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1
Hadzic, Alena, Teresa D. Nguyen, Makoto Hosoyamada, et al. "The Lactate Receptor HCA1 Is Present in the Choroid Plexus, the Tela Choroidea, and the Neuroepithelial Lining of the Dorsal Part of the Third Ventricle." International Journal of Molecular Sciences 21, no. 18 (2020): 6457. http://dx.doi.org/10.3390/ijms21186457.
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The volume, composition, and movement of the cerebrospinal fluid (CSF) are important for brain physiology, pathology, and diagnostics. Nevertheless, few studies have focused on the main structure that produces CSF, the choroid plexus (CP). Due to the presence of monocarboxylate transporters (MCTs) in the CP, changes in blood and brain lactate levels are reflected in the CSF. A lactate receptor, the hydroxycarboxylic acid receptor 1 (HCA1), is present in the brain, but whether it is located in the CP or in other periventricular structures has not been studied. Here, we investigated the distribution of HCA1 in the cerebral ventricular system using monomeric red fluorescent protein (mRFP)-HCA1 reporter mice. The reporter signal was only detected in the dorsal part of the third ventricle, where strong mRFP-HCA1 labeling was present in cells of the CP, the tela choroidea, and the neuroepithelial ventricular lining. Co-labeling experiments identified these cells as fibroblasts (in the CP, the tela choroidea, and the ventricle lining) and ependymal cells (in the tela choroidea and the ventricle lining). Our data suggest that the HCA1-containing fibroblasts and ependymal cells have the ability to respond to alterations in CSF lactate in body–brain signaling, but also as a sign of neuropathology (e.g., stroke and Alzheimer’s disease biomarker).
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Morigaki, Ryoma, Kiyohito Shinno, Kyong-Hon Pooh, and Yoshinobu Nakagawa. "Giant glioependymal cyst in an infant." Journal of Neurosurgery: Pediatrics 7, no. 2 (2011): 175–78. http://dx.doi.org/10.3171/2010.11.peds10270.
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The authors report the case of an infant with a giant glioependymal cyst. Although it has been suggested that these cysts originate from the tela choroidea, their origin remains controversial. This 35-month-old girl with truncal ataxia was referred to the authors' hospital. Magnetic resonance imaging revealed a giant cystic mass extending from the anterior to the posterior cranial fossa. Hydrocephalus was caused by obstruction of the sylvian aqueduct. Endoscopic fenestration of the cyst wall was performed. Histochemical and immunohistochemical staining identified the lesion as a glioependymal cyst. Magnetic resonance imaging performed 8 months later suggested that the cyst originated from the tela choroidea. At 5-year follow-up, there was no tumor recurrence and she had fully recovered. The origin of glioependymal cysts is discussed, and the authors suggest that their origin is the tela choroidea.
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Iacoangeli, Maurizio, Lucia Giovanna Maria di Somma, Alessandro Di Rienzo, Lorenzo Alvaro, Davide Nasi, and Massimo Scerrati. "Combined endoscopic transforaminal-transchoroidal approach for the treatment of third ventricle colloid cysts." Journal of Neurosurgery 120, no. 6 (2014): 1471–76. http://dx.doi.org/10.3171/2014.1.jns131102.
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Colloid cysts are histologically benign lesions whose primary goal of treatment should be complete resection to avoid recurrence and sudden death. Open surgery is traditionally considered the standard approach, but, recently, the endoscopic technique has been recognized as a viable and safe alternative to microsurgery. The endoscopic approach to colloid cysts of the third ventricle is usually performed through the foramen of Monro. However, this route does not provide adequate visualization of the cyst attachment on the tela choroidea. The combined endoscopic transforaminal-transchoroidal approach (ETTA), providing exposure of the entire cyst and a better visualization of the tela choroidea, could increase the chances of achieving a complete cyst resection. Between April 2005 and February 2011, 19 patients with symptomatic colloid cyst of the third ventricle underwent an endoscopic transfrontal-transforaminal approach. Five of these patients, harboring a cyst firmly adherent to the tela choroidea or attached to the middle/posterior roof of the third ventricle, required a combined ETTA. Postoperative MRI documented a gross-total resection in all 5 cases. There were no major complications and only 1 patient experienced a transient worsening of the memory deficit. To date, no cyst recurrence has been observed. An ETTA is a minimally invasive procedure that can allow for a safe and complete resection of third ventricle colloid cysts, even in cases in which the lesions are firmly attached to the tela choroidea or located in the middle/posterior roof of the third ventricle.
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Varghese, Prithvi, Julio Kandathil, Jayasree Govindan, Rashmi R., and Muhammed Jalal. "Meningioma in Lateral Cerebellomedullary Cistern without Dural Attachment." Indian Journal of Neurosurgery 06, no. 02 (2017): 144–48. http://dx.doi.org/10.1055/s-0037-1602754.
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AbstractIntracranial meningiomas without dural attachment are rare and posterior cranial fossa meningiomas without dural attachment are rarer. Such meningiomas are thought to arise from arachnoid cap cells in pial membrane, tela choroidea, or choroid plexus. MRI is the best imaging modality for the diagnosis of meningiomas and typically shows an enhancing, dural based, extra-axial soft tissue mass with a characteristic dural tail. Meningioma without dural attachment should be suspected if the MRI shows a space-occupying lesion having features of a meningioma but without a dural base and dural tail. We report a case of meningioma in the lateral cerebellomedullary cistern without dural attachment.
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HJORT, JOHN. "Aflösning af choroidea; en klinisk iagttagelse1." Nordiskt Medicinskt Arkiv 14, no. 18 (2009): 1–8. http://dx.doi.org/10.1111/j.0954-6820.1882.tb01468.x.
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Mussi, Antonio C. M., and Albert L. Rhoton. "Telovelar approach to the fourth ventricle: microsurgical anatomy." Journal of Neurosurgery 92, no. 5 (2000): 812–23. http://dx.doi.org/10.3171/jns.2000.92.5.0812.
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Object. In the past, access to the fourth ventricle was obtained by splitting the vermis or removing part of the cerebellum. The purpose of this study was to examine the access to the fourth ventricle achieved by opening the tela choroidea and inferior medullary velum, the two thin sheets of tissue that form the lower half of the roof of the fourth ventricle, without incising or removing part of the cerebellum.Methods. Fifty formalin-fixed specimens, in which the arteries were perfused with red silicone and the veins with blue silicone, provided the material for this study. The dissections were performed in a stepwise manner to simulate the exposure that can be obtained by retracting the cerebellar tonsils and opening the tela choroidea and inferior medullary velum.Conclusions. Gently displacing the tonsils laterally exposes both the tela choroidea and the inferior medullary velum. Opening the tela provides access to the floor and body of the ventricle from the aqueduct to the obex. The additional opening of the velum provides access to the superior half of the roof of the ventricle, the fastigium, and the superolateral recess. Elevating the tonsillar surface away from the posterolateral medulla exposes the tela, which covers the lateral recess, and opening this tela exposes the structure forming the walls of the lateral recess.
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Kondziolka, Douglas, and Juan M. Bilbao. "An immunohistochemical study of neuroepithelial (colloid) cysts." Journal of Neurosurgery 71, no. 1 (1989): 91–97. http://dx.doi.org/10.3171/jns.1989.71.1.0091.
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✓ Monoclonal and polyclonal antisera were used against 12 cases of neuroepithelial (colloid) cysts to determine the specific antigenic profile of the cyst epithelium. Intermediate filament markers (cytokeratin, vimentin, neurofilament, and glial fibrillary acidic protein) and epithelial markers (epithelial membrane antigen and monoclonal antibody lu-5) demonstrated that colloid cyst epithelium has a unique antigenic profile in contrast to that of choroid plexus or glial tissue. Theories raised to explain the etiology of colloid cysts have included derivation from the embryonic paraphysis, detachments of developing neuroepithelium from the tela choroidea, and remnants of respiratory epithelium; a more recent theory suggests that these cysts are products of developing choroid plexus or ependyma. The present study shows that colloid cyst epithelium is distinct from that of choroid plexus or ependyma and therefore does not represent a product of their formation, nor does it represent a form of immature glia. This finding supports the conclusion that colloid cysts in any ventricular location represent a developmental anomaly of primitive neuroectoderm in the embryo, which remains unique from other products of neuroectodermal derivation.
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Johnson, Mahlon D., Noel Tulipan, and William O. Whetsell. "Osteoblastic Meningioma of the Fourth Ventricle." Neurosurgery 24, no. 4 (1989): 587–90. http://dx.doi.org/10.1227/00006123-198904000-00017.
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ABSTRACT 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.
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Ho, Khang-Loon, and Julio H. Garcia. "New observations of colloid cysts of the third ventricle: An ultrastructural study of the lining epithelium and the wall." Proceedings, annual meeting, Electron Microscopy Society of America 49 (August 1991): 94–95. http://dx.doi.org/10.1017/s0424820100084776.
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Colloid cysts of the third ventricle represent one of the variety of the epithelial-lined cysts of the neuraxis. Their histogenesis remains unsettled. Ultrastructural and immunohistochemical analyses have suggested the following possible origins: (a) neuroectoderm, including paraphysis, ependyma, choroid plexus, and tela choroidea and (b) endoderm, including respiratory and enteric epithelium.This report describes the ultrastructure of the lining epithelium and the wall of four cases of colloid cyst. Six distinct cell types were recognized in the epithelium (Fig.1,2): (1) ciliated cells with various types of ciliary abnormalities, (2) non-ciliated cells with microvilli coated with granulo-fibrillary material, (3) goblet cells showing discharge of secretory granules, (4) basal cells with prominent tonofilaments, (5) basal-located cells with elongated cell bodies parallel to the basement membrane and electron-lucent cytoplasm containing sparse, membrane-bound dense core granules (150-250 nm) and (6) small undifferentiated cells with scanty organelles.
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Santos, Maria M., and Mark M. Souweidane. "Purely endoscopic resection of a choroid plexus papilloma of the third ventricle: case report." Journal of Neurosurgery: Pediatrics 16, no. 1 (2015): 54–57. http://dx.doi.org/10.3171/2014.12.peds14287.
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The authors report an illustrative case of a purely endoscopic surgical approach to successfully remove a solid choroid plexus papilloma of the third ventricle in an infant. A 10-week-old male infant first presented with transient episodes of forced downward gaze, divergent macrocephaly, a tense anterior fontanel, diastasis of the cranial sutures, and papilledema. Brain MRI revealed a small, multilobulated contrast-enhancing mass situated within the posterior third ventricle, with resultant obstructive hydrocephalus. A purely endoscopic removal of the tumor was performed through a single right frontal bur hole. Intraoperatively, a unique vascular tributary was recognized coming from the tela choroidea and was controlled with coagulation and sharp dissection. Postoperative MRI confirmed complete tumor removal, and the tumor was classified as a choroid plexus papilloma. There has been no evidence of tumor recurrence over 42 months of follow-up. With this case report the authors intended to show that endoscopic surgery can be an additional tool to consider when planning a choroid plexus tumor approach. It seems to be of particular interest in selected cases in which there are concerns about the patient's total blood volume, as in infants with potential hemorrhagic tumors and when it is possible to preoperatively identify a single vascular pedicle that can be approached early in the surgery.
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Firbas, Ulrike, Wolfgang Michlits, and Seyedhossein Aharinejad. "Venous sphincters in the choroidea of spontaneously hypertensive rats." Anatomical Record Part A: Discoveries in Molecular, Cellular, and Evolutionary Biology 284A, no. 2 (2005): 537–43. http://dx.doi.org/10.1002/ar.a.20189.
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Aydin, A., S. Yilmaz, G. Dinc, D. Ozdemir, and M. Karan. "The morphology of circulus arteriosus cerebri in the porcupine (Hystrix cristata)." Veterinární Medicína 50, No. 3 (2012): 131–35. http://dx.doi.org/10.17221/5605-vetmed.
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: The circulus arteriosus cerebri of the porcupine was investigated in this study. Five porcupines were used. Coloured latex was given from the left ventricles of three and from the communis carotid artery of two porcupines. The circulus arteriosus cerebri was examined after dissection was done. The basilar artery was formed by a merge of the right and left vertebral artery. The caudal communicans artery which was the caudal part of circulus arteriosus cerebri was formed by the basilar artery on crus cerebri. From caudal to cranial, the branches originating from the basilar artery and circulus arteriosus cerebri to cerebrum and cerebellum were as follows: caudal cerebelli artery, media cerebelli artery, rostral cerebelli artery, caudal choroidea artery, artery which extended to the mesencephalon, caudal cerebral artery, internal ophthalmic artery, rostral choroidea artery, media cerebral artery, rami striati and rostral cerebral artery. The rostral cerebral artery dexter and sinister joined to each other by the rostral communicans artery, forming the circulus arteriosus cerebri. It was determined that the internal carotid artery did not participate in the formation of circulus arteriosus cerebri and the arterial blood to the circulus arteriosus cerebri of porcupine is provided via the basilar artery only.
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Zhdankina, A. A., M. B. Plotnikov, V. I. Smoliyakova, et al. "Morphological aspects used of semisynthetic antioxidant dibornol in treatment of rats OXYS with involutional central chorioretinal degeneration." Bulletin of Siberian Medicine 8, no. 3 (2009): 27–31. http://dx.doi.org/10.20538/1682-0363-2009-3-27-31.
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Retina of rats OXYS 6 months of age by treatment of 4-methyl-2,6-diisobornylphenol (dibornol) was researched. Mainly, rats OXYS have of vascular disturbances such as reduction open functional vasculars of choroidea, destruction of retinal pigmental epithelium and retinal neurons. Dibornol was protected of retina increased area of open vascular and safety of retinal neurons. Besides dibornol was prevented thrombosis in retinal vasculars.
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Volný, Ondřej, Petra Cimflová, Linda Kašičková, and David Kachlík. "A complete syndrome of the anterior choroidal artery in a non-dominant hemisphere due to acute ischemic stroke." Neurologie pro praxi 19, no. 2 (2018): 139–41. http://dx.doi.org/10.36290/neu.2018.060.
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Aydin, A. "The morphology of circulus arteriosus cerebri in the red squirrel (Sciurus vulgaris)." Veterinární Medicína 53, No. 5 (2008): 272–76. http://dx.doi.org/10.17221/1948-vetmed.
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In this study, the circulus arteriosus cerebri of the squirrel was investigated. Ten squirrel were used. Coloured latex was given from left ventriculi of the all squirrels. Circulus arteriosus cerebri was examined after the dissection was made. The basilar artery was formed by merge of the right and left vertebral artery. The caudal communicans artery which was caudal part of circulus arteriosus cerebri was formed by the basilar artery on sulcus pontocrurale. From caudal to cranial, the branches originated from the basilar artery and circulus arteriosus cerebri to cerebrum and cerebellum were as follows: the caudal cerebelli artery,rami ad pontem, the rostral cerebelli artery, the caudal choroidea artery, the caudal cerebral artery, the internal ophtalmic artery, the rostral choroidea artery, the media cerebral artery, rami striati and the rostral cerebral artery. In squirrels a variability was observed in the branches that the rostral cerebral artery gives, and their endings. It was determined that the internal carotid artery didn’t exist in 4 animals when the right and left vertebral artery were ligatured. It was found that the internal carotid artery didn’t contribute to the arterial blood to circulus arteriosus cerebri and the arterial blood to circulus arteriosus cerebri of squirrels is provided via only the basilar artery.
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Whitehead, Matthew T., Gilbert Vezina, Sarah D. Schlatterer, Sarah B. Mulkey, and Adre J. du Plessis. "Taenia–tela choroidea complex and choroid plexus location help distinguish Dandy-Walker malformation and Blake pouch cysts." Pediatric Radiology 51, no. 8 (2021): 1457–70. http://dx.doi.org/10.1007/s00247-021-04991-3.
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Funaki, Takeshi, Yasuhide Makino, Yoshiki Arakawa, et al. "Arachnoid cyst of the velum interpositum originating from tela choroidea." Surgical Neurology International 3, no. 1 (2012): 120. http://dx.doi.org/10.4103/2152-7806.102334.
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Berry, Kenneth, and Jennifer Rice. "Traumatic Tear of Tela Choroidea Resulting in Fatal Intraventricular Hemorrhage." American Journal of Forensic Medicine and Pathology 15, no. 2 (1994): 132–37. http://dx.doi.org/10.1097/00000433-199406000-00008.
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Dumont, Isabelle, Pierre Hardy, Krishna G. Peri, et al. "Regulation of endothelial nitric oxide synthase by PGD2 in the developing choroid." American Journal of Physiology-Heart and Circulatory Physiology 278, no. 1 (2000): H60—H66. http://dx.doi.org/10.1152/ajpheart.2000.278.1.h60.
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We investigated if prostaglandins might regulate the increased choroidal endothelial (e) nitric oxide synthase (NOS) expression in the perinate. Prostaglandins, eNOS mRNA, immunoreactive protein and activity, and nitrite [stable metabolite of nitric oxide (NO)] production were markedly higher in newborn (1 day old) than juvenile (6–8 wk old) pig choroid. Treatment of isolated newborn choroids with the prostaglandin synthase inhibitor ibuprofen for 24 h reduced eNOS mRNA and nitrite production to values in juveniles. This effect was equally observed with the PGD2 receptor (DP) blocker BW A868C and was prevented by cotreatment with PGD2 but not other prostaglandins; similar observations were made on NOS activity in vivo. PGD2 also increased eNOS expression on choroids of juveniles, and this effect was blocked by BW A868C. The manifestation of this upregulation of eNOS by PGD2 on the control of choroidal vasomotor response was tested by using NO-dependent vasorelaxants, ACh, bradykinin (Bk), and substance P (SP). ACh-, Bk-, and SP-elicited choroidal vasorelaxation was greater in saline-treated newborn than juvenile pigs. Ibuprofen (24 h) decreased ACh-, Bk-, and SP-evoked vasorelaxation in newborns, whereas PGD2 increased that in juveniles and prevented the ibuprofen-induced attenuated relaxation in newborns; infusion of N ω-monomethyl-l-arginine in choroids of those animals treated with PGD2 reversed the augmented vasorelaxation to ACh, Bk, and SP. Finally, PGD2-induced upregulation of NOS in the perinate was also reflected by curtailed choroidal blood flow autoregulatory response to increased perfusion pressure. In conclusion, PGD2 exhibits a major role in upregulating eNOS expression and activity in the choroid, which in turn results in greater NO-mediated vasorelaxation; a new mechanism for eNOS regulation via DP is hereby disclosed. The relationship between PGD2 and eNOS in the developing subject provides an explanation for the interactive role of these two factors in the absent choroidal blood flow autoregulation in the perinate.
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Gergely, Róbert, Mónika Ecsedy, Illés Kovács, et al. "Pachychorioidealis kórképek." Orvosi Hetilap 162, no. 20 (2021): 770–81. http://dx.doi.org/10.1556/650.2021.32062.
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Összefoglaló. Célunk, hogy közleményünkben összefoglaljuk a pachychorioidealis kórképekkel kapcsolatos ismereteket egy-egy saját esettel illusztrálva. Az irodalmi adatok és a saját klinikai tapasztalatok alapján összegeztük a pachychorioidealis kórképekkel kapcsolatos ismereteinket, az alcsoportok kezelési lehetőségeiről összefoglaló folyamatábrát készítettünk. A pachychorioidealis kórképekbe a következő betegségek tartoznak: centrális serosus chorioretinopathia (CSCR), pachychorioidealis pigmentepitheliopathia (PPE), pachychorioidealis neovasculopathia (PNV), polypoid chorioidealis vasculopathia (PCV), peripapillaris pachychorioidealis syndroma (PPS), focalis chorioideaexcavatio (FCE). A pachychorioidealis kórképek közös jellemzője a chorioidea kvantitatív vagy kvalitatív eltérései, melyekhez gyakran subretinalis folyadékgyülem társul. A betegségcsoportnak jelenleg nincs standard kezelési protokollja; a többféle kezelési mód közül néhány hatékonyabbnak bizonyul, az alcsoportok között azonban lényeges különbségek mutatkoznak. Összegezzük, hogy melyik alcsoportban érdemes eplerenonetablettás kezeléssel, mikropulzuslézer-kezeléssel, verteporfinos fotodinámiás kezeléssel (PDT) vagy intravitrealis anti-VEGF-injekciós kezeléssel kezdeni. Orv Hetil. 2020; 162(20): 770–781. Summary. The aim of this study is to present our knowledge about pachychoroid diseases using case reports, literature review and our own clinical experiences. A summary flow chart of treatment options for the subgroups was prepared, too. Pachychoroid diseases include the following: central serous chorioretinopathy (CSCR), pachychoroid pigment epitheliopathy (PPE), pachychoroid neovasculopathy (PNV), polypoidal choroidal vasculopathy (PCV), peripapillary pachychoroid syndrome (PPS), focal choroidal excavation (FCE). A common feature of pachychoroid diseases is the quantitative or qualitative abnormality of the choroidea, which is often associated with subretinal fluid accumulation. The disease group does not currently have a standard treatment protocol; some of the multiple treatments prove to be more effective, however, there are significant differences between the subgroups. We summarize which subgroup benefits from eplerenone tablet therapy, micropulse laser therapy, verteporfin photodynamic therapy or intravitreal anti-VEGF injection therapy. Orv Hetil. 2020; 162(20): 770–781.
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Mazurenko, N. N., I. V. Tsyganova, V. V. Nazarova, et al. "Molecular and genetic diversity in melanoma of eye." Advances in molecular oncology 5, no. 3 (2018): 51–58. http://dx.doi.org/10.17650/2313-805x-2018-5-3-51-58.
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Background. Ocular melanoma is the most common cancer of adult eye and is represented by two main subtypes of uveal (UM) and conjunctival (CM) melanoma with distinct clinical (frequency, localization, histology) and genomic features. The objective is to compare molecular and genetic characteristics of tumors in patients with melanoma of the eye. Materials and methods. In this study molecular profiling of 78 tumors including 73 UM (choroidea, ciliar body and iris) and 5 СM, was evaluated. DNA was isolated from tumor cells collected by macrodissection of FEPE sections of tumor biopsies using proteinase K. The following genes were studied by Sanger sequencing: GNAQ, GNA11, KIT, BRAF, NRAS. Results. Mutations in GNAQ and GNA11 were found in 81 % (59/73) of UM, in 42 % (31/73) and 38 % (28/73) of cases correspondently. GNAQ mutations were more frequent in primary UM (63 %), while GNA11 mutations dominated in metastatic UM (42 %). There was а correlation between frequency of GNAQ/GNA11 mutations and histologic type of UM. GNAQ mutations were identified in 55 % of spindle cell UM, while GNA11 mutations were more frequent in epithelioid cell UM (42 %). There were no differences in frequency of GNAQ/GNA11 mutations in UM of patients of different age (younger and elder 50 years). There was no statistically difference in UM patient outcome with GNAQ or GNA11 mutations. We also detected 3 UM with KIT mutations and 2 UM with BRAF mutations. There was no big difference in frequency of «driver mutations» in UM of choroidea, ciliar body and iris. Molecular profiling of conjunctival melanoma (CM) resembles that of cutaneous melanoma of skin: in 3 (60 %) CM BRAF V600E was identified and in 1 (20 %) – NRAS Q61K. Conclusion. Genetic analysis reveals wide diversity of melanoma of eye and is important for it characterization and treatment.
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Jean, Walter C., Khaled M. Abdel Aziz, Jeffrey T. Keller, and Harry R. van Loveren. "Subtonsillar Approach to the Foramen of Luschka: An Anatomic and Clinical Study." Neurosurgery 52, no. 4 (2003): 860–66. http://dx.doi.org/10.1227/01.neu.0000053146.83780.74.
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Abstract OBJECTIVE Conventional approaches to tumors of the foramen of Luschka are limited because the foramen is viewed from either the fourth ventricle laterally (transvermian approach) or the cerebellopontine angle medially (suboccipital approach). The definitive approach is subtonsillar, because the foramen of Luschka is actually the end of the natural cleavage plane between the cerebellar tonsil and the medulla. We describe the microsurgical anatomic features of the foramen of Luschka region and the operative technique for the subtonsillar approach to this region. METHODS In the anatomic study, five formalin-fixed, silicone-injected, cadaveric heads were used. In the clinical study, the records for five patients treated via the subtonsillar approach were examined; several illustrative cases are presented. RESULTS The foramen of Luschka is formed by the tela choroidea and the rhomboid lip and exists at the lateral end of the cerebellomedullary fissure, which is a natural cleavage plane between the cerebellar tonsil and the medulla. The subtonsillar approach is performed via a suboccipital craniotomy; the patient is positioned in the lateral decubitus position, with the tumor side down. After the cerebellar tonsil is freed from arachnoid adhesions, it can be retracted rostrodorsally from the medulla, to expose the cerebellomedullary fissure. Clinically, the tela choroidea and rhomboid lip are significantly attenuated by tumor expansion. Therefore, by dissecting in a subtonsillar manner around the tumor, one can reach the foramen of Luschka without traversing any neural tissue. CONCLUSION The subtonsillar approach yields a panoramic view to the foramen of Luschka laterally and up to the middle cerebellar peduncle superiorly. This approach minimizes the distance between the tumor and the surgeon, while maximizing neural preservation. We think this is the definitive approach to this difficult region of the posterior fossa.
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SHIEN, Tadahiko, Hiroyoshi DOIHARA, Naruto TAIRA, and Nobuyoshi SHIMIZU. "A CASE OF BREAST CANCER METASTASIZED TO THE CHOROIDEA OF THE LEFT EYE." Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 64, no. 5 (2003): 1082–85. http://dx.doi.org/10.3919/jjsa.64.1082.
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Mathis, Ute, Marita Pauline Feldkaemper, and Frank Schaeffel. "Effects of Single and Repeated Intravitreal Applications of Atropine on Choroidal Thickness in Alert Chickens." Ophthalmic Research 64, no. 4 (2021): 664–74. http://dx.doi.org/10.1159/000515755.
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<b><i>Introduction:</i></b> Atropine, a muscarinic antagonist, is known since the 19th century to inhibit myopia development in children. One of its effects is that it stimulates choroidal thickening. Thicker choroids, in turn, have been linked to myopia inhibition. We used the atropine-stimulated choroidal response in the chicken to learn more about the time courses and amplitudes of the effects of atropine, as well as whether repeated applications lead to accumulation or desensitization. <b><i>Methods:</i></b> Intravitreal injections containing 250 µg atropine sulfate were performed in 1 eye around 10:00 in the morning, the fellow eye received vehicle. Chickens with bilateral vehicle injections served as controls. Choroidal thickness was measured over the day for every 2–3 h in alert animals, using spectral domain optical coherence tomography, with 3–5 independent measurements in each eye. Three experiments were done – (1) single injection and time course measured over 1 day, (2) single injection and time course measured over 4 days, and (3) daily injections and time course measured over 4 days for measuring the effects of atropine on vitreal, retinal, and choroidal dopamine, and 3,4-dihydroxyphenylacetic acid levels by using high-performance liquid chromatography with electrochemical detection. <b><i>Results:</i></b> Atropine induced an increase in choroidal thickness by about 60 percent, with a peak amplitude after about 2 h. The effect persisted only for a few hours and had nearly disappeared by evening. Initially, similar amounts of choroidal thickening were observed in vehicle-injected fellow eyes but recovery to baseline was faster. When atropine was injected daily for 4 days, choroids thickened every day with similar amplitudes and time courses, with no signs of either accumulation or desensitization effects. Interestingly, while dopamine release from the retina was stimulated by atropine and followed approximately, the time course of choroidal thickening, its tissue concentration dropped in the choroid. <b><i>Conclusions:</i></b> Even at relatively high intravitreal doses, effects of atropine on choroidal thickness remained transient, similar to its effects on retinal dopamine. With repeated application every day, the diurnal patterns of choroidal thickening could be reproduced for 4 days with similar amplitudes and time courses. The transient nature of the effects of atropine on the choroid may be relevant for application protocols of atropine against myopia.
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Raper, Daniel M. S., Kunal P. Raygor, Caleb Rutledge, Todd B. Dubnicoff, and Adib A. Abla. "Suboccipital craniectomy with bilateral cerebellomedullary fissure dissection for resection of a ruptured tonsillar/vermian AVM occupying the roof of the fourth ventricle in a pregnant patient." Neurosurgical Focus: Video 4, no. 1 (2021): V6. http://dx.doi.org/10.3171/2020.10.focvid2059.
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Posterior fossa arteriovenous malformations (AVMs) in pregnant patients can present unique considerations for surgical treatment, including positioning to minimize pressure on the fetus, minimization of radiation exposure, and ethical considerations regarding emergency surgery. This video outlines surgical treatment of a ruptured tonsillar/vermian AVM performed in a staged fashion after emergent suboccipital craniotomy with posterior fossa decompression in the setting of a life-threatening infratentorial hemorrhage. Later, bilateral cerebellomedullary fissure dissection, exposure and dissection of the tela choroidea and inferior medullary velum, and disconnection of arterial feeders from the posterior inferior cerebellar artery (PICA) allowed resection of this AVM occupying the roof of the fourth ventricle.This study was approved by the UCSF Human Research Protection Program IRB no. 18-26938.The video can be found here: https://youtu.be/rTYUGanopUEhttps://thejns.org/doi/abs/10.3171/2020.10.FOCVID2059
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Krasnovid, T., N. Grubnyk, E. Ivanitskaya, and A. Kurilyuk. "Morphological peculiarities of the retina, nerve fiber layer and choroidea in patients after posttraumatic endophthalmitis." Oftalmologicheskii Zhurnal 48, no. 2 (2014): 66–71. http://dx.doi.org/10.31288/oftalmolzh201426671.
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Gabel, Brandon C., Michael L. Levy, and John R. Crawford. "Delayed Diagnosis of Enhancing Posterior Fossa Tumors Mimicking the Tela Choroidea of the Fourth Ventricle." World Neurosurgery 84, no. 3 (2015): 865.e1–865.e5. http://dx.doi.org/10.1016/j.wneu.2015.03.054.
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Colletti, Vittorio, Francesco Fiorino, Marco Carner, Luca Sacchetto, Veronica Miorelli, and Alessandro Orsi. "Auditory Brainstem Implantation: The University of Verona Experience." Otolaryngology–Head and Neck Surgery 127, no. 1 (2002): 84–96. http://dx.doi.org/10.1067/mhn.2002.126723.
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OBJECTIVE: We sought to describe the advantages of the retrosigmoid-transmeatal (RS-TM) approach in the application of auditory brainstem implants (ABIs) in adults with monolateral and bilateral vestibular schwannoma (VS) and in children with cochlear nerve aplasia. STUDY DESIGN: We conducted a retrospective case review. SETTING: The study was conducted at the ENT Department of the University of Verona, Italy. PATIENTS: Six adult patients (5 men and 1 woman) with neurofibromatosis type 2 (NF2) were operated on for VS removal with ABI. An additional patient had a unilateral VS in the only hearing ear. Tumor size ranged from 12 to 40 mm. In addition, 2 children received ABIs for bilateral cochlear nerve aplasia. INTERVENTION: An RS-TM approach was used in all VS patients, and an RS approach was used in the subjects with cochlear nerve aplasia. After tumor excision, landmarks (VII, VIII and IX cranial nerves, choroid plexus) for the foramen of Luschka were carefully identified. The choroid plexus was then partially removed and the tela choroidea divided and bent back; the floor of the lateral recess of the fourth ventricle and the convolution of the dorsal cochlear nucleus became visible. In the 2 subjects with no cochlear nerve, the choroid plexus and VII and IX cranial nerves were used as landmarks. The electrode array was then inserted into the lateral recess and the correct position was monitored with the aid of electrically evoked auditory brainstem responses (EABR) and neural response telemetry (NRT). RESULTS: Correct implantation was possible in all patients. Auditory sensations were induced in all patients with various numbers of electrodes. Different pitch sensations could be identified with different electrode stimulation. CONCLUSIONS: We believe that the RS approach is the route of choice for patients who are candidates for ABI due to the easy and clear access to the cochlear nucleus area. This route avoids some of the drawbacks of the translabyrinthine approach, such as mastoidectomy, labyrinthectomy, sealing of the cavity and posterior fossa with abdominal fat, and contamination from the middle ear. For this reason, it is the route of choice in children with cochlear nerve aplasia or severe cochlear malformation and in adults with complete ossification of the cochlea or cochlear nerve disruption due to cranial trauma.
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Dammers, Ruben, Ernst J. Delwel, and Ali F. Krisht. "CAVERNOUS HEMANGIOMA OF THE MESENCEPHALON: TONSILLOUVEAL TRANSAQUEDUCTAL APPROACH." Operative Neurosurgery 64, suppl_5 (2009): ons296—ons300. http://dx.doi.org/10.1227/01.neu.0000341530.36757.20.
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Abstract OBJECTIVE Recent advances in microsurgical techniques facilitate surgical resection of brainstem lesions that were previously considered inoperable. In this article we present, for the first time, the tonsillouveal transaqueductal approach to access a progressively symptomatic cavernoma within the depth of the tegmentum of the mesencephalon. METHODS A 52-year-old woman presented with a history of slowly progressive right-sided hemiparesis and ataxia. On magnetic resonance imaging, a relatively large cavernoma involving the tegmentum of the mesencephalon was shown. The sylvian aqueduct was patent and there was no secondary ventriculomegaly. The patient underwent surgery via a suboccipital craniotomy and C1 laminectomy. The right tonsillouveal and medullotonsillar spaces were opened to the level of the choroidal point of the posteroinferior cerebellar artery. The tela choroidea was incised from the foramen of Magendie to the telovelar junction. Looking through the aqueduct and at a point 5 mm superior to its inferior inlet, there was a small cherry-like blister protruding into the aqueductal anterior surface. This was used as an entry point to access the cavernoma. The space around the cavernoma was gently dissected and the cavernoma was circumferentially coagulated to shrink it in a concentric manner toward its center. RESULTS The total removal of the lesion was achieved and the histopathological findings were consistent with a cavernoma. As a result of noncommunicating hydrocephalus, the patient needed a ventriculoperitoneal shunt. The 1-year postoperative neurological examination was consistent with preoperative findings. CONCLUSION This report shows, for the first time, direct surgical removal of a cavernous hemangioma in the mesencephalic tegmentum via the aqueduct. This approach adds to contemporary microneurosurgery, respecting functional anatomy and minimizing neurological deficits.
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Liu, James K., and Vincent N. Dodson. "Telovelar approach for microsurgical resection of fourth ventricular subependymoma arising from rhomboid fossa: operative video and technical nuances." Neurosurgical Focus: Video 1, no. 2 (2019): V5. http://dx.doi.org/10.3171/2019.10.focusvid.19452.
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Fourth ventricular tumors have traditionally been removed via transvermian approaches, which can result in potential dysequilibrium and mutism. The telovelar approach is an excellent alternative to widely expose fourth ventricular tumors without transgressing the cerebellar vermis. This is achieved by opening the cerebellomedullary fissure and incising the tela choroidea and inferior medullary velum, which form the lower half of the roof of the fourth ventricle. In this operative video manuscript, the authors demonstrate microsurgical resection of a fourth ventricular subependymoma arising from the rhomboid fossa via the telovelar approach. The key technical nuance in this video is to demonstrate a gentle and safe technique to identify a dissectable plane to peel the tumor off of the rhomboid fossa using a microspreading technique with fine micro-bayonetted forceps. A gross-total resection was achieved, and the patient was neurologically intact.The video can be found here: https://youtu.be/ZEHHbUGb9zk.
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Jeklová, Edita, Lenka Levá, Vladimír Kummer, Vladimír Jekl, and Martin Faldyna. "Immunohistochemical Detection of Encephalitozoon cuniculi in Ocular Structures of Immunocompetent Rabbits." Animals 9, no. 11 (2019): 988. http://dx.doi.org/10.3390/ani9110988.
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Encephalitozoonosis is a common infectious disease widely spread among rabbits. Its causative agent, Encephalitozoon cuniculi, is considered as a zoonotic and emerging pathogen capable of infecting both immunocompetent and immunocompromised hosts, including humans. In rabbits, clinical signs include neurological, kidney and ocular disease. The aim of this study was to detect E. cuniculi in ocular structures in immunocompetent rabbits after experimental oral infection using immunohistochemistry. In infected animals, E. cuniculi spores were present in periocular connective tissue, sclera, cornea, choroidea, iris, retina and lens, as a round to ovoid organism reacting with a specific anti-E. cuniculi monoclonal antibody as early as 2 weeks after infection. There were no signs of inflammatory lesions in any of the ocular tissues examined at 2, 4, 6 and 8 weeks after infection. In the present study, E. cuniculi was also detected in the lenses of adult rabbits, which indicates that ways of lens infection other than intrauterine and haematogenic are possible.
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Francis, Jasmine H., Ethan K. Sobol, Molly Greenberg, Robert Folberg, and David H. Abramson. "Optical Coherence Tomography Characteristics of the Choroid Underlying Congenital Hypertrophy of the Retinal Pigment Epithelium." Ocular Oncology and Pathology 6, no. 4 (2020): 238–43. http://dx.doi.org/10.1159/000504712.
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Purpose: This study evaluates and characterizes the choroid underlying congenital hypertrophy of the retinal pigment epithelium (CHRPE). Methods: Retrospective observational study of CHRPE at least 2 mm in diameter. Choroidal vascular architecture was qualitatively examined. Choroidal thickness was measured by 2 independent observers using enhanced depth imaging spectral domain optical coherence tomography. Results: Forty-six eyes of 46 patients with CHRPE were included. Thirty-two lesions had imaging sufficient for analysis. Haller’s layer was healthy in 18 (56%), thin in 13 (41%), and absent in 1 (2%). Sattler’s layer was atrophic in 30 (94%), and choriocapillaris was atrophic in 31 (97%). CHRPE with thinned Haller’s layer had significantly larger diameter. The mean sub-CHRPE choroidal thickness was 82.4 ± 7.9 µm, compared to a thickness of 148.4 ± 9.6 µm in the normal adjacent choroid (p < 0.0001). Mean retinal thickness overlying the CHRPE was 77.3 ± 4.3 µm, compared to a retinal thickness of 137.8 ± 2.9 µm overlying the normal adjacent choroid (p < 0.0001). Sub-CHRPE choroidal thickness was a mean of 56.2 ± 3.1% of the adjacent normal choroidal thickness. Conclusion: The underlying choroid CHRPE is thinner than the adjacent normal choroid. All layers of the choroid can be thin with a preference of the inner Sattler’s and choriocapillaris layers.
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Chiang, Samuel T. H., and John R. Phillips. "Effect of Atropine Eye Drops on Choroidal Thinning Induced by Hyperopic Retinal Defocus." Journal of Ophthalmology 2018 (2018): 1–6. http://dx.doi.org/10.1155/2018/8528315.
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Purpose. To investigate the effects of atropine on choroidal thinning induced by hyperopic retinal defocus. Methods. Ten young adults with myopia (−1.00 D to −5.00 D) viewed a video at 6 metres for 60 minutes on successive days. On day 1, one eye (control) was distance corrected with a contact lens; the other (experimental) eye wore a contact lens imposing 2.00 D of hyperopic retinal defocus. Sub- and perifoveal choroidal thickness (SFCT, PFCT) were monitored with optical coherence tomography. On day 2, the procedure was repeated but the experimental eye had received one drop of 0.5% atropine 22 hours earlier. Results. On day 1, eyes exposed to hyperopic defocus developed progressively thinner choroids (SFCT (baseline) = 253 ± 32 μm versus SFCT (40 mins) = 244 ± 31 μm, p=0.004), whereas SFCT and PFCT in control eyes did not change (p>0.17). On day 2 (22 hours after instilling atropine), baseline SFCT and PFCT were not different to day 1 (p>0.05) and hyperopic defocus failed to thin the choroid (max change in SFCT = +2 ± 2 μm, p=0.36). Conclusions. Atropine abolished choroidal thinning induced by hyperopic defocus without changing baseline choroidal thickness. The results suggest that atropine inhibits signals associated with hyperopic defocus, for example, from lag of accommodation during near work. This trial is registered with ACTRN12617001519347.
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Munk, Marion, and Chantal Dysli. "Modern Imaging Techniques for Visualising Choroidal Morphology and Function." Klinische Monatsblätter für Augenheilkunde 238, no. 09 (2021): 951–61. http://dx.doi.org/10.1055/a-1562-8731.
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AbstractThe choroid is directly adjacent to the retina and consists of a dense vascular network that supplies the outer retina. Pathologies in the choroid can lead to changes in the retinal pigment epithelium (RPE) and photoreceptors. Thus, the choroid plays a crucial role in the development of retinal diseases such as age-related macular degeneration (AMD), central serous chorioretinopathy (CSCR), pathologic myopia, and inflammatory diseases such as Vogt-Koyanagi-Harada syndrome (VKH). Basic knowledge of the structure and physiology of the choroid, as well as diagnostic options for visualizing choroidal changes, provides a better understanding of the physiology and pathology of choroidal processes. This review provides an overview of the anatomy and function of the choroid, and describes the diagnostic techniques currently available to characterize and visualize the choroid. It also includes an overview of various retinal conditions, which are associated with choroidal changes.
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May, Christian Albrecht. "Chronologic versus Biologic Aging of the Human Choroid." Scientific World Journal 2013 (2013): 1–7. http://dx.doi.org/10.1155/2013/378206.
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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, chronologic aging should not be used as a factor for physiological changes in the human choroid. Longitudinal study designs are necessary to further establish the impact of age. Meanwhile, a more biologic oriented model of aging processes in the choroid should be established, including specified conditions (e.g., light exposure and refractory state). This would help to define more individual strategies for prevention and early stages of a certain defined disease.
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Terada, Noriko, Manabu Miyata, Yuki Muraoka, et al. "Abnormal Outer Choroidal Vasculature in Amblyopia." Journal of Ophthalmology 2019 (January 10, 2019): 1–7. http://dx.doi.org/10.1155/2019/2097087.
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Purpose. Several studies have indicated morphological changes in the choroid in amblyopia cases. This study investigates whether choroidal vasculature was different among amblyopic and fellow eyes in unilateral amblyopia patients and healthy eyes, using en face images acquired via swept-source optical coherence tomography (SS-OCT). Design. Prospective, observational case-control study. Methods. This study included 14 consecutive patients with unilateral amblyopia and 22 age- and axial length-matched healthy eyes. Using SS-OCT, we obtained en face images of choroidal vasculature midway through the subfoveal inner and total choroid, corresponding to the vasculature of the choriocapillaris and Sattler’s layer (inner choroid) and Haller’s layer (outer choroid), respectively. We analyzed the en face images of the inner and outer choroidal vascular areas in 3 × 3 mm squares adjusted from 6 × 6 mm squares, using Littmann’s magnification correction, after binarization of the images as a portion of the whole area. Results. The outer choroidal vascular areas were larger in both amblyopic and fellow eyes than in healthy eyes (both P<0.001), although there were no significant differences in inner (56.35 ± 2.46% and 56.27 ± 3.75%, respectively) or outer (61.49 ± 4.95% and 61.48 ± 3.73%, respectively) choroidal vascular area between amblyopic and fellow eyes (P=0.98 and 0.91, respectively). An outer choroidal vascular area of 59% was set as an appropriate cutoff value for distinguishing patients from controls. Conclusions. The outer choroidal vascular area was larger in both amblyopic eyes and fellow eyes compared to healthy eyes. Our findings may help clarify the etiology of amblyopia.
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Danilova, Irina, Svetlana Medvedeva, Svetlana Shmakova, Margarita Chereshneva, Alexey Sarapultsev, and Petr Sarapultsev. "Pathological changes in the cellular structures of retina and choroidea in the early stages of alloxan-induced diabetes." World Journal of Diabetes 9, no. 12 (2018): 239–51. http://dx.doi.org/10.4239/wjd.v9.i12.239.
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Baltmr, Abeir, Sue Lightman, and Oren Tomkins-Netzer. "Examining the Choroid in Ocular Inflammation: A Focus on Enhanced Depth Imaging." Journal of Ophthalmology 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/459136.
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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 objectivein vivovisualization 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.
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Zainodin, Elly Liyana, and Chen Ai-Hong. "Comparison of choroidal thickness between amblyopic and non-amblyopic eyes." Malaysian Journal of Fundamental and Applied Sciences 14, no. 3 (2018): 364–67. http://dx.doi.org/10.11113/mjfas.v14n3.1126.
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Our study examined the choroidal thickness profile of children with myopic anisometropic amblyopia and compared the thickness with the fellow eyes. The choroidal thickness was measured with the enhanced depth imaging with spectral-domain optical coherence tomography. Manual segmentations of the choroid were performed on a 25-raster horizontal scan. The choroidal thickness measurements of the 9 subfields defined by the Early Treatment Diabetic Retinopathy Study (ETDRS) were evaluated. The mean spherical equivalent of the amblyopic eyes was -10.80 ± 0.41 D and the fellow eyes was -4.40 ± 2.05 D. The mean best corrected visual acuity of the amblyopic eyes and the fellow eyes were 0.94 ± 0.27 and 0.14 ± 0.05 logMAR respectively. The amblyopic eyes have longer axial length (26.46 ± 0.44 mm) compared to the fellow eyes (23.59 ± 1.18 mm). The average subfoveal choroidal thickness was 124.30 ± 40.71 µm in the amblyopic eyes and 246.80 ± 58.63 µm in the fellow eyes. The horizontal and vertical distribution pattern of choroidal thickness in amblyopic eyes was different from the fellow eyes. In amblyopic eye the choroidal thickness reduced from the temporal region to the nasal region. The fellow eyes had thickest choroid at the subfoveal area, followed by the temporal region and nasal region. In conclusion, the choroid was thinner in the amblyopic eyes than that of the fellow eyes at all regions.
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Jiang, Zhaoxin, Ting Zhang, Xing Liu, et al. "Multimodal Imaging Features of Bilateral Choroidal Ganglioneuroma." Journal of Ophthalmology 2020 (May 12, 2020): 1–8. http://dx.doi.org/10.1155/2020/6231269.
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Purpose. Bilateral choroidal ganglioneuroma is extremely rare, and no cases have been described in the literature. Multimodal images are crucial for its diagnosis. Here, we evaluated multimodal images in the early stage of choroidal ganglioneuroma. Methods. A 6-year-old boy was recruited who had experienced gradually progressive vision loss and rapidly progressive myopia in both eyes over the past 2 years. His eyes were comprehensively evaluated via slit-lamp microscopy, ultrasound biomicroscopy, swept-source optical coherence tomography (SS-OCT), fundoscopy, fundus fluorescein angiography, indocyanine green angiography (ICGA), ultrasound B scanning, and magnetic resonance imaging. Electrophysiological examinations included electrooculography and electroretinography. Choroid biopsy and pathological examination were performed. Results. Over the past 2 years, the patient’s best-corrected visual acuity had gradually decreased to hand motions at 10 cm in the right eye and 20/63 in the left, with axial length growth to 25.89 mm in the right and 28.99 mm in the left. Diffuse thickening in bilateral eyewalls was depicted in B scanning and magnetic resonance imaging. Secondary exudative retinal detachment was evident in SS-OCT and B scanning. SS-OCT depicted low optical reflections in the choroidal layer, revealing a lack of choroidal vasculature. Diffuse hypofluorescence in ICGA photography confirmed extensive loss of choroidal vasculature. In electrophysiological function investigations, electrooculography revealed remarkable bilateral low Arden ratios, with almost extinguished electroretinogram in the right eye. Right-eye choroid biopsy was performed, resulting in a histological diagnosis of choroidal ganglioneuroma. Conclusion. Choroidal ganglioneuroma is rare. To our knowledge, no bilateral cases have been described in the literature. Major clinical features include a rapid increase in axial length, diffuse choroidal thickening, hyper-reflectivity in the choroid on optical coherence tomography, and loss of choroidal vasculature on ICGA. The current report provides multimodal imaging of choroidal ganglioneuroma for the first time and can be valuable for early diagnosis.
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Michalewski, Janusz, Zofia Michalewska, Zofia Nawrocka, Maciej Bednarski, and Jerzy Nawrocki. "Correlation of Choroidal Thickness and Volume Measurements with Axial Length and Age Using Swept Source Optical Coherence Tomography and Optical Low-Coherence Reflectometry." BioMed Research International 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/639160.
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Purpose. To report choroidal thickness and volume in healthy eyes using swept source optical coherence tomography (SS-OCT).Methods. A prospective observational study of 122 patients examined with swept source OCT (DRI-OCT, Topcon, Japan). In each eye, we performed 256 horizontal scans, 12 mm in length and centered on the fovea. We calculated choroidal thickness manually with a built-in caliper and automatically using DRI-OCT mapping software. Choroidal volume was also automatically calculated. We measured axial length with optical low-coherence reflectometry (Lenstar LS 900, Haag-Streit, Switzerland).Results. The choroid has focally increased thickness under the fovea. Choroid was thinnest in the outer nasal quadrant. In stepwise regression analysis, age was estimated as the most significant factor correlating with decreased choroidal thicknessF=23.146, P<0.001followed by axial lengthF=4.902, P=0.03. Refractive error was not statistically significantF=1.16, P=0.28.Conclusions. SS-OCT is the first commercially available system that can automatically create choroidal thickness and volume maps. Choroidal thickness is increased at the fovea and is thinnest nasally. Age and axial length are critical for the estimation of choroidal thickness and volume. Choroidal measurements derived from SS-OCT images have potential value for objectively documenting disease-related choroidal thickness abnormalities and monitoring progressive changes over time.
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Bashir, Nusrat, Farzana Manzoor, Bilal Musharaf, and Ruby Reshi. "Bone marrow involvement as a rare manifestation of relapsed choroidal melanoma." International Journal of Research in Medical Sciences 8, no. 8 (2020): 3110. http://dx.doi.org/10.18203/2320-6012.ijrms20203475.
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Choroidal Melanoma is the most common primary intra-ocular malignancy. Incidence of primary choroidal melanoma is about 6 cases per 1 million population. It disseminates hematogenously. The most common site of metastasis is liver. Metastatic melanoma involving the bone marrow is rare, occurring in 5% of patients with disseminated disease. However, Choroid melanoma with bone marrow involvement is very rare. Only a few case reports are published in literature. Authors present a case of bone marrow metastasis from choroid melanoma in 55 years old female who has been treated for primary choroidal melanoma by enucleation of left eye three years back. In the evaluation of symptomatic anemia, features suggestive of bone marrow infiltration by choroidal melanoma were observed on bone marrow aspiration and biopsy. The diagnosis was confirmed by positivity of immune-histochemistry markers HMB-45 and Melana.
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Baro, Valentina, Joseph Domenico Gabrieli, Giacomo Cester, et al. "Preoperative Devascularization of Choroid Plexus Tumors: Specific Issues about Anatomy and Embolization Technique." Brain Sciences 11, no. 5 (2021): 540. http://dx.doi.org/10.3390/brainsci11050540.
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(1) Background: Surgical treatment of choroid plexus tumors is challenging, burdened by a notable risk of bleeding. Neoadjuvant chemotherapy and preoperative embolization have been attempted, with encouraging results; however, the consensus on these procedures is lacking. (2) Methods: We present a case of a 10-month-old girl who underwent preoperative embolization of a hemorrhagic choroid plexus carcinoma of the lateral ventricle via the anterior choroidal artery, followed by total resection. (3) Results: The endovascular procedure was successfully completed, despite the rectification of the anterior choroidal artery associated with the absence of flow proximal to the plexal point. Minimal bleeding was observed during resection and the patient remained neurologically intact. (4) Conclusions: The time from entrance to exit in the anterior choroidal artery should be monitored and regarded as a potential ‘occlusion time’ in this specific group of patients. Nevertheless, our case supports the feasibility and effectiveness of preoperative embolization of a choroid plexus carcinoma of the lateral ventricle via the anterior choroidal artery, without complications. Furthermore, we suggest the use of a fast-embolic agent, such as N-butyl cyanoacrylate glue, as the preferred agent for this specific pathology and patient population.
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Zhou, Ying, and Er-Teng Jia. "Significance of choroidal thickness." International Eye Research 1, no. 4 (2020): 256–61. http://dx.doi.org/10.18240/ier.2020.04.10.
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This article summarized the choroidal thickness systematically and followed by relevant findings which describes the influencing factors of the choroidal thickness, the changes of the choroidal thickness in ophthalmic diseases and the relationship between the blood flow and the choroidal thickness detailedly. Choroidal thickness is affected by many factors, such as age, gender, intraocular pressure, refractive error, axial length, systolic blood pressure, daily rhythm, body position, smoking history, etc., and choroid is significantly correlated with many ophthalmic diseases. Choroidal thickness is of great importance in the diagnosis and treatment of ophthalmic diseases.
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Yu, D. Y., S. J. Cringle, V. A. Alder, E. N. Su, and P. K. Yu. "Intraretinal oxygen distribution and choroidal regulation in the avascular retina of guinea pigs." American Journal of Physiology-Heart and Circulatory Physiology 270, no. 3 (1996): H965—H973. http://dx.doi.org/10.1152/ajpheart.1996.270.3.h965.
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O2-sensitive microelectrodes were used to measure PO2 as a function of depth through the retina and choroid of anesthetized and artificially ventilated guinea pigs. The guinea pig retina is of particular interest, because it has a typically mammalian structure but no retinal circulation; it relies totally on choroidal delivery of O2 and other nutrients. Measurements of intraretinal O2 distribution in an avascular mammalian retina have not previously been reported. Under normal ventilation conditions, PO2 decreased monotonically from the choroid (33.6 +/- 2.9 mmHg, n = 11) to near zero (0.4 +/- 0.1 mmHg) at the retina-vitreous boundary. The inner half of the retina had an average PO2 of only 0.6 +/- 0.1 mmHg. Stepwise increases in inspired O2 (from 20 to 40 to 60 to 80 to 100%) had surprisingly little effect on choroidal PO2. Rapid changes (20-100%) produced overshoot-type responses in the choroid before recovery to levels only slightly above those found in normoxia. This indicates the presence of an active O2-regulatory mechanism in the guinea pig choroid. Addition of CO2 (5%) to O2 ventilation appeared to break down this control mechanism and led to dramatic and sustained increases in PO2 throughout the retina and choroid. The demonstration of an O2-regulating mechanism in the guinea pig choroid that maintains choroidal PO2 well below that in the systemic arterial blood, coupled with the observation of very low O2 levels throughout the inner retina, suggests that the O2 requirement of the inner retina in the guinea pig is small and that O2 levels in the choroid are deliberately constrained.
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Voigt, Andrew P., Kelly Mulfaul, Nathaniel K. Mullin, et al. "Single-cell transcriptomics of the human retinal pigment epithelium and choroid in health and macular degeneration." Proceedings of the National Academy of Sciences 116, no. 48 (2019): 24100–24107. http://dx.doi.org/10.1073/pnas.1914143116.
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The human retinal pigment epithelium (RPE) and choroid are complex tissues that provide crucial support to the retina. Disease affecting either of these supportive tissues can lead to irreversible blindness in the setting of age-related macular degeneration. In this study, single-cell RNA sequencing was performed on macular and peripheral regions of RPE-choroid from 7 human donor eyes in 2 independent experiments. In the first experiment, total RPE/choroid preparations were evaluated and expression profiles specific to RPE and major choroidal cell populations were identified. As choroidal endothelial cells represent a minority of the total RPE/choroidal cell population but are strongly implicated in age-related macular degeneration (AMD) pathogenesis, a second single-cell RNA-sequencing experiment was performed using endothelial cells enriched by magnetic separation. In this second study, we identified gene expression signatures along the choroidal vascular tree, classifying the transcriptome of human choriocapillaris, arterial, and venous endothelial cells. We found that the choriocapillaris highly and specifically expresses the regulator of cell cycle gene (RGCC), a gene that responds to complement activation and induces apoptosis in endothelial cells. In addition, RGCC was the most up-regulated choriocapillaris gene in a donor diagnosed with AMD. These results provide a characterization of the human RPE and choriocapillaris transcriptome, offering potential insight into the mechanisms of choriocapillaris response to complement injury and choroidal vascular disease in age-related macular degeneration.
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Pinheiro-Costa, João, João Viana Pinto, Sara Perestrelo, et al. "Increased Choroidal Thickness in Keratoconus Patients: Perspectives in the Disease Pathophysiology." Journal of Ophthalmology 2019 (December 3, 2019): 1–7. http://dx.doi.org/10.1155/2019/2453931.
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Purpose. To analyze and compare choroidal thickness between keratoconus (KC) patients and age-matched non-KC subjects. Methods. A cross-sectional, case-control study. One hundred and thirty-four keratoconic eyes and 78 control eyes, from individuals aged from 12 to 30 years old, were studied. Patients with KC followed in Corneal Department of Centro Hospitalar São João, Porto, Portugal, were identified and consecutively included between December 2017 and February 2018. A spectral-domain optical coherence tomography (OCT) using depth enhanced imaging was performed, and choroidal thickness in the center of the fovea and at 500 μm intervals along a horizontal section was measured and compared. Results. The statistical analysis showed that keratoconic eyes present a thicker choroid in every measured location (p<0.05). Mean subfoveal choroidal thickness (SFCT) values obtained were 375.86 ± 89.29 and 322.91 ± 85.14 in keratoconus and control groups, respectively (p<0.001). In a multivariate analysis, SFCT was significantly associated with spherical equivalent (p=0.004) and the presence of keratoconus (p<0.001), but not with age (p=0.167), gender (p=0.579), or best-corrected visual acuity (p=0.178). In a “fixed model,” keratoconus patients were found to have a 67.55 μm (95% CI 36.61–98.49) thicker subfoveal choroid compared to controls. Conclusion. Keratoconus patients seem to have a thicker choroid than healthy individuals. The exact pathophysiological mechanism resulting in a thicker choroid in KC patients is not known, but it could possibly be associated with inflammatory choroidal mechanisms.
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Platt, Sean, Diva R. Salomao, and Jose Pulido. "Histologic Findings of Choroidal Vasculopathy in Eyes Enucleated following Radiation Therapy for Uveal Melanoma: Radiation Choroidopathy." Klinische Monatsblätter für Augenheilkunde 238, no. 05 (2021): 584–90. http://dx.doi.org/10.1055/a-1275-0626.
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Abstract Introduction Little has been published about the choroidal vascular changes that occur years after radiation exposure. The aim of this study was to review the histological changes observed in the choroidal vasculature following radiotherapy for uveal melanoma. Methods Records from a single institution were retrospectively reviewed from June 7, 2007 to June 7, 2017; 101 patients with a diagnosis of uveal melanoma that underwent enucleation had their records reviewed. Out of these, a total of 26 eyes had undergone plaque brachytherapy prior to enucleation, which had been performed at a mean time of 7.2 years (range from 0 years to 30 years) after the initial plaque placement. A histopathologic analysis was conducted on all 26 eyes with special emphasis on the choroidal changes. Of these 26 eyes, 18 demonstrated evidence of radiation-induced vasculopathy. Results Of the 18 eyes, 10/18 (55%) had radiation retinopathy and 16/18 (89%) had radiation choroidal vasculopathy. One patient had a phthisical eye, and the choroid could not be evaluated because the characteristics of the vasculature could not be determined. Nine cases had vitreous hemorrhage (50%), all cases had radiation retinopathy, and 8/9 (89%) had radiation choroidopathy. Of the 16 cases with radiation choroidal vasculopathy, 3/16 (19%) had only intratumoral radiation choroidal vasculopathy, 3/16 (19%) had only extratumoral radiation choroidal vasculopathy, and, thus, 10/16 (32%) had both intratumoral and extratumoral radiation choroidal vasculopathy. In patients with radiation choroidal vasculopathy, 2/16 (13%) had hyalinization of the choroidal vessels. Another 3/16 (19%) cases with radiation choroidal vasculopathy had ectatic vessels. The other 11/16 (68%) had evidence of both hyalinization of the choroidal vessels as well as ectatic vessels in the choroid. Histological evidence of radiation retinopathy and choroidopathy were seen in 69% of eyes enucleated after receiving radiation therapy, which, in some cases, also had vitreous hemorrhage. Polypoidal choroidal vasculopathy, choroidal neovascularization, and retinal choroidal anastomoses (RAP-type lesions) were seen in 12 of the 16 eyes (75%). Discussion/Conclusion Irradiation of malignant tumors of the eye causes not only radiation retinopathy but also radiation choroidopathy. The role of radiation choroidopathy in the subsequent visual loss following radiotherapy and the role of anti-VEGF therapy needs to be recognized and distinguished from radiation retinopathy. Our data adds to the prior limited knowledge that radiation affects the choroid and can induce specific phenotypes similar to the clinical spectrum of CNV, PCV, and RAP.
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Odrobina, Dominik, Iwona Laudańska-Olszewska, Piotr Gozdek, Mariusz Maroszyński, and Michael Amon. "Influence of Scleral Buckling Surgery with Encircling Band on Subfoveal Choroidal Thickness in Long-Term Observations." BioMed Research International 2013 (2013): 1–4. http://dx.doi.org/10.1155/2013/586894.
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Purpose. The aim of this study is the presentation of subfoveal choroidal thickness with enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) several months after scleral buckling with encircling band surgery.Methods. 48 patients who underwent scleral buckling with encircling band surgery for unilateral rhegmatogenous retinal detachment were included in the retrospective observational study. The mean time from scleral buckling surgery to the final EDI-OCT examination was months. We compare choroidal thickness between operated and fellow eyes.Results. In all patients, the macula was detached before the surgery. The subfoveal choroidal thickness in 48 treated eyes was µm (range 155–383 µm) and in the fellow eyes was µm (range 98–326 µm). The subfoveal choroidal thickness of eyes after scleral buckling surgery in long-term EDI-OCT examination was significantly thicker () than in fellow eyes.Conclusions. The subfoveal choroid in eyes undergoing encircling band surgery was significantly thicker than in fellow eyes. We suspect that this may be the result of reduced choroidal blood flow. It also seems that the width and size of the material used in scleral buckling surgery may affect a change in the choroid circulation and increase subfoveal choroidal thickness.
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Braga, J., R. Rothwell, M. Oliveira, et al. "Choroid thickness profile in patients with lupus nephritis." Lupus 28, no. 4 (2019): 475–82. http://dx.doi.org/10.1177/0961203319828525.
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Background Choroidopathy is a rare manifestation of systemic lupus erythematosus (SLE). This entity is associated with active phases of severe SLE and it is frequently accompanied by acute kidney failure, central nervous system involvement and coagulopathy. Purpose To evaluate the choroid thickness of patients with lupus nephritis (LN) without choroidopathy, and to compare this with that of age-matched SLE patients without LN and healthy control subjects. Study design Cross-sectional case control study. Material and methods Fifteen women with LN in remission phase (study group), 15 women with SLE in remission without LN (SLE control group), and 15 healthy women (healthy control group), without ocular diseases or significant refractive error, were recruited. Full ophthalmological examination and a macular optical coherence tomography in enhanced depth imaging mode were performed. The choroid thickness was measured at nine macular points and six lines of mean choroidal thickness were determined. A comparative analysis between the three groups was performed using the one-way ANOVA test and the paired t-test. The choroid thickness of patients under corticotherapy was also compared to that of patients without corticotherapy. Additionally, the correlation between choroid thickness and disease duration was evaluated using the Pearson analysis. Results The mean macular choroidal thickness was 295.73 ± 67.62 μm in the study group, 233.34 ± 41.01 µm in the SLE control group, and 240.98 ± 37.93 μm in the control group ( p = 0.00006 and p = 0.0003, respectively). Additionally, the choroid thickness was significantly thicker than in the SLE and healthy control groups at the foveal ( p = 0.004 and p < 0.000), nasal ( p < 0.000 and p = 0.001), superior ( p = 0.002 and p < 0.000) and inferior ( p < 0.000 and p = 0.001) mean lines. The choroidal thickness in this group was not associated with the duration of the disease. The subgroup of patients with LN under corticotherapy did not reveal a significantly different choroidal thickness. Conclusion This study suggests a relationship between LN and choroidal changes, which may represent an increased risk for choroidopathy in these patients. Choroid thickening was not related with the duration of the disease. This thickening may be correlated with histopathological changes similar to those occurring in kidney glomeruli.