to be thickest subfoveally, then temporally. Age, AXL and SEq showed a significant correlation with choroidal thickness, whereas gender did not affect choroidal thickness. Conclusion: Our study provides a valid normative database of choroidal thickness in healthy Indian children. This database could be useful for further studies evaluating choroidal changes in various chorioretinal disorders. Age and AXL are critical factors, which negatively correlated with choroidal thickness.

  16. Innervation of the rabbit cardiac ventricles.

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    Pauziene, Neringa; Alaburda, Paulius; Rysevaite-Kyguoliene, Kristina; Pauza, Audrys G; Inokaitis, Hermanas; Masaityte, Aiste; Rudokaite, Gabriele; Saburkina, Inga; Plisiene, Jurgita; Pauza, Dainius H

    2016-01-01

    The rabbit is widely used in experimental cardiac physiology, but the neuroanatomy of the rabbit heart remains insufficiently examined. This study aimed to ascertain the architecture of the intrinsic nerve plexus in the walls and septum of rabbit cardiac ventricles. In 51 rabbit hearts, a combined approach involving: (i) histochemical acetylcholinesterase staining of intrinsic neural structures in total cardiac ventricles; (ii) immunofluorescent labelling of intrinsic nerves, nerve fibres (NFs) and neuronal somata (NS); and (iii) transmission electron microscopy of intrinsic ventricular nerves and NFs was used. Mediastinal nerves access the ventral and lateral surfaces of both ventricles at a restricted site between the root of the ascending aorta and the pulmonary trunk. The dorsal surface of both ventricles is supplied by several epicardial nerves extending from the left dorsal ganglionated nerve subplexus on the dorsal left atrium. Ventral accessing nerves are thicker and more numerous than dorsal nerves. Intrinsic ventricular NS are rare on the conus arteriosus and the root of the pulmonary trunk. The number of ventricular NS ranged from 11 to 220 per heart. Four chemical phenotypes of NS within ventricular ganglia were identified, i.e. ganglionic cells positive for choline acetyltransferase (ChAT), neuronal nitric oxide synthase (nNOS), and biphenotypic, i.e. positive for both ChAT/nNOS and for ChAT/tyrosine hydroxylase. Clusters of small intensely fluorescent cells are distributed within or close to ganglia on the root of the pulmonary trunk, but not on the conus arteriosus. The largest and most numerous intrinsic nerves proceed within the epicardium. Scarce nerves were found near myocardial blood vessels, but the myocardium contained only a scarce meshwork of NFs. In the endocardium, large numbers of thin nerves and NFs proceed along the bundle of His and both its branches up to the apex of the ventricles. The endocardial meshwork of fine NFs was

  17. Tumor seeding after diagnostic vitrectomy for choroidal metastasis in breast cancer.

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    Kung, Ya-Hsin; Wu, Tsung-Tien; Lin, Chia-Shian

    2012-09-01

    Choroidal metastasis is the most common type of intraocular tumor in adults, and in females the most common primary site is the breast. We report a case of unilateral choroidal metastasis with exudative retinal detachment as the initial presentation of recurrent breast cancer, and subsequent ophthalmic metastasis following diagnostic vitrectomy. A 49-year-old woman with a 7-year-history of well-treated bilateral breast cancer had been suffering from blurred vision in the left eye for 1 week. Ocular examination was normal except for superotemporal retinal detachment in the left eye. Neither retinal break nor choroidal mass was seen. The patient received scleral buckling and pneumatic retinopexy without significant improvement. Fluorescein angiography revealed a suspected choroidal metastasis in the left eye, but ocular ultrasonography did not show a visible choroidal mass. Two consecutive diagnostic vitrectomies with cytology could not confirm malignancy. A systemic workup was also negative. Six months later, two tumor masses were noted over two of the sclerotomy wounds of the left eye. Pathology showed adenocarcinoma compatible with invasive ductal carcinoma of the breast. Ocular metastasis may present as infiltrative choroidal lesions with exudative retinal detachment without a visible mass. Invasive procedures, such as fine-needle aspiration biopsy and diagnostic vitrectomy, may risk tumor seeding.

  18. 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.

  19. 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.

  20. Bilateral choroidal osteoma with choroidal neovascular membrane treated with bevacizumab in a child.

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    Agarwal, Manisha; Kantha, Meha; Mayor, Rahul; Venkatesh, Ramesh; Shroff, Cyrus M

    2014-01-01

    Choroidal osteoma is a rare benign tumor. We report a male child diagnosed with bilateral choroidal osteoma, high myopia and secondary choroidal neovascularization (CNV) membrane in one eye. Co-existence of posterior staphyloma made the clinical diagnosis of choroidal osteoma difficult due to the osteoma filling the depression of the posterior staphyloma. Typical findings on fundus fluorescein angiography, optical coherence tomography, B-scan and indocyanine green angiography confirmed the diagnosis. A review of literature was performed. CNV secondary to choroidal osteoma was treated with intravitreal bevacizumab and it responded well. Regular follow-up is essential for recurrence of CNV and decalcification of the osteoma.

  1. Enlargement of cerebral ventricles as an early indicator of encephalomyelitis.

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    Stefano Lepore

    Full Text Available Inflammatory disorders of the central nervous system such as multiple sclerosis and acute disseminated encephalomyelitis involve an invasion of immune cells that ultimately leads to white matter demyelination, neurodegeneration and development of neurological symptoms. A clinical diagnosis is often made when neurodegenerative processes are already ongoing. In an attempt to seek early indicators of disease, we studied the temporal and spatial distribution of brain modifications in experimental autoimmune encephalomyelitis (EAE. In a thorough magnetic resonance imaging study performed with EAE mice, we observed significant enlargement of the ventricles prior to disease clinical manifestation and an increase in free water content within the cerebrospinal fluid as demonstrated by changes in T2 relaxation times. The increase in ventricle size was seen in the lateral, third and fourth ventricles. In some EAE mice the ventricle size started returning to normal values during disease remission. In parallel to this macroscopic phenomenon, we studied the temporal evolution of microscopic lesions commonly observed in the cerebellum also starting prior to disease onset. Our data suggest that changes in ventricle size during the early stages of brain inflammation could be an early indicator of the events preceding neurological disease and warrant further exploration in preclinical and clinical studies.

  2. Choroidal thickness changes after intravitreal ranibizumab and photodynamic therapy in recurrent polypoidal choroidal vasculopathy.

    Science.gov (United States)

    Maruko, Ichiro; Iida, Tomohiro; Oyamada, Hiroshi; Sugano, Yukinori; Ojima, Akira; Sekiryu, Tetsuju

    2013-09-01

    To evaluate subfoveal choroidal thickness changes in cases with recurrent polypoidal choroidal vasculopathy (PCV) after combination therapy with intravitreal ranibizumab and photodynamic therapy (PDT). Retrospective observational case series study. We measured subfoveal choroidal thickness in PCV using optical coherence tomography (OCT) before and after PDT. In recurrent cases, the choroidal thickness was measured at the time of the recurrence. In nonrecurrent cases, choroidal thickness was measured 1 year after PDT. Combination therapy was performed in 27 eyes (27 patients). Polypoidal lesions regressed within 3 months after initial treatment in all eyes. Retreatment was needed in 10 of 27 eyes (37.0%) after more than 3 months of follow-up. In recurrent cases, subfoveal choroid decreased from 188 μm at baseline to 157 μm 3 months after PDT (P choroidal thickness increased to 179 μm with recurrence (P = .54 compared to baseline; average, 8.0 months). In nonrecurrent cases, subfoveal choroid decreased from 257 μm at baseline to 210 μm 3 months after PDT and 212 μm 1 year after PDT (P choroidal thickness in PCV at the time of recurrence returned to the baseline level after choroidal thinning as a result of PDT treatment. Choroidal thickness changes after PDT examined using OCT may reflect disease activity in PCV. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. 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

  4. Peripapillary choroidal thickness in healthy Chinese subjects

    Science.gov (United States)

    2013-01-01

    Background To evaluate the peripapillary choroidal thickness of a healthy Chinese population, and to determine its influencing factors. Methods A total of 76 healthy volunteers (76 eyes) without ophthalmic or systemic symptoms were enrolled. Choroidal scans (360-degree 3.4 mm diameter peripapillary circle scans) were obtained for all eyes using enhanced depth imaging spectral-domain optical coherence tomography. Choroid thickness was measured at the temporal, superotemporal, superior, superonasal, nasal, inferonasal, inferior, and inferotemporal segments. Results The average peripapillary choroidal thicknesses were 165.03 ± 40.37 μm. Inferonasal, inferior, and inferotemporal thicknesses were significantly thinner than temporal, superotemporal, superior, superonasal, nasal thicknesses (p thicknesses. The average peripapillary choroidal thickness decreased linearly with age (β = −1.33, 95% CI −1.98, -0.68, P choroidal thickness and other factors (gender, refractive error, axial length, average retinal nerve fiber layer thickness, intraocular pressure, diastolic blood pressure, systolic blood pressure, mean blood pressure, diastolic ocular perfusion pressure, systolic ocular perfusion pressure, and mean ocular perfusion pressure). Conclusions The inferonasal, inferior, inferotemporal peripapillary choroidal thicknesses were significantly thinner than temporal, superotemporal, superior, superonasal, and nasal thicknesses. A thinner peripapillary choroid is associated with increasing age. PMID:23758729

  5. Vascular tumors of the choroid and retina

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    Shanmugam, P Mahesh; Ramanjulu, Rajesh

    2015-01-01

    Vascular tumors of the retina and choroid can be seen occasionally. In the following article, the key clinical and diagnostic features of the major retinal and choroidal vascular tumors, their systemic associations, and the literature pertaining to the most currently available treatment strategies are reviewed. PMID:25827544

  6. Decalcified choroidal osteoma found in the retina

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    Yoshikawa T

    2012-11-01

    Full Text Available Tadanobu Yoshikawa, Kanji TakahashiDepartment of Ophthalmology, Kansai Medical University, Hirakata Hospital, Osaka, JapanAbstract: Choroidal osteoma is a benign tumor of the choroid. Herein, we report a rare case of decalcified choroidal osteoma found in the retina. A 27-year-old woman presented with visual loss. Her best-corrected visual acuity was 20/50 OS. Ophthalmoscopy of the left eye revealed a yellow-white calcified region accompanied by a decalcified region of four disc diameters in size. After 6 years, spectral-domain optical coherence tomography showed a tumor projected strongly upwards from the choroid and partially through the retina with serous retinal detachment, with both a lamellar appearance and mound-like area. The calcified region became more contractive than was observed on the first visit. Conversely, the decalcified region was wider than was observed on the first visit. Her best-corrected visual acuity was 20/400 OS. Choroidal osteoma was worsened by progression of decalcification. The decalcified choroidal osteoma resulted in poor visual acuity, and projected strongly upward from the choroid and into the retina.Keywords: osteoma, decalcification, choroidal osteoma

  7. Bietti crystalline dystrophy and choroidal neovascularisation.

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    Gupta, B; Parvizi, S; Mohamed, M D

    2011-02-01

    Bietti crystalline dystrophy is a rare autosomal recessive condition characterised by the presence of crystals in the retina and is followed by retinal and choroidal degeneration. We present a novel finding of juxtafoveal choroidal neovascularisation in Bietti crystalline dystrophy and demonstrate a spectral domain optical coherence tomography image of this disorder.

  8. Expression and functional activity of nucleoside transporters in human choroid plexus

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    Grujicic Danica

    2010-01-01

    Full Text Available Abstract Background Human equilibrative nucleoside transporters (hENTs 1-3 and human concentrative nucleoside transporters (hCNTs 1-3 in the human choroid plexus (hCP play a role in the homeostasis of adenosine and other naturally occurring nucleosides in the brain; in addition, hENT1, hENT2 and hCNT3 mediate membrane transport of nucleoside reverse transcriptase inhibitors that could be used to treat HIV infection, 3'-azido-3'-deoxythymidine, 2'3'-dideoxycytidine and 2'3'-dideoxyinosine. This study aimed to explore the expression levels and functional activities of hENTs 1-3 and hCNTs 1-3 in human choroid plexus. Methods Freshly-isolated pieces of lateral ventricle hCP, removed for various clinical reasons during neurosurgery, were obtained under Local Ethics Committee approval. Quantification of mRNAs that encoded hENTs and hCNTs was performed by the hydrolysis probes-based reverse transcription real time-polymerase chain reaction (RT-qPCR; for each gene of interest and for 18 S ribosomal RNA, which was an endogenous control, the efficiency of PCR reaction (E and the quantification cycle (Cq were calculated. The uptake of [3H]inosine by the choroid plexus pieces was investigated to explore the functional activity of hENTs and hCNTs in the hCP. Results RT-qPCR revealed that the mRNA encoding the intracellularly located transporter hENT3 was the most abundant, with E-Cq value being only about 40 fold less that the E-Cq value for 18 S ribosomal RNA; mRNAs encoding hENT1, hENT2 and hCNT3 were much less abundant than mRNA for the hENT3, while mRNAs encoding hCNT1 and hCNT2 were of very low abundance and not detectable. Uptake of [3H]inosine by the CP samples was linear and consisted of an Na+-dependent component, which was probably mediated by hCNT3, and Na+-independent component, mediated by hENTs. The latter component was not sensitive to inhibition by S-(4-nitrobenzyl-6-thioinosine (NBMPR, when used at a concentration of 0.5 μM, a finding that

  9. Choroidal thickness profiles in retinitis pigmentosa.

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    Ayton, Lauren N; Guymer, Robyn H; Luu, Chi D

    2013-01-01

    Little quantitative information exists regarding the effect that retinitis pigmentosa (RP) has on the choroid. The aim of this study was to determine choroidal thickness profiles in patients with RP. Prospective. Forty-two RP and 22 control subjects participated in the study. RP patients had mild to severe disease, with a visual acuity range of logMAR 0.1 to no light perception. Images of the retina and choroid were obtained using the enhanced depth-imaging method and optical coherence tomography (OCT). Choroidal thickness measures were determined via manual segmentation of the OCT image. The thickness profiles of the normal and RP groups were compared. The associations between choroidal thickness, visual acuity and duration of RP were determined. The choroid was thickest in the control eyes at the subfoveal location (336.60 ± 70.42 μm), and the thickness gradually decreased towards the peripheral retina (temporal 8° = 295.55 ± 60.52 μm; nasal 8° = 251.68 ± 49.93 μm). In RP, the mean thickness was also greater at the fovea (215.60 ± 94.91 μm) than the temporal (191.66 ± 72.42 μm) and nasal (149.91 ± 57.42 μm) retina, but all values were significantly lower than those of the controls (P ≤ 0.001). Subfoveal choroidal thickness was significantly correlated with visual acuity (r = -0.46, P choroid than controls. Patients with poorer visual acuity or longer duration of symptoms tended to have thinner choroids. Knowledge of choroidal thickness profile in RP is important for the field of restorative vision research and the development of suprachoroidal retinal prostheses. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.

  10. Anti-vascular endothelial growth factors for choroidal neovascularization secondary to choroidal osteoma: Long-term results

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    T Lekha

    2015-01-01

    Full Text Available Choroidal osteoma is an uncommon benign osseous intraocular tumor typically seen unilaterally in young women. Visual loss can occur due to choroidal neovascularization (CNV complicating osteoma. We report a rare case of bilateral choroidal osteoma with secondary CNV in a young male and the long-term results following anti-vascular endothelial growth factor (VEGF therapy. A 30-year-old male with history of defective vision in both eyes since several years and recent worsening in the right eye (RE since 2 months was found to have bilateral macular osteoma with CNV in the RE based on clinical evaluation, fluorescein angiography, optical coherence tomography, and ultrasonography. Intravitreal injection of ranibizumab at monthly intervals for three doses resulted in resolution of CNV and remained stable for 5 years. Recurrent CNV detected 6 years later responded to an injection of intravitreal bevacizumab and has remained stable till date. Anti-VEGF therapy stabilized the secondary CNV in our patient for 7 years with satisfactory structural and functional outcome, demonstrating the long-term efficacy of this modality of treatment.

  11. Value of lateral ventricle and cerebellum plane scanning in diagnosis of fetal midline structure abnormalities%侧脑室及小脑平面对胎儿神经系统中线结构畸形的诊断价值

    Institute of Scientific and Technical Information of China (English)

    符忠蓬; 林如; 戴蓓蓓; 谢梦; 黄晓微; 任芸芸; 严英榴; 孙莉; 孔凡斌; 赵蔚; 姚英; 胡雁来; 曹丽

    2015-01-01

    Objective:To evaluate the value of the lateral ventricle and cerebellum plane scanning in the diagnosis of fetal central nerve system (CNS) midline structure abnormalities. Methods:Ultrasound imaging features of 97 fetuses with fetal CNS midline structure abnormalities from 3 921 abnormal fetuses were analyzed retrospectively. Results: Among the 97 fetuses, there were 9 cases of encephalocele, 7 cases of anencephaly, 4 cases of meningocele, 11 cases of transparent septum widened, 16 cases of complete agenesis of the corpus callosum (ACC), 15 cases of partial ACC, 15 cases of holoprosencephaly, 4 cases of arachnoid cyst, 10 cases of Dandy-Walker malformation, 4 cases of malformation Arnold-Chiari typeⅡ, and 2 cases of vein of Galen aneurysm malformation. Conclusion: The lateral ventricle and cerebellum plane scanning is a safe, liable, practical and quick method to diagnose the fetal CNS midline structure abnormalities.%目的:探讨在产前常规超声检查中,侧脑室及小脑平面对胎儿中枢神经系统中线结构畸形的诊断价值。方法:从复旦大学附属妇产科医院3921例畸形胎儿中选出97例中枢神经系统中线结构畸形胎儿,对其声像图特征进行回顾性分析。结果:产前超声诊断胎儿中枢神经系统中线结构畸形97例,其中脑膜脑膨出9例、无脑儿7例、脑膜膨出4例、透明隔腔增宽11例、完全型胼胝体缺失(ACC)16例、部分型ACC 15例、全前脑15例、蛛网膜下腔囊肿4例、Dandy-Walker畸形10例、Arnold-Chiari畸形Ⅱ型4例、Galen静脉瘤2例。结论:胎儿侧脑室平面及小脑平面的超声检查安全有效、方便快捷,是胎儿中枢神经系统畸形筛查最常用的切面,对胎儿中枢神经系统中线结构畸形检出率高。

  12. Association Between Choroidal Thickness and Metabolic Activity on Positron Emission Tomography in Eyes With Choroidal Melanoma.

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    Lee, Ji Hwan; Lee, Sung Chul; Cho, Arthur; Keum, Ki Chang; Suh, Yang-Gun; Lee, Christopher Seungkyu

    2015-12-01

    To investigate the relationship between subfoveal choroidal thickness and metabolic activity in eyes with choroidal melanoma. Retrospective, interventional case series. The medical records of 16 patients with unilateral choroidal melanoma who underwent ruthenium (Ru) 106 brachytherapy with adjuvant transpupillary thermotherapy and who had available pretreatment positron emission tomography-computed tomography (PET-CT) images were retrospectively reviewed. Subfoveal choroidal thickness was measured in tumor eyes and in unaffected fellow eyes using enhanced-depth imaging spectral-domain optical coherence tomography (EDI OCT). Tumor eyes were divided into 2 groups (metabolically active and inactive) based on PET-CT findings and subfoveal choroidal thickness was compared between groups. Additionally, choroidal thickness measurements were compared before and after treatment. Before treatment, mean choroidal thickness was 293.31 ± 46.80 μm in tumor eyes and 242.44 ± 65.37 μm in fellow eyes, a difference that was statistically significant (P = .003). Eyes with metabolically active tumors had a significantly thicker choroid (348.00 ± 17.32 μm) than eyes with metabolically inactive tumors (280.69 ± 42.04 μm, P = .019). In tumor eyes, mean choroidal thickness significantly decreased from pretreatment values to 253.56 ± 61.27 μm 6 months after treatment (P = .018). Eyes with choroidal melanoma had thicker choroids than unaffected fellow eyes. Increased choroidal thickness was more prominent in metabolically active tumors. Choroidal thickness significantly decreased in tumor eyes 6 months after treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Estudo microanatômico da fissura coroidéia na abordagem dos ventrículos e cisternas cerebrais Microanatomical study of the choroidal fissure in ventricular and cisternal approaches

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    Gustavo R. Isolan

    2005-09-01

    Full Text Available A fissura coroidéia é uma estreita fenda situada na parte medial dos ventrículos laterais, em formato de "C", entre o fórnix e o tálamo e onde o plexo coróide se adere. O fato de não haver tecido nervoso entre o epêndima e a pia-máter ao longo deste acidente anatômico torna-o uma importante via no acesso aos ventrículos e cisternas cerebrais. Foram estudados cinco cérebros, injetando-se artérias e veias com material siliconado colorido e cinco cérebros sem realce colorido dos vasos, num total de 20 hemisférios cerebrais. Foram analisadas e revisadas as relações neurais, arteriais e venosas, bem como as abordagens cirúrgicas em cada parte da fissura coroidéia. Concluiu-se que o conhecimento prévio detalhado desta microanatomia é fundamental para os neurocirurgiões que vão abordar lesões nos ventrículos e cisternas cerebrais, pois se obtém uma noção tridimensional que será indispensável durante o ato cirúrgico.The choroidal fissure is a narrow cleft in the medial part of the lateral ventricle, in a C-shaped arc, between the fornix and the thalamus, where the choroidal plexus join. Due to absence nervous tissue between ependima and pia-mater along this invagination, it is an important route in brain ventricles and cisterns. Five brains were studied by injecting colored silicone arteries and veins and five brains without colored silicone, in a total number of 20 brain hemispheres. It was analized and revised the neural, arterial and venous relationships and surgical approaches in all parts of the choroidal fissure. In conclusion, the previous knowledge detailed this microanatomy is primordial for neurosurgeons that will approach brain ventricular and cisternal lesions because the neurosurgeons gain a tridimensional notion that will be indispensable during surgery.

  14. Choroidal Imaging with Swept-Source Optical Coherence Tomography in Patients with Birdshot Chorioretinopathy: Choroidal Reflectivity and Thickness.

    Science.gov (United States)

    Dastiridou, Anna I; Bousquet, Elodie; Kuehlewein, Laura; Tepelus, Tudor; Monnet, Dominique; Salah, Sawsen; Brezin, Antoine; Sadda, Srinivas R

    2017-08-01

    To characterize choroidal thickness and choroidal reflectivity in the eyes of patients with birdshot chorioretinopathy (BSCR). Cross-sectional observational study. Two hundred twenty BSCR patients and 59 healthy controls. Patients with BSCR and healthy controls underwent imaging of the macula in both eyes with a swept-source optical coherence tomography device (DRI-OCT1 Atlantis; Topcon). Images were exported from the device, and analysis was performed by 2 graders in the Doheny Image Reading Center using Image J software. The choroidal thickness at the foveal center was measured. In addition, the inner and outer boundaries of the choroid and retinal pigment epithelium (RPE) as well as the inner retinal surface all were segmented to allow the brightness and reflectivity of the pixels in the choroid, RPE band, and overlying vitreous to be quantified. An adjusted or normalized choroidal reflectivity, with the RPE as the bright reference standard and the vitreous as the dark reference standard, was computed using the formula: normalized choroidal reflectivity = (choroidal reflectivity-vitreous reflectivity)/RPE reflectivity. Choroidal reflectivity and choroidal thickness. Three hundred eighty-six eyes in the BSCR group and 59 eyes in the control group were included in this analysis. Higher choroidal reflectivity and lower choroidal thickness were documented in inactive BSCR patients compared with active BSCR and controls (P choroidal thickness compared with controls (P choroidal reflectivity and choroidal thickness (r = -0.793; P choroidal thickness, age, and disease duration (all P choroidal reflectivity. Choroidal reflectivity and choroidal thickness changes are evident in active and inactive BSCR patients. Novel choroidal parameters such as choroidal reflectivity may warrant further study in the setting of BSCR. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  15. Microsurgical resection of craniopharyngioma of the third ventricle via an improved transventricular approach

    Institute of Scientific and Technical Information of China (English)

    XU Jian-guo; YOU Chao; CAI Bo-wen; JIANG Shu; SUN Hong; GUO Fu-you; YANG Yong-bo; WU Bo

    2005-01-01

    Background Craniopharyngioma of the third ventricle is difficult to treat and its therapeutic regimens and operative approaches have been controversial. This study was undertaken to probe indications for microsurgical resection of craniopharyngioma of the third ventricle via an improved transventricular approach, its surgical procedures and therapeutic effects, and prevention of postoperative complications.Methods Fifty-one patients with craniopharyngioma of the third ventricle were treated from January 2000 to October 2004 by an improved transventricular approach for removing the tumor via the interventricular foramen,the intermedius of the septum pellucidum or choroid fissure. Symptoms and signs of the patients, and results of imaging, operation, and follow-up were analyzed. Results Of the 51 patients who had received the improved transventricular resection, 4 underwent a combined approach with an entrance of the pterion. Forty patients (78.43%) underwent total resection and others subtotal resection, without an operative death. Epileptic seizures were found in 3 patients (5.88%) and subdural effusion in the operative field in 4 (7.84%). All patients showed good general conditions after operation, and follow-up for an average of 27.52 months showed relapse of the tumour in 8 patients (15.69%).Conclusions Microsurgical resection of craniopharyngioma of the third ventricle by an improved transventricular approach has advantages of operative safety and efficacy, lower mortality and disability, and less complications.

  16. Chronologic versus Biologic Aging of the Human Choroid

    OpenAIRE

    Christian Albrecht May

    2013-01-01

    Several aspects of chronologic and biologic aging in the human choroid are reviewed from the literature. They often reveal methodological problems for age-dependent changes of the following parameters: choroidal thickness, choroidal pigmentation, choroidal vasculature and blood flow, and choroidal innervation. On reinterpreting some data of studies concerning Bruch’s membrane, changes observed at different age points seem more likely to be nonlinear. Concluding from the data presented so far,...

  17. 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.].

  18. Longitudinal tracking of triple labeled umbilical cord derived mesenchymal stromal cells in a mouse model of Amyotrophic Lateral Sclerosis

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    Martina Bruna Violatto

    2015-07-01

    Full Text Available The translational potential of cell therapy to humans requires a deep knowledge of the interaction between transplanted cells and host tissues. In this study, we evaluate the behavior of umbilical cord mesenchymal stromal cells (UC-MSCs, labeled with fluorescent nanoparticles, transplanted in healthy or early symptomatic transgenic SOD1G93A mice (a murine model of Amyotrophic Lateral Sclerosis. The double labeling of cells with nanoparticles and Hoechst-33258 enabled their tracking for a long time in both cells and tissues. Whole-body distribution of UC-MSCs was performed by in-vivo and ex-vivo analyses 1, 7, 21 days after single intravenous or intracerebroventricular administration. By intravenous administration cells were sequestered by the lungs and rapidly cleared by the liver. No difference in biodistribution was found among the two groups. On the other hand, UC-MSCs transplanted in lateral ventricles remained on the choroid plexus for the whole duration of the study even if decreasing in number. Few cells were found in the spinal cord of SOD1G93A mice exclusively. No migration in brain parenchyma was observed. These results suggest that the direct implantation in brain ventricles allows a prolonged permanence of cells close to the damaged areas and makes this method of tracking reliable for future studies of efficacy.

  19. Application of MRI volume rendering in surgical approach by superior temporal sulcus-temporal horn of lateral ventricle%MRI容量重建技术在颞上沟-侧脑室颞角手术入路选择中的应用

    Institute of Scientific and Technical Information of China (English)

    白芃; 刘彩霞; 贾林沛; 刘浩源; 苏略; 孙维; 李幼琼

    2014-01-01

    目的:通过测量经颞上沟-侧脑室颞角手术入路的相关数据,初步定位大脑背外侧面颞上沟进入侧脑室最短距离的点,寻找经颞上沟进入侧脑室颞角的最佳手术入路点。方法:选取120例成年人脑部 MRI扫描标本,利用容量重建技术构建大脑三维立体模型,测得颞上沟的长度 S1。沿垂直于颞叶长轴的方向以1.0 mm间距切割得到多个冠状切面,依次测量颞上沟到侧脑室颞角的距离并确定最短距离S2,同时测量颞上沟的深度S3,测量大脑颞上沟表面相对应的最短距离点到颞上沟前端起始部的距离 S4,计算 S4与 S1的比值 M,同时测量最短距离与正中矢状位方向之间的夹角α。所有样本进行双侧测量,对比两侧的测量结果。结果:120例国人的 S1左侧为(159.56±17.55)mm,右侧为(164.35±15.07)mm,左右两侧比较差异无统计学意义(P>0.05);S2左侧为(8.18±0.96)mm,右侧为(7.81±0.90)mm,左右两侧比较差异无统计学意义(P>0.05);S3左侧为(12.19±1.43)mm,右侧为(11.57±1.33)mm,左右两侧比较差异无统计学意义(P>0.05);S4左侧为(100.88±16.09)mm,右侧为(104.15±14.49)mm,左右两侧比较差异无统计学意义(P>0.05);M左侧为(0.63±0.07),右侧为(0.63±0.06),左右两侧比较差异无统计学意义(P>0.05);α左侧为(55.80±3.64)°,右侧为(56.46±4.17)°,左右两侧比较差异无统计学意义(P>0.05)。结论:颞上沟前端3/5处可能为理想的手术入路点,由该点进入侧脑室颞角距离最短,提示实施颞上沟-侧脑室颞角手术时该入路可减少对脑组织损伤。%Objective To acquire some related data of surgical approach through brain superior temporal sulcus to temporal horn of lateral ventricle by MRI volume rendering, and to orientate the point of superior temporal sulcus on the lateral

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

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    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.

  1. Does the treatment of amblyopia normalise subfoveal choroidal thickness in amblyopic children?

    Science.gov (United States)

    Öner, Veysi; Bulut, Asker

    2017-03-01

    Recent studies have found a choroidal thickening in amblyopic eyes and suggested that there might be a relationship between the choroid and amblyopia. The present study aimed to evaluate the effect of a six-month treatment of amblyopia on choroidal thickness in anisometropic hyperopic amblyopic children. Thirty-two anisometropic hyperopic children with unilateral amblyopia were included in this prospective study. Subfoveal choroidal thickness was measured as the distance between the retinal pigment epithelium and the chorioscleral edge, by using spectral domain enhanced depth imaging optical coherence tomography. The treatment of amblyopia was performed based on the full correction of the refractive error with eyeglasses, a refractive adaptation phase and occlusion by patching the fellow eye. The mean visual acuity of the amblyopic eyes significantly increased from 0.35 ± 0.3 to 0.16 ± 0.2 logMAR after the treatment (p amblyopia increased the visual acuity of the anisometropic hyperopic amblyopic eyes, it could not significantly change choroidal thickness. Our results were in accordance with the conventional explanation, which suggests visual cortex and lateral geniculate nucleus abnormalities in the pathophysiology of amblyopia. © 2016 Optometry Australia.

  2. 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.

  3. Matrix Metalloproteinases Expression in Choroidal Neovascular Membranes

    Institute of Scientific and Technical Information of China (English)

    Jun Zeng; Deyong Jiang; Xiangping Liu; Xiaohua Zhu; Luosheng Tang

    2004-01-01

    Purpose: To investigate the expression of matrix metalloproteinases (MMPs) in choroidal neovascular membranes with age-related macular degeneration (AMD).Methods: Seventeen choroidal neovascular membranes surgically removed from AMD patients with pars plana vitrectomy and subretinal membranes peeling were investigated.The expression of MMP-2 and MMP-9 was determined with immunohistochemical technique.Results: Immunohistochemistry staining in choroidal neovascular membranes for MMP2 and MMP-9 was observed in 17 specimens. There was no detective of MMP-2 and MMP-9 in normal retinas.Conclusions: MMP-2 and MMP-9 were found in choroidal neovascular membranes, may degrade the Bruch membrane and be associated with the perforation of new vessels into Bruch membrane, involving a basic pathogenic process of AMD.

  4. [Evaluation of the choroid in central serous chorioretinopathy].

    Science.gov (United States)

    Maruko, Ichiro

    2012-11-01

    Studies using indocyanine green angiography (ICGA) revealed that the main cause of central serous chorioretionopathy (CSC) stems from choroidal abnormalities such as choroidal vascular hyperpermeability. However, there are no methods to evaluate the choroid except for either the invasive ICGA or low-resolution ultrasonography. The recently developed enhanced depth imaging optical coherence tomography (EDI-OCT) technique can visualize the choroid appropriately and noninvasively using conventional OCT. EDI-OCT showed that both the affected and unaffected eyes in CSC patients have a thickened choroid; whereas the remarkably thickened choroid in Vogt-Koyanagi-Harada disease decreases immediately after corticosteroid treatment and the eyes with high myopia show a thinner choroid. We evaluated the choroidal thickness after treatment of CSC. The subfoveal choroidal thickness in typical CSC treated with laser photocoagulation showed no changes during the follow-up. On the other hand, the subfoveal choroid in chronic CSC treated with half-dose verteporfin photodynamic therapy (PDT) showed temporary thickening after 2 days but thinned back 1 month after treatment. Both the choroidal thickness and choroidal vascular hyperpermeability in ICGA decreased after PDT, but they did not change after laser photocoagulation. These findings suggest that PDT can affect the abnormal choroid directly and works through a different mechanism from conventional laser photocoagulation. It is important to evaluate the choroid using OCT in CSC and other macular diseases.

  5. The Choroid and Optical Coherence Tomography

    OpenAIRE

    Taha Sezer; Muhammet Altınışık; İbrahim Arif Koytak

    2016-01-01

    The choroid is the most vascular tissue in the eye and it plays an important role in the pathophysiology of various common chorioretinal diseases such as central serous retinopathy, age-related macular degeneration and degenerative myopia. Quantitative assessment of the choroid has been quite challenging with traditional imaging modalities such as indocyanine green angiography and ultrasonography due to limited resolution and repeatability. With the advent of optical coherence tomography (OCT...

  6. 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.

  7. The choroid as a sclera growth regulator.

    Science.gov (United States)

    Summers, Jody A

    2013-09-01

    Emmetropization is a vision dependent mechanism that attempts to minimize refractive error through coordinated growth of the cornea, lens and sclera such that the axial length matches the focal length of the eye. It is generally accepted that this visually guided eye growth is controlled via a cascade of locally generated chemical events that are initiated in the retina and ultimately cause changes in scleral extracellular matrix (ECM) remodeling which lead to changes in eye size and refraction. Of much interest, therefore, are the molecular mechanisms that underpin emmetropization and visually guided ocular growth. The choroid, a highly vascularized layer located between the retina and the sclera is uniquely situated to relay retina-derived signals to the sclera to effect changes in ECM synthesis and ocular size. Studies initiated by Josh Wallman clearly demonstrate that the choroid plays an active role in emmetropization, both by modulation of its thickness to adjust the retina to the focal plane of the eye (choroidal accommodation), and well as through the release of growth factors that have the potential to regulate scleral extracellular matrix remodeling. His discoveries prompted numerous investigations on the molecular composition of the choroid and changes in gene expression associated with visually guided ocular growth. This article will review molecular and functional studies of the choroid to provide support for the hypothesis that the choroid is a source of sclera growth regulators that effect changes in ocular growth in response to visual stimuli. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Evaluating choroidal thickness in diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Chan CY

    2014-06-01

    Full Text Available Chee Yee Chan,1 Thanos D Papakostas,2 Demetrios Vavvas2 1Department of Ophthalmology, 2Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USAWe read with interest the article by Unsal et al1 and congratulate them on their work assessing choroidal thickness in patients with diabetic retinopathy. We will like to highlight some factors of relevance.Unsal et al state that their measurement of the choroid was from the outer part of the retinal pigment epithelial layer to the choroidal scleral junction.1 However, their Figure 2 seems to draw the upper border of the choroid at various locations (external limiting membrane, inner/outer segment junction, top of the retinal pigment epithelium.1 An illustrative diagram (Figure 1 for measuring choroidal thickness can be seen in the study reported by Copete et al.2 Recent studies of the thickness of the retinal pigment epithelium–Bruch’s membrane complex in normal individuals ranged from 17.5 μm to 28.2 μm.3 Hence, measurement of choroidal thickness has to be drawn correctly and consistently at the same location (outer part of the retinal pigment epithelium to minimize potential inaccuracies. View original paper by Unsal and colleagues.

  9. Isolated pseudohypoplasia of the right ventricle.

    Science.gov (United States)

    Pastor, Esteban; Aramendi, José I; Luis, Maite; Voces, Roberto; Rodríguez, Miguel A; Galdeano, José M

    2007-08-01

    We present a case of a 12-year-old girl with severe cyanosis due to abnormal moderator band producing a hidden trabecular component of the right ventricle, mimicking isolated hypoplasia of the right ventricle. A marked hypoplasia was confirmed by echocardiography and catheterization. At operation an anomalously thickened moderator band obstructing the apical infundibulum was found. Repair consisted of a section of the moderator band and closure of the atrial septal defect. Postoperatively the right ventricle showed normal dimension and function.

  10. Macular choroidal thickness in unilateral amblyopic children.

    Science.gov (United States)

    Xu, Jinling; Zheng, Jingwei; Yu, Shujuan; Sun, Zuhua; Zheng, Weiwei; Qu, Peng; Chen, Yuanyuan; Chen, Wuhe; Yu, Xinping

    2014-10-14

    To investigate the choroidal thickness (CT) in children with amblyopia through spectral-domain optical coherence tomography (SD-OCT). Thirty-seven children with unilateral amblyopia and 22 children with normal vision participated in the study. Cross-sectional images of the choroid of evaluated eyes were obtained by SD-OCT. The choroidal thickness was measured directly below the fovea and at eight other locations: 1 and 2 mm superior, temporal, inferior, and nasal to the fovea. The researchers compared the choroidal thickness among amblyopic eyes, fellow eyes of children with amblyopia, and the eyes of children with normal vision. Age, sex, refractive error, axial length, and best-corrected visual acuity were also recorded. A paired t-test was used to compare measurements between amblyopic eyes and fellow eyes in patients with amblyopia. A generalized estimating equation (GEE) was used to compare measurements among amblyopic eyes, fellow eyes, and control eyes, adjusting for the possible effects of age, sex, and axial length on CT. The correlation between choroidal thickness and other continuous variables was determined using the Pearson correlation coefficient. The choroidal thickness at the fovea, 1 and 2 mm superior, 1 mm inferior, 1 mm nasal, and 1 mm temporal to the fovea was greater in amblyopic eyes and in fellow eyes of children with amblyopia than in the eyes of children with normal vision. The choroidal thickness at the fovea and 2 mm nasal to the fovea in amblyopic eyes was greater (P = 0.002, P = 0.043) than in the fellow eyes of the children with amblyopia. The subfoveal CT in amblyopic eyes negatively correlated with axial length (r = -0.501, P = 0.002), but did not correlate with spherical equivalent, logMAR visual acuity, or age. In the subfoveal area, the choroid was thicker in amblyopic eyes than in fellow eyes in children with amblyopia. Furthermore, differences were found in the choroidal thickness in both eyes of children with amblyopia compared

  11. 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.

  12. A flexible endoscope-assisted interhemispheric transcallosal approach through the contralateral ventricle for the removal of a third ventricle craniopharyngioma: A technical report

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    Shigetoshi Yano

    2015-01-01

    Full Text Available Background: Intraventricular craniopharyngiomas are difficult to remove. We combined an interhemispheric transcallosal approach with a flexible endoscope (videoscope for successful tumor removal. Case Description: A 52-year-old male complained of general fatigue and memory disturbance. Magnetic resonance imaging revealed a well-enhanced third ventricle mass with dilatation of lateral ventricles. During removal with the interhemispheric transcallosal approach, a videoscope that was inserted into the left lateral ventricle revealed the interface of the tumor and the ventricular wall. The tumor was pushed to the right using forceps and removed totally through the right foramen of Monro without any fornix injury. Conclusion: This procedure is a safe option for removing third ventricular tumors especially in the case with hydrocephalus.

  13. Bilateral choroidal metastasis from carcinoma of the submandibular gland

    Directory of Open Access Journals (Sweden)

    John Sheeja

    2008-01-01

    Full Text Available Metastatic tumor is the most common uveal malignancy. However, choroidal metastasis from a salivary gland neoplasm is extremely rare. We report a case of bilateral, multifocal choroidal metastasis from carcinoma of the submandibular gland.

  14. 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.

  15. Spontaneous intracranial hypotension with slit ventricles.

    OpenAIRE

    Murros, K; Fogelholm, R

    1983-01-01

    A case of spontaneous intracranial hypotension syndrome is described. Computed tomography showed slit ventricles with tight basal cisterns. Prompt improvement of symptoms was achieved by intramuscular dexamethasone treatment. A follow-up CT scan demonstrated re-expansion of ventricles and basal cisterns.

  16. Osteoblastic meningioma of the fourth ventricle.

    Science.gov (United States)

    Johnson, M D; Tulipan, N; Whetsell, W O

    1989-04-01

    Meningiomas of the fourth ventricle are rare neoplasms. Only meningothelial and fibroblastic subtypes, purportedly arising from the tela choroidea, have been described. In this report we describe clinical, neuroradiological and pathological findings in a 52-year-old man with mild hydrocephalus produced by a large, calcified, osteoblastic meningioma of the fourth ventricle.

  17. Subretinal lipid exudation associated with untreated choroidal melanoma

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    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.

  18. CCR3 and choroidal neovascularization.

    Directory of Open Access Journals (Sweden)

    Yiwen Li

    Full Text Available Age-related macular degeneration (AMD is the leading cause of irreversible blindness in the elderly in industrialized countries. The "wet" AMD, characterized by the development of choroidal neovacularization (CNV, could result in rapid and severe loss of central vision. The critical role of vascular endothelial growth factor A (VEGF-A in CNV development has been established and VEGF-A neutralization has become the standard care for wet AMD. Recently, CCR3 was reported to play an important role in CNV development and that CCR3 targeting was reported to be superior to VEGF-A targeting in CNV suppression. We investigated the role of CCR3 in CNV development using the Matrigel induced CNV and found that in both rats and mice, CNV was well-developed in the control eyes as well as in eyes treated with CCR3 antagonist SB328437 or CCR3 neutralizing antibodies. No statistically significant difference in CNV areas was found between the control and SB328437 or CCR3-ab treated eyes. Immunostaining showed no specific expression of CCR3 in or near CNV. In contrast, both VEGF-A neutralizing antibodies and rapamycin significantly suppressed CNV. These results indicate that CCR3 plays no significant role in CNV development and question the therapeutic approach of CCR3 targeting to suppress CNV. On the other hand, our data support the therapeutic strategies of VEGF-A and mTOR (mammalian target of rapamycin targeting for CNV.

  19. Choroidal findings in idiopathic uveal effusion syndrome

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    Harada T

    2011-11-01

    Full Text Available Tomomi Harada, Shigeki Machida, Takamistu Fujiwara, Yasunori Nishida, Dajiro KurosakaDepartment of Ophthalmology, Iwate Medical University School of Medicine, Iwate, JapanPurpose: We report choroidal findings by means of enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT in a patient with idiopathic uveal effusion syndrome (IUES.Case report: A 41-year-old man was referred to us with ciliochoroidal and non-rhegmatogenous retinal detachments. Sclerectomies and sclerostomies were performed at the equator in the lower quadrants, resulting in resolution of the ciliochoroidal and retinal detachments. EDI-OCT demonstrated low-reflective areas in the outer choroid. The subfoveal choroidal thickness measured vertically from the outer border of the RPE to the inner border of the sclera was 787 µm which was significantly thicker than the normal value (272 ± 90 µm, n = 131 obtained from age-matched normal controls.Conclusions: The findings made by EDI-OCT have provided additional evidence that choroidal alterations play a role in the pathological process in IUES.Keywords: uveal effusion syndrome, spectral-domain optical coherence tomography, EDI-OCT, OCT, choroid

  20. Single intravitreal ranibizumab for myopic choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    Shatriah I

    2011-08-01

    Full Text Available Saidin Nor-Masniwati, Ismail Shatriah, Embong ZunainaDepartment of Ophthalmology, Universiti Sains Malaysia, Kelantan, MalaysiaAbstract: We report a case of myopic choroidal neovascularization that showed improvement after a single injection of ranibizumab. A 45-year-old Chinese man with high myopia presented with sudden onset painless central scotoma of his right eye of 2 weeks’ duration. There was no history of trauma. His right eye vision on presentation was 6/30 which showed no improvement with pinhole. The right fundus showed myopic maculopathy at the posterior pole with subretinal hemorrhage at the inferotemporal fovea. The optic disc was tilted with inferotemporal peripapillary atrophy. There was a myopic maculopathy appearance in the macula of the left eye. Fundus fluorescein angiography revealed choroidal neovascularization at the fovea of the right eye. A diagnosis of right eye choroidal neovascularization secondary to myopic maculopathy was made. A single intravitreal injection of ranibizumab 0.05 mL was given. Ten weeks following intravitreal injection, vision had improved to 6/7.5, and repeated fundus fluorescein angiography showed absence of choroidal neovascularization. Follow-up at 6 months showed visual acuity had normalized to 6/6 with glasses, which was maintained up to 12 months following treatment. The right fundus showed no further subretinal hemorrhage with no new lesions.Keywords: myopia, choroidal neovascularization, antivascular endothelial growth factor

  1. Automated Segmentation of the Choroid from Clinical SD-OCT

    OpenAIRE

    Zhang, Li; Lee, Kyungmoo; Niemeijer, Meindert; Mullins, Robert F.; Sonka, Milan; Michael D Abràmoff

    2012-01-01

    Aging and eye disease changes the choroid, but imaging it is hard. We describe a fully automated, highly reproducible, 3D method for segmentation of choroidal vessels, and quantification of choroidal and choriocapillaris-equivalent thickness, in standard clinical SD-OCT.

  2. Longitudinal changes in choroidal thickness and eye growth in childhood.

    Science.gov (United States)

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

    2015-05-01

    To examine longitudinal changes in choroidal thickness and axial length in a population of children with a range of refractive errors. One hundred and one children (41 myopes and 60 nonmyopes) aged 10 to 15 years participated in this prospective, observational longitudinal study. For each child, 6-month measures of choroidal thickness (using enhanced depth imaging optical coherence tomography) and axial ocular biometry were collected four times over an 18-month period. Linear mixed-models were used to examine the longitudinal changes in choroidal thickness and the relationship between changes in choroidal thickness and axial eye growth over the study period. A significant group mean increase in subfoveal choroidal thickness was observed over 18 months (mean increase 13 ± 22 μm, P choroids compared with nonmyopic children (P choroidal thickness over time in myopes and nonmyopes. However, a significant association between the change in choroidal thickness and the change in axial length over time was found (P choroidal thickening over time compared with children showing slower axial eye growth. A significant increase in choroidal thickness occurs over an 18-month period in normal 10- to 15-year-old children. Children undergoing faster axial eye growth exhibited less thickening and, in some cases, a thinning of the choroid. These findings support a potential role for the choroid in the mechanisms regulating eye growth in childhood.

  3. Treatment with cyclosporine A in serpiginous choroiditis: A case report

    OpenAIRE

    Kovačević Dragana; Detanac Dženana A.; Marković Vujica; Radosavljević Aleksandra; Doklestić Krstina; Detanac Džemail S; Milenković Svetislav

    2012-01-01

    Serpiginous choroiditis is a rare clinical entity. The clinical course of serpiginous choroiditis is very variable, there is no universal marker of treatment success, and even among experts there is debate about what is the most appropriate treatment. The aim of this paper is to describe a case of serpiginous choroiditis treated with Cyclosporine A at a tertiary uveitis referral centre.

  4. Treatment with cyclosporine A in serpiginous choroiditis: A case report

    Directory of Open Access Journals (Sweden)

    Kovačević Dragana

    2012-03-01

    Full Text Available Serpiginous choroiditis is a rare clinical entity. The clinical course of serpiginous choroiditis is very variable, there is no universal marker of treatment success, and even among experts there is debate about what is the most appropriate treatment. The aim of this paper is to describe a case of serpiginous choroiditis treated with Cyclosporine A at a tertiary uveitis referral centre.

  5. Ventricular function following radiation damage of the right ventricle. [Dogs, gamma radiation

    Energy Technology Data Exchange (ETDEWEB)

    Stone, H.L.; Bishop, V.S.; Guyton, A.C.

    The right ventricles of four dogs were exposed to 20,000 R /sup 60/Co irradiation. The animals were carried through complete stages of: (a) control studies for several weeks, (b) irradiation, and (c) postirradiation studies until death from typical heart failure 23 to 33 days later. Several different types of cardiac function curves were measured at intervals during the control and postirradiation periods. No evident deterioration of the ventricles could be discerned from the function curves during the first 14 days following irradiation. However, during the ensuing 9 to 19 days the ventricles deteriorated rapidly, as evidenced by deteriorating ventricular function curves, terminating in death. Ventricular function, as estimated by the method used in the present study, declined to an average of 43% below that of normal ventricles prior to death of the animal.

  6. Laparoscopic colectomy in an adult with single ventricle physiology: Anesthetic implications and management

    Directory of Open Access Journals (Sweden)

    Kelly J Zach

    2015-01-01

    Full Text Available Increasing numbers of adult patients with complex congenital heart conditions are presenting for noncardiac surgery later in life. These disorders can present challenges for surgical and anesthesia providers. Specifically, single ventricle lesions offer anatomic and physiologic concerns during the perioperative period. Single ventricle physiology represents a delicate balance between systemic and pulmonary blood flow. Any alterations in blood flow through these systems can produce undesirable hemodynamic changes, especially during the perioperative period. We present a case of an adult patient with a single left ventricle who presented for laparoscopic total colectomy due to inflammatory bowel disease. His abnormal anatomy coupled with the hemodynamic disruptions caused by laparoscopy presented significant anesthetic challenges. We highlight the anesthetic concerns of single ventricle physiology, specifically pertaining to laparoscopic surgery. We provide recommendations for safely managing these patients perioperatively. With detailed preoperative evaluation and close hemodynamic monitoring during the perioperative period, these patients can experience successful surgical and anesthetic outcomes.

  7. Choroidal vasculature characteristics based choroid segmentation for enhanced depth imaging optical coherence tomography images

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Qiang; Niu, Sijie [School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing 210094 (China); Yuan, Songtao; Fan, Wen, E-mail: fanwen1029@163.com; Liu, Qinghuai [Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029 (China)

    2016-04-15

    Purpose: In clinical research, it is important to measure choroidal thickness when eyes are affected by various diseases. The main purpose is to automatically segment choroid for enhanced depth imaging optical coherence tomography (EDI-OCT) images with five B-scans averaging. Methods: The authors present an automated choroid segmentation method based on choroidal vasculature characteristics for EDI-OCT images with five B-scans averaging. By considering the large vascular of the Haller’s layer neighbor with the choroid-sclera junction (CSJ), the authors measured the intensity ascending distance and a maximum intensity image in the axial direction from a smoothed and normalized EDI-OCT image. Then, based on generated choroidal vessel image, the authors constructed the CSJ cost and constrain the CSJ search neighborhood. Finally, graph search with smooth constraints was utilized to obtain the CSJ boundary. Results: Experimental results with 49 images from 10 eyes in 8 normal persons and 270 images from 57 eyes in 44 patients with several stages of diabetic retinopathy and age-related macular degeneration demonstrate that the proposed method can accurately segment the choroid of EDI-OCT images with five B-scans averaging. The mean choroid thickness difference and overlap ratio between the authors’ proposed method and manual segmentation drawn by experts were −11.43 μm and 86.29%, respectively. Conclusions: Good performance was achieved for normal and pathologic eyes, which proves that the authors’ method is effective for the automated choroid segmentation of the EDI-OCT images with five B-scans averaging.

  8. Choroidal vasculature characteristics based choroid segmentation for enhanced depth imaging optical coherence tomography images.

    Science.gov (United States)

    Chen, Qiang; Niu, Sijie; Yuan, Songtao; Fan, Wen; Liu, Qinghuai

    2016-04-01

    In clinical research, it is important to measure choroidal thickness when eyes are affected by various diseases. The main purpose is to automatically segment choroid for enhanced depth imaging optical coherence tomography (EDI-OCT) images with five B-scans averaging. The authors present an automated choroid segmentation method based on choroidal vasculature characteristics for EDI-OCT images with five B-scans averaging. By considering the large vascular of the Haller's layer neighbor with the choroid-sclera junction (CSJ), the authors measured the intensity ascending distance and a maximum intensity image in the axial direction from a smoothed and normalized EDI-OCT image. Then, based on generated choroidal vessel image, the authors constructed the CSJ cost and constrain the CSJ search neighborhood. Finally, graph search with smooth constraints was utilized to obtain the CSJ boundary. Experimental results with 49 images from 10 eyes in 8 normal persons and 270 images from 57 eyes in 44 patients with several stages of diabetic retinopathy and age-related macular degeneration demonstrate that the proposed method can accurately segment the choroid of EDI-OCT images with five B-scans averaging. The mean choroid thickness difference and overlap ratio between the authors' proposed method and manual segmentation drawn by experts were -11.43 μm and 86.29%, respectively. Good performance was achieved for normal and pathologic eyes, which proves that the authors' method is effective for the automated choroid segmentation of the EDI-OCT images with five B-scans averaging.

  9. 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.

  10. Choroidal and skin metastases from colorectal cancer.

    Science.gov (United States)

    Ha, Joo Young; Oh, Edward Hynseung; Jung, Moon Ki; Park, Song Ee; Kim, Ji Tak; Hwang, In Gyu

    2016-11-21

    Choroidal and skin metastasis of colon cancer is rare. In women, the frequency of cutaneous metastasis from colon cancer as the primary lesion in is 9% and skin metastasis occurs in 0.81% of all colorectal cancers. We report a patient with colonic adenocarcinoma who presented with visual disorder in her right eye and scalp pain as her initial symptoms. Contrast-enhance orbital magnetic resonance imaging with fat suppression revealed an infrabulbar mass, and skin biopsy of the posterior parietal scalp confirmed adenocarcinoma. These symptoms were diagnosed as being caused by choroidal and skin metastases of colonic adenocarcinoma. We started palliative chemotherapy with oral capecitabine (1000 mg/m(2), twice a day, on days 1-14) every 3 wk, which was effective at shrinking the brain masses and improving the visual disorder. This is the first report that capecitabine is effective at reducing a choroidal and cutaneous metastatic lesion from right-sided colorectal cancer.

  11. 丹参注射液联合侧脑室外引流救治急性重型原发性颅脑损伤临床观察%Clinical observation of Danshen Injections combined with lateral ventricle external drainage in the treatment of acute severe primary craniocerebral injury

    Institute of Scientific and Technical Information of China (English)

    杜海平; 崔艳杰

    2015-01-01

    Objective To study the effect of Danshen Injections combined with lateral ventricle external drainage in the treatment of acute severe primary craniocerebral injury .Methods 68 cases of acute severe patients with primary brain injury in our hospital in 2013 July‐2014 July was selected as the research objects ,divided into control group and observation group .The control group were given Danshen Injections treatment ,while the observation group were treated by Danshen Injections combined with lateral cerebral ventricular drainage treatment .1 week later Glasgow coma score (GCS) ,clinical curative effect and hematoma removal time were statistically analyzed and compared .Results Before treatment ,no significant difference was observed between the 2 groups .3 days after treatment ,GCS of the observation group of GSC score was significantly higher than the control group .And 1 week after the optimal effect ;the total effective rate of treatment were 70 .59% and 88 .24% for the control group and the observation group .The observation group was obviously higher than that of the control group ,with significant difference (P<0 .05);The mean elimina‐ting times were 10 .0 ± 4 .5 and 4 .0 ± 2 .5 d for the control group and the observation group with significant difference (P<0 .05) . Conclusion Danshen Injections combined with lateral ventricle external drainage in the treatment of acute severe patients with pri‐mary brain injury can improve the patient's total efficiency ,shorten the time of patients with persistent coma ,improve the prognosis of patients and the quality of life .%目的:探讨丹参注射液联合侧脑室外引流救治急性重型原发性颅脑损伤的效果。方法选取我院2013年7月~2014年7月的68例急性重型原发性颅脑损伤患者为研究对象,将其随机分为对照组和观察组。对照组患者使用丹参注射液进行治疗,观察组患者采用丹参注射液联合侧脑室外引流进行治疗。观察2组

  12. [Diagnostic Approaches to Suspected Choroidal Melanoma].

    Science.gov (United States)

    Girbardt, C; Rehak, M; Wiedemann, P

    2017-03-10

    Whenever funduscopy reveals possible choroidal melanoma, all available information must be gathered to either confirm or exclude the diagnosis. Well-defined funduscopic criteria are available, which can already lead to a high degree of diagnostic certainty. Additional technical examinations can be used to exclude possible differential diagnoses. In cases where no clear diagnosis can be established, it is possible to take a biopsy or to watch and wait in order to observe possible growth. Whenever the diagnosis of a choroidal melanoma is established, cancer staging has to be performed in order to search for possible metastases.

  13. Choroidal Tuberculoma in an Immunocompetent Young Patient

    Institute of Scientific and Technical Information of China (English)

    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.

  14. [Macular serpiginous choroiditis complicated by macular hole].

    Science.gov (United States)

    Brănişteanu, D; Moraru, Andreea

    2014-01-01

    Macular serpiginouschoroiditis is a rare variant of serpiginous choroiditis characterized by a severe recurrent inflammation of both central choroid and retinal pigment epithelium. Visual prognosis is severe due to subsequent distruction of retinal structures. Permanent central visual loss is the consequence of retinal pigment epithelium hyper or hypoplasia and/or subretinal neovascularization leading to fibrous scarring. This article reports the unusual case of rapid development of a macular hole soon after the onset of characteristic clinical features. Despite anti-inflammatory treatment and successful macular hole surgery the visual function remained significantly impaired by secondary central retinal pigment epithelium changes.

  15. [Bilateral choroidal osteoma--a case report].

    Science.gov (United States)

    Jędrychowska-Jamborska, Justyna; Kulig-Stochmal, Agnieszka; Markiewicz, Anna; Jakubowska, Barbara; Romanowska-Dixon, Bożena

    2014-01-01

    Choroidal osteoma is a an extremely rare (especially located bilaterally), benign, intraocular tumor, the type of choristoma. It occurs between 2-3 decades of life, women are particularly vulnerable. The main complication in 1/3 cases is a subretinal neovascularization which may cause bleeding. The gradually progressive decalcification develops within the tumour over time, which causes atrophy of the retinal pigment epithelium and Bruch's membrane deformity. The article presents a case of a 26-year-old woman with bilateral choroidal osteoma complicated by subretinal hemorrhage; the diagnosis was based on clinical examination (biomicroscopy and indirect ophthalmoscopy) as well as specialised tests including: ultrasonography, optical coherence tomography, and fluorescein angiography.

  16. Choroidal metastasis from leiomyosarcoma in two cases

    Directory of Open Access Journals (Sweden)

    Eric Feinstein

    2014-01-01

    Full Text Available Leiomyosarcoma is a malignant tumor of mesenchymal cells and is the most common soft-tissue sarcoma. Leiomyosarcoma is a notably rare tumor in the ophthalmic region and can be of primary, secondary or metastatic origin. To the best of our knowledge, there has only been one published case of leiomyosarcoma metastasis to the choroid. In this case study, we report two cases of primary leiomyosarcoma with metastasis to the choroid of the eye. Both cases displayed systemic metastasis and showed response to high dose plaque radiotherapy. Despite its prevalence as the leading form of sarcoma, leiomyosarcoma rarely metastasizes to the ocular region.

  17. Choroidal Freckling in Pediatric Patients Affected by Neurofibromatosis Type 1.

    Science.gov (United States)

    Vagge, Aldo; Nelson, Leonard B; Capris, Paolo; Traverso, Carlo Enrico

    2016-09-01

    Greater understanding of choroidal freckling in patients affected by neurofibromatosis type 1 (NF1) has changed the previous belief that choroidal lesions are unusual in eyes with this disease. In fact, the high frequency of freckling suggests that the choroid is a structure commonly affected in patients with NF1. A review of patients aged 16 years or younger was performed. Recent studies using near-infrared reflectance imaging have shown that choroidal freckling frequently occurred in pediatric patients. As a result of these findings, some authors have suggested that choroidal freckling should be considered as a new diagnostic criterion for NF1. [J Pediatr Ophthalmol Strabismus. 2016;53(5):271-274.].

  18. CHOROIDAL IMAGING USING SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY

    Science.gov (United States)

    Regatieri, Caio V.; Branchini, Lauren; Fujimoto, James G.; Duker, Jay S.

    2012-01-01

    Background A structurally and functionally normal choroidal vasculature is essential for retinal function. Therefore, a precise clinical understanding of choroidal morphology should be important for understanding many retinal and choroidal diseases. Methods PUBMED (http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed) was used for most of the literature search for this article. The criterion for inclusion of an article in the references for this review was that it included materials about both the clinical and the basic properties of choroidal imaging using spectral-domain optical coherence tomography. Results Recent reports show successful examination and accurate measurement of choroidal thickness in normal and pathologic states using spectral-domain optical coherence tomography systems. This review focuses on the principles of the new technology that make choroidal imaging using optical coherence tomography possible and on the changes that subsequently have been documented to occur in the choroid in various diseases. Additionally, it outlines future directions in choroidal imaging. Conclusion Optical coherence tomography is now proven to be an effective noninvasive tool to evaluate the choroid and to detect choroidal changes in pathologic states. Additionally, choroidal evaluation using optical coherence tomography can be used as a parameter for diagnosis and follow-up. PMID:22487582

  19. The Choroidal Eye Oximeter - An instrument for measuring oxygen saturation of choroidal blood in vivo

    Science.gov (United States)

    Laing, R. A.; Danisch, L. A.; Young, L. R.

    1975-01-01

    The Choroidal Eye Oximeter is an electro-optical instrument that noninvasively measures the oxygen saturation of choroidal blood in the back of the human eye by a spectrophotometric method. Since choroidal blood is characteristic of blood which is supplied to the brain, the Choroidal Eye Oximeter can be used to monitor the amount of oxygen which is supplied to the brain under varying external conditions. The instrument consists of two basic systems: the optical system and the electronic system. The optical system produces a suitable bi-chromatic beam of light, reflects this beam from the fundus of the subject's eye, and onto a low-noise photodetector. The electronic system amplifies the weak composite signal from the photodetector, computes the average oxygen saturation from the area of the fundus that was sampled, and displays the value of the computed oxygen saturation on a panel meter.

  20. Optical Coherence Tomography Angiography for Detecting Choroidal Neovascularization Secondary to Choroidal Osteoma.

    Science.gov (United States)

    Szelog, Jason T; Bonini Filho, Marco A; Lally, David R; de Carlo, Talisa E; Duker, Jay S

    2016-01-01

    Choroidal osteoma is an ossifying tumor that is found predominantly in the peripapillary and macular areas. It typically affects otherwise healthy females. Vision loss may occur secondary to the development of choroidal neovascularization (CNV). Fluorescein angiography (FA) remains the gold standard for diagnosing CNV; however, the use of optical coherence tomography angiography (OCTA) as an adjunct to FA is growing. In this report, a 16-year-old female with a large, unilateral peripapillary choroidal osteoma presented with blurred vision. Exam revealed scattered intraretinal hemorrhage, but FA was unable to detect CNV overlying the tumor. OCTA detected abnormal flow in the outer retina corresponding to a type 2 CNV. Following intravitreal anti-vascular endothelial growth factor therapy, the CNV regressed, the hemorrhage resolved, and there was less fluid. OCTA may be helpful in detecting CNV noninvasively in eyes in which FA is equivocal, such as those with choroidal osteoma.

  1. Parapapillary Diffuse Choroidal Atrophy in Children Is Associated With Extreme Thinning of Parapapillary Choroid.

    Science.gov (United States)

    Yokoi, Tae; Zhu, Dan; Bi, Hong Sheng; Jonas, Jost B; Jonas, Rahul A; Nagaoka, Natsuko; Moriyama, Muka; Yoshida, Takeshi; Ohno-Matsui, Kyoko

    2017-02-01

    To analyze morphologic features of segmental parapapillary diffuse choroidal atrophy (PDCA) in children. The study group included children (age ≤15 years) with high myopia who attended the Tokyo High Myopia Clinic. Control groups comprised participants of the population-based Gobi Desert Children Eye Study (GobiDCES). Fundus photographs were examined for presence of PDCA and choroidal thickness (CT) was measured by optical coherence tomography. The study group included 41 eyes of 21 children with PDCA (mean age: 9.4 ± 3.7 years; mean refractive error: -11.5 ± 3.1 diopters) and the GobiDCES included 1463 children (age: 11.8 ± 3.5 years). In the study group, all eyes showed an extreme and abrupt thinning of the temporal parapapillary choroid. At 2500 μm nasal to the foveola, CT was choroidal atrophy in children is associated with abrupt segmental thinning of the choroid in the temporal parapapillary region, in addition to the thinning of the subfoveal choroid after adjusting for refractive error and age.

  2. The effect of nicotine on choroidal thickness.

    Science.gov (United States)

    Zengin, Mehmet Ozgur; Cinar, Esat; Kucukerdonmez, Cem

    2014-02-01

    To investigate the effect of nicotine on choroidal thickness using optical coherence tomography (OCT). Prospective, case-control study. Sixteen young, healthy subjects and 16 age and gender matched control cases were included in this study; 4 mg nicotine gum was given to the study group and placebo gum to the control group. All participants underwent OCT scanning with a high-speed and resolution spectral-domain OCT device (3D OCT 2000, Topcon, Japan) at baseline, and 1 h following nicotine or placebo administration. The measurements were taken in the morning (10:00-12:00 hours) to avoid diurnal fluctuation. The median foveal choroidal thickness at baseline was 337.00 μm (IQR 84.50), which decreased to 311.00 μm (IQR 78.00) at 1 h following oral nicotine intake (p=0.001). The median choroidal thickness was also significantly decreased at five other extrafoveal points (pchoroidal thickness at the fovea was 330.50 μm (IQR 104.25), and was 332.00 μm (IQR 103.75) at 1 h (p=0.271). Nicotine causes a significant decrease in choroidal thickness following oral intake. This acute decrease might be a result of reduced ocular blood flow due to the vasoconstrictive effect of nicotine.

  3. Choroidal melanoma clinically simulating a retinal angioma

    Energy Technology Data Exchange (ETDEWEB)

    Shields, J.A.; Joffe, L.; Guibor, P.

    1978-01-01

    An amelanotic fundus lesion in a 35-year-old man was associated with a dilated retinal vessel, thus suggesting the diagnosis of retinal angioma. Fluorescein angiography and B-scan ultrasonography were not diagnostic, but a radioactive phosphorus uptake test suggested the lesion was malignant. The enucleated globe showed a malignant choroidal melanoma drained by a large retinal vein.

  4. Choroidal melanoma clinically simulating a retinal angioma.

    Science.gov (United States)

    Shields, J A; Joffe, L; Guibor, P

    1978-01-01

    An amelanotic fundus lesion in a 35-year-old man was associated with a dilated retinal vessel, thus suggesting the diagnosis of retinal angioma. Fluorescein angiography and B-scan ultrasonography were not diagnostic, but a radioactive phosphorus uptake test suggested the lesion was malignant. The enucleated globe showed a malignant choroidal melanoma drained by a large retinal vein.

  5. 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.

  6. Double-outlet right ventricle revisited.

    Science.gov (United States)

    Ebadi, Ameneh; Spicer, Diane E; Backer, Carl L; Fricker, F Jay; Anderson, Robert H

    2017-08-01

    Double-outlet right ventricle is a form of ventriculoarterial connection. The definition formulated by the International Society for Nomenclature of Paediatric and Congenital Heart Disease is based on hearts with both arterial trunks supported in their greater part by a morphologically right ventricle. Bilateral infundibula and ventricular septal defects are highly debated criteria. This study examines the anatomic controversies surrounding double-outlet right ventricle. We show that hearts with double-outlet right ventricle can have atrioventricular-to-arterial valvular continuity. We emphasize the difference between the interventricular communication and the zone of deficient ventricular septation. The hearts examined were from the University of Florida in Gainesville; Johns Hopkins All Children's Hospital, St Petersburg, Fla; and Lurie Children's Hospital, Chicago, Ill. Each specimen had at least 75% of both arterial roots supported by the morphologically right ventricle, with a total of 100 hearts examined. The morphologic method was used to assess anatomic features, including arterial-atrioventricular valvular continuity, subarterial infundibular musculature, and the location of the hole between the ventricles. Most hearts had fibrous continuity between one of the arterial valves and an atrioventricular valve, with bilateral infundibula in 23%, and intact ventricular septum in 5%. Bilateral infundibula are not a defining feature of double-outlet right ventricle, representing only 23% of the specimens in our sample. The interventricular communication can have a posteroinferior muscular rim or extend to become perimembranous (58%). Double-outlet right ventricle can exist with an intact ventricular septum. Copyright © 2017 The American Association for Thoracic Surgery. All rights reserved.

  7. 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.

  8. Somatic growth in 94 single ventricle children -- comparing systemic right and left ventricle patients

    DEFF Research Database (Denmark)

    Hessel, Trine witzner; Greisen, Gorm; Idorn, Lars;

    2013-01-01

    We sought to compare and assess growth in single ventricle children with a systemic right or left ventricle in five time periods: at birth, before neonatal surgery, before the Glenn anastomosis and finally before and after the Fontan operation to 11 years of age.......We sought to compare and assess growth in single ventricle children with a systemic right or left ventricle in five time periods: at birth, before neonatal surgery, before the Glenn anastomosis and finally before and after the Fontan operation to 11 years of age....

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

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    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.

  10. Effect of brain-derived neurotrophic factor on tyrosine kinase B and endogenous brain-derived neurotrophic factor expressions by lateral ventricle infusion into AD mice%侧脑室内注入脑源性神经营养因子对AD小鼠酪氨酸激酶B及内源性BDNF表达的影响

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    张炜; 王培军; 李铭华

    2013-01-01

    目的 探讨侧脑室内注入脑源性神经营养因子(BDNF)对APP/PS1双转基因阿尔茨海默病(AD)小鼠酪氨酸激酶B (TrkB)及内源性BDNF表达的影响. 方法 10只10月龄APP/PS1雄性小鼠按随机数字表法分为2组,实验组5只,双侧侧脑室内注入BDNF;磷酸盐缓冲液(PBS)组5只,双侧侧脑室内注入PBS,为阳性对照组;干预时间均为6周.同时选择5只同窝生10月龄野生型小鼠,不予任何处理,为阴性对照组.采用荧光免疫组化法观察小鼠皮层区β-淀粉样蛋白(Aβ)斑块形态学改变,硫磺素S法检测致密斑的数量,同时检测小鼠皮层区TrkB、BDNF蛋白表达的情况. 结果 (1)治疗前、后BDNF组Aβ斑块总数分别为(101.58±7.86)个、(102.83±8.22)个,与PBS组(97.23±1 1.62)个、(103.6±6.46)个比较差异均无统计学意义(t=0.695、-0.171,P=-0.509、0.869);治疗6周后BDNF组Aβ斑块直径缩小至(34.65±9.33)μm,TS+斑块数量减少至(51.70±4.18)个,与PBS组(46.17±10.16)μm、(58.85±7.55)个比较,差异均具有统计学意义(t=-2.401、-2.536,P=0.047、0.039);(2)治疗后BDNF组TrkB、BDNF蛋白表达明显增强. 结论 侧脑室内注入BDNF减少了Aβ致密斑的形成,使Aβ蛋白沉积导致的神经毒性作用减弱,从而促进皮层区TrkB表达增强,导致内源性BDNF表达增强,可在一定程度上延缓AD小鼠的病程.%Objective To explore the effect of brain-derived neurotrophic factor (BDNF) on expressions oftyrosine kinase B (TrkB) and endogenous BDNF by infusing it into lateral ventricle of the APP/PS1 double transgenic Alzheimer's disease (AD) mice.Methods Ten 10-month-old APP/PS1 transgenic mice were randomly divided into two groups:one group receiving BDNF infusion (BDNF group) and the other receiving phosphate buffer solution (PBS) (PBS group,positive control group);treatments were given twice a week for 6 weeks.The negative control group included 5 wild type (WT) mice not receiving any treatment.The changes of A

  11. Peripapillary and Macular Choroidal Thickness in Glaucoma

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    Hamid Hosseini

    2014-01-01

    Full Text Available Purpose: To compare choroidal thickness (CT between individuals with and without glaucomatous damage and to explore the association of peripapillary and submacular CT with glaucoma severity using spectral domain optical coherence tomography (SD-OCT. Methods: Ninety-one eyes of 20 normal subjects and 43 glaucoma patients from the UCLA SD-OCT Imaging Study were enrolled. Imaging was performed using Cirrus HDOCT. Choroidal thickness was measured at four predetermined points in the macular and peripapillary regions, and compared between glaucoma and control groups before and after adjusting for potential confounding variables. Results: The average (± standard deviation mean deviation (MD on visual fields was −0.3 (±2.0 dB in controls and −3.5 (±3.5 dB in glaucoma patients. Age, axial length and their interaction were the most significant factors affecting CT on multivariate analysis. Adjusted average CT (corrected for age, axial length, their interaction, gender and lens status however, was not different between glaucoma patients and the control group (P=0.083 except in the temporal parafoveal region (P=0.037; nor was choroidal thickness related to glaucoma severity (r=−0.187, P=0.176 for correlation with MD, r=−0.151, P=0.275 for correlation with average nerve fiber layer thickness. Conclusions: Choroidal thickness of the macular and peripapillary regions is not decreased in glaucoma. Anatomical measurements with SD-OCT do not support the possible influence of the choroid on the pathophysiology of glaucoma.

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

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    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.

  13. Characterization of neonatal patients with intraventricular hemorrhage using 3D ultrasound cerebral ventricle volumes

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    Kishimoto, Jessica; Fenster, Aaron; Lee, David S. C.; de Ribaupierre, Sandrine

    2015-03-01

    One of the major non-congenital cause of neurological impairment among neonates born very preterm is intraventricular hemorrhage (IVH) - bleeding within the lateral ventricles. Most IVH patients will have a transient period of ventricle dilation that resolves spontaneously. However, those patients most at risk of long-term impairment are those who have progressive ventricle dilation as this causes macrocephaly, an abnormally enlarged head, then later causes increases intracranial pressure (ICP). 2D ultrasound (US) images through the fontanelles of the patients are serially acquired to monitor the progression of the ventricle dilation. These images are used to determine when interventional therapies such as needle aspiration of the built up CSF might be indicated for a patient. Initial therapies usually begin during the third week of life. Such interventions have been shown to decrease morbidity and mortality in IVH patients; however, this comes with risks of further hemorrhage or infection; therefore only patients requiring it should be treated. Previously we have developed and validated a 3D US system to monitor the progression of ventricle volumes (VV) in IVH patients. This system has been validated using phantoms and a small set of patient images. The aim of this work is to determine the ability of 3D US generated VV to categorize patients into those who will require interventional therapies, and those who will have spontaneous resolution. Patients with higher risks could therefore be monitored better, by re-allocating some of the resources as the low risks infants would need less monitoring.

  14. Colesteatomas dos plexos coróides dos eqüídeos: observação de 14 casos Çholesteatomas of the choroid plexus of equidae: report on 14 cases

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    Milton Thiago de Mello

    1949-12-01

    Full Text Available O autor faz considerações sobre os colesteatomas dos plexos coróides dos ventrículos laterais do cérebro e da base do cerebelo dos eqüídeos, examinando alguns aspectos da etiologia dessas colesteatose, baseado na literatura e em suas observações pessoais. Descreve, pela primeira vez no Brasil, casos de colesteatomas em eqüídeos, em número de 14, num total de 38 solípedes examinados (38,8%. Constatou a presença da lesão em muar, fato ainda não registrado na literatura.The author discusses cholesteatomas of the choroid plexus of the lateral ventricles of the cerebrum and of the base of the cerebellum in Equidae, examining some aspects of aetiology of this cholesteatosis based on the literature and on his personal observations. He describes for the first time in Brazil, cases of cholesteatomas in Equidae, 14 in number of a total of 38 solipeds examined (36,8%. He found the presence of the lesion in the mule: a fact not yet men¬tioned in the literature.

  15. Choroid plexus carcinoma: clinical and radiological features of four cases and review of literature; Carcinoma do plexo coroide: achados clinicos e radiologicos de quatro casos e revisao da literatura

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    Rogacheski, Enio; Carvalho Neto, Arnolfo de; Nascimento, Alessandra Bettega [Parana Univ., Curitiba, PR (Brazil). Hospital de Clinicas. Servico de Radiologia; Jacob, Graciela Vanessa Vicelli [Hopsital Universitario Cajuru, Curitiba, PR (Brazil). Servico de Radiologia; Delle, Linei Augusta Brolini; Liu, Christian Bark [Parana Univ., Curitiba, PR (Brazil). Hospital de Clinicas; Belggi-Torres, Luis Fernando [Parana Univ., Curitiba, PR (Brazil). Hospital de Clinicas. Servico de Anatomia Patologica

    1998-10-01

    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 fourpatients 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)

  16. Morphologic and vasculature features of the choroid and associated choroid-retinal thickness alterations in neurofibromatosis type 1.

    Science.gov (United States)

    Abdolrahimzadeh, Solmaz; Felli, Lorenzo; Plateroti, Rocco; Plateroti, Andrea Maria; Giustini, Sandra; Calvieri, Stefano; Recupero, Santi Maria

    2015-06-01

    A normal structural and functional choroid is essential in supplying blood flow to the retina. Neurofibromatosis type 1 (NF1) is a neurocristopathy where the choroid is altered due to the presence of nodules. The present transversal study was conducted to examine choroidal nodules and their effect on choroidal and retinal thickness in NF1 patients. Near-infrared reflectance and optical coherence tomography with enhanced depth imaging were used to evaluate choroidal morphology and vasculature in 19 patients with NF1 and 19 healthy, age-matched control subjects. Choroidal thickness, neuroepithelium thickness, photoreceptors together with retinal pigment epithelium (RPE) thickness and outer nuclear layer (ONL) thickness were measured at the fovea and 1000 μm nasal, temporal, superior and inferior to the fovea in NF1 patients and control subjects. Choroidal and neuroepithelium thickness were assessed overlying and adjacent to nodules in NF1 patients. Choroidal nodules were classified as 'dome-shaped' or 'placcoid' subtypes in 17 patients. Small and medium calibre choroidal vessels were observed above dome-shaped nodules where choroidal thickness was significantly reduced. There was a statistically significant reduction in mean choroidal thickness (p=0.013) in NF1 patients with respect to control subjects. The neuroepithelium, photoreceptors together with RPE and ONL had a statistically significant reduction in mean thickness in NF1 patients (pchoroidal nodules which alter choroidal morphology and thickness. There is reduction in mean choroid thickness with generalised thinning of the neuroepithelium, photoreceptors together with RPE and ONL in NF1 patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Macrophages and dendritic cells in the rat meninges and choroid plexus: three-dimensional localisation by environmental scanning electron microscopy and confocal microscopy.

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    McMenamin, Paul G; Wealthall, Rosamund J; Deverall, Marie; Cooper, Stephanie J; Griffin, Brendan

    2003-09-01

    The present investigation provides novel information on the topographical distribution of macrophages and dendritic cells (DCs) in normal meninges and choroid plexus of the rat central nervous system (CNS). Whole-mounts of meninges and choroid plexus of Lewis rats were incubated with various anti-leucocyte monoclonal antibodies and either visualised with gold-conjugated secondary antibody followed by silver enhancement and subsequent examination by environmental scanning electron microscopy or by the use of fluorochromes and confocal microscopy. Large numbers of MHC class II(+) putative DCs were identified on the internal or subarachnoid aspect of dural whole-mounts, on the surface of the cortex (pia/arachnoid) and on the surface of the choroid plexus. Occupation of these sites would allow DCs access to cerebrospinal fluid (CSF) and therefore allow antigens into the subarachnoid space and ventricles. By contrast, macrophages were less evident at sites exposed to CSF and were more frequently located within the connective tissue of the dura/arachnoid and choroid plexus stroma and also in a sub-pial location. The present data suggest that DC may be strategically located within the CNS to sample CSF-borne antigens. Furthermore, the data suggest that CNS tissue samples collected without careful removal of the meninges may inadvertently be contaminated by DCs and meningeal macrophages.

  18. High Frequency Color Doppler Image of Choroidal Detachment

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    Jinghong Wu; Lijuan Zou; Zhongyao Wu; Lixun Cheng

    2000-01-01

    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.

  19. Prognostic factors of choroidal melanoma in Slovenia, 1986–2008

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    Jancar Boris

    2016-03-01

    Full Text Available Choroidal melanoma is the most common primary malignancy of the eye, which frequently metastasizes. The Cancer Registry of Slovenia reported the incidence of choroid melanoma from 1983 to 2009 as stable, at 7.8 cases/million for men and 7.4/million for women. The aim of the retrospective study was to determinate the prognostic factors of survival for choroidal melanoma patients in Slovenia.

  20. Orthostatic hypotension associated with an epidermoid tumor of the IV ventricle.

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    Gómez-Esteban, Juan Carlos; Berganzo, Koldo; Tijero, Beatriz; Barcena, Joseba; Zarranz, Juan J

    2009-08-01

    We report the case of a 32-year-old man with an epidermoid tumor of the fourth ventricle. About 14 years later, he showed a tumor recurrence which was removed. After this procedure the patient complained of presyncopal and syncopal crisis while attempting to stand or walk. On examination, severe orthostatic hypotension was confirmed and autonomic tests were abnormal. The brain MRI showed a tetraventricular hydrocephalus predominating in the fourth ventricle. A ventriculo-peritoneal shunt was performed, and after surgery the orthostatic intolerance improved. We believe that hydrocephalus has probably been a contributory factor to orthostatic hypotension, and suggest expanding testing for dysautonomia in patients with hydrocephalus.

  1. [Radiotherapy of choroid metastases in breast carcinoma].

    Science.gov (United States)

    Dobrowsky, W; Schmid, A P; Dobrowsky, E

    1987-06-01

    From 1975 to 1984, thirteen patients were submitted to radiotherapy for choroid metastases of mammary carcinoma. Bilateral manifestation was found in three cases, thus sixteen eyes have been treated. All irradiations were performed with high voltage equipment. The posterior section of the eye was irradiated with 25 to 50 Gy over 2.5 to 5 weeks. Complete regression was achieved in nine out of sixteen cases, five patients showed an improvement of at least 50%, no considerable effect was found in two cases. The survival is 4 to 48 months (median survival 20 months) from the beginning of radiotherapy. Radiotherapy is a quick, efficient, and sparing treatment in choroid metastases. If applied in due time, it can prevent a visual disorder or amaurosis, thus improving the patients' quality of life.

  2. Symptomatic bilateral xanthogranuloma of the choroid plexus

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    Selin Tural Emon

    2017-01-01

    Full Text Available Xanthogranulomas (XGRs of the choroid plexus are rare, asymptomatic, and benign lesions usually found incidentally. Here, we present a case of a 47-year-old male with bilateral XGR of the choroid plexus with periventricular edema and discuss our case in relation to a review of existing literature pertaining to the radiology of XGRs. To the best of our knowledge, this is the first reported case of bilateral trigonal XGR causing brain edema without ventricular dilatation. Despite the fact that they can cause hydrocephalus, XGRs are silent and benign lesions. Although the etiopathology of XGRs remains poorly understood, enhanced imaging analyses may provide additional information regarding edema and focal white matter signal changes.

  3. Choroidal Thickness in Eyes with Unilateral Ocular Ischemic Syndrome

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    Dong Yoon Kim

    2015-01-01

    Full Text Available Aim. To analyze the subfoveal choroid thickness and choroidal volume in unilateral ocular ischemic syndrome (OIS. Methods. A retrospective review was conducted for all patients with unilateral OIS from October 2010 through June 2014. The subfoveal choroidal thickness (SFChT and choroidal volume of both eyes were compared. Results. 19 unilateral OIS patients were included in this study. The mean SFChT of OIS eyes was significantly lower than that of fellow eyes (OIS eyes: 208.89 ± 82.62 μm and fellow eyes: 265.31 ± 82.77 μm, P<0.001. The choroidal volume of OIS eyes was significantly smaller than that of fellow eyes (OIS eyes: 0.16 ± 0.05 mm3 and fellow eyes: 0.21 ± 0.05 mm3, P<0.001. Conclusion. The choroidal thickness and volume of OIS eyes were smaller than those of unaffected fellow eyes. Decreased choroidal circulation caused by carotid artery stenosis might affect the discordance of choroidal thickness and choroidal volume.

  4. Long-Term Follow-Up of Intravitreal Ranibizumab for the Treatment of Choroidal Neovascularization due to Choroidal Osteoma

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    Zenith H.Y. Wu

    2012-06-01

    Full Text Available Choroidal osteoma is an uncommon benign osseous intraocular tumor that typically affects young adult women. Choroidal neovascularization (CNV is one of the complications that can develop in eyes with choroidal osteoma. We present a case of CNV secondary to choroidal osteoma treated with intravitreal ranibizumab. A 57-year-old lady presented with painless loss of vision with a right-eye visual acuity of 20/800. Fundus examination showed a well-demarcated yellowish peripapillary choroidal osteoma with associated retinal and subretinal hemorrhage due to CNV. Three intravitreal ranibizumab injections at monthly intervals were given and her visual acuity improved to 20/30 following treatment. After 1.2 years of follow-up, the right eye visual acuity was maintained at 20/30 with no evidence of CNV recurrence. Our findings suggest that intravitreal ranibizumab may be an effective therapeutic option for treating CNV secondary to choroidal osteoma.

  5. Initial formation of zebrafish brain ventricles occurs independently of circulation and requires the nagie oko and snakehead/atp1a1a.1 gene products.

    Science.gov (United States)

    Lowery, Laura Anne; Sive, Hazel

    2005-05-01

    The mechanisms by which the vertebrate brain develops its characteristic three-dimensional structure are poorly understood. The brain ventricles are a highly conserved system of cavities that form very early during brain morphogenesis and that are required for normal brain function. We have initiated a study of zebrafish brain ventricle development and show here that the neural tube expands into primary forebrain, midbrain and hindbrain ventricles rapidly, over a 4-hour window during mid-somitogenesis. Circulation is not required for initial ventricle formation, only for later expansion. Cell division rates in the neural tube surrounding the ventricles are higher than between ventricles and, consistently, cell division is required for normal ventricle development. Two zebrafish mutants that do not develop brain ventricles are snakehead and nagie oko. We show that snakehead is allelic to small heart, which has a mutation in the Na+K+ ATPase gene atp1a1a.1. The snakehead neural tube undergoes normal ventricle morphogenesis; however, the ventricles do not inflate, probably owing to impaired ion transport. By contrast, mutants in nagie oko, which was previously shown to encode a MAGUK family protein, fail to undergo ventricle morphogenesis. This correlates with an abnormal brain neuroepithelium, with no clear midline and disrupted junctional protein expression. This study defines three steps that are required for brain ventricle development and that occur independently of circulation: (1) morphogenesis of the neural tube, requiring nok function; (2) lumen inflation requiring atp1a1a.1 function; and (3) localized cell proliferation. We suggest that mechanisms of brain ventricle development are conserved throughout the vertebrates.

  6. Radiographic studies of the ventricles in syringomyelia

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    West, R.J.; Williams, B.

    1980-08-01

    Radiographic investigations of 171 patients with communicating syringomyelia have been reviewed. Hydrocephalus was found in one third of the cases and has occasionally progressed after operation on the posterior fossa, sometimes with accompanying clinical deterioration. The outlets of the fourth ventricle were usually abnormal; tonsillar descent, arachnoiditis and both together were seen. Arachnoiditis correlated strongly with a history of difficult birth. The foramen of Magendie was sometimes patent and sometimes blocked. There was no consistent level of occlusion corresponding to a persistent roof of the fourth ventricle. The cisterna magna was usually small or obliterated but some examples of large cisterns or subarachnoid pouches were found. Radiological demonstration of a communication from the fourth ventricle to the syrinx occurred in only seven patients by positive contrast material and not by air. It is suggested that a sizable communication is rare at the time when patients seek treatment.

  7. Notch receptors in human choroid plexus tumors.

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    Beschorner, R; Waidelich, J; Trautmann, K; Psaras, T; Schittenhelm, J

    2013-08-01

    Notch signaling plays a role in development and formation of the normal choroid plexus (nCP), and in formation of various tumors in humans. Activation of Notch3 has been reported to promote tumor growth in invasive gliomas and to initiate formation of choroid plexus tumors (CPT) in mice. We investigated the expression of all currently known Notch receptors (Notch 1-4) in 55 samples of nCP and 88 CPT, including 61 choroid plexus papillomas (CPP), 22 atypical CPP and 5 choroid plexus carcinomas by immunohistochemistry. Notch expression was semiquantitatively evaluated separately for membranous/cytoplasmic and for nuclear staining. In addition, we examined Her2 expression (EGFR2, Her2/neu, ErbB2, CD340) because of its functional link to Notch signaling. All samples were negative for Notch3. Membranous/cytoplasmic expression of Notch1 (pnCP compared to CPT. Nuclear expression of Notch1, -2 and -4 was significantly higher in CPT compared to nCP (pnCP to a predominant nuclear expression in CPT. Her2 was weakly expressed in 42/84 CPT but only in 2/53 nCP (p=0.0001) and positively correlated with nuclear expression of Notch1, -2 and 4 in CPT. In summary, a shift between membranous/cytoplasmic (non-canonical signaling pathway) and nuclear expression (canonical signaling pathway) of Notch1, -2 and -4 and upregulation of Her2 indicate neoplastic transformation in human CP and may reveal new therapeutic approaches.

  8. [Histological findings in an irradiated choroidal melanoma].

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    Koinzer, S; Hasselbach, H; Bräsen, J H; Leuschner, I; Roider, J

    2011-06-01

    Histological findings of choroidal melanomas after proton beam irradiation have been reported for complicated cases after enucleation. We present specimens of a tumor after transretinal probe excision. One year after irradiation, the biopsy was examined histologically. The specimens showed pigmented, spindle-shaped cells staining positively for Melan-A and HMB-45. Ki-67 showed low proliferation. Caspase-3 staining was normal. The melanoma still contained vital and even single proliferating cells, but regressed afterwards without additional therapy.

  9. PERIPAPILLARY CHOROIDAL THICKNESS IN CENTRAL SEROUS CHORIORETINOPATHY: Is Choroid Outside the Macula Also Thick?

    Science.gov (United States)

    Yun, Cheolmin; Oh, Jaeryung; Han, Ji Yun; Hwang, Soon-Young; Moon, Sang Woong; Huh, Kuhl

    2015-09-01

    To investigate peripapillary choroidal thickness (CT) outside the macula in central serous chorioretinopathy (CSC). We reviewed the medical records of 34 patients with unilaterally symptomatic idiopathic CSC and 34 age-matched controls. Subfoveal and peripapillary CT were measured from images obtained by spectral domain optical coherence tomography. The nasal peripapillary CT of the choroid outside the macula was determined. The subfoveal CT of CSC (369.74 ± 54.17 μm) and fellow eyes (316.18 ± 54.68 μm) of the patient group were thicker than those of the normal controls (281.90 ± 40.97 μm, all P thick choroids both within and outside the macula, especially when subfoveal CT is increased.

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

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    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

  11. Photodynamic therapy combined with intravitreal bevacizumab in a patient with choroidal neovascularization secondary to choroidal osteoma.

    Science.gov (United States)

    Jang, Jung Hyun; Kim, Keong Hwan; Lee, Soo Jung; Park, Jung Min

    2012-12-01

    Choroidal osteoma is a benign ossified tumor that is found predominantly in healthy young women during their second and third decades of life. The lesions are white-to-cream or orange in color, are located in the peripapillary and macular areas, and are unilateral in most patients. The symptoms of choroidal osteoma include decreased visual acuity and metamorphopsia or scotoma corresponding to the location of the osteoma, but some patients have no symptoms. Prognosis of vision varies according to tumor location, retinal pigment epithelial and sensory retinal degeneration, subretinal fluid and hemorrhage, and development of a subretinal neovascular membrane.

  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. Impedance matching between ventricle and load.

    Science.gov (United States)

    Piene, H

    1984-01-01

    Impedance matching in the cardiovascular system is discussed in light of two models of ventricle and load: a Thevenin equivalent consisting of a hydromotive pressure source and an internal, source resistance and compliance in parallel; and a time-varying compliance filled from a constant pressure source and ejecting into a load of three components, a central resistor, a compliance, and a peripheral resistance. According to the Thevenin analog, the energy source and the load are matched when the load resistance is T/t times the internal source resistance (T is total cycle length, t is systolic time interval). Both from this model and from the variable compliance model it appears that optimum matching between source and load depends on the compliance of the Windkessel, as low compliance shifts the matching load resistance to a low value. Animal experiments (isolated cat hearts) indicated that both left and right ventricles at normal loads work close to their maxima of output hydraulic power, and, according to experiments in the right ventricle, maximum power output is related to load resistance and compliance as predicted by the above models. From an experimentally determined relationship among instantaneous ventricular pressure and volume (right ventricle of isolated cat hearts), an optimum load impedance was calculated on the basis of the assumption that the ratio between stroke work and static, potential energy developed in the ventricular cavity is maximum. The optimum load impedance found by this procedure closely resembles the normal input impedance of the cat lung vessel bed.

  14. Nonlinear dynamics of the left ventricle.

    Science.gov (United States)

    Munteanu, Ligia; Chiroiu, Calin; Chiroiu, Veturia

    2002-05-01

    The cnoidal method is applied to solve the set of nonlinear dynamic equations of the left ventricle. By using the theta-function representation of the solutions and a genetic algorithm, the ventricular motion can be described as a linear superposition of cnoidal pulses and additional terms, which include nonlinear interactions among them.

  15. CHOROIDAL THICKNESS IN MULTISYSTEMIC AUTOIMMUNE DISEASES WITHOUT OPHTHALMOLOGIC MANIFESTATIONS.

    Science.gov (United States)

    Ferreira, Carla S; Beato, João; Falcão, Manuel S; Brandão, Elisete; Falcão-Reis, Fernando; Carneiro, Ângela M

    2017-03-01

    To evaluate choroidal morphology and thickness at the posterior pole of individuals affected by multisystemic autoimmune diseases and without known ophthalmologic manifestations. Retrospective cross-sectional study including 75 patients with autoimmune diseases (divided according to their specific disease) and 80 healthy controls. A spectral-domain optical coherence tomography using enhanced depth imaging was performed and choroidal thickness was measured in the center of fovea and at 500 μm intervals along a horizontal section. Lupus patients presented a thicker subfoveal choroid than controls (408.624 vs. 356.536, P choroid than controls (297.867 vs. 356.536 subfoveally, P = 0.004; P = 0.005-0.019 in other measurements). Results were adjusted for the covariates age (P = 0.007), spherical equivalent (P choroidal thickness. No morphologic abnormalities were found. The choroid may be subclinically involved in autoimmune diseases. However, the choroidal response seems to differ depending on the autoimmune disease. Infiltrative mechanisms specific for lupus may justify the thickened choroid found in these patients.

  16. Hemosideric heterochromia iridum in malignant melanoma of the choroid.

    Science.gov (United States)

    Awan, K J

    1975-08-01

    A case is reported in which hyperchromic heterochromia iridum developed due to blood staining of an eye with malignant melanoma of the choroid in which massive hemorrhage developed. It is suggested that a possibility of the malignant melanoma of the choroid be kept in mind where hemosiderin deposits are suspected to be the cause of heterochromia but no intraocular iron foreign body is present.

  17. Retino-choroidal ischemia in central retinal vein occlusion

    OpenAIRE

    Hussain, Nazimul; Hussain, Anjli

    2014-01-01

    A 41-year-old gentleman with insulin dependent diabetes had decreased vision in the right eye due to non-ischemic central retinal vein occlusion with macular edema. One month following intravitreal ranibizumab, he developed retino-choroidal ischemia with further loss of vision. Authors show the fluorescein angiographic transition from non-ischemic central retinal vein occlusion to retino-choroidal ischemia.

  18. [In the light of current knowledge right ventricle].

    Science.gov (United States)

    Taçoy, Gülten; Cengel, Atiye

    2014-09-01

    There are important differences between left and right ventricle. Due to anatomical location and structural features, in daily clinical practice the right ventricle cannot be assessed easily as the left ventricle. Therefore, the right ventricle has remained in the background of the left ventricle. Recent clinical studies and advanced imaging modalities have demonstrated that right ventricle is decisive for survival particularly in patients with congenital heart disease, pulmonary hypertension and heart failure. Therefore, the detailed evaluation of the right ventricle has become necessary in current clinical practice. For this reason, in our review we aimed to examine the embryological development, anatomical structure, physiological, metabolic characteristics, responses to different pathological conditions, effects on arrhythmias, causes of failure and imaging modalities of the right ventricle in light of the current knowledge's.

  19. Suprachoroidal collection of internal tamponading agents through a choroidal hole

    Directory of Open Access Journals (Sweden)

    Gopal Lingam

    2008-01-01

    Full Text Available We report two cases of significantly large choroidal holes following penetrating trauma that led to suprachoroidal migration of internal tamponading agents during repair of retinal detachments with proliferative vitreoretinopathy secondary to penetrating trauma. In the first case, choroidal hole was a direct result of the injury and was identified immediately after vitreoretinal surgery which was done for traumatic retinal detachment with hemorrhagic choroidal detachment. In the second case, the hole occurred over a period of several months after the repair of traumatic retinal detachment with silicone oil tamponade. This was attributed to progressive fibrosis exerting traction on the bare choroid/retinal pigment epithelium. Choroidal hole significant enough to cause suprachoroidal migration of internal tamponading agents is a very rare complication seen in eyes with posttraumatic retinal detachment with proliferative vitreoretinopathy.

  20. Choroidal Thickness in Children with Beta Thalassemia Major.

    Science.gov (United States)

    Simsek, Ali; Tekin, Mehmet; Bilak, Semsettin; Karadag, Ayse Sevgi; Konca, Capan; Almis, Habip

    2016-06-01

    The purpose of this study was to determine whether there are differences in choroidal thickness in children with beta thalassemia major (β-TM). Thirty-five patients with β-TM and 38 healthy children aged between 3 and 16 years participated in the study. After complete eye examinations were conducted on the participants, choroidal thickness measurements were performed using optical coherence tomography. Correlations between choroidal thickness and laboratory and clinical parameters, such as age, sex, hemoglobin and ferritin levels, duration of disease, type and duration of chelating therapy, visual acuity, intraocular pressure, central corneal thickness, and axial length were also evaluated. The mean ages for the study group and for the control group were 8.2 ± 2.7 and 7.9 ± 2.4 years, respectively. There were no statistical differences between groups in terms of visual acuity, intraocular pressure, central corneal thickness, or axial length (p > 0.05). Choroidal thicknesses at the foveal center were 286 ± 33 μm in β-TM patients and 335 ± 423 μm in the healthy control children. Choroidal thicknesses at each point within the horizontal nasal and temporal quadrants were thinner in the β-TM group. There was a positive correlation between choroidal thickness and hemoglobin levels and a negative correlation between choroidal thickness and ferritin levels (r = 0.924, p choroidal thickness. Choroidal thickness was significantly thinner in all quadrants in children with β-TM. This thinning of the choroid may be the reason for the development of eye disorders in older patients with β-TM.

  1. 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;

    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.......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....

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

    DEFF Research Database (Denmark)

    Johansson, P.A.; Dziegielewska, K.M.; Ek, C.J.

    2005-01-01

    Cerebrospinal fluid, Cerebral ventricles, Blood-CSF barrier, Water transport, Fetus, Human, Rat (Sprague Dawley)......Cerebrospinal fluid, Cerebral ventricles, Blood-CSF barrier, Water transport, Fetus, Human, Rat (Sprague Dawley)...

  3. Pitfalls in colour photography of choroidal tumours.

    Science.gov (United States)

    Schalenbourg, A; Zografos, L

    2013-02-01

    Colour imaging of fundus tumours has been transformed by the development of digital and confocal scanning laser photography. These advances provide numerous benefits, such as panoramic images, increased contrast, non-contact wide-angle imaging, non-mydriatic photography, and simultaneous angiography. False tumour colour representation can, however, cause serious diagnostic errors. Large choroidal tumours can be totally invisible on angiography. Pseudogrowth can occur because of artefacts caused by different methods of fundus illumination, movement of reference blood vessels, and flattening of Bruch's membrane and sclera when tumour regression occurs. Awareness of these pitfalls should prevent the clinician from misdiagnosing tumours and wrongfully concluding that a tumour has grown.

  4. Pitfalls in colour photography of choroidal tumours

    Science.gov (United States)

    Schalenbourg, A; Zografos, L

    2013-01-01

    Colour imaging of fundus tumours has been transformed by the development of digital and confocal scanning laser photography. These advances provide numerous benefits, such as panoramic images, increased contrast, non-contact wide-angle imaging, non-mydriatic photography, and simultaneous angiography. False tumour colour representation can, however, cause serious diagnostic errors. Large choroidal tumours can be totally invisible on angiography. Pseudogrowth can occur because of artefacts caused by different methods of fundus illumination, movement of reference blood vessels, and flattening of Bruch's membrane and sclera when tumour regression occurs. Awareness of these pitfalls should prevent the clinician from misdiagnosing tumours and wrongfully concluding that a tumour has grown. PMID:23238442

  5. Choroidal thickness in patients with diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Ünsal E

    2014-03-01

    Full Text Available Erkan Ünsal, Kadir Eltutar, Sibel Zirtiloğlu, Nurhan Dinçer, Sezin Özdoğan Erkul, Hülya GüngelDepartment of Ophthalmology, Istanbul Education and Research Hospital, Istanbul, TurkeyPurpose: The aim of the study reported here was to assess choroidal thickness (CT and central macular thickness (CMT in patients with diabetic retinopathy.Materials and methods: A total of 151 eyes from 80 patients from the retina department of Istanbul Training and Research Hospital who had type 2 diabetes mellitus with diabetic retinopathy were studied retrospectively in this cross-sectional research. Patients were divided into three groups: mild–moderate nonproliferative diabetic retinopathy without macular edema (NPDR, mild–moderate nonproliferative diabetic retinopathy with macular edema (DME, and proliferative diabetic retinopathy (PDR. In addition, 40 eyes of 20 healthy individuals comprised a control group. Choroidal thickness was measured from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction at 500-µm intervals up to 1,500 µm temporal and nasal to the fovea. The CMT measurement was obtained for each eye. Serum hemoglobin A1c (HbA1c levels were measured.Results: The study included 191 eyes, comprising 151 eyes of 80 patients and 40 eyes of 20 healthy individuals. Of the 151 patient eyes, 61 had NPDR, 62 had PDR, and 28 eyes had DME. There was no statistically significant difference in age between the groups (P>0.05. In both the PDR and DME groups, the CT was statistically significantly decreased compared with the control group (P<0.001, P<0.001 for the PDR and DME groups, respectively. The mean CMT in the DME group was increased significantly compared with both the NPDR and PDR groups (P<0.001, P<0.001, respectively. In all three groups, serum HbA1c levels were found to be increased significantly compared with the control group (P=0.000. We found a statistically weak–moderate negative correlation between

  6. Telocytes in meninges and choroid plexus.

    Science.gov (United States)

    Popescu, B O; Gherghiceanu, M; Kostin, S; Ceafalan, L; Popescu, L M

    2012-05-16

    Telocytes (TCs) are a recently identified type of interstitial cells present in a wide variety of organs in humans and mammals (www.telocytes.com). They are characterized by a small cell body, but extremely long cell processes - telopodes (Tp), and a specific phenotype. TCs establish close contacts with blood capillaries, nerve fibers and stem cells. We report here identification of TCs by electron microscopy and immunofluorescence in rat meninges and choroid plexus/subventricular zone, in the vicinity of putative stem cells. The presence of TCs in brain areas involved in adult neurogenesis might indicate that they have a role in modulation of neural stem cell fate.

  7. Analysis of Choroidal Morphology and Vasculature in Healthy Eyes Using Spectral-Domain Optical Coherence Tomography

    Science.gov (United States)

    Branchini, Lauren A; Adhi, Mehreen; Regatieri, Caio V; Nandakumar, Namrata; Liu, Jonathan J; Laver, Nora; Fujimoto, James G; Duker, Jay S

    2013-01-01

    Objective To analyze the morphology and vasculature of the choroid in healthy eyes using spectral-domain optical coherence tomography (SD-OCT). Design Cross-sectional retrospective review. Participants Forty-two healthy subjects (42 eyes), with no ocular disease who underwent high-definition scanning with Cirrus HD-OCT at the New England Eye Center, Boston, Massachusetts between November 2009 and September 2010. Methods The SD-OCT images were evaluated for morphological features of the choroid, including the shape of the choroid-scleral border, location of the thickest point of choroid and regions of focal choroidal thinning. Total choroidal thickness and large choroidal vessel layer thickness were measured by two independent observers experienced in analyzing OCT images using the Cirrus linear measurement tool at the fovea, 750μm nasal and temporal to the fovea. Custom software was used to calculate the ratio of choroidal stroma to the choroidal vessel lumen. Main Outcome Measures Qualitative assessment of the choroidal morphology, quantitative analysis of choroidal vasculature and use of a novel automated software to determine the ratio of choroidal stromal area to the area of choroidal vessel lumen. Results The 42 subjects had a mean age of 51.6 years. All subjects (100%) had a “bowl” or convex shape to the choroid-sclera junction and the thickest point of the choroid was under the fovea in 88.0% of the subjects. The mean choroidal thickness was 256.8±75.8μm, thickness of the large choroidal vessel layer was 204.3±65.9μm and that of medium choroidal vessel layer/choriocapillaris layer was 52.9±20.6μm beneath the fovea. The ratio of large choroidal vessel layer thickness to the total choroidal thickness beneath the fovea was 0.7±0.06. The software generated ratio of choroidal stromal area to the choroidal vessel lumen area to be 0.27±0.08, suggesting that choroidal vessel lumen forms a greater proportion of the choroid than choroidal stroma in

  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 choroidal thickness and vessel measurements showed no significant difference when the subjects were subgrouped according to the age cut point (P > 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.

  9. Choroid development and feasibility of choroidal imaging in the preterm and term infants utilizing SD-OCT.

    Science.gov (United States)

    Moreno, Tomas A; O'Connell, Rachelle V; Chiu, Stephanie J; Farsiu, Sina; Cabrera, Michelle T; Maldonado, Ramiro S; Tran-Viet, Du; Freedman, Sharon F; Wallace, David K; Toth, Cynthia A

    2013-06-14

    To determine whether choroidal imaging is feasible in preterm and term infants using an 840-nm portable spectral domain optical coherence tomography (SD-OCT) system without the use of enhanced-depth imaging techniques and to assess choroidal development by comparing choroidal thickness of preterm infants, term infants, and adults. SD-OCT images were obtained from 86 preterm infants, 59 term infants, and nine adults using a portable SD-OCT system plus nine adults using a tabletop system. An unprocessed image across the macula from one randomly selected eye of each participant was selected for determination of whether the choroidal-scleral junction (CSJ) could be visualized and for measurement of choroidal thickness. Subfoveal CSJ was visualized in 96% of young-preterm infants (imaged from 30-36 weeks postmenstrual age [PMA]); 78% of term-aged preterm infants (imaged from 37-42 weeks PMA); 49% of term infants; and 39% of adult subjects. Racial pigmentation did not affect CSJ visibility in young-preterm infants (P = 0.57). Subfoveal choroidal thickness (SFCT) in young-preterm infants, term-aged preterm infants, term infants, and adults was 176 ± 53 μm, 289 ± 92 μm, 329 ± 66 μm, and 258 ± 66 μm, respectively, and these were all statistically significantly different from one another except term-aged preterms to adults. Infant choroid can be imaged with a portable SD-OCT system without enhanced depth imaging. Melanin in the RPE and choroid does not hinder outer choroidal imaging in young-preterm infants without advanced retinopathy of prematurity (ROP). In preterm infants, choroidal thickness increased with age but was thinner when compared to term infants suggesting delayed development due to ROP.

  10. Penetrating Stab Wound of the Right Ventricle

    Directory of Open Access Journals (Sweden)

    Onursal Buğra

    2010-04-01

    Full Text Available 18 years old male patient was admitted to our emergency unit with a penetrating stab wound to the right ventricle. A stab wound to the right ventricle was found to be 3 cm in diameter. The bleeding was controlled by insertion of a Foley catheter and inflation of the balloon. The stab wound had transected distal acute marginal side ofthe right coronary artery. A successful repair was performed with the use of a foley catheter and application of the Medtronic Octopus Tissue Stabilization System. The wound was closed with pledgeted mattress sutures. The distal acute marginal side of the right coronary artery was ligated. In this presentation, the surgical intervention method was reported and followed by a discussion of emergency surgical procedures of the heart.

  11. Minimally invasive keyhole approaches for removal of tumors of the third ventricle

    Institute of Scientific and Technical Information of China (English)

    LAN Qing; DONG Jun; HUANG Qiang

    2006-01-01

    Background In recent years, keyhole microsurgery has become an important subject of modem minimally invasive neurosurgery. In this study, minimally invasive techniques avoiding unnecessary tissue injuries were applied to refine traditional approaches for the removal of third ventricular tumors within a limited operative filed.Methods Individualized keyhole approaches were designed according to the characteristics of third ventricular tumors and their growth patterns. A series of keyhole approaches such as supraorbital subfrontal approach,infratentorial supracerebellar approach, interhemispheric transcallosal approach, pterional approach were taken to enter the third ventricle anteriorly, posteriorly, superiorly or laterally, respectively. A total of 34 removed tumors in or extended into the third ventricle included 11 craniopharyngiomas, 10 pituitary adenomas, 2 pinealomas, 1cholesteatoma, 3 germinomas, and 7 gliomas.Results Total tumor resection was done in 27 (79.4%) of the patients, and subtotal resection in 7 patients (20.6%). Residual tumor was due to tight adherence of germinoma to the vein of Galen (1 patient),craniopharyngioma to the pituitary stalk (3), supratentorial extension of pineal region gliomas (1), suprasellar extension of gliomas (1) and giant pituitary adenoma (1). Complications such as brain contusion, postoperative hemorrhage and infection were not associated with keyhole approaches. Extended incision or enlarged bone flap was not made because of episode during operation or inadequate exposure.Conclusions Keyhole approaches are safe, effective and minimally invasive in the surgical treatment of tumors deeply seated in the third ventricle. Individualized keyhole approach ensures a successful treatment. Tumors in the upper middle part of the third ventricle can be exposed by the interhemispheric transcallosal keyhole approach. Tumors of the posterior third ventricle may be well exposed by the infratentorial supracerebellar keyhole approach

  12. Peripapillary choroidal thickness in healthy Turkish subjects

    Directory of Open Access Journals (Sweden)

    Erbagci H

    2015-07-01

    Full Text Available Hulya Erbagci,1 Burak Oren,2 Seydi Okumus,3 Serhat Kenan,3 Pelin Celemler,3 Ibrahim Erbagci3 1Department of Anatomy, Medical Faculty, Zirve University Emine Bahattin Nakiboglu, Gaziantep, 2Department of Ophthalmology, Kilis State Hospital, Kilis, 3Department of Ophthalmology, Faculty of Medicine, University of Gaziantep, Gaziantep, Turkey Aim: The objective of the study reported here was to investigate the normal peripapillary choroidal thickness (CT, measured by enhanced depth imaging optical coherence tomography (EDI-OCT, in healthy Turkish volunteers. Materials and methods: In this prospective cross-sectional study, 57 eyes of 57 healthy Turkish subjects were enrolled. Each participant underwent a comprehensive ophthalmic examination and peripapillary CT measurement using EDI-OCT. Results: The mean age of the 25 female and 32 male patients in the study was 30.9±10.6 years (range, 18–56 years. The mean peripapillary CT at the superior, inferior, nasal, and temporal sites was 225±57, 183±47, 220±57, and 233±59 µm, respectively. The inferior peripapillary CT value was significantly lower than the peripapillary CT values (P<0.001 for all, whereas no significant differences were found between the superior, nasal, and temporal peripapillary CT values. Conclusion: The findings of the study revealed that Turkish people had significantly lower peripapillary CT values in the inferior quadrant than in the superior, nasal, and temporal quadrants. Keywords: peripapillary choroidal thickness, enhanced depth imaging optical coherence tomography, EDI-OCT

  13. Coronary artery to left ventricle fistula

    Directory of Open Access Journals (Sweden)

    Kumar Vivek

    2005-11-01

    Full Text Available Abstract Background Coronary cameral fistulas are an uncommon entity, the etiology of which may be congenital or traumatic. They involve abnormal termination of a coronary artery, usually the right coronary, into a cardiac chamber, usually the right ventricle. Case Presentation We describe a case of female patient with severe aortic stenosis and interventricular septal hypertrophy that underwent bioprosthetic aortic valve replacement with concomitant septal myectomy. On subsequent follow-up an abnormal flow traversing the septum into the left ventricle was identified and Doppler interrogation demonstrated a continuous flow, with a predominantly diastolic component, consistent with coronary arterial flow. Conclusion The literature on coronary cameral fistulas is reviewed and the etiology of the diagnostic findings discussed. In our patient, a coronary artery to left ventricle fistula was the most likely explanation secondary to trauma to the septal perforator artery during myectomy. Since the patient was asymptomatic at the time of diagnosis no intervention was recommended and has done well on follow-up.

  14. Peripapillary choroidal thickness in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Ozcimen, Muammer; Sakarya, Yasar; Kurtipek, Ercan; Bekci, Taha T; Goktas, Sertan; Sakarya, Rabia; Yener, Halil I; Demir, Lutfi S; Erdogan, Erkan; Ivacik, Ismail S; Alpfidan, Ismail; Bukus, Abdulkadir

    2016-03-01

    To evaluate the peripapillary choroidal thickness of patients with chronic obstructive pulmonary disease (COPD) via enhanced depth imaging optical coherence tomography (EDI-OCT). A total of 80 patients with COPD (80 eyes) and 50 control subjects (50 eyes) were enrolled. Choroidal scans and the retinal nerve fiber layer (RNFL) thickness were obtained for all eyes using OCT. The average peripapillary choroidal thickness measurements of the COPD group (147.58 ± 53.53 μm) were lower than the control group (160.84 ± 44.73 μm) (p = 0.068). Inferior segment thicknesses were significantly thinner than the other segments (p choroidal thickness and RNFL thickness measurements of the COPD group were also lower than those of the control group (p = 0.111). Hypoxia in COPD seems to affect the choroidal thickness. Thinning of the choroid may be attributed to increased vascular resistance and reduced blood flow in patients with COPD. The possible effects of the disease to the eye may be clarified through the role of the choroidal vasculature in the blood supply of the anterior optic nerve head.

  15. Metástasis coroideas Choroidal metastases

    Directory of Open Access Journals (Sweden)

    C. Camarillo

    2008-01-01

    Full Text Available Las metástasis uveales son el tumor intraocular maligno más frecuente y de ellas, más del 80% se localizan en la coroides. Esto, unido al progresivo aumento de la incidencia, hace necesario su estudio y revisión para un correcto diagnóstico y tratamiento en la práctica clínica actual. La etiología varía según el sexo del paciente, siendo el carcinoma de pulmón el que con más frecuencia metastatiza en el varón y el de mama en la mujer. Tienden a la multifocalidad y generalmente se localizan en el polo posterior. En el 50% de los casos cursan de forma asintomática, pero pueden producir pérdida de visión, escotomas, metamorfopsias, y fotopsias. La exploración oftalmoscópica característica muestra una lesión coroidea placoide, homogénea y de aspecto cremoso. En el diagnóstico diferencial se debe considerar el nevus amelanótico, el melanoma amelanótico de coroides, el hemangioma coroideo, la escleritis posterior, el osteoma de coroides, las coriorretinitis, la enfermedad de Harada, el desprendimiento de retina rhegmatógeno, el síndrome de efusión uveal, y la coriorretinopatía serosa central. Una exhaustiva anamnesis y exploración oftalmológica completa son imprescindibles para el diagnóstico, a lo que se pueden añadir como pruebas complementarias la angiografía con fluoresceína, la ecografía ocular, la punción-aspiración con aguja fina (PAAF, la tomografía computarizada y la resonancia magnética. El tratamiento de estos tumores suele ser el tratamiento sistémico del tumor primario; las posibilidades de tratamiento local son la observación, la radioterapia externa, la braquiterapia, la termoterapia transpupilar y la enucleación.Uveal metastases are the most frequent malign intraocular tumour, of which more than 80% are localized in the choroids. This, together with the progressive increase in its incidence, makes its study and review necessary for a correct diagnosis and treatment in current clinical practice

  16. Automated Segmentation of the Choroid from Clinical SD-OCT

    Science.gov (United States)

    Zhang, Li; Lee, Kyungmoo; Niemeijer, Meindert; Mullins, Robert F.; Sonka, Milan; Abràmoff, Michael D.

    2012-01-01

    Purpose. We developed and evaluated a fully automated 3-dimensional (3D) method for segmentation of the choroidal vessels, and quantification of choroidal vasculature thickness and choriocapillaris-equivalent thickness of the macula, and evaluated repeat variability in normal subjects using standard clinically available spectral domain optical coherence tomography (SD-OCT). Methods. A total of 24 normal subjects was imaged twice, using clinically available, 3D SD-OCT. A novel, fully-automated 3D method was used to segment and visualize the choroidal vasculature in macular scans. Local choroidal vasculature and choriocapillaris-equivalent thicknesses were determined. Reproducibility on repeat imaging was analyzed using overlapping rates, Dice coefficient, and root mean square coefficient of variation (CV) of choroidal vasculature and choriocapillaris-equivalent thicknesses. Results. For the 6 × 6 mm2 macula-centered region as depicted by the SD-OCT, average choroidal vasculature thickness in normal subjects was 172.1 μm (95% confidence interval [CI] 163.7–180.5 μm) and average choriocapillaris-equivalent thickness was 23.1 μm (95% CI 20.0–26.2 μm). Overlapping rates were 0.79 ± 0.07 and 0.75 ± 0.06, Dice coefficient was 0.78 ± 0.08, CV of choroidal vasculature thickness was 8.0% (95% CI 6.3%–9.4%), and of choriocapillaris-equivalent thickness was 27.9% (95% CI 21.0%–33.3%). Conclusions. Fully automated 3D segmentation and quantitative analysis of the choroidal vasculature and choriocapillaris-equivalent thickness demonstrated excellent reproducibility in repeat scans (CV 8.0%) and good reproducibility of choriocapillaris-equivalent thickness (CV 27.9%). Our method has the potential to improve the diagnosis and management of patients with eye diseases in which the choroid is affected. PMID:23060139

  17. Choroidal Melanoma Causing Contralateral Amaurosis via Orbital Invasion

    Directory of Open Access Journals (Sweden)

    Melis Palamar Onay

    2011-06-01

    Full Text Available To report a case of tumor invasion into the ipsilateral orbit/optic chiasm and into the contralateral optic nerve. A 51- year-old male who declared removal of his left eye ten years ago elsewhere, attended to our clinic for swelling of the left eyelids and pain. He was ophthalmologically and radiologically evaluated. A hyperpigmented mass was detected at the socket conjunctiva of the patient whose eyelids were swollen and hyperemic. Anterior and posterior segments of the right eye were normal, and the best corrected visual acuity was 10/10. On orbital computed tomography, the left orbit was found to be filled with mass. No intracranial invasion was detected. Exenteration was performed to the patient who had no systemic metastasis. Histopathological examination revealed malignant melanoma. Ten months later, the patient presented with sudden visual loss. Light perception was absent in the right eye. Optic nerve head was pale at fundus examination. No p100 wave was obtained from the right eye with visual evoked potentials. On orbital magnetic resonance imaging, a mass invading the optic chiasm and the right optic nerve was evident. When treated with appropriate methods, choroidal malignant melanoma with no extraocular extension has pretty good prognosis. When performing enucleation in patients with intraocular tumor suspicion, extra care should be spent not to make any unnecessary maneuver leading to extraocular spread. In the presence of extraocular dissemination, exenteration should be performed. (Turk J Ophthalmol 2011; 41: 194-6

  18. Quantification of cerebral ventricle volume change of preterm neonates using 3D ultrasound images

    Science.gov (United States)

    Chen, Yimin; Kishimoto, Jessica; Qiu, Wu; de Ribaupierre, Sandrine; Fenster, Aaron; Chiu, Bernard

    2015-03-01

    Intraventricular hemorrhage (IVH) is a major cause of brain injury in preterm neonates. Quantitative measurement of ventricular dilation or shrinkage is important for monitoring patients and in evaluation of treatment options. 3D ultrasound (US) has been used to monitor the ventricle volume as a biomarker for ventricular dilation. However, volumetric quantification does not provide information as to where dilation occurs. The location where dilation occurs may be related to specific neurological problems later in life. For example, posterior horn enlargement, with thinning of the corpus callosum and parietal white matter fibres, could be linked to poor visuo-spatial abilities seen in hydrocephalic children. In this work, we report on the development and application of a method used to analyze local surface change of the ventricles of preterm neonates with IVH from 3D US images. The technique is evaluated using manual segmentations from 3D US images acquired in two imaging sessions. The surfaces from baseline and follow-up were registered and then matched on a point-by-point basis. The distance between each pair of corresponding points served as an estimate of local surface change of the brain ventricle at each vertex. The measurements of local surface change were then superimposed on the ventricle surface to produce the 3D local surface change map that provide information on the spatio-temporal dilation pattern of brain ventricles following IVH. This tool can be used to monitor responses to different treatment options, and may provide important information for elucidating the deficiencies a patient will have later in life.

  19. Aborted choroidal coloboma: fundus imaging and optical coherence tomography.

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    Takkar, Brijesh; Venkatesh, Pradeep; Khokhar, Sudarshan; Gagrani, Meghal

    2017-08-07

    Choroidal coloboma is characterised by poor embryonic development of chorioretinal structures and is of different types. We present a case of choroidal coloboma where the retinal pigment epithelium was present, clinically and on imaging, but rest of the structures were poorly formed. This observation suggests that in some cases, fusion of the fetal cleft may occur aberrantly, resulting in an aborted choroidal coloboma. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

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    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.

  1. Choroidal neovascularisation on optical coherence tomography angiography in punctate inner choroidopathy and multifocal choroiditis.

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    Levison, Ashleigh L; Baynes, Kimberly M; Lowder, Careen Y; Kaiser, Peter K; Srivastava, Sunil K

    2017-05-01

    To describe the findings seen on optical coherence tomography angiography (OCTA) in patients with punctate inner choroidopathy (PIC) and multifocal choroiditis and panuveitis (MCP) complicated by choroidal neovascular membranes. This was an Institutional Review Board-approved prospective, descriptive case series. 12 patients with PIC and MCP complicated by choroidal neovascularisation (CNV) were included. Each patient underwent slit-lamp examination by a uveitis specialist followed by conventional spectral domain OCT imaging of the macula. OCTA images of the macula were then obtained. 12 patients were enrolled in the study, out of which 9 patients were followed longitudinally. CNV was identified in 11 of the 12 patients. In all patients where fluorescein angiography (FA) was inconclusive for presence of CNV, OCTA identified CNV. Various lesions on OCT suggestive of activity correlated with changes in the vascular structure of OCTA to confirm suspicion of clinical activity. In patients with PIC and MCP complicated by CNV, OCTA successfully identified underlying CNV. Given the difficulty of differentiating inflammatory lesions from early CNV on OCT and FA, OCTA may provide a valuable method of monitoring patients with posterior uveitis highly correlated with development of CNV. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

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

    Science.gov (United States)

    Mansour, Ahmad M; Arevalo, J Fernando; Al Kahtani, Eman; Zegarra, Hernando; Abboud, Emad; 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.

  3. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Evaluation of choroidal thickness via enhanced depth-imaging optical coherence tomography in patients with systemic hypertension

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    Mustafa Gök

    2015-01-01

    Full Text Available Purpose: The purpose was to evaluate choroidal thickness via spectral domain optical coherence tomography (SD-OCT and to compare the data with those of 24-h blood pressure monitoring, elastic features of the aorta, and left ventricle systolic functions, in patients with systemic hypertension. Materials and Methods: This was a case-control, cross-sectional prospective study. A total of 116 patients with systemic hypertension, and 116 healthy controls over 45 years of age, were included. Subfoveal choroidal thickness (SFCT was measured using a Heidelberg SD-OCT platform operating in the enhanced depth imaging mode. Patients were also subjected to 24-h ambulatory blood pressure monitoring (ABPM and standard transthoracic echocardiography (STTE. Patients were divided into dippers and nondippers using ABPM data and those with or without left ventricular hypertrophy (LVH+ and LVH- based on STTE data. The elastic parameters of the aorta, thus aortic strain (AoS, the beta index (BI, aortic distensibility (AoD, and the left ventricular mass index (LVMI, were calculated from STTE data. Results: No significant difference in SFCT was evident between patients and controls (P ≤ 0.611. However, a significant negative correlation was evident between age and SFCT in both groups (r = −0.66/−0.56, P ≤ 0.00. No significant SFCT difference was evident between the dipper and nondipper groups (P ≤ 0.67, or the LVH (+ and LVH (- groups (P ≤ 0.84. No significant correlation was evident between SFCT and any of AoS, BI, AoD, or LVMI. Discussion : The choroid is affected by atrophic changes associated with aging. Even in the presence of comorbid risk factors including LVH and arterial stiffness, systemic hypertension did not affect SFCT.

  6. The rapid flow of cerebrospinal fluid from ventricles to cisterns via subarachnoid velae in the normal rat.

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    Fenstermacher, J D; Ghersi-Egea, J F; Finnegan, W; Chen, J L

    1997-01-01

    14C-sucrose in 0.5 microliter of buffered saline was infused over 30 sec into one lateral ventricle, and its subsequent distribution was determined in brain, meninges, cerebral blood vessels, and cerebrospinal fluid (CSF) by quantitative autoradiography. Within 3.5 min, infused radiotracer had moved into the third ventricle, the velum interpositum (an extension of the subarchnoid system that contains many blood vessels), the aqueduct, the mesencephalic and fourth ventricles, and the superior medullary velum (a part of the subarachnoid system that touches the mesencephalic and fourth ventricles). The CSF within both of these velae appears to empty into the quadrigeminal and ambient cisterns. Within 5 min radioactive sucrose was also found in the interpeduncular cistern. About 15% of the injected sucrose quickly left the ventricles and entered these large cisterns. In contrast to most CSF-brain interfaces, little sucrose moved from CSF into the medulla next to the lateral recesses and tissues such as the superior colliculus that lie adjacent to the large CSF cisterns. A thick, multilayered glia limitans visible on electron micrographs seemed to form a CSF-brain barrier at these interfaces. Some of the infused 14C-sucrose persisted in the perivascular spaces and walls of arteries and arterioles for more than 3.5 hr. These findings suggest that CSF may function to deliver various agents and factors to pial and parenchymal arteries and arterioles.

  7. 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.

  8. 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.

  9. Automatic measurements of choroidal thickness in EDI-OCT images.

    Science.gov (United States)

    Tian, Jing; Marziliano, Pina; Baskaran, Mani; Tun, Tin Aung; Aung, Tin

    2012-01-01

    Enhanced Depth Imaging (EDI) optical coherence tomography (OCT) provides high-definition cross-sectional images of the choroid in vivo, and hence is used in many clinical studies. However, measurement of choroidal thickness depends on the manual labeling, which is tedious and subjective of inter-observer differences. In this paper, we propose a fast and accurate algorithm that could measure the choroidal thickness automatically. The lower boundary of the choroid is detected by searching the biggest gradient value above the retinal pigment epithelium (RPE) and the upper boundary is formed by finding the shortest path of the graph formed by valley pixels using dynamic programming. The average of Dice's Coefficient on 10 EDI-OCT images is 94.3%, which shows good consistency of the algorithm with the manual labeling. The processing time for each image is about 2 seconds.

  10. Update of choroidal imaging techniques: Past, present and future.

    Science.gov (United States)

    Ruiz-Medrano, J; Flores-Moreno, I; Gutierrez-Bonet, R; Chhablani, J; Ruiz-Moreno, J M

    2017-03-01

    The choroid is the middle layer of the eye, a very vascular and pigmented tissue, with its role in several ophthalmological pathologies already having been clearly established. But it was not until the last few years that we have been able to reliably and precisely measure and quantify its shape and thickness. Ultrasound technology and indocyanine green angiography were the first techniques used for the study of the choroid, and they still maintain their use and clinical indications for the diagnosis and management of several pathologies. But it was the advent of optical coherence tomography that was the greatest breakthrough in choroidal imaging. In this chapter, the past, current and future image modalities for the study of the choroid will be discussed, with special focus on optical coherence tomography and its latest developments. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Diagnosis of Choroidal Melanoma in Dense Asteroid Hyalosis.

    Science.gov (United States)

    Motiani, Meghna V; McCannel, Colin A; Almanzor, Robert; McCannel, Tara A

    2017-01-01

    To demonstrate the utility of Optos ultra-wide field imaging in the diagnosis and management of choroidal melanoma in the setting of asteroid hyalosis. Observational case report. A 52-year-old female was referred for evaluation of floaters, photopsias, and blurry vision in the right eye. Clinical examination revealed dense asteroid hyalosis obscuring the fundus, and a limited view of a pigmented choroidal lesion in the nasal periphery. Optos ultra-wide field fluorescein angiography and ultrasonography facilitated the diagnosis of a choroidal melanoma. The patient underwent Iodine-125 brachytherapy for local tumor control and excellent tumor response was confirmed with serial follow-up Optos imaging and ultrasonography. Ultra-wide field fundus fluorescein angiography facilitated the diagnosis of a choroidal melanoma, which was obscured by dense asteroid hyalosis, allowing for local tumor control with brachytherapy. Optos wide-field imaging may be a valuable tool for detecting potentially life-threatening lesions in the setting of asteroid hyalosis.

  12. Symptomatic third ventricular choroid plexus cysts

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    Lam, A.H. (Children' s Hospital, Sydney (Australia). Dept. of Radiology); Villanueva, A.C. (Jose Reyes Memorial Medical Center, Manila (Philippines))

    1992-10-01

    We describe the imaging findings in 3 children with choroid plexus cysts (CPC) at the foramen of Monro. All CPC measured less than 2 cm and produced symptoms of raised intracranial pressure when located at the foramen of Monro where there was obstruction to the cerebrospinal fluid (CSF) flow. Two of our patients had relief of symptoms after resection of the cyst. One patient with inoperable cardiac defects died and had no surgery performed. Cranial sonography and CT-ventriculography are the modalities of choice in evaluating ventriculomegaly when the diagnosis of occult obstructive CPC is entertained in children. Cranial sonography is indicated in infants with an open fontanelle and CT-ventriculography is reserved for older children with hydrocephalus which is not responding to shunting. (orig./GDG).

  13. Treatment of choroid hemangioma with argon laser

    Science.gov (United States)

    Yang, Chuanzhu; Song, Man

    1993-03-01

    The treatment effects of 7 cases of choroid hemangioma are reported. Of them, 4 cases were men and 3 cases were women. Ages varied from 34 to 52 years. The mean age was 43 years. All of their eyesight was between 0.01 and 0.4. Six of the seven cases were solitary hemangioma, the other one was Sturge-Weber syndrome. After treatment photography, the color of the hemangioma body gradually got weak and the local presented pigmentation. The results of the fluorescein fundus angiography indicated that the hemangioma body reduced, then got atrophy and fibrosis. In five cases eyesight increased, and it didn't in the other two cases.

  14. Beals–Hecht syndrome and choroidal neovascularization

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    Roberto Gallego-Pinazo

    2010-07-01

    Full Text Available Roberto Gallego-Pinazo1, Ruth López-Lizcano1, José María Millán2,3, J Fernando Arevalo5, J Luis Mullor6, Manuel Díaz-Llopis1,3,41Department of Ophthalmology, 2Department of Genetics, Unit of Experimental Opthalmology, Hospital Universitario La Fe, Valencia, Spain; 3Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Valencia, Spain; 4Faculty of Medicine, University of Valencia, Valencia, Spain; 5Retina and Vitreous Service, Clínica Oftalmológica Centro Caracas, Caracas, Venezuela; 6Unit of Experimental Opthalmology, Fundación Parala Investigación del Hospital La Fe, Valencia, SpainPurpose: To describe a case of choroidal neovascularization (CNV in a female diagnosed with Beals–Hecht syndrome.Methods: A retrospective, interventional case is described in a 26-year-old female complaining of metamorphopsia and visual loss in her left eye (counting fingers. The fluorescein angiogram and the optical coherence tomography supported the diagnosis of CNV. Intravitreal ranibizumab was administered.Results: After the third intravitreal ranibizumab, her visual acuity improved to 0.8 and the morphology of the macular area was restored.Conclusions: To our knowledge this is the first report of CNV in Beals–Hecht syndrome treated with ranibizumab. Self-monitoring by periodically performing Amsler grid test is strongly recommended in these patients in order to achieve an early diagnosis of eventual CNV and avoid visual acuity loss.Keywords: Beals–Hecht syndrome, connective tissue disease, choroidal neovascularization, ranibizumab

  15. Automatic segmentation of choroidal thickness in optical coherence tomography.

    Science.gov (United States)

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

    2013-01-01

    The assessment of choroidal thickness from optical coherence tomography (OCT) images of the human choroid is an important clinical and research task, since it provides valuable information regarding the eye's normal anatomy and physiology, and changes associated with various eye diseases and the development of refractive error. Due to the time consuming and subjective nature of manual image analysis, there is a need for the development of reliable objective automated methods of image segmentation to derive choroidal thickness measures. However, the detection of the two boundaries which delineate the choroid is a complicated and challenging task, in particular the detection of the outer choroidal boundary, due to a number of issues including: (i) the vascular ocular tissue is non-uniform and rich in non-homogeneous features, and (ii) the boundary can have a low contrast. In this paper, an automatic segmentation technique based on graph-search theory is presented to segment the inner choroidal boundary (ICB) and the outer choroidal boundary (OCB) to obtain the choroid thickness profile from OCT images. Before the segmentation, the B-scan is pre-processed to enhance the two boundaries of interest and to minimize the artifacts produced by surrounding features. The algorithm to detect the ICB is based on a simple edge filter and a directional weighted map penalty, while the algorithm to detect the OCB is based on OCT image enhancement and a dual brightness probability gradient. The method was tested on a large data set of images from a pediatric (1083 B-scans) and an adult (90 B-scans) population, which were previously manually segmented by an experienced observer. The results demonstrate the proposed method provides robust detection of the boundaries of interest and is a useful tool to extract clinical data.

  16. Severe iritis and choroidal effusion following selective laser trabeculoplasty.

    Science.gov (United States)

    Kim, Danny Y; Singh, Anna

    2008-01-01

    A patient with uncontrolled primary open-angle glaucoma underwent selective laser trabeculoplasty and developed a significant anterior chamber reaction, shallow anterior chamber, and choroidal effusion. Common complications associated with selective laser trabeculoplasty include conjunctival injection, mild anterior chamber reaction, and post-treatment intraocular pressure elevation. The authors believe this is the first reported case of severe iritis and choroidal effusion following selective laser trabeculoplasty.

  17. The Use of Intravitreal Ranibizumab for Choroidal Neovascularization Associated with Vogt-Koyanagi-Harada Syndrome

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    A. M. Kolomeyer

    2011-01-01

    Full Text Available Purpose. To describe the use of intravitreal ranibizumab for choroidal neovascular membrane (CNVM secondary to Vogt-Koyanagi-Harada (VKH syndrome. Methods. Interventional case report. Results. A 50-year-old woman presented with conjunctival injection and bilateral eye pain. Vision was 20/400 and 20/80 in the right and left eyes, respectively. Bilateral iritis, vitritis, and choroidal thickening were evident. Exudative retinal detachment was present in the left eye. Corticosteroid treatment improved vision to 20/40 bilaterally. Methotrexate (MTX was initiated and vision remained stable for 3 months. After a 5-month loss to follow-up, vision in the left eye decreased to finger counting (CF and a parafoveal CNVM was identified. After 3 intravitreal ranibizumab injections, vision improved to 20/40. Twelve months later, despite inflammation control, vision decrease to CF due to recurrent CNVM. A fourth ranibizumab injection was given. Twenty months later, best-corrected vision was 20/400, and an inactive CNVM was present in the left eye. Conclusion. After initial CNVM regression and visual acuity improvement due to ranibizumab, the CNVM recurred and became refractory to treatment. Despite control of inflammation and neovascularization, VKH chronicity lead to permanent vision loss in our patient. A combinational treatment approach may be required in such patients.

  18. Differential expression of fibroblast growth factor receptors in the developing murine choroid plexus.

    Science.gov (United States)

    Reid, Sarah; Ferretti, Patrizia

    2003-03-14

    The choroid plexuses (CPs) are specialised secretory organs situated within the ventricles of the brain involved in the production of cerebrospinal fluid (CSF) and the maintenance of the blood-CSF barrier. Abnormal function of the CPs can lead to hydrocephalus and raised intracranial pressure, pathologies frequently observed in certain craniofacial syndromes caused by single point mutations in fibroblast growth factor receptors (FGFRs). At present, relatively little is known about the embryonic CPs in terms of gene or protein expression, function as the brain develops or on the potential role of FGFRs within this context. Given the limited information available on the regulation of FGFRs during development of the CPs and periventricular tissues, we have carried out a detailed analysis of the localisation of FGFR1, 2, 3 and 4 proteins in these regions of the murine embryo from the time of formation of the CP in the third ventricle at E12.5 throughout the second half of gestation, and examined the expression of different FGFR isoforms at E12.5 by RT-PCR. We show here that FGFR1 and FGFR4 are expressed in murine CPs at E12.5 but not at E15.5 or E18.5, suggesting a role for the signaling pathways transduced by these receptors at early stages of CP development. In contrast, FGFR2 expression is maintained throughout CP development, indicating that this receptor may play a role in the function of immature and mature CP. Also FGFR3 is detected at each developmental stage studied, but surprisingly its expression appears confined to the nuclei of CP cells, suggesting that FGFR3 in the CP does not respond to extracellular FGFs but may act in intracrine fashion.

  19. The Flow Field Inside Ventricle Assist Device

    Science.gov (United States)

    Einav, Shmuel; Rosenfeld, Moshe; Avrahami, Idit

    2000-11-01

    The evaluation of innovative ventricle assist devices (VAD), is of major importance. A New Left Heart Assist Device, with an improved energy converter unit, has been investigated both numerically and experimentally. For this purpose, an experimental Continuous Digital Particle Imagining Velocimetry (CDPIV) is combined with a computational fluid dynamics (CFD) analysis. These tools complement each other to result into a comprehensive description of the complex 3D, viscous and time-dependent flow field inside the artificial ventricle. A 3D numerical model was constructed to simulate the VAD pump and a time-depended CFD analysis with moving walls was performed to predict the flow behaviour in the VAD during the cardiac cycle. A commercial finite element package was used to solve the Navier-Stokes equations (FIDAP, Fluent Inc., Evanston). In the experimental analysis, an optically clear elastic model of the VAD was placed inside a 2D CDPIV system. The CDPIV system is capable of sampling 15 velocity vector fields per second based on image-pairs intervals lower than 0.5 millisecond. Continuous sequences of experimental images, followed by their calculated velocity transient fields, are given as animated presentation of the distensible VAD. These results are used for validating the CFD simulations. Once validated, the CFD results provide a detailed 3D and time dependent description of the flow field, allowing the identification of stagnation or high shear stress regions.

  20. A feline case of isolated fourth ventricle with syringomyelia suspected to be related with feline infectious peritonitis.

    Science.gov (United States)

    Kitagawa, Masato; Okada, Midori; Sato, Tsuneo; Kanayama, Kiichi; Sakai, Takeo

    2007-07-01

    A one-year-old female cat was unable to stand. Magnetic resonance imaging was performed, and an enlargement of the lateral, third, and fourth ventricles and syringomyelia were detected. The cat was diagnosed with an isolated fourth ventricle (IFV) with syringomyelia. The serum isoantibody test for the feline infectious peritonitis (FIP) virus was 1:3,200. After the cat died, a pathological examination revealed nonsuppurative encephalomyelitis. We suspected that the IFV, detected in the cat, was associated with FIP encephalomyelitis. To our knowledge, there has been no report on IFV in veterinary medicine.

  1. Choroidal and macular thickness changes induced by cataract surgery

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    Falcão MS

    2013-12-01

    Full Text Available Manuel S Falcão,1,2 Nuno M Gonçalves,2 Paulo Freitas-Costa,1,3 João B Beato,2 Amândio Rocha-Sousa,1,2 Ângela Carneiro,1,2 Elisete M Brandão,2 Fernando M Falcão-Reis1,21Department of Sense Organs, Faculty of Medicine, University of Porto, 2Department of Ophthalmology of Hospital de São João, 3Department of Anatomy, Faculty of Medicine, University of Porto, Porto, PortugalBackground: The aim of this study was to evaluate the effect of uneventful phacoemulsification on the morphology and thickness of the macula, the submacular choroid, and the peripapillary choroid.Methods: In 14 eyes from 14 patients, retinal macular thickness, choroidal submacular thickness, and choroidal peripapillary thickness were measured preoperatively and at one week and one month after phacoemulsification using enhanced depth imaging spectral domain optical coherence tomography. Changes in thickness of the different ocular tissues were evaluated.Results: There was a statistically significant increase in mean retinal macular thickness at one month. In horizontal scans, the mean increase was +8.67±6.75 µm (P<0.001, and in vertical scans, the mean increase was +8.80±7.07 µm (P=0.001. However, there were no significant changes in choroidal morphology in the submacular and peripapillary areas one month after surgery. In vertical scans, there was a nonsignificant increase in choroidal thickness (+4.21±20.2 µm; P=0.47 whilst in horizontal scans a nonsignificant decrease was recorded (−9.11±39.59 µm; P=0.41. In peripapillary scans, a nonsignificant increase in mean choroidal thickness was registered (+3.25±11.80 µm; P=0.36.Conclusion: Uncomplicated phacoemulsification induces nonpathologic increases in retinal macular thickness probably due to the inflammatory insult of the surgery; however these changes are not accompanied by significant changes in choroidal thickness. In the posterior segment, the morphologic response to the inflammatory insult of

  2. Choroidal Thickness and Choroidal Vessel Density in Nonexudative Age-Related Macular Degeneration Using Swept-Source Optical Coherence Tomography Imaging.

    Science.gov (United States)

    Zheng, Fang; Gregori, Giovanni; Schaal, Karen B; Legarreta, Andrew D; Miller, Andrew R; Roisman, Luiz; Feuer, William J; Rosenfeld, Philip J

    2016-11-01

    To analyze the relationship between choroidal thickness and the distribution of choroidal blood vessels in eyes with nonexudative AMD. Eyes with a diagnosis of nonexudative AMD were imaged using a prototype 100-kHz swept-source (SS) optical coherence tomography (OCT) instrument (Carl Zeiss Meditec, Dublin, CA, USA) with a central wavelength of 1050 nm. We used an OCT cube scan pattern consisting of 512 × 512 A-scans over a 12 × 12 mm retinal area. The eyes were partitioned into two groups based on the presence or absence of reticular pseudodrusen (RPD). All scans were segmented using an automated algorithm. In addition, five eyes from each of the two groups were randomly chosen for manual segmentation. Binary choroidal vessels maps were generated from suitable OCT choroidal slabs, and the relationship between the density of large choroidal vessels and choroidal thickness was analyzed using an Early Treatment Diabetic Retinopathy Study-like target centered on the fovea. Twenty-five eyes were enrolled in each group. The automated algorithm produced accurate choroidal thickness maps with an average difference between the manual and automated segmentations of 13.7 μm. There was a significant and stable correlation between choroidal thickness and choroidal vessel density across the two groups. Both average choroidal thickness and vessel density were significantly lower in eyes with RPD. Our fully automated choroidal segmentation algorithm was able to capture the different patterns of choroidal thickness over a wide area. Choroidal thickness has a clear relationship with the density of large choroid vessels in our sample, irrespective of the presence or absence of RPD.

  3. Macrophage activation associated with chronic murine cytomegalovirus infection results in more severe experimental choroidal neovascularization.

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    Scott W Cousins

    Full Text Available The neovascular (wet form of age-related macular degeneration (AMD leads to vision loss due to choroidal neovascularization (CNV. Since macrophages are important in CNV development, and cytomegalovirus (CMV-specific IgG serum titers in patients with wet AMD are elevated, we hypothesized that chronic CMV infection contributes to wet AMD, possibly by pro-angiogenic macrophage activation. This hypothesis was tested using an established mouse model of experimental CNV. At 6 days, 6 weeks, or 12 weeks after infection with murine CMV (MCMV, laser-induced CNV was performed, and CNV severity was determined 4 weeks later by analysis of choroidal flatmounts. Although all MCMV-infected mice exhibited more severe CNV when compared with control mice, the most severe CNV developed in mice with chronic infection, a time when MCMV-specific gene sequences could not be detected within choroidal tissues. Splenic macrophages collected from mice with chronic MCMV infection, however, expressed significantly greater levels of TNF-α, COX-2, MMP-9, and, most significantly, VEGF transcripts by quantitative RT-PCR assay when compared to splenic macrophages from control mice. Direct MCMV infection of monolayers of IC-21 mouse macrophages confirmed significant stimulation of VEGF mRNA and VEGF protein as determined by quantitative RT-PCR assay, ELISA, and immunostaining. Stimulation of VEGF production in vivo and in vitro was sensitive to the antiviral ganciclovir. These studies suggest that chronic CMV infection may serve as a heretofore unrecognized risk factor in the pathogenesis of wet AMD. One mechanism by which chronic CMV infection might promote increased CNV severity is via stimulation of macrophages to make pro-angiogenic factors (VEGF, an outcome that requires active virus replication.

  4. Influx mechanisms in the embryonic and adult rat choroid plexus: a transcriptome study

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    Norman Ruthven Saunders

    2015-04-01

    Full Text Available The transcriptome of embryonic and adult rat lateral ventricular choroid plexus, using a combination of RNA-Sequencing and microarray data, was analysed by functional groups of influx transporters, particularly solute carrier (SLC transporters. RNA-Seq was performed at embryonic day (E 15 and adult with additional data obtained at intermediate ages from microarray analysis. The largest represented functional group in the embryo was amino acid transporters (twelve with expression levels 2-98 times greater than in the adult. In contrast, in the adult only six amino acid transporters were up-regulated compared to the embryo and at more modest enrichment levels (<5-fold enrichment above E15. In E15 plexus five glucose transporters, in particular Glut-1, and only one monocarboxylate transporter were enriched compared to the adult, whereas only two glucose transporters but six monocarboxylate transporters 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 brain with higher amino acid transport activity reported previously. Data for divalent metal transporters are also considered. Immunohistochemistry of several transporters (e.g. Slc16a10, a thyroid hormone transporter gene products was carried out to confirm translational activity and to define cellular distribution of the proteins. Overall the results show that there is substantial expression of numerous influx transporters in the embryonic choroid plexus, many at higher levels than in the adult. This, together with immunohistochemical evidence and data from published physiological transport studies suggests that the choroid plexus in embryonic brain plays a major role in supplying the developing brain with essential nutrients.

  5. Vasopressin content in the cerebrospinal fluid and fluid perfusing cerebral ventricles in rats after the afferent vagus nerve fibres stimulation

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    Orlowska-Majdak, M.; Traczyk, W.Z. [Akademia Medyczna, Lodz (Poland). Katedra Fizjologii

    1996-12-31

    Experiments were carried out on male rats in urethane anaesthesia. Cerebroventricular system was perfused with McIlwain-Rodniht`s solution from lateral ventricles to cerebellomedullary cistern. Both vagus nerves were cut and the central ends of the nerves were electrically stimulated during the collection of the third 30-min portion of perfusing fluid. Vasopressin (AVP) was determined by radioimmunoassay in samples of the cerebrospinal fluid (CSF) (the first portion) and in five successive samples of the perfusing fluid. AVP concentration in the CSF was several times greater than in the fluid perfusing cerebral ventricles. Alternate electrical stimulation of both vagus nerves did not change considerably the release of AVP into the fluid perfusing the cerebral ventricles in rat, although a certain upward tendency could be observed. It seems that only AVP raised in circulating blood and not in CSF, after vagus nerves stimulation may act on the central nervous structures. (author). 37 refs, 3 figs, 1 tab.

  6. 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.

  7. Angiographic leakage of polypoidal choroidal vasculopathy on indocyanine angiography

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    ZUO Cheng-guo; WEN Feng; HUANG Shi-zhou; LUO Guang-wei; YAN Hong; WU Wei-ju; WU De-zheng

    2010-01-01

    Background There is no detailed report about the angiographic leakage of polypoidal choroidal vasculopathy (PCV)lesions on indocyanine green (ICG) angiography. This study aimed to investigate the angiographic leakage of polypoidal lesions in PCV on ICG angiography.Methods One hundred and forty-four eyes of 137 patients diagnosed as PCV were prospectively observed. Fundus examination, fluorescein angiography, and ICG angiography were performed. Leakage of polypoidal lesions and clinical features were recorded according to the angiograms.Results In all 144 eyes, 110 eyes showed angiographic leakage (leakage group) on ICG angiography and three subtypes of leakage group were noted, which were polypoidal dilations leakage (47 eyes, 42.7%), branching vascular networks leakage (14 eyes, 12.7%) and leakage of both (49 eyes, 44.5%). The other 34 eyes showed regression of polypoidal lesions (regression group). In leakage group, the rates of pigment epithelial detachment (PED), best corrected visual acuity (BCVA) <0.1 and old subretinal hemorrhages were 56.4% (62 eyes), 19.1% (21 eyes), and 4.6% (5 eyes)respectively, compared with 8.8% (3 eyes), 50% (17 eyes) and 38.2% (13 eyes) of regression group (P <0.001). The history of regression group was significantly longer (P <0.001).Conclusions Angiographic leakage and regression can be observed in PCV lesions. Leakage of both polypoidal dilations and branching vascular networks is the most common subtype in leakage group. PCV in leakage group is more likely to be related to PED, better BCVA and shorter history, while PCV regression group tends to relevant to old subretinal hemorrhage, worse BCVA and longer history. This may reflect that the former is active or in the early course while the later is resting or in the late phase of PCV.

  8. Pilomyxoid Astrocytoma Occurring in the Third Ventricle

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    Sanghyeon Kim

    2015-01-01

    Full Text Available Pilomyxoid astrocytoma (PMA is a rare central nervous system tumor that has been included in the 2007 World Health Organization Classification of Tumors of the Central Nervous System. Due to its more aggressive behavior, PMA is classified as Grade II neoplasm by the World Health Organization. PMA predominantly affects the hypothalamic/chiasmatic region and occurs in children (mean age of occurrence = 10 months. We report a case of a 24-year-old man who presented with headache, nausea, and vomiting. Brain CT and MRI revealed a mass occupying only the third ventricle. We performed partial resection. Histological findings, including monophasic growth with a myxoid background, and absence of Rosenthal fibers or eosinophilic granular bodies, as well as the strong positivity for glial fibrillary acidic protein were consistent with PMA.

  9. Fourth ventricle meningiomas: a rare entity.

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    Pichierri, Angelo; Ruggeri, Andrea; Morselli, Carlotta; Delfini, Roberto

    2011-08-01

    Fourth ventricle meningiomas (FVMs) are rare, often misdiagnosed, lesions. To the best of our knowledge, 47 cases have been reported in the literature: we describe our series of three cases treated at our Institution, focusing on some diagnostic tips and intraoperative features of these tumours. Our three patients have a history of headache. Gait disturbances, vomiting and/or diplopia complicated the clinical picture before the referral at our Department. The operations were uneventful, and the patients fully recovered from neurological symptoms. They are free of recurrence at a median follow-up of 19 years. FVMs are rare lesions, which are difficult to differentiate preoperatively from the much more common ependymomas. A preoperative distinction would be extremely advantageous: indeed, although both tumours share similar radiological and clinical patterns, they clearly differ as to surgical difficulty and outcome. In fact, meningiomas are comparatively easier to remove, granting better clinical results.

  10. COMPUTER MODELING IN THE DEVELOPMENT OF ARTIFICIAL VENTRICLES OF HEART

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    L. V. Belyaev

    2011-01-01

    Full Text Available In article modern researches of processes of development of artificial ventricles of heart are described. Advanta- ges of application computer (CAD/CAE technologies are shown by development of artificial ventricles of heart. The systems developed with application of the given technologies are submitted. 

  11. Radionuclide diagnostics of right ventricle; Diagnostyka radioizotopowa prawej komory serca

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    Zaorska-Rajca, J.

    1993-12-31

    Difficulties in evaluating the right ventricle function motivate to making research into new non-invasive methods. Four radionuclide methods that are used to access the right ventricle have been discussed in this paper: first-pass angiocardiography, gated equilibrium ventriculography with red blood cells labelled in vivo technetium-{sup 99}Tc, ventriculography with radioactive xenon 133 and a computerized single probe. Advantages and disadvantages of using each method have been discussed. RNV {sup 99m}Tc method has been recognized as the best one to evaluate RV function. Results of the right ventricle assessment in patients have been discussed in the following clinical groups: chronic cor pulmonale (CP), chronic lung disease without pulmonary arterial hypertension (LD), coronary artery disease (CAD), in patients after infarction (IMA and IMi), dilated cardiomyopathy (KZ) and valvular heart diseases (Wm and Wa). Abnormals in right ventricle function occur with different intensity in all groups, although they no specificity. The highest abnormality occurs in patients with KZ, CP, IMi and Wm, the lowest one - in patients with CAD. Abnormalities are higher in patients with congestive heart failure. In most pathological groups the right ventricle dysfunction is connected with the left ventricle insufficiency. The interdependence between the dysfunction of both ventricles is differs in particular diseases. Assessment of right ventricle function with radionuclide methods plays an important role in diagnosis and control therapy of cardiopulmonary diseases. (author). 385 refs, 48 figs, 6 tabs.

  12. 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

  13. Gamma Knife Radiosurgery for Choroidal Hemangioma

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    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.

  14. Optical coherence tomography: imaging of the choroid and beyond.

    Science.gov (United States)

    Mrejen, Sarah; Spaide, Richard F

    2013-01-01

    Seventy percent of the blood flow to the eye goes to the choroid, a structure that is vitally important to the function of the retina. The in vivo structure of the choroid in health and disease is incompletely visualized with traditional imaging modalities, including indocyanine green angiography, ultrasonography, and spectral domain optical coherence tomography (OCT). Use of new OCT modalities, including enhanced depth imaging OCT, image averaging, and swept-source OCT, have led to increased visualization of the choroidal anatomy. The correlation of these new anatomical findings with other imaging modalities results increases understanding of many eye diseases and recognises of new ones. The status of the choroid appears to be a crucial determinant in the pathogenesis of diseases such as age-related choroidal atrophy, myopic chorioretinal atrophy, central serous chorioretinopathy, chorioretinal inflammatory diseases, and tumors. Extension of these imaging techniques has provided insights into abnormalities of the sclera and optic nerve. Future developments will include blood flow information, 3D rendering of various ocular structures, and the ability to evaluate changes in 3D structural information over time (4D imaging). Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Choroid thickness and ocular pulse amplitude in migraine during attack.

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    Dervisogullari, M S; Totan, Y; Gençler, O S

    2015-03-01

    To compare the choroidal thickness and ocular pulse amplitude (OPA) measurements obtained during the attack period in migraine patients and age and gender matched control group participants using high definition optical coherence tomography (OCT). Thirty eyes at the side of the headache of 30 subjects with a diagnosis of migraine with or without aura and unilateral migraine and 29 age and gender matched healthy participants were enrolled in this observational, cross-sectional study. OCT scans were performed to all participants. Choroidal thicknesses were measured at the fovea, 1500 μm nasal and 1500 μm temporal to the fovea. Intraocular pressure (IOP) and OPA were also measured. The choroidal thickness measurements obtained during the attack period in migraine patients were (mean±SD) 279.82±35.87, 250.05±29.49, and 239.58±27.92 and in control group were 308.20±44.97, 276.95±41.39, and 281.60±41.38 at foveal, nasal, and temporal measurement points, respectively. Choroidal thickness significantly decreased according to the control group (P0.05). Choroidal thickness was found to be significantly decreased in unilateral migraine patients during the attack period when compared with the control group, whereas OPA did not change. The possible implications of these findings on the association between migraine and glaucoma are discussed.

  16. Ultrastructural changes in the melanocytes of aging human choroid.

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    Nag, Tapas Chandra

    2015-12-01

    Retinal pigment epithelial cells as well as choroidal melanocytes (CM) possess melanin granules. The former show clear, age-related changes (formation of lipofuscin granules with a concomitant decrease in melanin content); however, data on changes in the CM with aging are fairly limited. We examined CM in human macular and mid-peripheral areas by light- and transmission electron microscopy in 50-94 year-old donor eyes (N=12). Unlike in the choroid of lower ages, the melanocytes from aging choroid (>75 years) showed partial fusion of about 8-15 melanosomes, forming rosettes-like structures. Besides, there was evidence of emptiness in cytoplasm caused by the loss of melanosomes in aged CM, as was confirmed by quantification in macular part of choroid. In advanced aged eyes (85-94-year-old), the CM possessed many lipid droplets as well as irregular lipofuscin granules, the latter had a tendency to fuse with melanosomes, as happens in aged retinal pigment epithelium. Macrophages in their cytoplasm contained abundant irregular as well as clumped melanosomes of variable size, suggesting that damaged granules/melanocytes are cleared by these phagocytes. These obvious changes in the CM are likely to make the choroid prone to damage by visible light.

  17. Repeatability of Choroidal Thickness Measurements on Enhanced Depth Imaging Optical Coherence Tomography Using Different Posterior Boundaries.

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    Vuong, Vivian S; Moisseiev, Elad; Cunefare, David; Farsiu, Sina; Moshiri, Ala; Yiu, Glenn

    2016-09-01

    To assess the reliability of manual choroidal thickness measurements by comparing different posterior boundary definitions of the choroidal-scleral junction on enhanced depth imaging optical coherence tomography (EDI-OCT). Reliability analysis. Two graders marked the choroidal-scleral junction with segmentation software using different posterior boundaries: (1) the outer border of the choroidal vessel lumen, (2) the outer border of the choroid stroma, and (3) the inner border of the sclera, to measure the vascular choroidal thickness (VCT), stromal choroidal thickness (SCT), and total choroidal thickness (TCT), respectively. Measurements were taken at 0.5-mm intervals from 1.5 mm nasal to 1.5 mm temporal to the fovea, and averaged continuously across the central 3 mm of the macula. Intraclass correlation coefficient (ICC) and coefficient of reliability (CR) were compared to assess intergrader and intragrader reliability. Choroidal thickness measurements varied significantly with different posterior boundaries (P choroidal-scleral junction visibility was Choroidal thickness measurements are more reproducible when measured to the border of the choroid stroma (SCT) than the vascular lumen (VCT) or sclera (TCT). Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Review of spectral domain enhanced depth imaging optical coherence tomography of tumors of the choroid

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    Carol L Shields

    2015-01-01

    Full Text Available Background: Spectral domain enhanced depth imaging optical coherence tomography (EDI-OCT can provide anatomic localization of intraocular tumors. Aims: The aim was to identify topographical and intrinsic patterns of choroidal tumors on EDI-OCT. Settings and Design: Retrospective review. Materials and Methods: Analysis of published reports and personal observations using office based EDI-OCT. Results: Using EDI-OCT, choroidal nevus displayed a smooth, dome-shaped topography with overlying retinal pigment epithelium alterations, drusen, and occasional subretinal cleft demonstrating photoreceptor loss. Small choroidal melanoma showed smooth, moderately dome-shaped topography, commonly with overlying shallow subretinal fluid that often depicted "shaggy" photoreceptors. Choroidal metastasis showed a minimally "lumpy, bumpy" surface topography and with overlying subretinal fluid and shaggy photoreceptors. Choroidal hemangioma showed a smooth, dome-shaped topography, with expansion of the affected small, medium, and large choroidal vessels. Choroidal lymphoma showed varying topography with increasing tumor thickness as "flat, rippled, or undulating (seasick" surface. Choroidal osteoma displayed a smooth undulating surface with visible intralesional horizontal lines suggestive of bone lamellae and occasional horizontal and vertical tubules with intralesional "spongy" flecks. Choroidal melanocytosis appeared as uniformly thickened choroid with increased stromal density surrounding the normal choroidal vascular structures. Conclusions: Enhanced depth imaging-OCT can depict characteristic patterns that are suggestive of various choroidal tumors.

  19. Optimization of the assisted bidirectional Glenn for single ventricle palliation

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    Marsden, Alison; Shang, Jessica; Esmaily-Moghadam, Mahdi; Figliola, Richard; Reinhartz, Olaf; Hsia, Tain-Yen

    2015-11-01

    For neonates with single ventricle physiology, a systemic-pulmonary shunt (e.g., a modified Blalock-Taussig shunt (mBTS)) is typically employed as an early-stage procedure in preparation for a later-stage bidirectional Glenn (BDG). Mortality rates with the mBTS are high, yet the BDG has poorer outcomes in neonates. The assisted bidirectional Glenn (ABG) augments the inadequate pulmonary flow associated with early BDG implementation in neonates through an additional shunt between the innominate artery and the superior vena cava (SVC). The shunt uses a nozzle to inject high-velocity flow to the SVC, elevating downstream pulmonary pressure. Previous simulations and animal studies verified feasibility and higher pulmonary flow rates. In numerical simulations, we explore shunt geometries and placements implanted into a 3D model of the aorta and pulmonary arteries, coupled with a lumped parameter network describing the remaining circulatory system. We seek an ABG shunt that optimizes hemodynamic variables such as pulmonary flow rate and oxygenation and constrains SVC pressure. The optimized ABG will be evaluated against the mBTS and the BDG in simulations and experiments. A successful implementation of the ABG would replace the mBTS and BDG procedures and reduce mortality rates. Burroughs Wellcome Fund, Leducq Foundation.

  20. A Case of Mature Natural Killer-Cell Neoplasm Manifesting Multiple Choroidal Lesions: Primary Intraocular Natural Killer-Cell Lymphoma

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    Yoshiaki Tagawa

    2015-11-01

    Full Text Available Purpose: Natural killer (NK cell neoplasm is a rare disease that follows an acute course and has a poor prognosis. It usually emerges from the nose and appears in the ocular tissue as a metastasis. Herein, we describe a case of NK-cell neoplasm in which the eye was considered to be the primary organ. Case: A 50-year-old female displayed bilateral anterior chamber cells, vitreous opacity, bullous retinal detachment, and multiple white choroidal mass lesions. Although malignant lymphoma or metastatic tumor was suspected, various systemic examinations failed to detect any positive results. A vitrectomy was performed OS; however, histocytological analyses from the vitreous sample showed no definite evidence of malignancy, and IL-10 concentration was low. Enlarged choroidal masses were fused together. Three weeks after the first visit, the patient suddenly developed an attack of fever, night sweat, and hepatic dysfunction, and 5 days later, she passed away due to multiple organ failure. Immunohistochemisty and in situ hybridization revealed the presence of atypical cells positive for CD3, CD56, and Epstein-Barr virus-encoded RNAs, resulting in the diagnosis of NK-cell neoplasm. With the characteristic clinical course, we concluded that this neoplasm was a primary intraocular NK-cell lymphoma. Conclusions: This is the first report to describe primary intraocular NK-cell neoplasm. When we encounter atypical choroidal lesions, we should consider the possibility of NK-cell lymphoma, even though it is a rare disease.

  1. A Case of Mature Natural Killer-Cell Neoplasm Manifesting Multiple Choroidal Lesions: Primary Intraocular Natural Killer-Cell Lymphoma

    Science.gov (United States)

    Tagawa, Yoshiaki; Namba, Kenichi; Ogasawara, Reiki; Kanno, Hiromi; Ishida, Susumu

    2015-01-01

    Purpose Natural killer (NK) cell neoplasm is a rare disease that follows an acute course and has a poor prognosis. It usually emerges from the nose and appears in the ocular tissue as a metastasis. Herein, we describe a case of NK-cell neoplasm in which the eye was considered to be the primary organ. Case A 50-year-old female displayed bilateral anterior chamber cells, vitreous opacity, bullous retinal detachment, and multiple white choroidal mass lesions. Although malignant lymphoma or metastatic tumor was suspected, various systemic examinations failed to detect any positive results. A vitrectomy was performed OS; however, histocytological analyses from the vitreous sample showed no definite evidence of malignancy, and IL-10 concentration was low. Enlarged choroidal masses were fused together. Three weeks after the first visit, the patient suddenly developed an attack of fever, night sweat, and hepatic dysfunction, and 5 days later, she passed away due to multiple organ failure. Immunohistochemisty and in situ hybridization revealed the presence of atypical cells positive for CD3, CD56, and Epstein-Barr virus-encoded RNAs, resulting in the diagnosis of NK-cell neoplasm. With the characteristic clinical course, we concluded that this neoplasm was a primary intraocular NK-cell lymphoma. Conclusions This is the first report to describe primary intraocular NK-cell neoplasm. When we encounter atypical choroidal lesions, we should consider the possibility of NK-cell lymphoma, even though it is a rare disease. PMID:26668579

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

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    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

  3. Inhibition of the recombinant human endostatin adenavirus on experimental choroidal neovascularization in rats

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    Li-Juan Chen

    2017-06-01

    Full Text Available AIM: To investigate the inhibition of the recombinant human endostatin adenavirus(Ad-Eson the experimental choroidal neovascularization(CNVmodels by intravitreous injection. METHODS: Experimental CNV models were induced by semiconductor laser in 30 male Brown Norway(BNrats and randomly divided into 3 groups with 10 rats in each group. At 21d after photocoagulation, the single administration group were given intravitreous injection with Ad-Es 0.01mL; the repeated administration group were given intravitreous injection with Ad-Es 0.01mL and a repeated injection 7d later; the saline control group were given intravitreous injection with saline 0.01mL. At 7d after final administration, the leakage of fundus fluorescein angiography(FFAwas observed. Various CNV areas were measured by using laser confocal microscopy of choroidal flatmount method. Pathology and ultrastructure were observed with light microscopy, the expressions of CD105 were measured by immunohistochemistry. RESULTS: The leakage of CNV of the administration group abviously decreased as compared with those in the saline group, the leakage of repeated administration group decreased compared with that of single administration group(PPCONCLUSION: Ad-Es can effectively inhibit semiconductor laser induced CNV in BN rats, and the inhibition effect of repeated administration group is better than that of single administration group. It may be a useful new method in the treatment of CNV.

  4. File list: Unc.CDV.50.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.CDV.50.AllAg.Heart_Ventricles mm9 Unclassified Cardiovascular Heart Ventricles ...http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Unc.CDV.50.AllAg.Heart_Ventricles.bed ...

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

    Full Text Available Oth.CDV.10.AllAg.Heart_Ventricles mm9 TFs and others Cardiovascular Heart Ventricles... http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Oth.CDV.10.AllAg.Heart_Ventricles.bed ...

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  9. File list: Pol.CDV.50.AllAg.Heart_Ventricles [Chip-atlas[Archive

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  10. Retinal pigment epithelial cell expression of active Rap 1a by scAAV2 inhibits choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    Haibo Wang

    2016-01-01

    Full Text Available To test the hypothesis that increased Rap1a activity specifically in retinal pigment epithelial cells resists choroidal neovascularization (CNV, self-complementary adeno-associated virus 2 (scAAV2 with RPE65-promoter-driven GFP vectors were generated and introduced subretinally into Rap1b-deficient mice. Six-week-old mice that received subretinal control (scAAV2-Con or constitutively active Rap1a (scAAV2-CARap1a showed strong GFP at the 5 × 108 viral particle/μl dose 5 weeks later without altering retinal morphology or function. Compared to scAAV2-Con- or phosphate-buffered saline (PBS-injected, eyes injected with scAAV2-CARap1a had increased Rap1 in retinal pigment epithelial (RPE/choroidal lysates and a significant reduction in CNV volume 7 days after laser, comparable to eyes that received intravitreal anti-VEGF versus IgG control. scAAV2-CARap1a-, but not anti-VEGF-, injected eyes had increased pan-cadherin in RPE/choroids. In cultured RPE cells, increased active Rap1a inhibited TNFα-induced disassociation of junctional pan-cadherin/β-catenin complexes, increased transepithelial electrical resistance through an interaction of β-catenin with phosphorylated scaffold protein, IQGAP1, and inhibited choroidal endothelial cell (CEC transmigration of an RPE monolayer. This evidence shows that increased Rap1a activity specifically in RPE cells is sufficient to reduce CEC transmigration and CNV and involves IQGAP1-mediated protection of RPE junctional complexes.

  11. Retinal pigment epithelial cell expression of active Rap 1a by scAAV2 inhibits choroidal neovascularization.

    Science.gov (United States)

    Wang, Haibo; Han, Xiaokun; Bretz, Colin A; Becker, Silke; Gambhir, Deeksha; Smith, George W; Samulski, R Jude; Wittchen, Erika S; Quilliam, Lawrence A; Chrzanowska-Wodnicka, Magdalena; Hartnett, M Elizabeth

    2016-01-01

    To test the hypothesis that increased Rap1a activity specifically in retinal pigment epithelial cells resists choroidal neovascularization (CNV), self-complementary adeno-associated virus 2 (scAAV2) with RPE65-promoter-driven GFP vectors were generated and introduced subretinally into Rap1b-deficient mice. Six-week-old mice that received subretinal control (scAAV2-Con) or constitutively active Rap1a (scAAV2-CARap1a) showed strong GFP at the 5 × 10(8) viral particle/µl dose 5 weeks later without altering retinal morphology or function. Compared to scAAV2-Con- or phosphate-buffered saline (PBS)-injected, eyes injected with scAAV2-CARap1a had increased Rap1 in retinal pigment epithelial (RPE)/choroidal lysates and a significant reduction in CNV volume 7 days after laser, comparable to eyes that received intravitreal anti-VEGF versus IgG control. scAAV2-CARap1a-, but not anti-VEGF-, injected eyes had increased pan-cadherin in RPE/choroids. In cultured RPE cells, increased active Rap1a inhibited TNFα-induced disassociation of junctional pan-cadherin/β-catenin complexes, increased transepithelial electrical resistance through an interaction of β-catenin with phosphorylated scaffold protein, IQGAP1, and inhibited choroidal endothelial cell (CEC) transmigration of an RPE monolayer. This evidence shows that increased Rap1a activity specifically in RPE cells is sufficient to reduce CEC transmigration and CNV and involves IQGAP1-mediated protection of RPE junctional complexes.

  12. Optical Coherence Tomography of Retinal and Choroidal Tumors

    Directory of Open Access Journals (Sweden)

    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.

  13. [Radiation therapy in simultaneous choroidal and brain metastases].

    Science.gov (United States)

    Conill, C; Jorcano, S; Planas, I; Marruecos, J; Casas, F; Fontenla, J R

    2005-09-01

    Choroidal metastases from lung cancer can be the initial clinical manifestation of metastasic disease, although they generally coexist with at least two more metastasic sites. The most common symptom is decreased vision, however 20% of brain metastases can present with visual alterations. A differential diagnosis within brain metastases and/or choroidal is necessary. We present the case of a patient with lung cancer and decreased vision who was diagnosed as simultaneous choroidal and brain metastases. Radiation therapy (20Gy/5fractions) significantly improves decreased vision. This case shows that, although life expectancy of patients with metastasic lung cancer is short, an adequate diagnosis and treatment, can improve the quality of life of those patients.

  14. Choroid plexus failure in the Kearns-Sayre syndrome

    Directory of Open Access Journals (Sweden)

    Spector Reynold

    2010-08-01

    Full Text Available Abstract The Kearns-Sayre syndrome is a mitochondrial disorder (generally due to mitochondrial DNA deletions that causes ophthalmoplegia, retinopathy, ataxia and brain abnormalities such as leukoencephalopathy. In this syndrome, the choroid plexus epithelial cells, unlike brain cells, are greatly enlarged and granular, consistent with their inability to adequately transport folate from blood into cerebrospinal fluid (CSF, and homovanillic acid (a dopamine metabolite from CSF into blood. This inability to transport folates from blood into CSF (and brain adequately, causes cerebral folate deficiency that can be partially reversed by very high doses of reduced folates. The Kearns-Sayre syndrome is a disease that interferes with key choroid plexus functions and is a cause of generalized choroid plexus failure.

  15. 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.

  16. Frequency of choroidal abnormalities in neurofibromatosis type 1.

    Science.gov (United States)

    Yasunari, T; Shiraki, K; Hattori, H; Miki, T

    2000-09-16

    Choroidal neurofibromatosis is thought to be a rare form of neurofibromatosis that involves the eyes. The development of infrared light examination with a scanning laser ophthalmoscope (SLO) and indocyanine-green fundus angiography has allowed examination of the choroid. We studied choroidal abnormalities in patients with neurofibromatosis 1 and compared their frequency with that of other ocular abnormalities. We examined 33 eyes of 17 consecutive patients diagnosed with neurofibromatosis 1 by conventional ophthalmoscopy and by non-invasive infrared monochromatic light with confocal SLO. 76 eyes of 39 age-matched controls were examined similarly by confocal SLO. 21 digital fluorescein and indocyanine-green angiographies were obtained from 11 adult patients, and 77 angiograms were obtained from age-matched controls. Infrared monochromatic light examination by confocal SLO showed bright multiple patchy regions at and around the entire posterior pole of all 33 eyes examined. All bright patchy regions seen in adult patients corresponded to hypofluorescent areas on their indocyanine-green angiograms. However, no abnormalities were noted in any patient at corresponding areas under conventional ophthalmoscopic examination or fluorescein angiography. In SLO and indocyanine-green studies, controls and control angiograms showed no choroidal abnormalities. Iris nodules were noted in 25 eyes (76%) of 14 patients (82%) and eyelid neurofibroma in five patients (29%). The bright patchy regions noted under infrared fundus examination and the corresponding hypofluorescent areas seen on indocyanine-green angiograms are probably of choroidal origin. The high frequency (100%) of these abnormalities suggests that the choroid is one of the structures most commonly affected by neurofibromatosis 1.

  17. Rules for diagnosis of arterioventricular discordances and spatial identification of ventricles. Crossed great arteries and transposition of the great arteries.

    Science.gov (United States)

    de la Cruz, M V; Berrazueta, J R; Arteaga, M; Attie, F; Soni, J

    1976-04-01

    Rules are presented for the diagnosis of arterioventricular discordances and the spatial position of the ventricles in these cardiopathies by means of angiocardiography and the position of cardiac catheters. Because these rules are based on previous anatomo-embryological findings, the normal development of the conus and the truncus is briefly analysed. The probable morphogenesis of this group of truncoconal cardiopathies is discussed. The fundamental process required to establish the diagnosis of these cardiopathies is as follows: 1) The truncoconal morphology is identified in the lateral projection. a) The anterior position of the pulmonary artery and its infundibulum with respect to the aorta and its infundibulum is characteristic of crossed great arteries with arterioventricular concordance or discordance. b) The anterior position of the aorta and its infundibulum with respect to the pulmonary artery and its infundibulum is characteristic of transposition of the great arteries with arterioventricular concordance or discordance. 2) Once the truncoconal morphology is identified, the use of the anteroposterior projection allows the establishment of the differential diagnosis between arterioventricular concordances and discordances, and of the spatial location of the ventricles in these entities. a) An anterior pulmonary artery directed from right to left, emerging from an infundibulum placed on the left side (anatomically right ventricle on the left) or an anterior pulmonary artery directed from left to right, arising from an infundibulum located to the right (anatomically right ventricular placed on the right), is the specific image of discordant crossed great arteries. b) An anterior pulmonary artery directed from right to left emerging from an infundibulum placed on the right side (anatomically right ventricle on the right side) or the anterior pulmonary artery directed from left to right arising from a left-sided infundibulum (anatomically right ventricle

  18. The superior transvelar approach to the fourth ventricle and brainstem.

    Science.gov (United States)

    Ezer, Haim; Banerjee, Anirban Deep; Bollam, Papireddy; Guthikonda, Bharat; Nanda, Anil

    2012-06-01

    Objective The superior transvelar approach is used to access pathologies located in the fourth ventricle and brainstem. The surgical path is below the venous structures, through the superior medullary velum. Following splitting the tentorial edge, near the tentorial apex, the superior medullary velum is split in the cerebello-mesencephalic fissure. Using the supracerebellar infratentorial, transtentorial or parietal interhemispheric routes, the superior medullary velum is approached. Splitting this velum provides a detailed view of the fourth ventricle and its floor. Materials and Methods A total of 10 formalin-fixed specimens were dissected in a stepwise manner to simulate the superior transvelar approach to the fourth ventricle. The exposure gained the distance from the craniotomy site and the ease of access was assessed for each of the routes. We also present an illustrative case, operated by the senior author (AN). Results The superior transvelar approach provides access to the entire length of the fourth ventricle floor, from the aqueduct to the obex, when using the parietal interhemispheric route. In addition, this approach provides access to the entire width of the floor of the fourth ventricle; however, this requires retracting the superior cerebellar peduncle. Using the supracerebellar infratentorial route gives a limited exposure of the superior part of the fourth ventricle. The occipital interhemispheric route is a compromise between these two. Conclusion The superior transvelar approach to the fourth ventricle provides a route for approaching the fourth ventricle from above. This approach does not require opening the posterior fossa in the traditional way, and provides a reasonable alternative for accessing the superior fourth ventricle.

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

    OpenAIRE

    V. A. Solomin; D.A. Magaramov; G. F. Kachalina

    2012-01-01

    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...

  20. Hemodynamic forces in a model left ventricle

    Science.gov (United States)

    Domenichini, Federico; Pedrizzetti, Gianni

    2016-12-01

    Intraventricular pressure gradients were clinically demonstrated to represent one useful indicator of the left ventricle (LV) function during the development of heart failure. We analyze the fluid dynamics inside a model LV to improve the understanding of the development of hemodynamic forces (i.e., mean pressure gradient) in normal conditions and their modification in the presence of alterations of LV tissue motion. To this aim, the problem is solved numerically and the global force exchanged between blood flow and LV boundaries is computed by volume integration. We also introduce a simplified analytical model, based on global conservation laws, to estimate hemodynamic forces from the knowledge of LV tissue information commonly available in cardiac imaging. Numerical results show that the normal intraventricular gradients feature a deep brief suction at early diastolic filling and a persistent thrust during systolic ejection. In presence of abnormalities of the wall motion, the loss of time synchrony is more relevant than the loss of spatial uniformity in modifying the normal pressure gradient spatiotemporal pattern. The main findings are reproduced in the integral model, which represents a possible easy approach for integrating fluid dynamics evaluations in the clinical examination.

  1. Optical Coherence Tomography: An Adjunctive Tool for Differentiating between Choroidal Melanoma and Metastasis

    Science.gov (United States)

    Vishnevskia-Dai, Vicktoria; Zur, Dinah; Yaacobi, Shiran; Moroz, Iris; Newman, Hadas; Neudorfer, Meira

    2016-01-01

    Purpose. To investigate the value of optical coherence tomography (OCT) for differentiation between choroidal melanoma and metastasis based on characteristics of the anterior choroidal surface and the chorioretinal interface. Methods. This retrospective observational case series included 29 patients with untreated choroidal melanomas and 21 patients with untreated choroidal metastases. Regularity and lobularity characteristics of the anterior choroidal surface were evaluated in a masked manner. Retinal and retinal pigment epithelium (RPE) findings were documented as well. Results. OCT demonstrated a regular and smooth anterior choroidal surface in 89.7% of the eyes with melanoma and in 47.6% of the eyes with metastasis (p = 0.002; sensitivity = 89.7%; specificity = 52.4%). The anterior choroidal contour was lobulated in 81.0% of the eyes with metastasis versus 17.2% of the eyes with melanoma (p < 0.001; sensitivity = 82.8%; specificity = 81.0%). RPE thickness and neuroretinal characteristics (e.g., retinal thickness, the presence of cysts, and the presence of subretinal fluid) were similar in both choroidal tumors. Conclusion. OCT may serve as a noninvasive adjunctive tool for the differential diagnosis of choroidal tumors. Choroidal melanomas usually demonstrate regular surfaces on OCT, while choroidal metastases usually have an irregular and lobulated surface. PMID:26998354

  2. Juxtapapillary choroid is thinner in normal-tension glaucoma than in healthy eyes.

    Science.gov (United States)

    Lee, Kyoung Min; Lee, Eun Ji; Kim, Tae-Woo

    2016-12-01

    To measure the juxtapapillary choroidal thickness in eyes with normal-tension glaucoma (NTG) and to compare it with healthy eyes. Twelve radial B-scan images of the optic nerve head (ONH) were obtained from 96 patients with NTG and 48 healthy subjects matched by age using swept-source (SS) optical coherence tomography (OCT). The juxtapapillary choroidal thickness was defined as the average choroidal thickness within 500 μm from the border tissue of Elschnig. Choroidal thinning in patients with NTG was assessed by calculating the relative choroidal thickness, defined as the ratio of the measured juxtapapillary choroidal thickness in each meridian to the corresponding value in age-matched healthy controls. Retinal nerve fibre layer (RNFL) damage as reflected by circumpapillary RNFL thickness (measured using spectral-domain OCT) was also assessed. The juxtapapillary choroid was significantly thinner in NTG eyes than in healthy control eyes in the inferotemporal and superotemporal sectors. The relative choroidal thinning was topographically associated with the hemispheric location of dominant RNFL damage. The average juxtapapillary choroidal thickness was not associated with either the global RNFL thickness or the visual field mean deviation. Age and untreated intraocular pressure were significantly associated with the juxtapapillary choroidal thickness in NTG eyes in both univariate and multivariate analyses (all p choroidal thinning could be an important part of the pathogenesis of optic nerve damage in NTG. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  3. 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.

  4. Involvement of the choroid plexus in multiple sclerosis autoimmune inflammation: a neuropathological study.

    Science.gov (United States)

    Vercellino, Marco; Votta, Barbara; Condello, Cecilia; Piacentino, Chiara; Romagnolo, Alberto; Merola, Aristide; Capello, Elisabetta; Mancardi, Giovanni Luigi; Mutani, Roberto; Giordana, Maria Teresa; Cavalla, Paola

    2008-08-13

    An immunological function has been proposed for the choroid plexus (CP). In multiple sclerosis (MS) brains, CPs show (immunohistochemistry to HLA-DR, CD3, CD20, CD68, VCAM-1, CD138) T lymphocytes in vessels and stroma, VCAM-1 expression on endothelia, intense HLA-DR immunostaining on cells in CP stroma, among CP epithelium and on epiplexus cells. CPs in control or amyotrophic lateral sclerosis brains do not show such inflammatory changes. Intense CP inflammation is observed in viral encephalitis. Changes in MS CPs suggest persisting immune activation, with intensity similar to acute encephalitis, even in MS phases in which neurodegeneration prevails. In MS, CPs could represent a site for lymphocyte entry in the CSF and for CSF antigens presentation.

  5. An isolated fourth ventricle in neurosarcoidosis: MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Hesselmann, Volker; Terstegge, Klaus; Schulte, Oliver; Krug, Barbara; Lackner, Klaus [Department of Radiology, University of Cologne, Joseph Stelzmann Strasse 9, 50924 Cologne (Germany); Wedekind, Christoph [Department of Neurosurgery, University of Cologne, Joseph Stelzmann Strasse 9, 50924 Cologne (Germany); Voges, Juergen [Department of Stereotaxy und Functional Neurosurgery, University of Cologne, Joseph Stelzmann Strasse 9, 50924 Cologne (Germany)

    2002-07-01

    We report on an isolated enlargement of the fourth ventricle in a patient with neurosarcoidosis which developed 3 years after the insertion of a ventriculo-atrial shunt. Repeated MRI images were obtained in a patient with known neurosarcoidosis between 1995 and 2000. Imaging findings were correlated to the medical course of the patient, who developed a hydrocephalus and a trapped fourth ventricle consecutively. The isolation was presumably due to granulomatous inflammation of the ependyma surrounding the fourth ventricular outlets. The isolated fourth ventricle was responsible for a deterioration of neurological status. Neurosarcoidosis is a severe complication in sarcoidosis patients. An isolated enlargement of the fourth ventricle is a rare complication in clinically deteriorated patients with neurosarcoidosis and ventricular drainage, which may require neurosurgical treatment. (orig.)

  6. Development of neurogenic stress cardiomyopathy after fourth ventricle tumor surgery

    Directory of Open Access Journals (Sweden)

    D. A. Doroshenko

    2014-07-01

    Full Text Available The paper describes a clinical case of the development of neurogenic stress cardiomyopathy that had the characteristics of Takotsubo cardiomyopathyin a young female patient in the early periods after fourth ventricle tumor surgery.

  7. Development of neurogenic stress cardiomyopathy after fourth ventricle tumor surgery

    Directory of Open Access Journals (Sweden)

    D. A. Doroshenko

    2012-01-01

    Full Text Available The paper describes a clinical case of the development of neurogenic stress cardiomyopathy that had the characteristics of Takotsubo cardiomyopathyin a young female patient in the early periods after fourth ventricle tumor surgery.

  8. Syringomyelia regression after shunting of a trapped fourth ventricle

    Directory of Open Access Journals (Sweden)

    Dukagjin Morina

    2013-01-01

    Full Text Available We describe a case of progressive syringomyelia following post-infectious trapped fourth ventricle (TFV, which resolved after shunting of the fourth ventricle. A 28-year-old female who had previously undergone treatment of intracerebral hemorrhage and meningitis developed a hydrocephalus with TFV. After 3 years she developed disturbance of walking and coordination. Cranial-CT revealed an enlargement of the shunted fourth ventricle as a result of shunt dysfunction. Furthermore a cervical syringomyelia developed. The patient underwent a revision of a failed fourth ventriculo- peritoneal shunt. Postoperatively, syringomyelia resolved within 6 months and the associated neurological deficits improved significantly. An insufficiency of cerebrospinal fluid draining among patients with TFV can be associated with communicating syringomyelia. An early detection and treatment seems important on resolving syringomyelia and avoiding permanent neurological deficits. Ventriculo-peritoneal shunt in trapped fourth ventricles can resolve a secondary syringomyelia.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Primary Vitrectomy for Rhegmatogenous Retinal Detachment Associated with Choroidal Detachment

    Institute of Scientific and Technical Information of China (English)

    Xiaohui Zhao; Yiqiao Xing; Ying Chen

    2006-01-01

    Purpose: To evaluate the role and the anatomic and visual results of primary pars plana vitrectomy (PPV) in treating cases with rhegmatogenous retinal detachment associated with choroidal detachment.Methods: All patients were divided into 2 groups. Each group included 23 consecutive eyes with rhegmatogenous retinal detachment and choroidal detachment with proliferative vitreoretinopathy less than grade C. In the study group, controlled removal of vitreous traction was achieved by primary vitrectomy and augmented by scleral buckling if needed. The breaks were treated by focused endolaser coagulation.Postoperative tamponade was done by SF6 or C3F8 gas. In the control group, all patients underwent regular scleral buckling procedure. The cases were followed up for 6 to 12 months.Results: In the study group, retinal reattachment could be achieved in 21 cases (91.30%) after the first operation and in all cases after the second procedure. No occurrence of choroidal detachment occurred after the first procedure. Retinal reattachment rate and visual results tended to be better compared with conventional surgical techniques in the control group.Conclusion: Primary vitrectomy represents a safe, effective method in the management of rhegmatogenous retinal detachment associated with choroidal detachment.

  11. Peripapillary Choroidal Thickness in Adult Chinese: The Beijing Eye Study.

    Science.gov (United States)

    Jiang, Ran; Wang, Ya Xing; Wei, Wen Bin; Xu, Liang; Jonas, Jost B

    2015-06-01

    To measure peripapillary choroidal thickness (PPCT) and to assess its associations. The population-based cross-sectional Beijing Eye Study 2011 included 3468 participants. Detailed medical and ophthalmic examinations were performed. We measured PPCT by spectral-domain optical coherence tomography (SD-OCT) with a 3.4-mm scan circle centered on the optic nerve head. Peripapillary choroidal thickness measurements were available for 3060 (88.2%) study participants with a mean age of 64.4 ± 9.6 years (range, 50-93 years). Mean global PPCT was 134 ± 53 μm (range, 35-348 μm). Peripapillary choroid was thickest in the superior region (155 ± 60 μm), followed by the temporal region (144 ± 75 μm; P region (139 ± 55 μm; P region (110 ± 45 μm; P 0.05) associated with blood pressure, blood concentration of lipids, intraocular pressure and prevalence of glaucoma, diabetic retinopathy, and retinal vein occlusions. The decrease of PPCT with longer axial length occurred predominantly in the temporal region. Peripapillary choroidal thickness is thickest superiorly and thinnest inferiorly. It decreases by 2 μm per year of life and by 5 μm per diopter of myopia. Thinner PPCT is correlated with larger parapapillary α and β zones. The association of thinner PPCT with lower best corrected visual acuity may warrant further study.

  12. Bilateral Choroidal Metastasis from Non-Small Cell Lung Cancer

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    Tariq Namad

    2014-01-01

    Full Text Available Breast and lung cancers are the most common primary neoplasms to manifest with choroidal metastases. The incidence of choroidal metastases from metastatic lung cancer was reported to be 2–6.7%. We report a case of bilateral choroidal metastasis from non-small cell lung cancer. A 59-year-old Caucasian female patient, never a smoker, was diagnosed with stage IV lung adenocarcinoma metastatic to the pleura, bones, and the brain. Her initial scan of the chest showed innumerable soft tissue nodules and mediastinal adenopathy compatible with metastatic disease. Her initial brain MRI showed numerous small enhancing lesions consistent with extensive disease. Unfortunately, during her follow-up visits, she presented with bulge on her left eye. Simultaneously, her follow-up chest scan showed increase in the size of the lung nodules. She continued to have a reasonable performance status at that time, except for mild increase in her dyspnea. The choroidal metastases require a multidisciplinary care and should be among the differential patients with malignancy who present with ocular symptoms.

  13. Comparative response of right and left ventricles to volume overload.

    Science.gov (United States)

    Mathew, R; Thilenius, O G; Arcilla, R A

    1976-08-01

    The cardiac volume data of 49 normal children were compared with those of 23 with secundum atrial septal defect and 24 with patent ductus arteriosus. Significantly smaller ventricular end-diastolic volumes were observed in the normal infants than in older children (right ventricle 53.9 versus 75.5 cm3/m2; left ventricle 46.7 versus 63.6 cm3/m2). "Distensibility" of the right ventricle (DRV), left ventricle (DLV) and left atrium increased normally with age. DRV and DLV were similar shortly after birth; thereafter, DRV increased more rapidly than DLV (mean DRV 12.7; mean DLV 7.8 cm3/m2 per mm Hg, P less than 0.001). In both atrial septal defect and patent ductus arteriosus, the ipsilateral (involved) ventricles had increased volume, increased output, normal ejection fraction and increased distensibility. The contralateral (left) ventricle in atrial septal defect was smaller than normal (39.6 versus 49.7 cm3, P less than 0.001), and had a smaller ejection fraction (0.63 versus 0.71, P less than 0.01) and output (3.70 versus 4.57 liters/min per m2, P less than 0.005). In contrast, the contralateral (right) ventricle in patent ductus arteriosus remained normal. Left atrial maximal volume was larger than normal in atrial septal defect (46.6 versus 35.9 cm3/m2, P less than 0.001). The left atrial and left ventricular volumes in patent ductus arteriosus were, respectively, 152 and 142 percent of normal, indicating comparable response to the volume load. The left head changes in atrial septal defect may be related both to a functionally restrictive defect and to the difference in distensibility of the ventricles.

  14. Surgical treatment of double outlet ventricle: report on 72 cases

    Institute of Scientific and Technical Information of China (English)

    YANG Jin-fu; HU Dong-xu; HU Jian-guo; YIN Bang-liang; ZHOU Xin-min; ZHOU Wen-wu; TAN Si-chuang; YIN Ni

    2005-01-01

    @@ Double outlet ventricle (DOV) is defined as a congenital heart disease with: (1) both great arteries arising completely, or almost completely (≥90%), from a single ventricle (usually, right ventricle); (2) an aortic valve having no fibre connection with mitral valve; and (3) the only outlet of the other ventricle is a ventricular septal defect (VSD). The incidence of DOV accounts for 1% of all congenital heart disease.1 Clinically there are three common types: Fallot type or double outlet right ventricle (DORV) with subaortic VSD with pulmonary stenosis; Eisenmenger type or DORV with subaortic VSD without pulmonary stenosis and Taussig-Bing type or DORV with subpulmonary VSD. Operative techniques are different according to the position of the VSD and great arteries and the presence or absence of ventricular outflow tract obstruction. The operative difficulty increases in the presence of coronary artery malformation. Recently, our research centre has treated 72 cases of patients suffering from double outlet ventricle. This article is the report of the operative methods and the outcomes.

  15. Molecular pathogenesis of retinal and choroidal vascular diseases.

    Science.gov (United States)

    Campochiaro, Peter A

    2015-11-01

    There are two major types of ocular neovascularization that affect the retina, retinal neovascularization (NV) and subretinal or choroidal NV. Retinal NV occurs in a group of diseases referred to as ischemic retinopathies in which damage to retinal vessels results in retinal ischemia. Most prevalent of these are diabetic retinopathy and retinal vein occlusions. Subretinal and choroidal NV occur in diseases of the outer retina and Bruch's membrane, the most prevalent of which is age-related macular degeneration. Numerous studies in mouse models have helped to elucidate the molecular pathogenesis underlying retinal, subretinal, and choroidal NV. There is considerable overlap because the precipitating event in each is stabilization of hypoxia inducible factor-1 (HIF-1) which leads to upregulation of several hypoxia-regulated gene products, including vascular endothelial growth factor (VEGF), angiopoietin 2, vascular endothelial-protein tyrosine phosphatase (VE-PTP), and several others. Stimulation of VEGF signaling and suppression of Tie2 by angiopoietin 2 and VE-PTP are critical for sprouting of retinal, subretinal, and choroidal NV, with perturbation of Bruch's membrane also needed for the latter. Additional HIF-1-regulated gene products cause further stimulation of the NV. It is difficult to model macular edema in animals and therefore proof-of-concept clinical trials were done and demonstrated that VEGF plays a central role and that suppression of Tie2 is also important. Neutralization of VEGF is currently the first line therapy for all of the above disease processes, but new treatments directed at some of the other molecular targets, particularly stabilization of Tie2, are likely to provide additional benefit for subretinal/choroidal NV and macular edema. In addition, the chronicity of these diseases as well as the implication of VEGF as a cause of retinal nonperfusion and progression of background diabetic retinopathy make sustained delivery approaches for VEGF

  16. Molecular Pathogenesis of Retinal and Choroidal Vascular Diseases

    Science.gov (United States)

    Campochiaro, Peter A.

    2015-01-01

    There are two major types of ocular neovascularization that affect the retina, retinal neovascularization (NV) and subretinal or choroidal NV. Retinal NV occurs in a group of diseases referred to as ischemic retinopathies in which damage to retinal vessels results in retinal ischemia. Most prevalent of these are diabetic retinopathy and retinal vein occlusions. Subretinal and choroidal NV occur in diseases of the outer retina and Bruch’s membrane, the most prevalent of which is age-related macular degeneration. Numerous studies in mouse models have helped to elucidate the molecular pathogenesis underlying retinal, subretinal, and choroidal NV. There is considerable overlap because the precipitating event in each is stabilization of hypoxia inducible factor-1 (HIF-1) which leads to upregulation of several hypoxia-regulated gene products, including vascular endothelial growth factor (VEGF), angiopoietin 2, vascular endothelial-protein tyrosine phosphatase (VE-PTP), and several others. Stimulation of VEGF signaling and suppression of Tie2 by angiopoietin 2 and VE-PTP are critical for sprouting of retinal, subretinal, and choroidal NV, with perturbation of Bruch’s membrane also needed for the latter. Additional HIF-1-regulated gene products cause further stimulation of the NV. It is difficult to model macular edema in animals and therefore proof-of-concept clinical trials were done and demonstrated that VEGF plays a central role and that suppression of Tie2 is also important. Neutralization of VEGF is currently the first line therapy for all of the above disease processes, but new treatments directed at some of the other molecular targets, particularly stabilization of Tie2, are likely to provide additional benefit for subretinal/choroidal NV and macular edema. In addition, the chronicity of these diseases as well as the implication of VEGF as a cause of retinal nonperfusion and progression of background diabetic retinopathy make sustained delivery approaches for

  17. Change of regional choroid thickness after reduced-fluence photodynamic therapy for chronic central serous chorioretinopathy.

    Science.gov (United States)

    Manabe, Saki; Shiragami, Chieko; Hirooka, Kazuyuki; Izumibata, Saeko; Tsujikawa, Akitaka; Shiraga, Fumio

    2015-04-01

    To evaluate macular choroidal thickness after reduced-fluence photodynamic therapy (PDT) for chronic central serous chorioretinopathy (CSC). Prospective, consecutive, interventional case series. Twenty-two eyes with chronic CSC were treated with reduced-fluence PDT. Macular choroidal thickness was examined using spectral-domain optical coherence tomography with a 3-dimensinonal radial scan protocol in the choroidal mode before and 1, 3, and 6 months after the treatment. The mean choroidal thickness in the Early Treatment Diabetic Retinopathy Study grid (center, inner circle, and outer circle) was compared between before and after therapy, as well as between treated eyes and 54 volunteer normal eyes. Chronic CSC eyes showed significantly thicker choroids in the macular area compared with normal controls (P Choroidal thickness within the center area and inner circle showed a significant reduction at all time points after treatment (P choroidal thickness in the outer circle showed a statistically significant reduction at 1 and 3 months but not at 6 months. After treatment, the choroidal thickness reduced to the normal values at the center and inner circle, but was still significantly thicker in the outer circle (P choroids in the macular area. After reduced-fluence PDT, macular choroidal thickness became thinner within 6 months of treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Changes in Choroidal Thickness follow the RNFL Changes in Leber’s Hereditary Optic Neuropathy

    Science.gov (United States)

    Borrelli, Enrico; Triolo, Giacinto; Cascavilla, Maria Lucia; La Morgia, Chiara; Rizzo, Giovanni; Savini, Giacomo; Balducci, Nicole; Nucci, Paolo; Giglio, Rosa; Darvizeh, Fatemeh; Parisi, Vincenzo; Bandello, Francesco; Sadun, Alfredo A.; Carelli, Valerio; Barboni, Piero

    2016-01-01

    Leber’s hereditary optic neuropathy (LHON) is typically characterized by vascular alterations in the acute phase. The aim of this study was to evaluate choroidal changes occurring in asymptomatic, acute and chronic stages of LHON. We enrolled 49 patients with LHON, 19 with Dominant Optic Atrophy (DOA) and 22 healthy controls. Spectral Domain-Optical Coherence Tomography (SD-OCT) scans of macular and peripapillary regions were performed in all subjects, to evaluate macular and peripapillary choroidal thickness, and retinal nerve fiber layer (RNFL) thicknes. Macular and peripapillary choroidal thicknesses were significantly increased in the acute LHON stage. On the contrary, macular choroidal thickness was significantly reduced in the chronic stage. Furthermore, peripapillary choroidal thickness was decreased in chronic LHON and in DOA. Both RNFL and choroid had the same trend (increased thickness, followed by thinning), but RNFL changes preceded those affecting the choroid. In conclusion, our study quantitatively demonstrated the involvement of the choroid in LHON pathology. The increase in choroidal thickness is a feature of the LHON acute stage, which follows the thickening of RNFL. Conversely, thinning of the choroid is the common outcome in chronic LHON and in DOA. PMID:27853297

  19. Low-dose leptin infusion in the fourth ventricle of rats enhances the response to third-ventricle leptin injection.

    Science.gov (United States)

    Harris, Ruth B S

    2017-08-01

    We previously reported that low-dose leptin infusions into the third or fourth ventricle that do not affect energy balance when given independently cause rapid weight loss when given simultaneously. Therefore, we tested whether hindbrain leptin enhances the response to forebrain leptin or whether forebrain leptin enhances the response to hindbrain leptin. Rats received fourth-ventricle infusions of saline or 0.01, 0.1, 0.3, or 0.6 μg leptin/day for 13 days. On days 9 and 13, 0.1 μg leptin was injected into the third ventricle. The injection inhibited food intake for 36 h in saline-infused rats but for 60 h in those infused with 0.6 μg leptin/day. Leptin injection increased intrascapular brown fat temperature in leptin-infused, but not saline-infused, rats. In a separate experiment, rats received third-ventricle infusions of saline or 0.005, 0.01, 0.05, or 0.1 μg leptin/day and fourth-ventricle injections of 1.0 μg leptin on days 9 and 13 Leptin injection inhibited food intake, respiratory exchange ratio, and 14-h food intake in rats infused with saline or the two lowest doses of leptin. There was no effect with higher-dose leptin infusions because food intake, body fat, and lean mass were already inhibited. These data suggest that activation of leptin receptors in the hindbrain enhances the response to third-ventricle leptin, whereas activation of forebrain leptin receptors does not enhance the response to fourth-ventricle leptin, consistent with our previous finding that weight loss in rats treated with fourth-ventricle leptin is associated with indirect activation of hypothalamic STAT3. Copyright © 2017 the American Physiological Society.

  20. Brachmann-Cornelia de Lange syndrome with a papilloma of the choroid plexus: analyses of molecular genetic characteristics of the patient and the tumor. A single-case study.

    Science.gov (United States)

    de León, Fernando Chico-Ponce; Gordillo-Domínguez, Luis F; González-Carranza, Vicente; Torres-García, Samuel; García-Delgado, Constanza; Sánchez-Boiso, Adriana; Arenas-Huertero, Francisco; Perezpeña-Diazconti, Mario; Eguía-Aguilar, Pilar; Baqueiro-Hernández, César; Buenrostro-Márquez, Guillermo; Martínez-Rodríguez, Sonia; Dhellemmes, Patrick; Castro-Sierra, Eduardo

    2015-01-01

    A 10-month-old girl with a Brachmann-Cornelia de Lange syndrome and a choroid plexus papilloma of the brain was studied at the Hospital Infantil de México Federico Gómez (HIMFG) in Mexico City. Presumptive papilloma of the third ventricle was evidenced on CT and MR images and removed. Pathological analysis confirmed its origin. A posterior radiosurgery was required due to a tumor relapse. Karyotypes (GTG bands) of the patient and her parents undertaken at HIMFG were normal. Array comparative genomic hybridization (array CGH) analyses of blood DNA of the patient and her parents carried out at BlueGnome's Laboratory in Cambridge, UK, set in evidence amplification of genes SPNS2, GGT6, SMTNL2, PELP1, MYBBP1A, and ALOX15 in chromosome 17p of the patient. Since MYBBP1A is a proto-oncogene and ALOX15 participates in the development of cancer and metastases of tumors, further fluorescent in situ hybridization (FISH) analyses of these two genes were implemented at HIMFG. Amplification of the two genes was found in the tumor of the case under study but not in an unrelated papilloma of the choroid plexus. Further analyses of the association of choroid plexus papillomas with disorders of psycho-neural development and its relationship to molecular genetic modifications at chromosome 17p are now under way at HIMFG.

  1. Choroidal thickness in patients with a history of retinopathy of prematurity.

    Science.gov (United States)

    Wu, Wei-Chi; Shih, Chia-Pang; Wang, Nan-Kai; Lien, Reyin; Chen, Yen-Po; Chao, An-Ning; Chen, Kuan-Jen; Chen, Tun-Lu; Hwang, Yih-Shiou; Lai, Chi-Chun; Huang, Chung-Ying; Tsai, Shawn

    2013-11-01

    The cause of reduced vision in patients with a history of retinopathy of prematurity (ROP) is not yet fully understood. The role of the choroid in ROP remains unknown and existing studies of choroidal thickness in patients with a history of ROP are limited. It might be helpful to understand the association of the choroid with ROP by measuring the choroidal thickness in patients with a history of ROP and correlating these findings with the visual outcome of these patients. To examine choroidal thickness by spectral-domain optical coherence tomography in children with a history of ROP and assess the impact of choroidal thickness on visual acuity. A prospective cross-sectional analysis from August 2011 to September 2012. Institutional referral centers. Children aged 6 to 14 years with a history of ROP were classified into the following 2 groups: patients with a history of threshold ROP and treatment with laser or cryotherapy (treated group) and those with regressed ROP who had not received any treatment (nontreated group). All of the patients had a normal-appearing posterior pole. Examinations of visual acuity, refractive errors, and optical components and measurement of choroidal thickness. Best-corrected visual acuity, optical components, and optical coherence tomography findings. In total, 49 patients were enrolled in the study. Patients in the treated group had a significantly thinner choroidal thickness than the patients in the nontreated group after adjusting for age, axial length, and spherical power. Choroidal thickness was found to be positively associated with spherical power and spherical equivalent and negatively associated with axial length and vitreous depth. In addition, a thin choroidal thickness was associated with a worse best-corrected visual acuity. Choroidal thickness is thinner in patients with threshold ROP compared with the patients with spontaneously regressed ROP. A thinner choroid is associated with worse vision in these patients. This study

  2. 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.

  3. Gene expression and functional annotation of the human and mouse choroid plexus epithelium.

    Directory of Open Access Journals (Sweden)

    Sarah F Janssen

    Full Text Available BACKGROUND: The choroid plexus epithelium (CPE is a lobed neuro-epithelial structure that forms the outer blood-brain barrier. The CPE protrudes into the brain ventricles and produces the cerebrospinal fluid (CSF, which is crucial for brain homeostasis. Malfunction of the CPE is possibly implicated in disorders like Alzheimer disease, hydrocephalus or glaucoma. To study human genetic diseases and potential new therapies, mouse models are widely used. This requires a detailed knowledge of similarities and differences in gene expression and functional annotation between the species. The aim of this study is to analyze and compare gene expression and functional annotation of healthy human and mouse CPE. METHODS: We performed 44k Agilent microarray hybridizations with RNA derived from laser dissected healthy human and mouse CPE cells. We functionally annotated and compared the gene expression data of human and mouse CPE using the knowledge database Ingenuity. We searched for common and species specific gene expression patterns and function between human and mouse CPE. We also made a comparison with previously published CPE human and mouse gene expression data. RESULTS: Overall, the human and mouse CPE transcriptomes are very similar. Their major functionalities included epithelial junctions, transport, energy production, neuro-endocrine signaling, as well as immunological, neurological and hematological functions and disorders. The mouse CPE presented two additional functions not found in the human CPE: carbohydrate metabolism and a more extensive list of (neural developmental functions. We found three genes specifically expressed in the mouse CPE compared to human CPE, being ACE, PON1 and TRIM3 and no human specifically expressed CPE genes compared to mouse CPE. CONCLUSION: Human and mouse CPE transcriptomes are very similar, and display many common functionalities. Nonetheless, we also identified a few genes and pathways which suggest that the CPE

  4. Distribution and determinants of choroidal thickness and volume using automated segmentation software in a population-based study.

    Science.gov (United States)

    Gupta, Preeti; Jing, Tian; Marziliano, Pina; Cheung, Carol Y; Baskaran, Mani; Lamoureux, Ecosse L; Wong, Tien Yin; Cheung, Chui Ming Gemmy; Cheng, Ching-Yu

    2015-02-01

    To objectively quantify choroidal thickness and choroidal volume using fully automated choroidal segmentation software applied to images obtained from enhanced depth imaging spectral-domain optical coherence tomography (EDI SD OCT) in a population-based study; and evaluate the ocular and systemic determinants of choroidal thickness and choroidal volume. Prospective cross-sectional study. Participants ranging in age from 45 to 85 years were recruited from the Singapore Malay Eye Study-2 (SiMES-2), a follow-up population-based study. All participants (n = 540) underwent a detailed ophthalmic examination, including EDI SD OCT for measurements of thickness and volume of the choroid. The intrasession repeatability of choroidal thickness at 5 measured horizontal locations and macular choroidal volume using automated choroidal segmentation software was excellent (intraclass correlation coefficient, 0.97-0.99). Choroid was significantly thicker under the fovea (242.28 ± 97.58 μm), followed by 3 mm temporal (207.65 ± 80.98 μm), and was thinnest at 3 mm nasal (142.44 ± 79.19 μm) location. The mean choroidal volume at central macular region (within a circle of 1 mm diameter) was 0.185 ± 0.69 mm(3). Among the range of ocular and systemic factors studied, age, sex, and axial length were the only significant predictors of choroidal thickness and choroidal volume (all P choroidal segmentation software, we provide fast, reliable, and objective measurements of choroidal thickness and volume in a population-based sample. Male sex, younger age, and shorter axial length are the factors independently associated with thicker choroid and larger choroidal volume. These factors should be taken into consideration when interpreting EDI SD OCT-based choroidal thickness measurements in clinics. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Segmentation of the macular choroid in OCT images acquired at 830nm and 1060nm

    Science.gov (United States)

    Lee, Sieun; Beg, Mirza F.; Sarunic, Marinko V.

    2013-06-01

    Retinal imaging with optical coherence tomography (OCT) has rapidly advanced in ophthalmic applications with the broad availability of Fourier domain (FD) technology in commercial systems. The high sensitivity afforded by FD-OCT has enabled imaging of the choroid, a layer of blood vessels serving the outer retina. Improved visualization of the choroid and the choroid-sclera boundary has been investigated using techniques such as enhanced depth imaging (EDI), and also with OCT systems operating in the 1060-nm wavelength range. We report on a comparison of imaging the macular choroid with commercial and prototype OCT systems, and present automated 3D segmentation of the choroid-scleral layer using a graph cut algorithm. The thickness of the choroid is an important measurement to investigate for possible correlation with severity, or possibly early diagnosis, of diseases such as age-related macular degeneration.

  6. 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.

  7. Examining the Choroid in Ocular Inflammation: A Focus on Enhanced Depth Imaging

    Directory of Open Access Journals (Sweden)

    Abeir Baltmr

    2014-01-01

    Full Text Available The choroid is the vascular layer that supplies the outer retina and is involved in the pathogenesis of several ocular conditions including choroidal tumors, age related macular degeneration, central serous chorioretinopathy, diabetic retinopathy, and uveitis. Nevertheless, difficulties in the visualization of the choroid have limited our understanding of its exact role in ocular pathology. Enhanced depth imaging optical coherent topography (EDI-OCT is a novel, noninvasive technique that is used to evaluate choroidal thickness and morphology in these diseases. The technique provides detailed objective in vivo visualization of the choroid and can be used to characterize posterior segment inflammatory disorders, monitor disease activity, and evaluate efficacy of treatment. In this review we summarize the current application of this technique in ocular inflammatory disorders and highlight its utility as an additional tool in monitoring choroidal involvement in ocular inflammation.

  8. Diffuse choroid plexus hyperplasia: an under-diagnosed cause of hydrocephalus in children?

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    Aziz, Azian Abd.; Coleman, Lee [Royal Children' s Hospital Melbourne, Department of Medical Imaging, Parkville, Victoria (Australia); Morokoff, Andrew; Maixner, Wirginia [Royal Children' s Hospital Melbourne, Department of Neurosurgery, Parkville (Australia)

    2005-08-01

    Hydrocephalus is a common neurological disorder in children and the result of a variety of causes. However, with the advancement of imaging modalities, particularly MRI, previously reported rarer causes of hydrocephalus in children are now being more readily appreciated. We report an 11-year-old boy with diffuse villous hyperplasia of the choroid plexus. He had a ventriculo-peritoneal (VP) shunt in-situ and a prior diagnosis from infancy of congenital aqueduct stenosis as the cause of his hydrocephalus. His current presentation was with further shunt dysfunction. CT and MRI demonstrated enlarged choroid plexuses but did not confirm aqueduct stenosis. CSF overproduction was demonstrated from the externalized ventricular drain. The enlarged choroid plexuses were surgically resected and histology confirmed choroid plexus hyperplasia. Identification of choroid plexus hyperplasia is important since the neurosurgical management of hydrocephalus is not VP shunt insertion, but resection of the hyperplastic choroid plexus. (orig.)

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

    Science.gov (United States)

    Hussain, Rameez; Anantharaman, Giridhar; Rajesh, Bindu; Gopalakrishnan, Mahesh

    2015-05-01

    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.

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

    Science.gov (United States)

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

    2011-01-01

    PURPOSE To analyze the normal peripapillary choroidal thickness utilizing a commercial spectral domain optical coherence tomography (OCT) device and determine the inter-grader reproducibility of this method. DESIGN Retrospective, non-comparative, non-interventional 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. Two raster scans were obtained per eye, a horizontal and a vertical scan, both of which were centered at the optic nerve. Two independent graders individually measured the choroidal thickness. Choroidal thickness was measured from the posterior edge of the retinal pigment epithelium to the choroid-scleral junction at 500 μm intervals away from the optic nerve in the superior, inferior, nasal and temporal quadrants. Statistical analysis was conducted to compare mean choroidal thicknesses. Inter-grader reproducibility was assessed by intraclass correlation coefficient and Pearson’s correlation coefficient. Average choroidal thickness in each quadrant was compared to retinal nerve fiber layer (RNFL) thickness in their respective quadrants. MAIN OUTCOME MEASURES Peripapillary choroidal thickness, intraclass coefficient, Pearson’s correlation coefficient. RESULTS The peripapillary choroid in the inferior quadrant was significantly thinner compared to all other quadrants (pthickness. The inferior peripapillary choroid was significantly thinner compared to all other quadrants at all distances measured away from the optic nerve (pchoroid increases in thickness the farther it was away from the optic nerve and eventually approaching a plateau. Intraclass correlation coefficient ranged from 0.62 to 0.93 and Pearson’s correlation coefficient ranged from 0.74 to 0.95 (pthickness nor average age was significantly correlated with average choroidal thickness. CONCLUSIONS Manual segmentation of the

  11. Semiautomated segmentation of the choroid in spectral-domain optical coherence tomography volume scans.

    Science.gov (United States)

    Hu, Zhihong; Wu, Xiaodong; Ouyang, Yanwei; Ouyang, Yanling; Sadda, Srinivas R

    2013-03-07

    Changes in the choroid, in particular its thickness, are believed to be of importance in the pathophysiology of a number of retinal diseases. The purpose of this study was to adapt the graph search algorithm to semiautomatically identify the choroidal layer in spectral-domain optical coherence tomography (SD-OCT) volume scans and compare its performance to manual delineation. A graph-based multistage segmentation approach was used to identify the choroid, defined as the layer between the outer border of the RPE band and the choroid-sclera junction. Thirty randomly chosen macular SD-OCT (1024 × 37 × 496 voxels, Heidelberg Spectralis) volumes were obtained from 20 healthy subjects and 10 subjects with non-neovascular AMD. The positions of the choroidal borders and resultant thickness were compared with consensus manual delineation performed by two graders. For consistency of the statistical analysis, the left eyes were horizontally flipped in the x-direction. The algorithm-defined position of the outer RPE border and choroid-sclera junction was consistent with the manual delineation, resulting in highly correlated choroidal thickness values with r = 0.91 to 0.93 for the healthy subjects and 0.94 for patients with non-neovascular AMD. Across all cases, the mean and absolute differences between the algorithm and manual segmentation for the outer RPE boundary was -0.74 ± 3.27 μm and 3.15 ± 3.07 μm; and for the choroid-sclera junction was -3.90 ± 15.93 μm and 21.39 ± 10.71 μm. Excellent agreement was observed between the algorithm and manual choroidal segmentation in both normal eyes and those with non-neovascular AMD. The choroid was thinner in AMD eyes. Semiautomated choroidal thickness calculation may be useful for large-scale quantitative studies of the choroid.

  12. Lateral Concepts

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    Christopher Gad

    2016-06-01

    Full Text Available This essay discusses the complex relation between the knowledges and practices of the researcher and his/her informants in terms of lateral concepts. The starting point is that it is not the prerogative of the (STS scholar to conceptualize the world; all our “informants” do it too. This creates the possibility of enriching our own conceptual repertoires by letting them be inflected by the concepts of those we study. In a broad sense, the lateral means that there is a many-to-many relation between domains of knowledge and practice. However, each specific case of the lateral is necessarily immanent to a particular empirical setting and form of inquiry. In this sense lateral concepts are radically empirical since it locates concepts within the field. To clarify the meaning and stakes of lateral concepts, we first make a contrast between lateral anthropology and Latour’s notion of infra-reflexivity. We end with a brief illustration and discussion of how lateral conceptualization can re-orient STS modes of inquiry, and why this matters.

  13. 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.

  14. On the radiotherapy of choroid metastases in mammary carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Dobrowsky, W.; Schmid, A.P.; Dobrowsky, E.

    1987-06-01

    From 1975 to 1984, thirteen patients were submitted to radiotherapy for choroid metastases of mammary carcinoma. Bilateral manifestation was found in three cases, thus sixteen eyes have been treated. All irradiations were performed with high voltage equipment. The posterior section of the eye was irradiated with 25 to 50 Gy over 2.5 to 5 weeks. Complete regression was achieved in nine out of sixteen cases, five patients showed an improvement of at least 50%, no considerable effect was found in two cases. The survival is 4 to 48 months (median survival 20 months) from the beginning of radiotherapy. Radiotherapy is a quick, efficient, and sparing treatment in choroid metastases. If applied in due time, it can prevent a visual disorder or amaurosis, thus improving the patients' quality of life.

  15. 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

  16. Enhanced depth imaging-OCT of the choroid: a review of the current literature.

    Science.gov (United States)

    Laviers, H; Zambarakji, H

    2014-12-01

    With the advent of enhanced depth imaging optical coherence tomography (EDI-OCT), detailed visualisation of the choroid in vivo is now possible. Measurements of choroidal thickness (CT) have also enabled new directions in research to study normal and pathological processes within the choroid. The aim of the present study is to review the current literature on choroidal imaging using EDI-OCT. Studies were identified by a systematic search using Medline ( http://www.ncbi.nlm.nih.gov/pubmed ). Papers were also identified based on the reference lists of relevant publications. Papers were included in the review if the focus of the study involved imaging of the choroid using EDI-OCT. Recent studies have demonstrated successful imaging of the choroid and high reproducibility of measurements of CT using EDI-OCT. There are much data confirming that abnormalities in choroidal structure and function contribute to major ocular diseases and patterns of CT variation may be observed in certain disease states and may be influenced by treatment. However, it is not clear whether these variations are a contributing factor or a consequence of the disease. While more invasive methods such as indocyanine green (ICG) angiography remain the gold standard for detecting abnormalities of the choroidal vasculature in normal eyes and disease states, EDI-OCT has become an important adjunctive clinical tool in providing three-dimensional anatomical information of the choroid.

  17. Long-term increase in subfoveal choroidal thickness after surgery for senile cataracts.

    Science.gov (United States)

    Noda, Yasuo; Ogawa, Asako; Toyama, Taku; Ueta, Takashi

    2014-09-01

    To evaluate the impact of cataract surgery on subfoveal choroidal thickness and central retinal thickness in the elderly. Prospective observational case series. This cohort study included 29 eyes of 29 patients with senile cataract, but no previous ocular surgery or other ocular abnormality. All 29 eyes received standard surgery by phacoemulsification and intraocular lens implantation. Subfoveal choroidal thickness and central retinal thickness were measured at baseline and 1, 3, and 6 months postoperatively by spectral-domain optical coherence tomography. Multiple regression analysis was conducted to identify predictors of larger changes in subfoveal choroidal thickness, including sex, age, baseline choroidal thickness, axial length, refractive status before surgery, and duration of surgery. The 29 patients with senile cataract received cataract surgery without complication. Mean subfoveal choroidal thickness was 193.8, 208.9, 210.2, and 209.3 μm at baseline and at postoperative 1, 3, and 6 months, respectively, with a statistically significant increase after surgery (repeated-measures ANOVA; P choroidal thickness remained high even 6 months after surgery. Multiple regression analysis revealed that male sex (P = .014) and thicker baseline choroid (P = .0048) predicted larger increases in subfoveal choroidal thickness. In contrast, the tendency of transient increase in central retinal thickness was not statistically significant. Most elderly patients with senile cataracts are expected to maintain increased subfoveal choroidal thickness for at least 6 months after cataract surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Effects of Exercise on the Structure and Circulation of Choroid in Normal Eyes.

    Science.gov (United States)

    Kinoshita, Takamasa; Mori, Junya; Okuda, Natsuki; Imaizumi, Hiroko; Iwasaki, Masanori; Shimizu, Miho; Miyamoto, Hirotomo; Akaiwa, Kei; Semba, Kentaro; Sonoda, Shozo; Sakamoto, Taiji; Mitamura, Yoshinori

    2016-01-01

    To determine the effects of dynamic exercise on the circulation and the luminal and stromal areas of the choroid in normal eyes. This was a prospective interventional study of 38 eyes of 38 normal subjects enrolled by invitation. The systolic and diastolic blood pressures, heart rate, intraocularpressure, mean ocular perfusion pressure (MOPP), choroidal blood velocity, and enhanced depth imaging optical coherence tomographic (EDI-OCT) images were recorded before, and immediately after mild dynamic exercise. The same measurements were recorded after 10 min of rest. The choroidal blood velocity was measured bylaser speckle flowgraphy, and the mean blur rate was used for the evaluations. The horizontal EDI-OCT images of the subfoveal choroid were converted to binary images. The central choroidal thickness (CCT), total cross sectional choroidal area, luminal areas, stromal areas, and the ratio of luminal area to total choroidal area (L/C ratio) were determined from these images. The systolic and diastolic blood pressures, heart rate, MOPP, and the mean blur rate were significantly increased immediately after the exercise and significantly decreased 10 minutes after the exercise. There wereno significant changes in the mean CCT, the mean total choroidal area, the mean luminal and stromal areas, and the mean L/C ratio after the exercise. Our results suggest that a rest period is needed before measurements of blood flow velocity but not necessary for the EDI-OCT imaging to determine the choroidal thickness and area.

  19. EDI-OCT evaluation of choroidal thickness in retinitis pigmentosa.

    Science.gov (United States)

    Sodi, Andrea; Lenzetti, Chiara; Murro, Vittoria; Caporossi, Orsola; Mucciolo, Dario P; Bacherini, Daniela; Cipollini, Francesca; Passerini, Ilaria; Virgili, Gianni; Rizzo, Stanislao

    2017-06-09

    To evaluate choroidal thickness (CT) in retinitis pigmentosa (RP) using enhanced depth imaging (EDI) optical coherence tomography (OCT). A retrospective analysis of a group of patients with RP who underwent EDI-OCT was performed. Choroidal thickness measurements were compared with those of age- and sex-matched healthy subjects. In the RP group, the possible association between subfoveal CT and some clinical parameters (visual acuity, age, age at disease onset, duration of the disease, macular thickness, visual field loss, electroretinography [ERG]) was evaluated. The study recruited 39 patients with RP with an average age of 43.3 ± 11.3 years while the control group consisted of 73 healthy subjects with an average age of 42.9 ± 12.10 years. On average, CT was significantly thinner in the RP group compared to the controls (p<0.0001). In the RP group, we could not find any significant association between CT and the considered clinical parameters even if there was a trend for decreasing CT with increasing age (r = -0.23, p = 0.096). In the control group, subfoveal CT showed a slightly significant correlation with age (r = -0.21, p = 0.04) but not with macular thickness and visual acuity. In our series, CT was significantly lower in the RP group in comparison with the controls, as measured by EDI-OCT, but did not correlate with age, age at onset, duration of the disease, macular thickness, visual acuity, visual field loss, or ERG responses. Although the clinical implications of choroidal changes in RP have not yet been clearly determined, the evaluation of choroidal features may provide information that could be useful to clarify the pathophysiology of the disease.

  20. Prognostic factors of choroidal melanoma in Slovenia, 1986–2008

    Science.gov (United States)

    Budihna, Marjan; Drnovsek-Olup, Brigita; Andrejcic, Katrina Novak; Zupancic, Irena Brovet; Pahor, Dusica

    2016-01-01

    Introduction Choroidal melanoma is the most common primary malignancy of the eye, which frequently metastasizes. The Cancer Registry of Slovenia reported the incidence of choroid melanoma from 1983 to 2009 as stable, at 7.8 cases/million for men and 7.4/million for women. The aim of the retrospective study was to determinate the prognostic factors of survival for choroidal melanoma patients in Slovenia. Patients and methods From January 1986 to December 2008 we treated 288 patients with malignant choroidal melanoma; 127 patients were treated by brachytherapy with beta rays emitting ruthenium-106 applicators; 161 patients were treated by enucleation. Results Patients with tumours thickness < 7.2 mm and base diameter < 16 mm were treated by brachytherapy and had 5- and 10-year overall mortality 13% and 32%, respectively. In enucleated patients, 5- and 10-year mortality was higher, 46% and 69%, respectively, because their tumours were larger. Thirty patients treated by brachytherapy developed local recurrence. Twenty five of 127 patients treated by brachytherapy and 86 of 161 enucleated patients developed distant metastases. Patients of age ≥ 60 years had significantly lower survival in both treatment modalities. For patients treated by brachytherapy the diameter of the tumour base and treatment time were independent prognostic factors for overall survival, for patients treated by enucleation age and histological type of tumour were independent prognosticators. In first few years after either of treatments, the melanoma specific annual mortality rate increased, especially in older patients, and then slowly decreased. Conclusions It seems that particularly younger patients with early tumours can be cured, whereby preference should be given to eyesight preserving brachytherapy over enucleation. PMID:27069456

  1. Altered choroid plexus gene expression in major depressive disorder

    Directory of Open Access Journals (Sweden)

    Cortney Ann Turner

    2014-04-01

    Full Text Available Given the emergent interest in biomarkers for mood disorders, we assessed gene expression in the choroid plexus, the region that produces cerebrospinal fluid (CSF, in individuals with major depressive disorder (MDD. Genes that are expressed in the choroid plexus (CP can be secreted into the CSF and may be potential biomarker candidates. Given that we have previously shown that fibroblast growth factor family members are differentially expressed in post-mortem brain of subjects with MDD and the CP is a known source of growth factors in the brain, we posed the question whether growth factor dysregulation would be found in the CP of subjects with MDD. We performed laser capture microscopy of the choroid plexus at the level of the hippocampus in subjects with MDD and psychiatrically normal controls. We then extracted, amplified, labeled and hybridized the cRNA to Illumina BeadChips to assess gene expression. In controls, the most highly abundant known transcript was transthyretin. Moreover, half of the 14 most highly expressed transcripts in controls encode ribosomal proteins. Using BeadStudio software, we identified 169 transcripts differentially expressed (p< 0.05 between control and MDD samples. Using pathway analysis we noted that the top network altered in subjects with MDD included multiple members of the transforming growth factor-beta (TGFβ pathway. Quantitative real-time PCR (qRT-PCR confirmed downregulation of several transcripts that interact with the extracellular matrix in subjects with MDD. These results suggest that there may be an altered cytoskeleton in the choroid plexus in MDD subjects that may lead to a disrupted blood-CSF-brain barrier.

  2. Prevalence of outer retinal tubulation in eyes with choroidal neovascularization

    OpenAIRE

    Giachetti Filho, Richard Geraldo; Zacharias,Leandro Cabral; Monteiro,Thaís Vera; Preti, Rony Carlos; Pimentel, Sérgio Gianoti

    2016-01-01

    Background Outer retinal tubulations (ORTs) are branching tubular structures located in the outer nuclear layer of the retina. The goal of this study is to determine the prevalence of ORTs observed in eyes with choroidal neovascularization (CNV) undergoing treatment with anti-angiogenic intravitreous injection (IVI) with anti-VEGF (vascular endothelial growth factor) at the Ophthalmology Department of a tertiary hospital in São Paulo, Brazil. Methods This is a descriptive study based on medic...

  3. Radiological and clinical features of the single ventricle

    Energy Technology Data Exchange (ETDEWEB)

    Maisch, B.; Kulke, H.; Marcin, S.; Deeg, P.; Braun, H.; Kochsiek, K.

    1983-03-01

    The case a twenty year old patient is reported, whose chest X-ray demonstrated cardiomegaly with a prominent pulmonary segment. The echocardiographical examination indicated a single ventricle with septal rudiments; heart catherization confirmed the diagnosis of a single ventricle of the right ventricular type with a well-sized left ventricular outlet chamber and the banding of the pulmonary artery. In addition the case of a 17 year old patient is reported, whose chest X-ray demonstrated dextrocardia. Clinical manifestations (cyanosis, elevated hemoglobin, clubbing, 3rd heart sound) as well as one- and two-dimensional echocardiography with echocontrast media confirmed the diagnosis of corrected transposition of the great arteries, pulmonary stenosis and incompetence, single ventricle and dextrocardia, a diagnosis made already 12 years ago by heart catherization.

  4. Report of two cases of double outlet left ventricle

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Chul Soon; Lim, Tae Hwan; Park, Jae Hyung; Yeon, Kyung Mo; Han, Man Chung [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    1983-03-15

    Double outlet left ventricle (DOLV), even defined as origins or both great vessels from left ventricle, implies varieties of morphology in concern with loop pattern, location of ventricular septal defect, conotruncal anatomy, and presence or absence of pulmonary stenosis. With the improvement of surgical technique, corrective surgery of DOLV become possible, and preoperative diagnosis and determination of the accurate anatomical relationship between great vessels, ventricular septal defect, and ventricles is very important in surgical implication. Authors have recently experienced two cases of DOLV. The one is with subpulmonic conus, subpulmonic ventricular septal defect, patent ductus arteriosus, and preductal type coarctation of aorta. The other is with bilateral coni and subaortic ventricular septal defect. Loop patterns are [S, D, D]in both cases.

  5. SLIT-ventricle - clinical syndrome or radiological phenomenon

    Energy Technology Data Exchange (ETDEWEB)

    Kalff, R.; Brenner, A.; Kocks, W.; Roosen, K.; Loehr, E.

    1985-09-01

    Between 1976 and 1982 336 patients with an age range from several days to 65 years, were treated by ventriculo-atrial or peritoneal shunt, because of internal hydrocephalus of different origins. Regular computerized tomographies demonstrated slit-ventricles in 36 patients. Twenty-eight patients were free of complaints. In 8 patients there were symptoms like nausea and vomiting. In 5 patients these complaints were explainable by other diseases. In only 3 patients were these signs caused by increased intracranial pressure because of ventricular-catheter obliteration. In these 3 cases an enlargement of the ventricles at the time of obliteration was seen. In our series slit-ventricles were seen only as a radiological phenomenon. There was no necessity for neurosurgical treatment at all.

  6. Development and Notch signaling requirements of the zebrafish choroid plexus.

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    Brent R Bill

    Full Text Available BACKGROUND: The choroid plexus (CP is an epithelial and vascular structure in the ventricular system of the brain that is a critical part of the blood-brain barrier. The CP has two primary functions, 1 to produce and regulate components of the cerebral spinal fluid, and 2 to inhibit entry into the brain of exogenous substances. Despite its importance in neurobiology, little is known about how this structure forms. METHODOLOGY AND PRINCIPAL FINDINGS: Here we show that the transposon-mediated enhancer trap zebrafish line Et(Mn16 expresses green fluorescent protein within a population of cells that migrate toward the midline and coalesce to form the definitive CP. We further demonstrate the development of the integral vascular network of the definitive CP. Utilizing pharmacologic pan-notch inhibition and specific morpholino-mediated knockdown, we demonstrate a requirement for Notch signaling in choroid plexus development. We identify three Notch signaling pathway members as mediating this effect, notch1b, deltaA, and deltaD. CONCLUSIONS AND SIGNIFICANCE: This work is the first to identify the zebrafish choroid plexus and to characterize its epithelial and vasculature integration. This study, in the context of other comparative anatomical studies, strongly indicates a conserved mechanism for development of the CP. Finally, we characterize a requirement for Notch signaling in the developing CP. This establishes the zebrafish CP as an important new system for the determination of key signaling pathways in the formation of this essential component of the vertebrate brain.

  7. Visual Loss from Choroidal Melanoma Mimicking Neurological Syndromes

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    Karim Hammamji

    2017-03-01

    Full Text Available Melanoma of the eye is rare, but can mimic a range of disorders. This report highlights 2 cases of choroidal melanoma with vision loss mimicking neurological diagnoses. The first patient is a 41-year-old white male with a known history of multiple sclerosis and a previous episode of optic neuritis in the right eye, who presented with a 6-month history of decreased vision in the same eye, and occasional photopsiae. He was treated with 2 courses of oral steroids for presumed recurrent optic neuritis. After a temporary improvement in his symptoms, his vision worsened, following which he had a head MRI, which revealed a solid intraocular mass. He was subsequently diagnosed with a choroidal melanoma for which he was treated successfully with ruthenium-106 plaque brachytherapy. The second patient is a 57-year-old female, who presented with a progressive cerebellar syndrome under investigation by the neurology service, as well as decreased vision in the right eye. Her visual acuity gradually deteriorated and her neurological assessment, which included a PET-CT, revealed uptake in the right eye. The diagnosis of a choroidal melanoma was made, and following conservative treatment with proton beam radiotherapy, she had an enucleation of the eye. Intraocular tumours can masquerade as many different entities. Unexplained unilateral visual loss, especially if it is atypical for a neurological syndrome, should prompt dilated fundoscopy and referral to an ophthalmologist.

  8. Matching models of left ventricle and systemic artery

    Institute of Scientific and Technical Information of China (English)

    柳兆荣; 吴驰

    1997-01-01

    To reveal how the matching models of the left ventricle and its afterload affect the pressure and flow in the aortic root, the differences between the measured pressure and flow waveforms and those determined by three kinds of matching model were compared. The results showed that, compared with the results by both matching models 1 and 2, the pressure and flow waveforms determined by matching model 3 established in this work were in the closest agreement with the corresponding experimental waveforms, therefore indicating that matching model 3 was a matching model that closely and rationally characterized the match between the left ventricle and the systemic artery.

  9. 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.

  10. Choroidal Thickness in Turkish Children with Anisometric Amblyopia.

    Science.gov (United States)

    Karaca, Emine Esra; Çubuk, Mehmet Özgür; Akçam, Hanife Tuba; Uzun, Feyzahan; Yüksel, Erdem

    2017-01-01

    To assess macular choroidal thickness (CT) and axial length measurements in children with anisometropic amblyopia and to compare the measurements with that of fellow non-amblyopic eyes and age-sex matched controls. Forty patients with anisometropic amblyopia and 40 age-/sex-matched controls were evaluated in this study. Eyes were classified into three groups as follows: amblyopic eyes (n = 40), fellow non-amblyopic eyes, and healthy eyes (n = 40). All subjects underwent complete ophthalmic examination and macular choroidal thickness measurements by enhanced depth imaging method of the Spectralis optical coherence tomography system. CT was measured at the fovea and at 1000-μm intervals from the foveal center in both temporal and nasal directions. The statistical assessment was performed with the assistance of one-way analysis of variance (ANOVA) and Pearson's correlation test. The mean subfoveal CT was 389.35, 349.07, and 315.8 μm in the amblyopic, fellow non-amblyopic and healthy eyes, respectively. Choroid was thickest in subfoveal and thinnest in nasal regions among all groups. Both amblyopic and fellow non-amblopic eyes were more hyperopic than healthy eyes. While the subfoveal and nasal CT in amblyopic eyes and fellow eyes were significantly higher than healthy eyes, the temporal CT in amblyopic eyes was significantly higher than in healthy eyes. There was a significant positive correlation between the CT of the subfoveal, nasal, and temporal regions and the refractive state (r = 0.432 p = 0.001; r = 0.324 p = 0.001; r = 0.215 p = 0.01, respectively). The macular choroidal thickness-not only in amblyopic eyes but also in non-amblyopic fellow eyes-was significantly thicker than in the healthy subjects. The thick choroid in amblyopic and non-amblyopic fellow eyes may indicate bilateral delay of emmetropization, which probably means amblyopia affecting the visual feedback of both eyes.

  11. 侧脑室肿物%Tumor masses in lateral ventricle of brain

    Institute of Scientific and Technical Information of China (English)

    刘冬戈; 张伟

    2006-01-01

    1.病例简介:患者男,31岁,间断性头痛3年,不伴有恶心、头晕,休息后可缓解。近3个月来,出现记忆力不降,睡眠差,心情烦躁,1d前突然出现剧烈头痛,言语不流利,并出现呕吐,继而出现意识不清,于2004年1月4日入院。专科体检:嗜睡,言语尚流利,对答切题,不能回忆起发病时情节。双侧视乳头水肿,右下肢Babinski征阳性,余无阳性体征。

  12. Choroidal thickness in non-ocular Behçet's disease – A spectral-domain OCT study

    Directory of Open Access Journals (Sweden)

    Aman Mittal

    2017-09-01

    Conclusion: This study demonstrates that BD may have subclinical manifestations in the choroid, resulting in thinning of the choroid relative to normal eyes, even without overt signs of ocular involvement.

  13. Choroidal haemangioma and photodynamic therapy. Anatomical and functional response of patients with choroidal hemangioma treated with photodynamic therapy.

    Science.gov (United States)

    Subirà, O; Brosa, H; Lorenzo-Parra, D; Arias-Barquet, L; Català-Mora, J; Cobos, E; Garcia-Bru, P; Rubio-Caso, M J; Caminal-Mitjana, J M

    2017-06-01

    To study the effectiveness and limitations of photodynamic therapy (PDT) as treatment of choice in patients with symptomatic circumscribed choroidal haemangioma. A retrospective study was conducted on 16 patients (13 men and 3 women, with mean age of 54.88 years) with circumscribed choroidal haemangioma, who attended our centre and were treated with PDT in the last 7 years. All patients had circumscribed choroidal haemangioma, which caused a decrease in visual acuity (VA) secondary to the presence of intraretinal microcystic oedema or neurosensory detachment. The mean initial VA was 0.23, and the final mean VA after performing PDT was 0.38 (all the VA were measured in decimal scale). It should be noted that patients needed a mean of 1.69 PDT sessions. Three of the patients needed rescue treatment with trans-pupillary thermotherapy, intravitreal injection of anti-vascular endothelial growth factor (ranibizumab, aflibercept) or a dexamethasone intravitreal implant (Ozurdex(®)). The indication for a change of treatment was the persistence of intraretinal microcystic oedema and/or neurosensory detachment (or incomplete resolution) after 3 PDT sessions. As overall results, 62.5% of patients evolved into anatomical and functional (increase in AV or stability) resolution. PDT is a straight forward and fast procedure, with a good anatomical and functional response, causing minimal damage to adjacent vessels. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Analysis of Choroidal Thickness Using Spectral-Domain OCT in Children With Unilateral Amblyopia.

    Science.gov (United States)

    Kara, Ozgur; Altintas, Ozgul; Karaman, Suleyman; Emre, Esra; Caglar, Yusuf

    2015-01-01

    To compare the subfoveal, parafoveal, and peripapillary choroidal thickness in amblyopic eyes with those of fellow and control eyes. This institutional study involved 114 eyes from 38 patients with unilateral amblyopia and 19 healthy children, aged 6 to 17 years. The cause of amblyopia was identified as hyperopic anisometropia in 17 cases and strabismus in 21 cases. All patients underwent central macular thickness (CMT) and choroidal thickness measurement at seven retinal sites with spectral-domain optical coherence tomography (OCT). Statistical analysis was performed to compare the CMT and choroidal thickness of amblyopic and fellow eyes with control eyes. Average CMT was 248.31 ± 24.18 μm in amblyopic eyes, 249.76 ± 26.08 μm in fellow eyes, and 243.65 ± 31.96 μm in controls (P = .604). Average subfoveal choroidal thickness was 394.15 ± 71.03 μm in amblyopic eyes, 356.07 ± 79.93 μm in fellow eyes, and 319.44 ± 87.29 μm in controls (P = .000). The choroidal thickness of the subfoveal area and at 750-μm intervals temporal and nasal to the fovea was significantly thicker in amblyopic eyes than in controls (P amblyopia did not differ significantly between foveal or parafoveal choroidal thickness (P > .05). There was a significant negative correlation between the nasal peripapillary choroidal thickness and the axial length in the amblyopic eyes (r = -0.37, P = .022). The choroidal thickness in the peripapillary area was not significantly different in the three groups (P > .05). This study demonstrated that choroidal thickness can be measured by spectral-domain OCT in children with amblyopia. Subfoveal choroidal thickness in amblyopic eyes was significantly thicker than in control eyes. The amblyopic process may involve the choroid, but not the macula. However, further evaluation is needed.

  15. Structural and Biochemical Analyses of Choroidal Thickness in Human Donor Eyes

    Science.gov (United States)

    Sohn, Elliott H.; Khanna, Aditi; Tucker, Budd A.; Abràmoff, Michael D.; Stone, Edwin M.; Mullins, Robert F.

    2014-01-01

    Purpose. The choroid plays a vital role in the health of the outer retina. While measurements of choroid using optical coherence tomography show altered thickness in aging and macular disease, detailed histopathologic and proteomic analyses are lacking. In this study we sought to evaluate biochemical differences in human donor eyes between very thin and thick choroids. Methods. One hundred forty-one eyes from 104 donors (mean age ± standard deviation, 81.5 ± 12.2) were studied. Macular sections were collected, and the distance between Bruch's membrane and the inner surface of the sclera was measured in control, early/dry age-related macular degeneration (AMD), neovascular AMD, and geographic atrophy eyes. Proteins from the RPE-choroid of eyes with thick and thin choroids were analyzed using two-dimensional electrophoresis and/or mass spectrometry. Two proteins with altered abundance were confirmed using Western blot analysis. Results. Donor eyes showed a normal distribution of thicknesses. Eyes with geographic atrophy had significantly thinner choroids than age-matched controls or early AMD eyes. Proteomic analysis showed higher levels of the serine protease SERPINA3 in thick choroids and increased levels of tissue inhibitor of metalloproteinases-3 (TIMP3) in thin choroids. Conclusions. Consistent with clinical imaging observations, geographic atrophy was associated with choroidal thinning. Biochemical data suggest an alteration in the balance between proteases and protease inhibitors in eyes that lie at the extremes of choroidal thickness. An improved understanding of the basic mechanisms associated with choroidal thinning may guide the development of new therapies for AMD. PMID:24519422

  16. Choroidal Thickness Variation According to Refractive Error Measured by Spectral Domain-optical Coherence Tomography in Korean Children

    Science.gov (United States)

    Lee, Geun Young; Yu, Sung; Kang, Hyun Gu; Kim, Jin Seon; Lee, Kyoo Won

    2017-01-01

    Purpose To assess choroidal thickness (CT) variation according to refractive errors using enhanced-depth imaging optical coherence tomography. Methods Eighty-nine eyes (in 89 children) Korean children, CTs were greater in the hyperopia group than in the emmetropia and myopia groups. The temporal choroid was thicker than the nasal choroid, regardless of the refractive error. The thickest location in the hyperopia group was the fovea; however, the temporal choroid was thickest in the emmetropia and myopia groups.

  17. Is the human left ventricle partially a fractal pump?

    Science.gov (United States)

    Moore, Brandon; Dasi, Lakshmi

    2011-11-01

    Ventricular systolic and diastolic dysfunctions represent a large portion of healthcare problems in the United States. Many of these problems are caused and/or characterized by their altered fluid-structure mechanics. The structure of the left ventricle in particular is complex with time dependent multi-scale geometric complexity. At relatively small scales, one facet that is still not well understood is the role of trabeculae in the pumping function of the left ventricle. We utilize fractal geometry tools to help characterize the complexity of the inner surface of the left ventricle at different times during the cardiac cycle. A high-resolution three dimensional model of the time dependent ventricular geometry was constructed from computed tomography (CT) images in a human. The scale dependent fractal dimension of the ventricle was determined using the box-counting algorithm over the cardiac cycle. It is shown that the trabeculae may indeed play an integral role in the biomechanics of pumping by regulating the mechanical leverage available to the cardiac muscle fibers.

  18. Left ventricle to left atrium shunt via a paravalvular abscess.

    Science.gov (United States)

    Gasparovic, H; Smalcelj, A; Brida, M

    2009-10-01

    Intracardiac fistulas are rare complications of infective endocarditis that contribute to the complexity of surgical management, and impose an additional hemodynamic burden on the already challenged heart. We report on a case of successful surgical management of a paravalvular communication between the left ventricle and the left atrium via an abscess cavity. Georg Thieme Verlag KG Stuttgart. New York.

  19. [Endomyocardial fibrosis with massive calcification of the left ventricle].

    Science.gov (United States)

    Trigo, Joana; Camacho, Ana; Gago, Paula; Candeias, Rui; Santos, Walter; Marques, Nuno; Matos, Pedro; Brandão, Victor; Gomes, Veloso

    2010-03-01

    Endomyocardial fibrosis is a rare disease, endemic in tropical countries. It is characterized by fibrosis of the endocardium that can extend to myocardium. Important calcification of the endocardium is rare with only a few cases reported in the literature. We report a case of endomyocardial fibrosis in a european caucasian patient, associated with massive calcification of left ventricle.

  20. Effect of cerebral ventricles perfusion with naloxone on trigemino-hypoglossal reflex in rats.

    Science.gov (United States)

    Zubrzycka, M; Janecka, A

    2001-02-02

    The goal of this study was to determine whether opioid receptor antagonist naloxone abolishes the influence of periaqueductal central gray (PAG) on nociceptive evoked tongue jerks (ETJ) -- a trigemino-hypoglossal reflex induced by tooth pulp stimulation. In rats under chloralose anesthesia three series of experiments were performed. In the first two groups perfusions of lateral ventricles-cerebellomedullary cistern with McIlwain-Rodnight's solution and naloxone were carried out. In group 3 naloxone was infused through a catheter through the jugular vein. The amplitudes of tongue jerks induced by tooth pulp stimulation were recorded during subsequent 10 min perfusions. Mean amplitude of tongue movements induced by tooth pulp stimulation was regarded as the indicator of the magnitude of trigemino-hypoglossal reflex. We observed that perfusion of the cerebral ventricles with naloxone (100 nmol/ml) increased the trigemino-hypoglossal reflex up to 143%. The amplitude of ETJ was significantly reduced during PAG stimulation with a train of electrical impulses. After obtaining a significant -- 93% -- inhibition of ETJ (7% of the control), naloxone (100 nmol/ml) was added to the perfusion fluid. This led to a significant increase of the reflex up to 68%. Infusion of naloxone through the jugular vein did not affect the reflex. The above results suggest that the inhibition of ETJ due to PAG stimulation is partially reversed by naloxone and mediated via interactions with endogenous opioid systems involved in modulation of nociception.

  1. Flat Choroidal Nevus Inaccessible to Ultrasound Sonography Evaluated by Enhanced Depth Imaging Optical Coherence Tomography

    Directory of Open Access Journals (Sweden)

    Chrysanthi Basdekidou

    2011-06-01

    Full Text Available Purpose: To demonstrate the usefulness of enhanced depth imaging optical coherence tomography (EDI-OCT in investigating choroidal lesions inaccessible to ultrasound sonography. Methods: In a 60-year-old woman with an asymptomatic choroidal nevus, normal OCT was used to observe the macula and EDI-OCT to image the choroidal nevus that was inaccessible to ultrasound. The exact location of the lesion in the choroid and the dimensions of the nevus were measured. Results: The lesion was located in the superior macula, and the nevus was homogeneous in its reflectivity. We observed a thickened choroid delineated by the shadow cone behind it, measuring 1,376 × 325 µm in the larger vertical cut and 1,220 × 325 µm in the larger horizontal cut in an image with a 1:1 pixel mapping and automatic zoom. The macular profile and thickness were both normal. Conclusions: EDI-OCT appears to be an excellent technique for measuring choroidal nevi and all choroidal lesions accessible to OCT imaging by depicting their exact location in the choroid, their dimensions, and their demarcation from the surrounding healthy tissue, thus allowing for a more efficient and accurate follow-up.

  2. Choroid thickness in central serous chorioretinopathy using enhanced depth imaging optical coherence tomography

    Directory of Open Access Journals (Sweden)

    Xiao-Long Yu

    2013-04-01

    Full Text Available AIM: To observe the choroidal thickness in the macular area in affected and unaffected fellow eyes with central serous chorio retinopathy(CSCand in healthy controls. METHODS: Twenty-six cases with unilateral CSC and controls were recruited in this study. All eyes were divided into three groups: 26 eyes in Group A(affected eyes with CSC, 26 eyes in group B(unaffected fellow eyesand 26 eyes in group C(right eyes of age and sex matched control. Enhanced depth imaging was obtained by using spectral-domain optical coherence tomography. Subfoveal choroidal thickness and choroidal thickness at 1mm/3mm nasal, temporal, superior and inferior to the fovea were measured. RESULTS: Choroidal thickness was significantly increased in affected eyes with CSC than unaffected fellow eyes(t=5.57, P<0.01.The mean subfoveal choroidal thickness(SFCTwas 528.31±91.24μm in group A, 413.71±79.35μm in group B, and 301.31±52.46 in group C. The subfoveal choroid was significantly thicker in group A than Group C(P<0.01. SFCT in unaffected fellow eyes were thicker than the controls(P<0.01. CONCLUSION:Choroidal thickness is thicker in affected eyes with CSC and also in fellow unaffected eyes, indicating that the choroid blood vessels are high and perfusion state, may be one of the factors of the disease CSC.

  3. Does acute primary angle-closure cause an increased choroidal thickness?

    Science.gov (United States)

    Wang, Wei; Zhou, Minwen; Huang, Wenbin; Chen, Shida; Ding, Xiaoyan; Zhang, Xiulan

    2013-05-01

    We compared the choroidal thickness of the eyes of patients with acute primary angle-closure (APAC) with fellow eyes in the same patients. The analysis included 21 participants with unilateral APAC affected eyes and 21 fellow eyes with a diagnosis of primary angle-closure suspect (PACS). Enhanced depth imaging-optical coherence tomography (EDI-OCT) was used to measure the macular and peripapillary retinal and choroidal thickness in both eyes. The average choroidal thickness of the APAC eyes at each location or segment was compared to that of the fellow eyes. At all macular locations, the choroidal thickness was greatest at the subfovea for both groups. Comparison of the choroidal thickness between the groups showed that the thickness in the APAC eyes was significantly greater than in the PACS eyes at all locations except at 1 mm, 3 mm superior, 3 mm inferior, and 3 mm temporal from the fovea (P choroidal thickness was 349.0 ± 78.1 μm in the APAC eyes and 308.1 ± 70.5 μm in the PACS eyes, with a statistically significant difference (P choroidal thickness was significantly greater in association with the APAC diagnosis and diastolic blood pressure and thinner in association with older subjects. APAC eyes have a higher level of macular choroidal thickness than PACS eyes when the IOP is reduced. However, the source of this difference is unclear and must be investigated further.

  4. Subfoveal choroidal thickness in relation to sex and axial length in 93 Danish university students

    DEFF Research Database (Denmark)

    Li, Xiao Qiang; Larsen, Michael; Munch, Inger Christine

    2011-01-01

    To investigate the association between subfoveal choroidal thickness and ocular axial length, refractive error, and blood pressure in healthy young women and men.......To investigate the association between subfoveal choroidal thickness and ocular axial length, refractive error, and blood pressure in healthy young women and men....

  5. CHOROIDAL THICKNESS IN UNILATERAL IDIOPATHIC MACULAR HOLE: A Cross-Sectional Study and Meta-Analysis.

    Science.gov (United States)

    Zhang, Pengfei; Zhou, Minwen; Wu, Ying; Lu, Bing; Li, Tong; Zhao, Jingke; Wang, Fenghua; Sun, Xiaodong

    2017-01-01

    To investigate the choroidal thickness in unilateral idiopathic macular hole (IMH) eyes and compare them with normal control eyes using enhanced depth imaging optical coherence tomography (EDI-OCT). In this cross-sectional study, the subfoveal choroidal thickness (SFCT) and choroidal thickness at 1 mm and 3 mm nasal, temporal, superior, and inferior to the fovea of IMH eyes and normal control eyes were measured using EDI-OCT. Univariate and multivariate linear regression analyses were performed to evaluate the correlation between choroidal thickness at various locations and clinical factors. A meta-analysis was conducted using the Stata software package to calculate the summary of weighted mean differences (WMDs). Thirty-two unilateral IMH patients and 32 controls were enrolled in this study. The IMH eyes had a thinner choroid than the control eyes at all macular locations (all P choroidal thickness at any of the nine points was significantly thinner in association with the IMH diagnosis, as well as being somewhat thinner in association with age and axial length. The result of our cross-sectional study was consistent with the meta-analysis with a pooled WMD of -56.99 (95% confidence interval [CI]: -68.58 to -45.41) for subfoveal choroidal thickness. The study of Chinese unilateral IMH patients, along with the comprehensive meta-analysis, suggested that the choroidal thickness at all macular locations in unilateral IMH eyes significantly decreased relative to the control group.

  6. Choroid plexus papillomas: advances in molecular biology and understanding of tumorigenesis.

    Science.gov (United States)

    Safaee, Michael; Oh, Michael C; Bloch, Orin; Sun, Matthew Z; Kaur, Gurvinder; Auguste, Kurtis I; Tihan, Tarik; Parsa, Andrew T

    2013-03-01

    Choroid plexus papillomas are rare, benign tumors originating from the choroid plexus. Although generally found within the ventricular system, they can arise ectopically in the brain parenchyma or disseminate throughout the neuraxis. We sought to review recent advances in our understanding of the molecular biology and oncogenic pathways associated with this disease. A comprehensive PubMed literature review was conducted to identify manuscripts discussing the clinical, molecular, and genetic features of choroid plexus papillomas. Articles concerning diagnosis, treatment, and long-term patient outcomes were also reviewed. The introduction of atypical choroid plexus papilloma as a distinct entity has increased the need for accurate histopathologic diagnosis. Advances in immunohistochemical staining have improved our ability to differentiate choroid plexus papillomas from other intracranial tumors or metastatic lesions using combinations of key markers and mitotic indices. Recent findings have implicated Notch3 signaling, the transcription factor TWIST1, platelet-derived growth factor receptor, and the tumor necrosis factor-related apoptosis-inducing ligand pathway in choroid plexus papilloma tumorigenesis. A combination of commonly occurring chromosomal duplications and deletions has also been identified. Surgical resection remains the standard of care, although chemotherapy and radiotherapy may be considered for recurrent or metastatic lesions. While generally considered benign, these tumors possess a complex biology that sheds insight into other choroid plexus tumors, particularly malignant choroid plexus carcinomas. Improving our understanding of the molecular biology, genetics, and oncogenic pathways associated with this tumor will allow for the development of targeted therapies and improved outcomes for patients with this disease.

  7. OCT Angiography Identification of Choroidal Neovascularization Secondary to Acute Zonal Occult Outer Retinopathy.

    Science.gov (United States)

    Levison, Ashleigh L; Baynes, Kimberly; Lowder, Careen Y; Srivastava, Sunil K

    2016-01-01

    A 74-year-old female with acute zonal occult outer retinopathy presented with a new lesion suspicious for choroidal neovascularization (CNV) in her right eye. Optical coherence tomography angiography (OCTA) confirmed the presence of CNV. OCTA is a new imaging technique that may help guide diagnosis and management of choroidal neovascular membranes in uveitic diseases.

  8. Quantification and anatomic distribution of choroidal abnormalities in patients with type I neurofibromatosis.

    Science.gov (United States)

    Nakakura, Shunsuke; Shiraki, Kunihiko; Yasunari, Takaharu; Hayashi, Yoko; Ataka, Shinsuke; Kohno, Takeya

    2005-10-01

    Choroidal abnormality manifesting as a bright patchy lesion under infrared monochromatic light has previously been described in neurofibromatosis type I patients in whom the choroid appears normal under conventional ophthalmoscopic examination or on the fluorescein angiogram. We investigated the correlation between patient age and the number of choroidal abnormalities, as well as the anatomic distribution of choroidal abnormalities in the fundus. We examined the fundus of 28 eyes in 14 patients with neurofibromatosis type I. Patients ranged in age from 2 to 38 years and were examined between April 2001 and April 2002 by confocal scanning laser ophthalmoscopy with infrared monochromatic light (780 nm wavelength). We divided the fundus into five regions (one within the retinal vascular arcade and those supero-temporal, infero-temporal, supero-nasal, and infero-nasal to it), and lesions on the border between regions were assigned to the region containing the greater part of the lesion. We studied the total number of choroidal abnormalities and the correlation between the total number and age. A positive correlation was found between the total number of choroidal abnormalities and age (Spearman rank correlation coefficient, r=0.6209, P=0.0178). There was a significantly greater number of choroidal abnormalities in the arcade region than in the other four regions (ANOVA, P<0.001). Choroidal abnormalities tend to increase with age and are most often observed within the vascular arcade.

  9. Brief light exposure at night disrupts the circadian rhythms in eye growth and choroidal thickness in chicks.

    Science.gov (United States)

    Nickla, Debora L; Totonelly, Kristen

    2016-05-01

    Changes in ocular growth that lead to myopia or hyperopia are associated with alterations in the circadian rhythms in eye growth, choroidal thickness and intraocular pressure in animal models of emmetropization. Recent studies have shown that light at night has deleterious effects on human health, acting via "circadian disruptions" of various diurnal rhythms, including changes in phase or amplitude. The purpose of this study was to determine the effects of brief, 2-h episodes of light in the middle of the night on the rhythms in axial length and choroidal thickness, and whether these alter eye growth and refractive error in the chick model of myopia. Starting at 2 weeks of age, birds received 2 h of light between 12:00 am and 2:00 am for 7 days (n = 12; total hours of light: 14 h). Age-matched controls had a continuous dark night (n = 14; 14L/10D). Ocular dimensions were measured using high-frequency A-scan ultrasonography on the first day of the experiment, and again on day 7, at 6-h intervals, starting at noon (12 pm, 6 pm, 12 am, 6 am, 12 pm). Measurements during the night were done under a photographic safe-light. These data were used to determine rhythm parameters of phase and amplitude. 2 groups of birds, both experimental (light at night) and control, were measured with ultrasound at various intervals over the course of 4 weeks to determine growth rates. Refractive errors were measured in 6 experimental and 6 control birds at the end of 2 weeks. Eyes of birds in a normal L/D cycle showed sinusoidal 24-h period diurnal rhythms in axial length and choroid thickness. Light in the middle of the night caused changes in both the rhythms in axial length and choroidal thickness, such that neither could be fit to a sine function having a period of 24 h. Light caused an acute, transient stimulation in ocular growth rate in the subsequent 6-h period (12 am-6 am), that may be responsible for the increased growth rate seen 4 weeks later, and the more

  10. Slit like ventricle and isolation of CSF pathway as complications of shunt procedure in child hydrocephalus, (3). Hydrodynamic change in isolated ventricle

    Energy Technology Data Exchange (ETDEWEB)

    Oi, Shizuo (National Kagawa Children' s Hospital (Japan)); Matsumoto, Satoshi

    1983-12-01

    The shunt procedure in hydrocephalus in 164 children (under 15 years of age) was followed by a slit-like ventricle in 46 cases, an isolated fourth ventricle in 6 cases, an isolated unilateral hydrocephalus in 4 cases, and a loculated ventricle in 3 cases. The pathological conditions of the isolation of the CSF pathway were observed and confirmed by metrizamide CT cisternography and ventriculography, while the hydrodynamics of the CSF under these pathological conditions was sequentially and dynamically analyzed. There was a complication of a slit ventricle in 4 cases of an isolated fourth ventricle, in all 4 cases of an isolated unilateral hydrocephalus, and in 1 case of a loculated ventricle, and a re-dilation of the slit-like ventricle resulted in an improvement in the pathological conditions in 2 cases, 1 case, and the 1 case respectively (reversible isolation). In 2 cases of an isolated fourth ventricle, the obstruction of the aqueduct of the midbrain persisted (permanent isolation), regardless of changes in the paracelic function of the shunt tube, resulting in a double compartment; the installation of a separate shunt tube was required in both cases. Some cases of isolated fourth ventricle remained asymptomatic (asymptomatic isolated fourth ventricle), although it could be confirmed on the basis of an examination of the CSF, that the pathological conditions had been completed.

  11. 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.

  12. [Serous macular detachment associated with circumscribed choroidal hemangioma: a case report].

    Science.gov (United States)

    Munteanu, M; Giuri, Stela; Rosca, C; Boruga, O; Chercota, V; Stanca, H T

    2013-01-01

    Choroidal hemangiomas are benign vascular hamartomas that typically present from second to fourth decade of life, when they can cause visual disturbance due to exudative retinal detachment. They represent uncommon benign choroidal vascular tumors, usually occuring sporadically in the absence of systemic disease. We report the case of a young female patient, presenting a juxtapapillary circumscribed choroidal haemangioma complicated with serous macular detachment. The patient underwent photodynamic therapy with verteporfin (PDT). Systematic follow-up using ophthalmoscopy, ultrasonography, Fluorescein angiography and Indocyanine green angiography was performed. The patient presented regression with flattening of tumour, resolution of the subretinal fluid, and significant improvement of vision. Mostly asymptomatic, the choroidal hemangiomas can be associated with serous retinal detachment, leading to reduced vision and metamorphopsia; in those cases, the long term visual prognosis is poor, even in adequately treated patients. PDT is effective in eliminating the subretinal fluid and improving vision in patients with circumscribed choroidal hemangioma.

  13. 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...... to -1] μm, P = 0.04) compared with appropriate for gestation children. Longer birth length was associated with a thicker subfoveal choroid (2 [1-4] μm/cm, P = 0.005). Macular choroidal thickness at 16 extrafoveal locations was measured in a subset of children and found to have the same associations...... with birth weight as the subfoveal choroidal thickness. CONCLUSIONS: In 11- to 12-year-old children, thinner choroids were associated with lower birth weight, lower birth length, and being small for the gestational age....

  14. A case of choroidal osteoma in a 10-year-old child

    Directory of Open Access Journals (Sweden)

    Behera M

    2015-11-01

    Full Text Available Madhusmita Behera,1 Manmath Kumar Das2 1Rotary Narayana Nethralaya, Kolkata, India; 2Vitreo-Retina Services, CL Gupta Eye Institute, Moradabad, India Abstract: Choroidal osteoma is a rare, benign tumor, usually diagnosed in healthy adult women in their second or third decade of life. Though its etiology and pathogenesis are unclear, it is usually diagnosed due to its typical clinical features of yellowish-orange colored subretinal lesion at posterior pole and a dense echogenic plaque persisting even in lower gains on B-scan ultrasonography. Mostly unilateral (79%, the median age of diagnosis is 26 years. It is relatively rare in children. We report a case of choroidal osteoma in a 10-year-old boy. Keywords: choroidal osteoma, choroidal osseous choristoma, choroidal tumor

  15. 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

    2012-01-01

    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.

  16. Changes in choroidal thickness after systemic administration of high-dose corticosteroids: a pilot study.

    Science.gov (United States)

    Han, Jeong Mo; Hwang, Jeong-Min; Kim, Ji Soo; Park, Kyu Hyung; Woo, Se Joon

    2014-01-21

    To characterize the effects of corticosteroids on choroidal thickness, we measured the choroid thickness in patients treated systemically with a high-dose corticosteroid. A prospective, pilot study was conducted on 20 patients who required high-dose corticosteroid pulse therapy (>500 mg/d). Choroidal thickness was measured at baseline, 1 day, 1 week, and 1 month after corticosteroid administration. Blood pressure was measured four times a day for the first 5 days of steroid treatment. This study ultimately included 35 eyes from 18 patients. Each patient was treated with high-dose corticosteroid therapy at a concentration of 19.5 ± 4.1 mg per kg body weight for 5.2 ± 1.1 days. Mean subfoveal choroidal thickness at baseline was 259.8 μm (range, 86.4-394.7 μm). Choroidal thickness showed no significant change at 1 day, 1 week, or 1 month after corticosteroid administration (P = 0.197). Mean systolic blood pressure increased by 13 mmHg (P = 0.008), but diastolic pressure did not change (P = 0.117). One patient (5.6%) who had presented with pigment epithelial detatchment (PED) and thick choroid (381.1 μm) developed bilateral focal subretinal fluid during the study and showed central serous chorioretinopathy (CSC) with a 13.1% increase in subfoveal choroidal thickness. No consistent changes in choroidal thickness were observed after systemic high-dose corticosteroid treatment, but one patient with PED and thick choroid showed an increase in choroidal thickening as well as features of CSC. Thus, steroid-induced CSC may be an idiosyncratic response in selected vulnerable individuals rather than a dose-dependent effect.

  17. Neuropilin 1 Involvement in Choroidal and Retinal Neovascularisation

    Science.gov (United States)

    Fernández-Robredo, Patricia; Sim, Dawn A.; Fruttiger, Marcus

    2017-01-01

    Purpose Inhibiting VEGF is the gold standard treatment for neovascular age-related macular degeneration (AMD). It is also effective in preventing retinal oedema and neovascularisation (NV) in diabetic retinopathy (DR) and retinal vein occlusions (RVO). Neuropilin 1 (Nrp1) is a co-receptor for VEGF and many other growth factors, and therefore a possible alternative drug target in intra ocular neovascular disease. Here we assessed choroidal and retinal NV in an inducible, endothelial specific knock out model for Nrp1. Methods Crossing Nrp1 floxed mice with Pdgfb-CreERT2 mice produced tamoxifen-inducible, endothelial specific Nrp1 knock out mice (Nrp1ΔEC) and Cre-negative, control littermates. Cre-recombinase activity was confirmed in the Ai3(RCL-EYFP) reporter strain. Animals were subjected to laser-induced CNV (532 nm) and spectral domain-optical coherence tomography (SD-OCT) was performed immediately after laser and at day 7. Fluorescein angiography (FA) evaluated leakage and postmortem lectin staining in flat mounted RPE/choroid complexes was also used to measure CNV. Furthermore, retinal neovascularisation in the oxygen induced retinopathy (OIR) model was assessed by immunohistochemistry in retinal flatmounts. Results In vivo FA, OCT and post-mortem lectin staining showed a statistically significant reduction in leakage (p<0.05), CNV volume (p<0.05) and CNV area (p<0.05) in the Nrp1ΔEC mice compared to their Cre-negative littermates. Also the OIR model showed reduced retinal NV in the mutant animals compared to wild types (p<0.001). Conclusion We have demonstrated reduced choroidal and retinal NV in animals that lack endothelial Nrp1, confirming a role of Nrp1 in those processes. Therefore, Nrp1 may be a promising drug target for neovascular diseases in the eye. PMID:28107458

  18. Lateral Mixing

    Science.gov (United States)

    2012-11-08

    being made on their analysis. A process we became very curious about was the separation of tendrils of warm salty water from the north wall figure 7...structure, and to remove the effect of internal waves by mapping this structure onto isopycnals. This has been very successful in elucidating lateral...we passed through the same water on multiple passes, and that changes in the horizontal structure of the water mas should be readily apparent from

  19. Magnetic resonance imaging characteristics of posterior scleritis mimicking choroidal mass

    Energy Technology Data Exchange (ETDEWEB)

    Osman Saatci, A.; Saatci, Isil E-mail: cekirgesaatci@superonline.com; Kocak, Niluefer; Durak, Ismet

    2001-08-01

    We present imaging findings in a case of posterior scleritis, which may mimic tumoral mass lesion resulting in unnecessary enucleation. Magnetic resonance imaging was remarkable for a subretinal mass hypointense on T2 and hyperintense on T1 weighted images. A peripheral rim of hypointensity was noteworthy, suggestive of sclerouveal thickening. There was an ill-defined area of increased T2 signal intensity adjacent to globe at the site of nodular lesion implying an inflammatory process. A linear contrast enhancement was seen within the bulbus oculi which may represent detached retina by exudation or displaced retina due to thickened sclera and choroidal layers. The CSF space around the optic nerve was enlarged.

  20. File list: His.CDV.20.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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  2. File list: InP.CDV.10.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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  4. File list: InP.CDV.05.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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  7. File list: ALL.CDV.10.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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  10. File list: InP.CDV.10.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  11. File list: DNS.CDV.05.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  12. File list: DNS.CDV.05.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  13. File list: DNS.CDV.10.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  14. File list: His.CDV.10.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  15. File list: His.CDV.50.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  16. File list: InP.CDV.50.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  17. File list: DNS.CDV.20.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  18. File list: DNS.CDV.50.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  20. File list: NoD.CDV.50.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  1. File list: NoD.CDV.10.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  2. File list: ALL.CDV.20.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  3. File list: NoD.CDV.05.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  4. File list: His.CDV.05.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  5. File list: InP.CDV.20.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  6. File list: ALL.CDV.05.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  7. File list: NoD.CDV.50.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  8. File list: NoD.CDV.10.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  9. File list: DNS.CDV.10.AllAg.Heart_Ventricles [Chip-atlas[Archive

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  10. File list: InP.CDV.20.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  11. File list: NoD.CDV.05.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  12. File list: ALL.CDV.05.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  13. File list: DNS.CDV.20.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  14. File list: ALL.CDV.10.AllAg.Heart_Ventricles [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  15. Intravitreal ranibizumab therapy versus photodynamic therapy for idiopathic choroidal neovascularization: a comparative study on visual acuity, retinal and choroidal thickness

    Institute of Scientific and Technical Information of China (English)

    Shi Xuehui; Wei Wenbin; Zhang Cong

    2014-01-01

    Background Photodynamic therapy (PDT) has been recommended as a main treatment for idiopathic choroidal neovascularization (I-CNV).But the visual results of PDT were inconsistent and variable,and PDT may bring severe damage to the retinal pigment epithelium and choriocapillaries.In recent years,intravitreal ranibizumab therapy,showing favorable visual outcomes,has developed as an advanced treatment for choroidal neovascularization (CNV).Although both methods have been reported to be effective in treating I-CNV,there is no detailed comparative report between the two methods.This study aimed to compare visual outcomes,retinal and choroidal thickness between intravitreal ranibizumab therapy and PDT in the treatment of I-CNV,and investigate the correlation of visual outcomes with retinal and choroidal thickness in each of the two groups.Methods Thirty-seven eyes of 37 patients with I-CNV were involved in this study; 19 eyes were treated with intravitreal ranibizumab therapy and 18 eyes were treated with PDT.The best corrected visual acuity (BCVA) was recorded before and at each follow-up visit after treatments (IogMAR).Enhanced-depth imaging optical coherence tomography (EDI-OCT) was used to evaluate the retinal structural changes,and to measure central retinal thickness (CRT) and central choroidal thickness (CCT).Results Mean BCVA was 0.64±0.27 in PDT group and 0.69±0.22 in ranibizumab group at baseline (P=0.55).When compared with the baseline,mean BCVA in PDT group was improved significantly at 3-month after PDT (0.41±0.16,P=0.002),then changed little (0.42±0.25 at 12-month,P=0.88).Whereas mean BCVA in Ranibizumab group was improved significantly at each follow-up visit.It improved much more obviously in the first month and then remained stable.The mean BCVA in the ranibizumab group was significantly better at each follow-up visit than that in PDT (P <0.05).When compared with the baseline,mean CRT in PDT group decreased significantly since 3-month visit

  16. Analysis of the morphology and vascular layers of the choroid in retinitis pigmentosa using spectral-domain OCT.

    Science.gov (United States)

    Adhi, Mehreen; Regatieri, Caio V; Branchini, Lauren A; Zhang, Jason Y; Alwassia, Ahmad A; Duker, Jay S

    2013-01-01

    To analyze choroidal morphology and vascular layers in eyes with retinitis pigmentosa (RP) using spectral-domain optical coherence tomography. Cross-sectional, retrospective analysis of 14 patients (14 eyes) with RP and 33 healthy subjects (33 eyes) who underwent high-definition one-line raster scanning at a single center. Two independent raters evaluated the morphology, thickness, and vascular layers of the choroid in both groups. The choroid had an irregular shape in 11 of 14 eyes (79%) with RP. The thickest point of choroid was not subfoveal as in healthy eyes, and exaggerated nasal thinning of the choroid was observed in nine of 14 eyes (65%) with RP. Mean subfoveal total choroidal thickness and large choroidal vessel layer thickness were significantly lower in eyes with RP (P = .04 and P = .02, respectively) than in healthy eyes. Choroidal morphology is altered and an exaggerated thinning of the large choroidal vessel layer is observed in eyes with RP. Further studies involving correlation of disease stage and severity with choroidal changes may provide further insight into the involvement of choroid in RP and other inherited retinal dystrophies. Copyright 2013, SLACK Incorporated.

  17. CHOROIDAL THICKNESS CHANGE AFTER INTRAVITREAL ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR TREATMENT IN RETINAL ANGIOMATOUS PROLIFERATION AND ITS RECURRENCE.

    Science.gov (United States)

    Kim, Yong-Kyu; Park, Sang Jun; Woo, Se Joon; Park, Kyu Hyung

    2016-08-01

    To investigate choroidal thickness changes after anti-vascular endothelial growth factor (VEGF) treatment in retinal angiomatous proliferation (RAP) and correlate choroidal thickness with disease recurrence. Twenty-six eyes from 21 patients with RAP were treated with 3 monthly intravitreal anti-VEGF injections and additional injections as needed. RAP was divided according to the component of pigment epithelial detachment. The subfoveal choroidal thickness and choroidal thickness under the RAP lesion were measured using spectral-domain optical coherence tomography and compared between recurrence and nonrecurrence groups during the first year. The subfoveal choroidal thickness and choroidal thickness under the RAP lesion showed a significant decrease during the first 3 months; however, this was not maintained for the first year. The recurrence group showed a significantly thicker subfoveal choroidal thickness (P = 0.021) and choroidal thickness under the RAP lesion (P = 0.020) during the first year in those with only drusen or drusenoid pigment epithelial detachment without serous component. A significant increase and decrease in choroidal thickness was observed during the recurrence and remission period. Increased choroidal thickness was associated with a higher rate of recurrence after anti-VEGF treatment in RAP with only drusen or drusenoid pigment epithelial detachment. Choroidal thickness could also reflect disease activity, even before manifestation of retinal disease activity.

  18. Clinical observations on treating thalamic hemorrhage into ventricle

    Institute of Scientific and Technical Information of China (English)

    Dong Aiqin; Lv Xiudong; Wang Huagang

    2000-01-01

    Objective To investigate the treatment of severe patients with thalamic hemorrhage into ventricles. Method 12 cases with thalamic hemorrhage into ventricular system were studied, 9 male, 3 femaie, with a mean age of 64 years. All patients were unconscious. The average size of hematoma was 65 ml. Besides general comprehensive care, they received ventricular puncture for ingertion of drainage tape into the cerebral ventricle, infusion with urokinase for clotlysis, lumbar puncture for letting out some cerebrospinal fluid and injection of dexemethasone. Result The patients' clinical symptoms and signs were obviously improved.. The CT scan also demonstrated that hematomas were removed faster. The effective rate was 83.3 per cent, with a murtality of 16.7 per cent. Cohclusion This kind of therapy can increase the clinical cure rate. decrease the disability rate and death rete.

  19. A strategic approach for cardiac MR left ventricle segmentation.

    Science.gov (United States)

    Dakua, Sarada Prasad; Sahambi, J S

    2010-09-01

    Quantitative evaluation of cardiac function from cardiac magnetic resonance (CMR) images requires the identification of the myocardial walls. This generally requires the clinician to view the image and interactively trace the contours. Especially, detection of myocardial walls of left ventricle is a difficult task in CMR images that are obtained from subjects having serious diseases. An approach to automated outlining the left ventricular contour is proposed. In order to segment the left ventricle, in this paper, a combination of two approaches is suggested. Difference of Gaussian weighting function (DoG) is newly introduced in random walk approach for blood pool (inner contour) extraction. The myocardial wall (outer contour) is segmented out by a modified active contour method that takes blood pool boundary as the initial contour. Promising experimental results in CMR images demonstrate the potentials of our approach.

  20. Colloidal cyst of the third ventricle. Case presentation

    Directory of Open Access Journals (Sweden)

    Ada Sánchez Lozano

    2009-09-01

    Full Text Available Colloidal cysts are congenital intracranial benign lesions of the anterior superior portion of the third ventricle. They represent between the 0,2 and 2 % of all the intracranial tumours and represent the 15 or 20 % of all the intraventricular masses. They become symptomatic during the adolescence or early adulthood and start normally with migraine or symptoms of intracranial hypertension causing obstructive hydrocephaly. We present the case of a teenager of 18 years of age with history of migraine after two years and the symptoms worsened in intensity and frequency including vomiting and bilateral paresthesia; the diagnosis was obstructive hydrocephaly with colloidal cyst of the third ventricle. An appropriate practice was adopted due to the uncertain diagnosis in order to avoid neurological damage and death. We discussed the main characteristics of the colloidal cyst, its clinical presentation and radiological characteristics and we performed.

  1. Repair of isolated double-chambered right ventricle

    Directory of Open Access Journals (Sweden)

    M El Kouache

    2013-01-01

    Full Text Available The finding of a double-chambered right ventricle (DCRV is exceptionally rare as an isolated anomaly. It is a congenital cardiac anomaly in which the right ventricle is separated into two chambers, a proximal high-pressure chamber and a distal low-pressure chamber, by anomalous muscles or fibrous tissues in the right ventricular cavity. We report the case of a 6-year-old infant who was admitted for growth retardation. The patient was diagnosed with an isolated DCRV without any other associated congenital anomalies. The patient underwent a successful cardiac surgical procedure of enlargement repair; he was discharged in good clinical condition with a normal cardiac function.

  2. Wide field visualization of retinal and choroidal microstructure in vivo using frequency domain OCT at 1060 nm with up to 47000 lines/s

    Science.gov (United States)

    Hermann, Boris; Esmaeelpour, M.; Povazay, Boris; Hofer, Bernd; Bounaparte, F.; Sheen, Nick; North, Rachel; Drexler, Wolfgang

    2009-02-01

    We present in vivo frequency domain optical coherence tomography of the human retina and choroid in the 1060 nm water transmission window with 72 nm optical bandwidth (choroidal vasculature without the need of contrast agents, the choroidal-scleral interface as well as the first scleral layer, the absorbing lamina fusca sclerae. Furthermore the choroidal thickness was quantified in 30 healthy subjects and correlated with axial eye length. First results indicate an decrease in choroidal thickness with increasing axial eye length.

  3. The Superior Transvelar Approach to the Fourth Ventricle and Brainstem

    OpenAIRE

    Ezer, Haim; Banerjee, Anirban Deep; Bollam, Papireddy; Guthikonda, Bharat; Nanda, Anil

    2012-01-01

    Objective The superior transvelar approach is used to access pathologies located in the fourth ventricle and brainstem. The surgical path is below the venous structures, through the superior medullary velum. Following splitting the tentorial edge, near the tentorial apex, the superior medullary velum is split in the cerebello-mesencephalic fissure. Using the supracerebellar infratentorial, transtentorial or parietal interhemispheric routes, the superior medullary velum is approached. Splittin...

  4. Multiscale modeling and surgical planning for single ventricle heart patients

    Science.gov (United States)

    Marsden, Alison

    2011-11-01

    Single ventricle heart patients are among the most challenging for pediatric cardiologists to treat, and typically undergo a palliative course of three open-heart surgeries starting immediately after birth. We will present recent tools for modeling blood flow in single ventricle heart patients using a multiscale approach that couples a 3D Navier-Stokes domain to a 0D closed loop lumped parameter network comprised of circuit elements. This coupling allows us to capture the effect of changes in local geometry, such as shunt sizes, on global circulatory dynamics, such as cardiac output. A semi-implicit numerical method is formulated to solve the coupled system in which flow and pressure information is passed between the two domains at the inlets and outlets of the model. A finite element method with outflow stabilization is applied in the 3D Navier-Stokes domain, and the LPN system of ordinary differential equations is solved numerically using a Runge-Kutta method. These tools are coupled via automated scripts to a derivative-free optimization method. Optimization is used to systematically explore surgical designs using clinically relevant cost functions for two stages of single ventricle repair. First, we will present results from optimization of the first stage Blalock Taussig Shunt. Second, we will present results from optimization of a new Y-graft design for the third stage of single ventricle repair called the Fontan surgery. The Y-graft is shown, in simulations, to successfully improve hepatic flow distribution, a known clinical problem. Preliminary clinical experience with the Y-graft will be discussed.

  5. Comparison of OCTA and ICGA used in polypoid choroidal vasculopathy

    Directory of Open Access Journals (Sweden)

    Hou-Yin Xu

    2017-07-01

    Full Text Available AIM: To observe of optical coherence tomography angiography(OCTAand indocyanine green angiography(ICGAimage feature in polypoidal choroidal vasculopathy(PCV. METHODS: Selected 21 patients 21 eyes with PCV in our hospital from January 2016 to December 2016. All the eyes were examined by ICGA, and was examined by OCTA after ICGA examination 1h. We observed the characteristics of OCTA and ICGA images. RESULTS:ICGA examination showed that there were 8 cases of choroidal abnormal branch vascular network(BVN, polypoid lesions 10 eyes, BVN with polypoid lesions 2 eyes, no abnormal performance 1 eyes. OCTA examination showed 8 eyes of BVN, and the location, range and shape of BVN were similar to ICGA in OCTA examination. ICGA examination showed 10 cases of polypoid lesions. OCTA showed strong signal highlights. ICGA examination showed 2 cases of BVN complicated with polypoid lesions, and OCTA examination showed strong signal highlights of BVN and corresponding parts. ICGA examination showed no abnormal performance in 1 eyes, and no abnormal findings in OCTA examination. CONCLUSION: OCTA and ICGA are similar in the location and morphology of PCV lesions, and OCTA may play a role in the diagnosis of PCV restricted ICGA.

  6. Segmentation of choroidal neovascularization in fundus fluorescein angiograms.

    Science.gov (United States)

    Abdelmoula, Walid M; Shah, Syed M; Fahmy, Ahmed S

    2013-05-01

    Choroidal neovascularization (CNV) is a common manifestation of age-related macular degeneration (AMD). It is characterized by the growth of abnormal blood vessels in the choroidal layer causing blurring and deterioration of the vision. In late stages, these abnormal vessels can rupture the retinal layers causing complete loss of vision at the affected regions. Determining the CNV size and type in fluorescein angiograms is required for proper treatment and prognosis of the disease. Computer-aided methods for CNV segmentation is needed not only to reduce the burden of manual segmentation but also to reduce inter- and intraobserver variability. In this paper, we present a framework for segmenting CNV lesions based on parametric modeling of the intensity variation in fundus fluorescein angiograms. First, a novel model is proposed to describe the temporal intensity variation at each pixel in image sequences acquired by fluorescein angiography. The set of model parameters at each pixel are used to segment the image into regions of homogeneous parameters. Preliminary results on datasets from 21 patients with Wet-AMD show the potential of the method to segment CNV lesions in close agreement with the manual segmentation.

  7. 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.

  8. 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

  9. 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.

  10. Choroidal structure determined by binarizing optical coherence tomography images in eyes with reticular pseudodrusen

    Science.gov (United States)

    Masuda, Naonori; Kojima, Masashi; Yamashita, Mariko; Nishi, Tomo; Ogata, Nahoko

    2017-01-01

    Purpose To compare the choroidal structure beneath the macular area in eyes with reticular pseudodrusen (RPD) and age-matched controls. Methods This study was performed at Nara Medical University Hospital, Japan. Twenty eyes of 14 patients (82.3±4.2 years, mean ± standard deviation) with RPD and 35 eyes of 20 age-matched controls (81.5±6.0 years) were studied. The choroidal structure was determined by binarizing the images obtained by enhanced depth imaging optical coherence tomography in all patients and controls. The total, luminal, and stromal choroidal areas were quantified by the binarization method. Results The total choroidal area of the eyes with RPD was significantly smaller than that of control eyes (P=0.001, unpaired t-test). Both the luminal and stromal areas in eyes with RPD were significantly smaller than that of control eyes (P=0.001, paired t-test), but there was no significant difference in the luminal/stromal ratio between eyes with RPD and control eyes. Conclusion The total, luminal, and stromal choroidal areas in eyes with RPD were smaller than those of the control eyes. The reduction of the choroidal luminal and stromal areas may be due to a loss of the oxygen demand of the choroid due to RPE dysfunction. PMID:28490860

  11. Choroidal structure determined by binarizing optical coherence tomography images in eyes with reticular pseudodrusen.

    Science.gov (United States)

    Masuda, Naonori; Kojima, Masashi; Yamashita, Mariko; Nishi, Tomo; Ogata, Nahoko

    2017-01-01

    To compare the choroidal structure beneath the macular area in eyes with reticular pseudodrusen (RPD) and age-matched controls. This study was performed at Nara Medical University Hospital, Japan. Twenty eyes of 14 patients (82.3±4.2 years, mean ± standard deviation) with RPD and 35 eyes of 20 age-matched controls (81.5±6.0 years) were studied. The choroidal structure was determined by binarizing the images obtained by enhanced depth imaging optical coherence tomography in all patients and controls. The total, luminal, and stromal choroidal areas were quantified by the binarization method. The total choroidal area of the eyes with RPD was significantly smaller than that of control eyes (P=0.001, unpaired t-test). Both the luminal and stromal areas in eyes with RPD were significantly smaller than that of control eyes (P=0.001, paired t-test), but there was no significant difference in the luminal/stromal ratio between eyes with RPD and control eyes. The total, luminal, and stromal choroidal areas in eyes with RPD were smaller than those of the control eyes. The reduction of the choroidal luminal and stromal areas may be due to a loss of the oxygen demand of the choroid due to RPE dysfunction.

  12. Diurnal variations in luminal and stromal areas of choroid in normal eyes.

    Science.gov (United States)

    Kinoshita, Takamasa; Mitamura, Yoshinori; Shinomiya, Kayo; Egawa, Mariko; Iwata, Akiko; Fujihara, Akiko; Ogushi, Yoko; Semba, Kentaro; Akaiwa, Kei; Uchino, Eisuke; Sonoda, Shozo; Sakamoto, Taiji

    2017-03-01

    To determine the diurnal variations of the luminal and stromal areas of the choroid in normal eyes. This was a prospective observational study of 38 eyes of 38 normal subjects. The blood pressure, heart rate, intraocular pressure and enhanced depth imaging optical coherence tomographic (EDI-OCT) images were recorded every 3 hours between 6:00 and 21:00 hours. The horizontal EDI-OCT images of the subfoveal choroid were converted to binary images. The central choroidal thickness (CCT), total cross-sectional choroidal area, the luminal areas, stromal areas and the ratio of luminal area to total choroidal area (L/C ratio) were determined. There were significant diurnal variations in the CCT, total choroidal area, luminal area and L/C ratio with the maximum values at 6:00 hours and the minimum values at 15:00 hours (pchoroidal area, pchoroidal area (pchoroidal parameters. The changes in the luminal area are most likely responsible for the diurnal change in the CCT and subfoveal choroidal area. UMIN000019060, Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. CHOROIDAL THICKNESS CHANGES AFTER VITRECTOMY WITH SILICONE OIL TAMPONADE FOR PROLIFERATIVE VITREORETINOPATHY RETINAL DETACHMENT.

    Science.gov (United States)

    Odrobina, Dominik; Gołębiewska, Joanna; Maroszyńska, Iwona

    2016-12-28

    To access the potential effect of vitrectomy and silicone oil tamponade on the choroid. Eighteen patients (18 eyes) who had undergone pars plana vitrectomy with 1,000-cSt silicone oil tamponade for proliferative vitreoretinopathy retinal detachment were included in this retrospective study. All patients underwent ophthalmologic examinations before treatment and 1 week and 1, 3, and 6 months after vitrectomy with silicone oil tamponade. Choroidal thickness was measured using enhanced depth imaging optical coherence tomography (Spectralis; Heidelberg Engineering) in a horizontal and vertical section beneath the fovea. Choroidal thickness statistically significantly decreased till 3 months after pars plana vitrectomy with silicone oil tamponade: under the center of the fovea (P = 0.014) and in the temporal (P = 0.029), superior (P = 0.046), and inferior areas, determined at 1,500 μm from the center of the fovea (P = 0.030). After 6 months, the desired effect in the form of a decrease in the choroidal thickness was even more prominent, both under the center of the fovea (P tamponade. Silicone oil tamponade may have an impact on the structure and proper functioning of the choroid. The measurements of the choroidal thickness by optical coherence tomography might be a very good tool to detect early changes in choroidal thickness and impact the decision when to remove silicone oil.

  14. Motion analysis of both ventricles using tagged MRI

    Science.gov (United States)

    Ozturk, Cengizhan; McVeigh, Elliot R.

    2000-04-01

    Although several methods exist for the analysis of tagged MRI images of the left ventricle (LV), analysis of the right ventricle (RV) remains challenging due to its complex anatomy and significant through plane motion. We present here preliminary results of our new motion analysis method, both for RV and LV, in healthy human volunteers. In this method, following standard myocardial and tag segmentation of cardiac gated cine tagged MR images; a 4D B-spline based parametric motion field was computed for a volume of interest encompassing both ventricles. Using this motion field, 3D displacements and strains were calculated on the RV and LV. We observed that for both chambers the circumferential strain (Ecc) decreased with a constant rate throughout systole. The systolic strain rate displayed spatial similarity not only for the LV but also for the RV. For RV free wall, mean systolic Ecc was -0.19 +/- 0.05 with an average coefficient of variability of 20%. The 4D B-spline based motion analysis technique for tagged MRI yields compatible results for the LV and gives consistent circumferential strain measures for the RV free wall. Tagged MRI based RV mechanical analysis can be used along with LV results for a more complete cardiac evaluation.

  15. Cardiac performance correlates of relative heart ventricle mass in amphibians.

    Science.gov (United States)

    Kluthe, Gregory J; Hillman, Stanley S

    2013-08-01

    This study used an in situ heart preparation to analyze the power output and stroke work of spontaneously beating hearts of four anurans (Rhinella marina, Lithobates catesbeianus, Xenopus laevis, Pyxicephalus edulis) and three urodeles (Necturus maculosus, Ambystoma tigrinum, Amphiuma tridactylum) that span a representative range of relative ventricle mass (RVM) found in amphibians. Previous research has documented that RVM correlates with dehydration tolerance and maximal aerobic capacity in amphibians. The power output (mW g(-1) ventricle mass) and stroke work (mJ g(-1) ventricle muscle mass) were independent of RVM and were indistinguishable from previously published results for fish and reptiles. RVM was significantly correlated with maximum power output (P max, mW kg(-1) body mass), stroke volume, cardiac output, afterload pressure (P O) at P max, and preload pressure (P I) at P max. P I at P max and P O at P max also correlated very closely with each other. The increases in both P I and P O at maximal power outputs in large hearts suggest that concomitant increases in blood volume and/or increased modulation of vascular compliance either anatomically or via sympathetic tone on the venous vasculature would be necessary to achieve P max in vivo. Hypotheses for variation in RVM and its concomitant increased P max in amphibians are developed.

  16. Ischemic contracture of the left ventricle. Production and prevention.

    Science.gov (United States)

    MacGregor, D C; Wilson, G J; Tanaka, S; Holness, D E; Lixfeld, W; Silver, M D; Rubis, L J; Goldstein, W; Gunstensen, J; Bigelow, W G

    1975-12-01

    Ischemic contracture of the left ventricle ("stone heart") is a recognized complication of prolonged periods of interruption of the coronary circulation during open-heart surgery. We have examined the effects of moderate hypothermia (28 degrees C.) and preoperative beta-adrenergic blockade (propranolol, 0.5 mg. per kilogram; 1.0 mg. per kilogram) on contracture development during ischemic arrest of the heart. Four groups of 8 dogs each were placed on total cardiopulmonary bypass, and ischemic arrest of the heart was produced by cross-clamping the ascending aorta and venting the left ventricle. Intramyocardial carbon dioxide tension was continuously monitored by mass spectrometry. When anaerobic energy production ceased, as indicated by a final plateau in the intramyocardial carbon dioxide accumulation curve, the ischemic arrest was terminated and the contractile state of the heart observed. These results are given in the text. We conclude that beta-adrenergic blockade delays, but does not prevent, the onset of ischemic contracture of the left ventricle under normothermic conditions. Moderate hypothermia appears to prevent this complication completely.

  17. Choroid is thinner in inferior region of optic disks of normal eyes.

    Science.gov (United States)

    Tanabe, Hirotaka; Ito, Yasuki; Terasaki, Hiroko

    2012-01-01

    To determine the thickness of the choroid across the posterior pole of normal eyes. Twenty-eight clinic-based normal eyes (54.1 ± 20.0 years, -3.6 ± 4.1 diopter) were studied. The macula and retina around the optic disk were scanned with a spectral-domain optical coherence tomographic instrument. The retinal mapping program with the enhanced depth imaging technique was used, and the borders of the choroid were drawn manually in each optical coherence tomographic image. A choroidal thickness map was constructed by the built-in program, and the choroidal thickness in the different sectors of the Early Treatment Diabetic Retinopathy Study grid was measured and compared. The choroid inferior to the optic disk was significantly thinner than that in the other sectors of the outer ring of the Early Treatment Diabetic Retinopathy Study grid (superior, 196 ± 62 μm; inferior, 146 ± 47 μm; nasal, 183 ± 80 μm; and temporal, 193 ± 64 μm, P choroidal thickness at the nasal sector of the macular region was significantly thinner than other regions of the Early Treatment Diabetic Retinopathy Study grid (superior, 268 ± 74 μm; inferior, 245 ± 73 μm; nasal, 190 ± 68 μm; temporal, 268 ± 63 μm; and central, 258 ± 88 μm; P Choroidal thickness maps showed that the thinner choroidal area spreads around the optic disk and the inferior part of the posterior pole. The thinner choroid inferior to the optic disk may be a natural anatomical architecture of normal eyes, and this area may be more susceptible to hypoxia or to elevated intraocular pressures.

  18. Imaging evidence of diabetic choroidopathy in vivo: angiographic pathoanatomy and choroidal-enhanced depth imaging.

    Directory of Open Access Journals (Sweden)

    Rui Hua

    Full Text Available PURPOSE: To describe the pathoanatomy of diabetic choroidopathy (DC in pre-diagnosed diabetic retinopathy (DR cases and to provide angiographic and optical evidence for DC using indocyanine green angiography (ICGA and enhanced depth imaging spectral-domain optical coherence tomography (EDI SD-OCT. METHODS: A retrospective analysis of 80 eyes from 40 DR patients was conducted. In Group One, choroidal vascular abnormalities were evaluated by comparing angiographic findings from simultaneous ICGA with those from fundus fluorescein angiography (FFA. In Group Two, EDI SD-OCT was used to evaluate the subfoveal choroidal thickness (SFCT and define the choroid boundary in order to acquire the bilateral and symmetric choroidal area (CA. Data were then analyzed by Image Pro Plus 6.0. RESULTS: In Group One, choroidal abnormalities that were evident using ICGA but not FFA included early hypofluorescent spots in 47 eyes (75.81%, late hyperfluorescent spots in 37 eyes (59.68%, and late choroidal non-perfusion regions in 32 eyes (51.61%. In particular, a significant difference between proliferative DR (PDR in 17 of 23 eyes (73.91% and non-PDR in 16 of 39 eyes (41.03% was observed in late choroidal non-perfusion regions. Eighteen of 31 eyes (58.06% also exhibited "inverted inflow phenomena." In Group Two, both the SFCT and CA of eyes with diabetic macular edema and serous macular detachment were significantly greater than those in the other eyes. The CA in panretinal photocoagulation (PRP treated cases was also greater than that in non-PRP treated cases. CONCLUSIONS: Early hypofluorescent spots, late choroidal non-perfusion regions, inverted inflow phenomena, higher SFCT, and larger CA are qualitative and quantitative indexes for DC. Moreover, the late choroidal non-perfusion region is a risk factor for DC with DR. Our study suggests that the supplemental use of ICGA and EDI SD-OCT with FFA is a better choice for DR patients.

  19. Subfoveal choroidal thickness as a predictor of treatment response to anti-vascular endothelial growth factor therapy for polypoidal choroidal vasculopathy.

    Science.gov (United States)

    Kim, Hyesun; Lee, Sung Chul; Kwon, Kye Yoon; Lee, Ji Hwan; Koh, Hyoung Jun; Byeon, Suk Ho; Kim, Sung Soo; Kim, Min; Lee, Christopher Seungkyu

    2016-08-01

    To investigate whether subfoveal choroidal thickness predicted treatment response to anti-vascular endothelial growth factor (VEGF) in polypoidal choroidal vasculopathy (PCV). This retrospective observational case series included 66 eyes of 60 patients who were diagnosed with new-onset PCV and who were followed for a minimum of 6 months. Patients received three monthly intravitreal injections of 0.5 mg ranibizumab or 1.25 mg bevacizumab, at baseline, month 1, and month 2. "Good responders" were defined as those who showed complete resolution of subretinal and/or intraretinal fluid at month 3 after the loading injections, whereas "poor responders" were defined as those who showed persistent retinal fluid on optical coherence tomography (OCT) at month 3 after treatment. Differences in best-corrected visual acuity, indocyanine green angiography, and spectral domain-OCT findings at baseline were analyzed between the two groups. The mean patient age was 68.2 ± 9.7 years, and the mean follow-up period was 27 ± 21 months. The mean subfoveal choroidal thickness was 273 ± 117 μm, and choroidal vascular hyperpermeability was observed in 35 eyes (53.0 %). Thirty-three eyes (50 %) showed good response to treatment, and a thinner subfoveal choroid at baseline significantly correlated with favorable treatment response (P = 0.024). However, there was no significant relationship between treatment response and choroidal vascular hyperpermeability (P = 0.999). The subfoveal choroid was found to be significantly thinner among patients who achieved complete resolution of macular exudation after three loading injections of anti-VEGF agents.

  20. 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.

  1. Choroidal neovascularization induced by immunogenic alteration of the retinal pigment epithelium in dengue Fever.

    Science.gov (United States)

    Veloso, Carlos Eduardo; Schmidt-Erfurth, Ursula; Nehemy, Márcio B

    2015-01-01

    To report the first case of choroidal neovascularization (CNV) secondary to dengue fever. A 54-year-old female was referred to our department with blurred vision and metamorphopsia in her left eye. Two weeks earlier, she had presented all of the classic symptoms of dengue fever including a positive serology. Her best-corrected visual acuity (BCVA) was 20/150 in the left eye. She underwent a fundus examination, fluorescein angiography (FA) and spectral domain optical coherence tomography. All findings were consistent with CNV secondary to dengue fever. FA revealed a classic CNV associated with focal retinal pigment epithelium (RPE) destruction and detachment. Three consecutive monthly injections of intravitreal ranibizumab resulted in functional and anatomical improvement for as long as 6 months with a BCVA of 20/25. However, CNV recurred 2 years later, again with an improvement after ranibizumab therapy, but with persistence of a fibrovascular RPE detachment, highlighting the pathomechanism of a classic CNV formation. Maculopathy in dengue fever may be followed by CNV as a result of the immunologic alteration of the RPE. Physicians should be aware of this manifestation to be able to initiate adequate treatment with excellent functional and anatomical results.

  2. Atrioventricular valve replacement in functional single-ventricle patients

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhong; CEN Jian-zheng; XU Gang; WEN Shu-sheng; CHEN Ji-mei

    2016-01-01

    Background This article summarized the experience of atrioventricular valve replacement operation for functional single ventricle patients whose atrioventricular valve was insufficiency.The follow-up time of operation was arranged from early-to medium-term.Methods From July 2009 to July 2015,there were 40 patients of functional single ventricle receiving the operation of atrioventricular valve replacement,including 23 male and 17 female patients.The age at A-Ⅴ valve replacement was ranged from 6 days to 32 years (the medium age of 9 years),and the body weight ranged from 2.7 to 57 kg (the medium body weight of 21.5 kg).Moreover,the atrioventricular valve replacement was performed on all patients under extracorporeal circulation.Results Atrioventricular valve replacement was performed on 40 patients with function single ventricle in hospital,of which eight (20.0%) died in hospital including two neonate and infant (age range:6 days-2 years old) accounting for 25% (2/8),Among them,seven patients died of low cardiac output syndrome two patients with repeated hypoxemia concurrent infection after operation,and one with bilateral diaphragmatic paralysis and malignant arrhythmia.For the patients suffering the severe perivalvular leakage,there was a reoperation,and the cardiac function before the first operation was class Ⅳ.One patient received heart transplantation finally for severe heart failure after AV valve replacement.For the rest of patients,their cardiac function recovered to class Ⅰ-Ⅱ after operation.Conclusions For function single ventricle patients with atrioventricular valve regurgitation,the mortality rate of atrioventricular valve replacement can be accepted if the operation was indicated.For patients with severe atrioventricular value regurgitation,the result of the operation in the early and medium term was satisfying.Thus,the atrioventricular valve replacement served as a useful treatment for patients diagnosed of A-Ⅴ valve regurgitation and

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

    Science.gov (United States)

    Mullins, Robert F.; Baumal, Caroline R.; Mohler, Kathrin J.; Kraus, Martin F.; Liu, Jonathan; Badaro, Emmerson; Alasil, Tarek; Hornegger, Joachim; Fujimoto, James G.; Duker, Jay S.; Waheed, Nadia K.

    2015-01-01

    Purpose To characterize qualitative and quantitative features of the choroid in normal eyes using enface swept-source optical coherence tomography (SS-OCT). Methods Fifty-two eyes of 26 consecutive normal subjects were prospectively recruited to obtain multiple three-dimensional 12x12mm volumetric scans using a long-wavelength high-speed SS-OCT prototype. A motion-correction algorithm merged multiple SS-OCT volumes to improve signal. Retinal pigment epithelium (RPE) was segmented as the reference and enface images were extracted at varying depths every 4.13μm intervals. Systematic analysis of the choroid at different depths was performed to qualitatively assess the morphology of the choroid and quantify the absolute thicknesses as well as the relative thicknesses of the choroidal vascular layers including the choroidal microvasculature (choriocapillaris, terminal arterioles and venules; CC) and choroidal vessels (CV) with respect to the subfoveal total choroidal thickness (TC). Subjects were divided into two age groups: younger (choroidal-scleral interface were used to assess specific qualitative features. In the younger age group, the mean absolute thicknesses were: TC 379.4μm (SD±75.7μm), CC 81.3μm (SD±21.2μm) and CV 298.1μm (SD±63.7μm). In the older group, the mean absolute thicknesses were: TC 305.0μm (SD±50.9μm), CC 56.4μm (SD±12.1μm) and CV 248.6μm (SD±49.7μm). In the younger group, the relative thicknesses of the individual choroidal layers were: CC 21.5% (SD±4.0%) and CV 78.4% (SD±4.0%). In the older group, the relative thicknesses were: CC 18.9% (SD±4.5%) and CV 81.1% (SD±4.5%). The absolute thicknesses were smaller in the older age group for all choroidal layers (TC p=0.006, CC p=0.0003, CV p=0.03) while the relative thickness was smaller only for the CC (p=0.04). Conclusions Enface SS-OCT at 1050nm enables a precise qualitative and quantitative characterization of the individual choroidal layers in normal eyes. Only the CC is

  4. Choroidal thickness in Chinese patients with non-arteritic anterior ischemic optic neuropathy.

    Science.gov (United States)

    Jiang, Libin; Chen, Lanlan; Qiu, Xiujuan; Jiang, Ran; Wang, Yaxing; Xu, Liang; Lai, Timothy Y Y

    2016-08-31

    Non-arteritic anterior ischemic optic neuropathy (NA-AION) is one of the most common types of ischemic optic neuropathy. Several recent studies suggested that abnormalities of choroidal thickness might be associated with NA-AION. The main objective of this case-control study was to evaluate whether choroidal thickness is an ocular risk factor for the development of NA-AION by evaluating the peripapillary and subfoveal choroidal thicknesses in affected Chinese patients. Forty-four Chinese patients with unilateral NA-AION were recruited and compared with 60 eyes of 60 normal age and refractive-error matched control subjects. Peripapillary and subfoveal choroidal thicknesses were measured by enhanced depth imaging optical coherence tomography. Choroidal thicknesses of eyes with NA-AION and unaffected fellow eyes were compared with normal controls. Choroidal thicknesses of NA-AION eyes with or without optic disc edema were also compared. The correlation between choroidal thickness and retinal nerve fiber layer (RNFL) thickness, logMAR best-corrected visual acuity (BCVA), and the mean deviation (MD) of Humphrey static perimetry in NA-AION eyes were analyzed. The peripapillary choroidal thicknesses at the nasal, nasal inferior and temporal inferior segments in NA-AION eyes with optic disc edema were significantly thicker compared with that of normal subjects (P choroidal thicknesses between the unaffected fellow eyes of NA-AION patients and normal eyes of healthy controls; or between the NA-AION eyes with resolved optic disc edema and normal eyes (all P > 0.05). No significant correlation between choroidal thickness and RNFL thickness, logMAR BCVA and perimetry MD was found in eyes affected by NA-AION (all P > 0.05). Increase in peripapillary choroid thickness in some segments was found in NA-ION eyes with optic disc edema. However, our findings do not support the hypothesis that choroidal thickness is abnormal in Chinese patients with NA-AION compared with

  5. Optical Coherence Tomography Imaging of Choroidal Abnormalities in Neurofibromatosis Type 1

    Directory of Open Access Journals (Sweden)

    Shinji Makino

    2013-01-01

    Full Text Available We report a case of neurofibromatosis type 1 (NF1 examined by infrared fundus autofluorescence (IR-FAF and optical coherence tomography (OCT to characterize the associated choroidal abnormalities. The conventional ophthalmoscopic findings were unremarkable. However, IR-FAF revealed multiple bright patchy lesions in the choroid of the posterior pole, in both eyes. OCT demonstrated irregular hyperreflectivity at the sites of these lesions. Patients with NF1 may have typical choroidal lesions that are visible on IR-FAF, which can be confirmed through OCT.

  6. Presence of bilateral limbal dermoids and choroidal osteomas in a family with inherited limbal dermoids.

    Science.gov (United States)

    Magli, A; De Marco, R; Capasso, L

    1999-06-01

    We report a case of bilateral limbal dermoids and bilateral choroidal osteomas in a 14-year-old girl with no extraocular anomalies. Histopathological examination of a limbal lesion confirmed the clinical diagnosis of dermoid. Computerized tomography and ultrasonography were compatible with a diagnosis of choroidal osteoma. Limbal dermoids were present in the patient's mother, in a brother with Down syndrome, and in an aunt with no choroidal osteoma. The present pedigree is compatible with autosomal dominant inheritance of bilateral limbal dermoids. The same gene may be involved in the pathogenesis of ocular choristomas in same patients.

  7. Choroid plexus papilloma originating in the sella turcica--case report.

    Science.gov (United States)

    Sameshima, Tetsuro; Tanikawa, Rokuya; Sugimura, Toshihide; Izumi, Naoto; Seki, Toshitaka; Maeda, Takahiro; Tsuboi, Toshiyuki; Hashimoto, Masaaki; Kimura, Teruo; Nabeshima, Kazuki

    2010-01-01

    A 51-year-old female presented with a rare case of choroid plexus papilloma originating in the sella turcica manifesting as headaches that was not readily distinguishable preoperatively from pituitary adenoma. Head magnetic resonance imaging revealed a tumor extending from the sella turcica to the suprasellar cistern. The tumor was removed via an endonasal transsphenoidal approach. Histological examination indicated a papillary structure covered with a layer of columnar epithelial cells that resembled normal choroid plexus. These findings, together with immunohistochemistry, led to a diagnosis of choroid plexus papilloma.

  8. Computed tomographic findings in cerebral palsy: Analysis of hemisphere and lateral ventricular volume

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Seoung Hwan; Kim, Hak Jin; Sol, Chang Hyo; Kim, Byung Soo [Pusan National University College of Medicine, Pusan (Korea, Republic of)

    1989-04-15

    Authors analysed the CT findings of 28 cerebral palsy patients at Pusan National University Hospital from January, 1984 to December, 1987. Volumes of hemispheres, lateral ventricles and paranchymes were measured in patients who showed no remarkable abnormality on CT film, and compared with those of normal control group. 1. Among the 28 cerebral palsy patients, there were 6 cases of diffuse atrophy in CT findings, and unilateral atrophy in 2 cases and encephalomalacia and diffuse white matter low density in 1 case and generalized symmetrical white matter low density in 1 case, but remaining 18 cases had no specific abnormal finding on CT. 2. Difference in volumes of brain parenchyma and lateral ventricles of each hemisphere was greater than that of control group. 3. There were more enlarged lateral ventricles and prominent unilateral brain atrophy in 18 cases of cerebral palsy who showed no specific abnormality on CT as compared with normal control group.

  9. 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.

  10. Correlation of Aging and Segmental Choroidal Thickness Measurement using Swept Source Optical Coherence Tomography in Healthy Eyes.

    Science.gov (United States)

    Wakatsuki, Yu; Shinojima, Ari; Kawamura, Akiyuki; Yuzawa, Mitsuko

    2015-01-01

    To assess and compare choroidal thickness changes related to aging, we determined whether changes are due to thinning of the choriocapillaris plus Sattler's (CS) layer and/or the large vessel layer in healthy eyes using swept-source optical coherence tomography (SS-OCT) at a wavelength of 1,050-nm. We studied 115 normal eyes of 115 healthy volunteers, all with refractive errors of less than -6 diopters. All 115 eyes underwent analysis of choroidal thickness at the fovea, the CS layer and the large choroidal vessel layer. In 68 of the 115 eyes, choroidal thickness was determined at five sites (the fovea, and superior, inferior, nasal, and temporal sites) using SS-OCT with an Early Treatment of Diabetic Retinopathy grid scan. Total choroidal thicknesses at each of the five sites were related to subject age (Pchoroid was thinnest at the nasal site, followed by the temporal, inferior, superior and finally the subfoveal site itself. The total choroidal thickness at the nasal site was significantly less than those at the other four sites (pthickness of the choroidal large vessel layer also decreased with age (p = 0.02). Subfoveal choroidal thickness was calculated as follows: 443.89-2.98×age (μm) (Pchoroidal thickness decreases by 2.98 μm each year. Total choroidal thickness diminishes with age. The CS and large vessel layers of the choroid at the subfovea showed significant decreases, though only the former correlated strongly with age.

  11. Lack of Association between Glaucoma and Macular Choroidal Thickness Measured with Enhanced Depth-Imaging Optical Coherence Tomography

    Science.gov (United States)

    Mwanza, Jean-Claude; Hochberg, Jessica T.; Banitt, Michael R.; Feuer, William J.

    2011-01-01

    Purpose. To compare choroidal thickness measurements among normal eyes, eyes with normal tension glaucoma (NTG), and those with primary open-angle glaucoma (POAG), and to correlate choroidal thickness with demographic and clinical ocular parameters. Methods. Choroidal thickness was measured with enhanced depth-imaging (EDI) optical coherence tomography (OCT) in one eye of 38 normal, 20 NTG, and 56 POAG subjects and compared among groups. The mean age was 69.3 ± 13.6 years (60.1 ± 13.4 years for normal subjects and 73.8 ± 11.3 years for glaucoma subjects; P choroid every 0.5 mm up to 3 mm away from the fovea. Univariate and multivariate linear regression analyses were performed to assess the association between choroidal thickness and demographic and ocular parameters. Results. There were no differences in foveal, temporal, or nasal choroidal thickness between normal, NTG, and POAG subjects (all P > 0.05) after adjusting for age, axial length, and intraocular pressure. Similarly, glaucoma severity groups did not differ from each other in all choroidal thickness measurements (all P > 0.05). Age (β = −1.78; P choroidal thickness in the entire group, followed by axial length (β = −11.8; P = 0.002). Conclusions. Choroidal thickness does not differ among normal, NTG, and POAG subjects, suggesting a lack of relationship between choroidal thickness and glaucoma based on EDI OCT measurements. PMID:21357398

  12. Measurement of Choroidal Thickness in Normal Eyes Using 3D OCT-1000 Spectral Domain Optical Coherence Tomography

    Science.gov (United States)

    Shin, Joong Won; Shin, Yong Un; Cho, Hee Yoon

    2012-01-01

    Purpose To study choroidal thickness and its topographic profile in normal eyes using 3D OCT-1000 spectral domain optical coherence tomography and the correlation with age and refractive error. Methods Fifty-seven eyes (45 individuals) with no visual complaints or ocular disease underwent horizontal and vertical line scanning using 3D OCT-1000. The definition of choroidal thickness was the vertical distance between the posterior edge of the hyper-reflective retinal pigment epithelium and the choroid/sclera junction. Choroidal thickness was measured in the subfoveal area at 500 µm intervals from the fovea to 2,500 µm in the nasal, temporal, superior, and inferior regions. The spherical equivalent refractive error was measured by autorefractometry. Statistical analysis was used to confirm the correlations of choroidal thickness with age and refraction error. Results The mean age of the 45 participants (57 eyes) was 45.28 years. Detailed visualization of the choroid for measuring its thickness was possible in 63.3% of eyes. The mean subfoveal choroidal thickness was found to be 270.8 µm (standard deviation [SD], ±51 µm), in horizontal scanning and 275.0 µm (SD, ±49 µm) in vertical scanning. The temporal choroidal thickness was greater than any 500 µm interval in corresponding locations, and there was no significant difference between the superior and inferior choroid as far as 2,000 µm from the fovea. Age and refractive error were associated with subfoveal choroidal thickness in terms of regression (p Choroidal thickness in normal Korean eyes can be measured using 3D OCT-1000 with high resolution line scanning. The topographical profile of choroidal thickness varies depending on its location. Age and refractive error are essential factors for interpretation of choroidal thickness. PMID:22870023

  13. Analysis of morphological features and vascular layers of choroid in diabetic retinopathy using spectral-domain optical coherence tomography.

    Science.gov (United States)

    Adhi, Mehreen; Brewer, Erika; Waheed, Nadia K; Duker, Jay S

    2013-10-01

    Diabetic retinopathy (DR) is characterized by microaneurysms, capillary nonperfusion, and ischemia within the retina, ultimately leading to neovascularization and/or macular edema. Evidence suggests that choroidal angiopathy may coexist with retinal vascular damage. Recent advances in spectral-domain optical coherence tomography (SD-OCT) permit an efficient visualization of the choroid. To analyze the morphological features and vascular layers of the choroid in patients with DR using SD-OCT. A cross-sectional retrospective review identified patients with DR and healthy (control) subjects who underwent 1-line raster scanning from February 1, 2010, through June 30, 2012. Patients were classified into the following 3 groups: nonproliferative DR without macular edema (9 eyes), proliferative DR without macular edema (PDR) (10 eyes), and diabetic macular edema (DME) (14 eyes). Two independent raters experienced in analyzing OCT images evaluated the morphological features and vasculature of the choroid. New England Eye Center. Thirty-three eyes of 33 patients with DR and 24 eyes of 24 controls. Diabetic retinopathy. Choroidal morphological features and vasculature analysis. The choroidoscleral interface had an irregular contour in 8 of 9 eyes with nonproliferative DR (89%), 9 of 10 eyes with PDR (90%), and 13 of 14 eyes with DME (93%) compared with 0 of 24 controls. The thickest point of the choroid was displaced from under the fovea, and focal choroidal thinning was observed in eyes with DR. Mean subfoveal choroidal thickness and mean subfoveal medium choroidal vessel layer and choriocapillaris layer thickness were significantly reduced in eyes with PDR (P Choroidal morphological features are altered in patients with moderate to severe DR. The subfoveal choroidal thickness and the subfoveal medium choroidal vessel layer and choriocapillaris layer thicknesses are significantly reduced in patients with PDR and DME. To our knowledge, this is the first study to analyze the

  14. Anatomicosurgical segmentectomy of the left ventricle for systematized partial resection of the heart: an experimental study

    Directory of Open Access Journals (Sweden)

    Liberato John Alphonse DI DIO

    1998-10-01

    Full Text Available A surgical experimental investigation is being carried out in an attempt to provide a viable alternative to the current approaches to cardiac resection of the left ventricular myocardium in cases of cardiomyopathies with dilated ventricle. The experiments are based upon the presence of anatomicosurgical segments in the dog's heart similar to those existing in the atria and ventricles of humans. So far three mongrel dogs (weight 15 kg were submitted to cardiac catheterism to evaluate the anatomy of the coronary arteries and their branches, the function and cavity of the left ventricle (LV. A lateral thoracotomy on the left side was performed to expose the heart. Cardiopulmonary bypass (CPB of each animal was established through the right atrium and the femoral artery (4 mg/kg Heparin, at 32°C, intermittent aorta cross-clamping. The left marginal artery and veins were ligated, causing an area of acute myocardial infarction, showing well-defined sharp limits. Such an area was then resected and the left ventricle was reconstructed. The animals were weaned from CPB, one dog having remained in a stable condition during a 7-day period of observation. The second was sacrificed after 4-day period of observation and the third dog died four hours after CPB owing to an excessive reduction of the LV chamber related to an anatomical variation. Pre and post operation transthoracic echocardiograms were obtained after undergoing cardiac catheterism. The echocardiogram revealed discrete mitral insufficiency, reduction of the diameter of the left ventricle with approximation of the papillary muscles, a dysfunction and an impressive reduction of the cavity of the left ventricle. Peri-sutural areas of infarction were not observed. The orientation given by the anatomicosurgical segmentation of the coronary circulation is an important alternative to the present surgical treatment of cardiomyopathies with dilated ventricle.Uma investigação experimental cir

  15. A Case of Expansion of Traumatic Choroidal Rupture with Delayed-Developed Outer Retinal Changes

    Directory of Open Access Journals (Sweden)

    Kun Moon

    2013-08-01

    Full Text Available Background: This study aims to report the expansion of a choroidal rupture site caused by blunt ocular trauma using scanning laser ophthalmoscope-optical coherence tomography. Case Report: The clinical course of a 15-year-old girl with a traumatic ocular injury after being hit in the eye by an elbow was evaluated. Upon the first examination, the best-corrected visual acuity was 16/20. The findings were subretinal pigment epithelial hemorrhage and vertical choroidal rupture. Three weeks after the trauma, the patient's visual acuity was reduced to counting fingers at 30 cm. On fundus examination and fluorescein angiography subretinal pigment epithelial hemorrhage decreased, while the choroidal rupture expanded; on optical coherence tomography outer retinal changes in the adjacent area were detected. Discussion: This study reveals that the delayed expansion of a choroidal rupture site and the delayed change of the adjacent outer retina improved.

  16. Automated choroid segmentation based on gradual intensity distance in HD-OCT images.

    Science.gov (United States)

    Chen, Qiang; Fan, Wen; Niu, Sijie; Shi, Jiajia; Shen, Honglie; Yuan, Songtao

    2015-04-06

    The choroid is an important structure of the eye and plays a vital role in the pathology of retinal diseases. This paper presents an automated choroid segmentation method for high-definition optical coherence tomography (HD-OCT) images, including Bruch's membrane (BM) segmentation and choroidal-scleral interface (CSI) segmentation. An improved retinal nerve fiber layer (RNFL) complex removal algorithm is presented to segment BM by considering the structure characteristics of retinal layers. By analyzing the characteristics of CSI boundaries, we present a novel algorithm to generate a gradual intensity distance image. Then an improved 2-D graph search method with curve smooth constraints is used to obtain the CSI segmentation. Experimental results with 212 HD-OCT images from 110 eyes in 66 patients demonstrate that the proposed method can achieve high segmentation accuracy. The mean choroid thickness difference and overlap ratio between our proposed method and outlines drawn by experts was 6.72µm and 85.04%, respectively.

  17. The Effect of Pseudoexfoliation Syndrome on the Retinal Nerve Fiber Layer and Choroid Thickness.

    Science.gov (United States)

    Demircan, Süleyman; Yılmaz, Uğur; Küçük, Erkut; Ulusoy, M Döndü; Ataş, Mustafa; Gülhan, Ahmet; Zararsız, Gökmen

    2017-01-01

    To investigate thickness of the retinal nerve fiber layer (RNFL) and choroid thickness in patients with pseudoexfoliation syndrome (PEX) and pseudoexfoliation glaucoma (PXG) compared to healthy volunteers. This cross-sectional, prospective study included 43 patients with PXG, 45 patients with PEX syndrome, and 48 healthy volunteers. The RNFL and macular thickness were analyzed with standard OCT protocol while choroidal thickness was analyzed with EDI protocol in all subjects. The RNFL thickness was higher in the PEX and control groups compared to the PXG group (pchoroid thickness was significantly higher in the control group compared to the PXG and PEX groups (pchoroid circulation by accumulating in choroid vessels. The thinner choroid in the PXG group suggests that ischemia affects the duration of PEX and has a role in the development of glaucoma.

  18. 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...... (full-dose verteporfin, half-light dose) in 16 eyes in 16 patients with serous detachment of the fovea secondary to extrafoveal angiographic fluorescein leakage. Treatment was confined to the area of leakage, whereas choroidal thickness before and after treatment was assessed over a larger area...... of the fundus using OCT. Results: Complete resolution of the serous detachment was seen in all 16 eyes within 1 month of extrafoveal PDT, while choroidal thickness in the area where PDT was applied decreased from 407 µm [mean; 95% confidence interval (CI(95) ) 356-458 µm] to 349 µm (mean; CI(95) 300-399 µm; p...

  19. A comparison of two methods to measure choroidal thickness by enhanced depth imaging optical coherence tomography

    DEFF Research Database (Denmark)

    Lundberg, Lars Kristian; Vestergaard, Anders Højslet; Vergmann, Anna Stage

    coherence tomography (EDI-SD OCT) has made it possible to visualize the choroid, and it is generally accepted that Heidelberg Spectralis OCT provides valid measurements of choroidal thickness (CT), although no fully automated software is commercially available. Two methods for CT-measurement are available...... the CT: 1: Segmentation method; by the use of the thickness profile window we manually edited and moved the inner limiting membrane (ILM) line to the choroid-scleral border (CSB), while we kept the automated defined Bruchs membrane (BM). Hereafter, the software calculated the vertical distance between......Introduction The choroid is believed to be involved in the pathophysiology of several vision threatening diseases such as age-related macular degeneration, central serous chorioretinopathy, inflammatory disorders and myopic macular degeneration. Enhanced depth imaging spectral-domain optical...

  20. Sturge-Weber Syndrome Associated with Early Diffuse Choroidal Hemangiaoma:A Case Report

    Institute of Scientific and Technical Information of China (English)

    Changzheng Chen; Yunxian Yu; Hongmei Zhen

    2004-01-01

    Purpose:To report indocyanine green angiography (ICGA) findings in one patient of diffuse choroidal hemangioma associated with Struge-Weber syndrome.Methods:Color fundus photography, fluorescein angiography (FA) and ICGA were performed in a patient with diffuse choroidal hemangioma associated with Sturge-Weber syndrome.Results: Three findings were unveiled by ICGA: rapid filling of diffuse choroidal hemangio's vascular network in the early stages; diffuse hyperfluorescence visual up to the late phase; no "wash-out" phenomenon was observed in the late phase.Conclusion:Indocyanine green angiography can provide information that is not detected by clinical or fluorescence angiographic examination in the patient with Sturge-Weber syndrome. ICGA may be important and sensitive in detecting the diffuse choroidal hamangioma associated with Sturge-Weber syndrome.

  1. De novo appearance of a choroidal osteoma in an eye with previous branch retinal vein occlusion.

    Science.gov (United States)

    Adhi, Mehreen; Bryant, Juanita Sonya; Alwassia, Ahmad A; Chen, Carolyn; Duker, Jay S

    2013-01-01

    This report describes the de novo appearance of a choroidal osteoma occurring 8 years after laser photocoagulation for previous branch retinal vein occlusion (BRVO). A 62-year-old man presented with an asymptomatic yellowish orange lesion in the macula on fundus examination of his left eye during a regular follow-up visit for bilateral BRVO associated with macular edema that had previously been treated with laser photocoagulation. The lesion was observed for 1.5 years until a decrease in vision occurred. Fundus photography revealed a yellow-to-orange, well-defined lesion in the macular region. Fluorescein angiography was consistent with choroidal neovascularization (CNV). Optical coherence tomography and B-scan ultrasonography showed features consistent with choroidal osteoma. This is the first report of the de novo appearance of a choroidal osteoma occurring years after laser photocoagulation for BRVO. CNV developed secondary to the lesion, which was treated with intravitreal bevacizumab, leading to subjective and anatomic improvement.

  2. 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

  3. Measurement of choroid plexus perfusion using dynamic susceptibility MR imaging: capillary permeability and age-related changes

    Energy Technology Data Exchange (ETDEWEB)

    Bouzerar, Roger; Chaarani, Bader; Baledent, Olivier [University Hospital, Image Processing Department, Amiens (France); Gondry-Jouet, Catherine [University Hospital, Radiology Department, Amiens (France); Zmudka, Jadwiga [University Hospital, Geriatric Unit, Amiens (France)

    2013-12-15

    The cerebrospinal fluid (CSF) plays a major role in the physiology of the central nervous system. The continuous turnover of CSF is mainly attributed to the highly vascularized choroid plexus (CP) located in the cerebral ventricles which represent a complex interface between blood and CSF. We propose a method for evaluating CP functionality in vivo using perfusion MR imaging and establish the age-related changes of associated parameters. Fifteen patients with small intracranial tumors were retrospectively studied. MR Imaging was performed on a 3T MR Scanner. Gradient-echo echo planar images were acquired after bolus injection of gadolinium-based contrast agent (CA). The software developed used the combined T1- and T2-effects. The decomposition of the relaxivity signals enables the calculation of the CP capillary permeability (K{sub 2}). The relative cerebral blood volume (rCBV), mean transit time (MTT), and signal slope decrease (SSD) were also calculated. The mean permeability K{sub 2} of the extracted CP was 0.033+/-0.18 s{sup -1}. K{sub 2} and SSD significantly decreased with subject's age whereas MTT significantly increased with subject's age. No significant correlation was found for age-related changes in rCBV and rCBF. The decrease in CP permeability is in line with the age-related changes in CSF secretion observed in animals. The MTT increase indicates significant structural changes corroborated by microscopy studies in animals or humans. Overall, DSC MR-perfusion enables an in vivo evaluation of the hemodynamic state of CP. Clinical applications such as neurodegenerative diseases could be considered thanks to specific functional studies of CP. (orig.)

  4. Proton beam irradiation and hyperthermia. Effects on experimental choroidal melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Riedel, K.G.; Svitra, P.P.; Seddon, J.M.; Albert, D.M.; Gragoudas, E.S.; Koehler, A.M.; Coleman, D.J.; Torpey, J.; Lizzi, F.L.; Driller, J.

    1985-12-01

    Ultrasonically induced hyperthermia (4.75 MHz) and proton irradiation (160 meV) were evaluated alone and combined to treat experimental choroidal melanoma in 58 rabbit eyes. Threshold tumoricidal doses were established for each modality. Therapy was performed combining subthreshold doses of heat and radiation. Focused ultrasonic energy via an external beam was found to deliver well-localized heat to an intraocular tumor. Ectopic temperature elevations due to soft-tissue-bone interfaces were alleviated by modifying beam alignment. The results indicate that hyperthermia (43 degrees C for one hour) potentiated the tumoricidal effects of radiation, while sparing normal ocular structures. Therefore, we believe that experimental hyperthermia is suitable as an adjuvant treatment modality. This shows that ultrasound hyperthermia has the potential to increase the efficacy of proton irradiation by lowering radiation doses and thus decreasing posttreatment ocular morbidity in human intraocular malignancies.

  5. SD-OCT findings in polypoidal choroidal vasculopathy.

    Science.gov (United States)

    Asensio-Sánchez, V M

    2016-01-01

    To examine patients with polypoidal choroidal vasculopathy (PCV), using spectral-domain optical coherence tomography (SD-OCT) to characterise and locate the PCV lesions. A series of 15 eyes of 10 patients diagnosed with PCV were examined. All eyes were imaged with macular SD-OCT. SD-OCT cross-sectional scan findings included atypical and typical pigment epithelial detachments (PEDs). Polyps and neovascularisation were located above Bruch membrane. All 15 eyes (100%) showed sub-retinal fluid (SRF) in association with PEDs. These SD-OCT findings located the vascular lesions of PCV in the sub-retinal pigment epithelium (RPE) space, and strongly suggest that PCV is a variant of type 1 neovascularization. Copyright © 2015. Published by Elsevier España, S.L.U.

  6. 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...... entered through a secure website and were reviewed centrally. Survival was analyzed using Kaplan-Meier analysis and Cox proportional hazards regression. MAIN OUTCOME MEASURES: Proportion of females, tumor-node-metastasis (TNM) stage, cell type, and melanoma-related mortality. RESULTS: Cumulative frequency...... type, known for 35% of tumors, and TNM stage (I in 22% and 21%, II in 49% and 52%, III in 30% and 28%, respectively) were comparable for children and young adults. Melanoma-related survival was 97% and 90% at 5 years and 92% and 80% at 10 years for children compared with young adults, respectively (P...

  7. Choroidal Neovascularization in a Patient with Crohn's Disease

    Directory of Open Access Journals (Sweden)

    Giuseppe Casalino

    2014-08-01

    Full Text Available Purpose: To report a case of subfoveal choroidal neovascularization (CNV in a patient with Crohn's disease (CD and to discuss a possible association between these two conditions. Methods: This is an observational case report. Results: A 69-year-old male affected by CD was referred to our department because of sudden visual acuity drop in the left eye. A subfoveal CNV was diagnosed based on slit-lamp fundus biomicroscopy and fluorescein angiography. Color fundus photography, infrared autofluorescence and spectral-domain optical coherence tomography imaging of both eyes were also performed. Following six intravitreal ranibizumab injections, visual improvement was obtained with no related adverse events. Conclusion: We report a case of CNV as a possible rare extraintestinal manifestation of CD. The use of ranibizumab successfully impacted on CNV, while not affecting CD, which remained quiescent.

  8. 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

  9. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Anorexia: an early sign of fourth ventricle astrocytoma in children.

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    Leroy, Henri-Arthur; Baroncini, Marc; Delestret, Isabelle; Florent, Vincent; Vinchon, Matthieu

    2014-12-01

    Paediatric low-grade astrocytomas of the fourth ventricle are rare tumours, generally revealed by hydrocephalus. However, some patients present with a history of severe anorexia. It might be a harbinger, which if recognized, could lead to earlier diagnosis. We decided to examine our database in order to evaluate the incidence and signification of anorexia in this context. Retrospective monocentric study of cases of low-grade astrocytomas of the fourth ventricle operated between 1991 and 2012 in our paediatric neurosurgery department. We particularly observed the clinical presentation and long-term clinical, oncological and radiological evolution. Non-parametrical tests were used (Mann-Whitney, Fisher). We reviewed 34 cases, 31 pilocytic astrocytomas and 3 diffuse astrocytomas, 16 boys and 18 girls, (M/F ratio 0.89). Mean age at diagnosis was 8 years old. Seven presented with notable anorexia, the average BMI in this group was ≤2 standard deviation (SD); with clinical signs evolving for 11.5 months. Twenty-seven children had no anorexia; average BMI in this group was +1 SD, with clinical evolution for 6 months on an average of p anorexia, body mass index improved markedly in the postoperative follow-up, which lasted, on average, for 6 years. Anorexia with stunted body weight curve is a non-exceptional presentation in children with low-grade astrocytomas of the fourth ventricle. Unexplained or atypical anorexia with negative etiologic assessment should prompt cerebral imaging. Clinical improvement after surgical resection, could suggest a possible interaction between tumour tissue and appetite-suppressing peptide secretion.

  12. Choroidal Thickness Changes After Intravitreal Ranibizumab for Exudative Age-Related Macular Degeneration.

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    Minnella, Angelo Maria; Federici, Matteo; Falsini, Benedetto; Barbano, Lucilla; Gambini, Gloria; Lanza, Angela; Caporossi, Aldo; Savastano, Maria Cristina

    2016-08-01

    The results regarding changes of choroidal thickness following intravitreal ranibizumab injections in the literature are controversial. Vascular endothelial growth factor A is implicated in pathogenesis of neovascular age-related macular degeneration (AMD). The suspected unchanged choroidal layer thickness after intravitreal injections of ranibizumab suggests a possible protection of the outer blood-retinal barrier in the human eye. The aim was to evaluate choroidal thickness following the first administration of the study drug ranibizumab into the eyes of naïve wet AMD patients (nAMD). In this open label, 3-month, prospective, single-center, interventional, single-arm pilot study, 20 nAMD eyes were included and underwent three consecutive monthly injections of ranibizumab (0.5 mg/0.05 ml). Vital signs (i.e., blood pressure and pulse), ophthalmic examinations, intraocular pressure, best correct visual acuity and subfoveal choroidal thickness as examined with optical coherence tomography using enhanced depth imaging (OCT-EDI) were assessed at each visit. All patients were evaluated at baseline and at 15, 30 60 and 90 days after intravitreal injection. Ten eyes with fibrotic AMD lesions were evaluated as the control group. In all eyes, the choroidal thicknesses (µm) exhibited no significant changes from the baseline visit to the visits at 15, 30, 60 and 90 days post-injection (P > 0.05). The intravitreal treatment with ranibizumab was well tolerated, and no adverse events were registered. Choroidal thickness appeared to be unmodified following the intravitreal injection of ranibizumab into nAMD eyes. Intravitreal ranibizumab injections probably elicit a pharmacologic effect only in the choroidal neovascularization and not in the choroid circulation under neovascular lesions. Clinical Trials Eudract Registration #: 2013-005091-17.

  13. Choroidal structure determined by binarizing optical coherence tomography images in eyes with reticular pseudodrusen

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    Masuda N

    2017-04-01

    Full Text Available Naonori Masuda, Masashi Kojima, Mariko Yamashita, Tomo Nishi, Nahoko Ogata Department of Ophthalmology, Nara Medical University, Nara, Japan Purpose: To compare the choroidal structure beneath the macular area in eyes with reticular pseudodrusen (RPD and age-matched controls.Methods: This study was performed at Nara Medical University Hospital, Japan. Twenty eyes of 14 patients (82.3±4.2 years, mean ± standard deviation with RPD and 35 eyes of 20 age-matched controls (81.5±6.0 years were studied. The choroidal structure was determined by binarizing the images obtained by enhanced depth imaging optical coherence tomography in all patients and controls. The total, luminal, and stromal choroidal areas were quantified by the binarization method.Results: The total choroidal area of the eyes with RPD was significantly smaller than that of control eyes (P=0.001, unpaired t-test. Both the luminal and stromal areas in eyes with RPD were significantly smaller than that of control eyes (P=0.001, paired t-test, but there was no significant difference in the luminal/stromal ratio between eyes with RPD and control eyes.Conclusion: The total, luminal, and stromal choroidal areas in eyes with RPD were smaller than those of the control eyes. The reduction of the choroidal luminal and stromal areas may be due to a loss of the oxygen demand of the choroid due to RPE dysfunction. Keywords: reticular pseudodrusen, age-related macular degeneration, choroidal structure, binarization method

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

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    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.

  15. Atypical Presentation of Ocular Toxoplasmosis: A Case Report of Exudative Retinal Detachment and Choroidal Ischemia.

    Science.gov (United States)

    Al-Zahrani, Yahya A; Al-Dhibi, Hassan A; Al-Abdullah, Abdulelah A

    2016-01-01

    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.

  16. The effect of topical adrenergic and anticholinergic agents on the choroidal thickness of young healthy adults.

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    Sander, Beata P; Collins, Michael J; Read, Scott A

    2014-11-01

    The human choroid is capable of rapidly changing its thickness in response to a variety of stimuli. However little is known about the role of the autonomic nervous system in the regulation of the thickness of the choroid. Therefore, we investigated the effect of topical parasympatholytic and sympathomimetic agents upon the choroidal thickness and ocular biometrics of young healthy adult subjects. Fourteen subjects (mean age 27.9 ± 4 years) participated in this randomized, single-masked, placebo-controlled study. Each subject had measurements of choroidal thickness (ChT) and ocular biometrics of their right eye taken before, and then 30 and 60 min following the administration of topical pharmacological agents. Three different drugs: 2% homatropine hydrobromide, 2.5% phenylephrine hydrochloride and a placebo (0.3% hydroxypropyl methylcellulose) were tested in all subjects; each on different days (at the same time of the day) in randomized order. Participants were masked to the pharmacological agent being used at each testing session. The instillation of 2% homatropine resulted in a small but significant increase in subfoveal ChT at 30 and 60 min after drug instillation (mean change 7 ± 3 μm and 14 ± 2 μm respectively; both p choroid also exhibited a similar magnitude, significant increase in thickness with time after 2% homatropine (p thickness (LT) and anterior chamber depth (ACD) (p choroidal thickness, or ocular biometrics were found after 2.5% phenylephrine or placebo at any examination points (p > 0.05). In human subjects, significant increases in subfoveal and parafoveal choroidal thickness occurred after administration of 2% homatropine and this implies an involvement of the parasympathetic system in the control of choroidal thickness in humans. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. First reported cases of gyrate atrophy of the choroid from Nepal

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    Shrestha, Sachet Prabhat; Arora, Reema; Pradhan, Rajesh; Bhatt, Subramaniam

    2010-01-01

    Two sisters previously diagnosed as having retinitis pigmentosa presented with complaints of frequent change of glasses. On ocular examination, the fundus showed the appearance of confluent arcuate equatorial full thickness lesions of the choroid and retina, sparing some of the large choroidal vessels, and separated from one another by thin margins of pigment, in both the sisters. Serum analysis was done for ornithine levels, which showed hyperornithinaemia (741 and 462 µmol/l in the elder an...

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

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    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.

  19. Choroidal thickness and retinal abnormalities by optical coherence tomography in endogenous Cushing’s syndrome

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    Maria Fernanda Abalem

    2016-12-01

    Full Text Available Context: Cortisol has been suggested as a risk factor for choroidal thickening, which may lead to retinal changes. Objective: To compare choroidal thickness measurements using optical coherence tomography (OCT in patients with endogenous active Cushing’s syndrome and to evaluate the occurrence of retinal abnormalities in the same group of patients. Design: Cross-sectional study.Setting: Outpatient clinic.Patients: Eleven female patients with Cushing’s syndrome in hypercortisolism state as determined by the presence of at least two abnormal measurements from urinary cortisol 24h, no suppression of cortisol with low dose dexamethasone suppression test and nocturnal salivary cortisol levels and 12 healthy controls.Methods: Choroidal and retinal morphology was assessed using OCT. Main outcome measures: Choroidal thickness measurements and the presence of retinal changes. Results: The mean subfoveal choroidal thickness was 372.96 ± 73.14 μm in the patients with Cushing’s syndrome and 255.63 ± 50.70 μm in the control group, (p<0.001. One patient (9.09% presented with central serous chorioretinopathy and one patient (9.09% with pachychoroid pigment epitheliopathy. Conclusions: Choroidal thickness is increased in the eyes of patients with active Cushing’s syndrome compared to healthy and matched control. Also, 18.18% of patients presented with macular changes, possibly secondary to choroidal thickening. While further studies are necessary to confirm our findings excess corticosteroid levels seems to have a significant effect on the choroid and might be associated with secondary retinal diseases.

  20. A Second New Choroidal Osteoma in the Same Eye: Differences between Them with New Imaging Techniques

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    Javier Sambricio

    2015-01-01

    Full Text Available The authors introduce a 42-year-old woman with a choroidal osteoma. After 10 years the patient presented a second choroidal osteoma in the same eye; this osteoma has been growing in the last years. New tests that were unavailable during the first diagnosis were performed such as Fundus Autofluorescence or Enhanced Depth Imaging-Optical Coherence Tomography (EDI-OCT. These tests show characteristics of the tumors and allow us to realize a visual prognosis for the patient.