Posterior scleritis must be one of the most underdiagnosed treatable conditions in ophthalmology, partly because its manifestations are so protean and partly because the diagnosis is rarely considered. Although ultrasonography and computer tomogram are ancilliary tests, a careful examination of the posterior segment of the eye including the area of the ora serrata, macula and disc is essential to discover the presence of a posterior scleritis. We experienced prolonged retinal pigment epithelial detachments which had appered at early phase of posterior scleritis.
Bruch Membrane ; Diagnosis ; Ophthalmology ; Retinal Detachment* ; Retinaldehyde* ; Scleritis* ; Ultrasonography

PURPOSE: To evaluate the effect of intravitreal aflibercept according to subfoveal choroidal thickness in patients with polypoidal choroidal vasculopathy (PCV). METHODS: We retrospectively analyzed the medical records of 60 eyes from 60 patients with PCV treated with intravitreal aflibercept. The patients were followed for at least 6 months after the first injection. Using software, subfoveal choroidal thickness was manually measured as the distance from the hyper-reflective line of Bruch's membrane to the chorioscleral interface on optical coherence tomography. The patients were divided into three groups based on subfoveal choroidal thickness. Visual acuity, subfoveal choroidal thickness, central macular thickness and largest pigment epithelial detachment (PED) height, polyp regression rate, and dry macula rate were evaluated to analyze the anatomical and functional outcomes. RESULTS: Baseline mean subfoveal choroidal thickness were 178.50 ± 28.42 µm in the thin group (14 eyes, 23.3%), 287.03 ± 43.58 µm in the medium group (33 eyes, 55.0%), and 379.77 ± 17.09 µm in the thick group (13 eyes, 21.7%). Baseline age, sex, visual acuity, central macular thickness, and the largest PED height did not differ significantly among the three subgroups. Only the thin group showed significant improvement of visual acuity at 6 months (p = 0.005). Subfoveal choroidal thickness, central macular thickness, and largest PED height were significantly decreased after treatment in all subgroups and did not differ among the subgroups. Compared with the other groups, the thin subfoveal choroidal thickness group showed higher polyp regression rate at 3 months and higher dry macula rate at 6 months (p = 0.013 and p = 0.004, respectively). CONCLUSIONS: Intravitreal aflibercept injection was effective for the treatment of PCV, and thin subfoveal choroidal thickness was associated with better anatomical and functional outcomes.
Bruch Membrane ; Choroid* ; Humans ; Medical Records ; Polyps ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity

We studied clinical applicability of the contact transscleral retinopexy using the continuous-wave Nd:YAG (CW-YAG) laser. CW-YAG laser photocoagulation was done over sclera through contact probe in the pigmented rabbit eyes. Cryoretinopexy was also done and their morphologic findings were compared. Acute lesions produced with the laser photocoagulation were noted to have the characteristic white-colored distinct depigmentation. Its microscopic findings were oharacterized by choroidal necrosis, disruption of Bruch's membrane, dispersion of retinal pigment epithelial cells, and disorganization of sensory retina. Acute lesions after the cryoretinopexy were much more broader in its area and showed slight tanslucent retinal edema. Its microscopic findings showed relatively well-preserved choroid including Bruch's membrane. These data demonstrated that the contact transscleral CW-YAG laser retinopexy is capable of inducing more localized, stronger chorioretinal adhesion than the cryoretinopexy.
Bruch Membrane ; Choroid ; Diathermy ; Epithelial Cells ; Light Coagulation ; Necrosis ; Papilledema ; Retina ; Retinaldehyde ; Sclera

Laser photocoagulation was applied in vitro to organ culture exoplants of porcine retinal pigment epithelium(RPE) attached to Bruch's membrane, choroid, and sclera using the Del Priore method for de-monstrating the proliferation of RPE cells and characterizing the response with respect to power level of treatment. Six-millimetor-round buttons of eyewall were treated with 20-30 spots from the argon bluegreen laser using a 500 micrometer spot size, 0.1s duration, and variable powers(100mW, 300mW, and 500mW). Group 1 is untreated control group and group 2(100mW) and group 4(500mW) showed less active proliferation of RPE than group 3(300mW). In group 3, all RPE cells, Bruch's membrane, and a part of choroid were disrupted and lifted off three hours after laser photocoagulation and then RPE cells began to proliferate actively at third day. The treated area became completely covered with several layers of RPE cells. The proliferation of RPE cells turned out to be larger when the power was moderate(300mW) as compared to the case when the power was too high(500mW) or too low(100mW).
Argon ; Bruch Membrane ; Choroid ; Light Coagulation* ; Organ Culture Techniques* ; Retinal Pigment Epithelium* ; Retinaldehyde* ; Sclera

The use of photocoagulation to treat proliferative diabetic retinopathy has gained widespread acceptance in ophthalmic practice since its introduction in 1959 by Meyer-Schwickerath. The purpose of photocoagulation is thought to reduce the stimulus for the vessel formation so characteristic of proliferative retinopathy. Photocoagulation may cause damage to Bruch's membrane, retinal pigment epithelium, and neurosensory retina and may result in either subretinal neovascularization or choroidal neovascularization. We found choroidal neovasaularization after performing photocogulation(one case is Argon laser the other Xenon-arch) in two diabetic retinopathy patients.
Argon ; Bruch Membrane ; Choroid* ; Choroidal Neovascularization ; Diabetic Retinopathy ; Humans ; Light Coagulation* ; Retina ; Retinal Pigment Epithelium

The authors investigated the possibility of transplanting cultured retinal pigment epithelial (RPE) cells to impaired retina. The authors induced injury of the outer sensory retina and RPE cells with the intravenous injection of 2% sodium iodate in forty pigmented rabbits. Transplantation of RPE cells was done by internal approach with a 30 gauge blunt needle. The neural retina spontaneously reattached within 36 hours. Light microscopic autoradiography showed that some labeled cells were attached to Bruch's membrane as early as in 2 hours and still found in 4 weeks after transplantation. Regeneration of the photoreceptor outer segment and its connection with transplanted RPE cell was not found. Present study demonstrates that cultured rabbit RPE cells can be successfully transplanted to injured rabbit retina if Bruch's membrane is intact. Although the regeneration of the photoreceptor outer segment failed to be demonstrated, further studies are necessary to confirm or disprove these results.
Autoradiography ; Bruch Membrane ; Injections, Intravenous ; Needles ; Rabbits ; Regeneration ; Retina* ; Retinal Pigment Epithelium* ; Retinaldehyde* ; Sodium*

PURPOSE: To analyze the structural changes in the beta-zone of peripapillary atrophy (PPA-beta) using cross-sectional image of the optic disc head from spectral-domain optical coherence tomography (SD-OCT) according to the optic disc shape. METHODS: One hundred thirty-seven eyes in 137 patients with glaucoma having PPA-beta and 31 normal eyes (control group) were evaluated retrospectively. Cross-sectional images of the optic disc were taken using the Cirrus HD-OCT. We classified optic disc patterns into normal, focal, myopic, generalized enlargement and senile sclerotic appearance types and analyzed the shape of Bruch's membrane (BM), composition of retinal layer and retinal slope according to the optic disc shape. RESULTS: Among the 137 eyes with glaucoma, 54 eyes were focal disc type, 34 eyes were myopic disc type, 28 eyes were generalized enlargement disc type and 21 eyes were senile sclerotic disc type. The myopic disc group showed a noticeable difference compared to the other groups in terms of a higher percentage of BM defect type, the lowest retinal slope (70.6 +/- 12.0degrees) and the earlier termination of retinal layers. The generalized enlargement disc group showed the highest percentage of curved BM type. Retinal slope angle increased with age and decreased with axial length. CONCLUSIONS: In the beta-zone of peripapillary atrophy, there were several differences in the shape of Bruch's membrane, composition of retinal layers and the retinal slope according to the optic disc shape.
Atrophy* ; Bruch Membrane ; Glaucoma ; Head ; Humans ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence

Lacquer cracks represent the healed mechanical breaks of retinal pigment epithelium, Bruch's membrane, and choriocapillaris complex.The etiologic mechanism of new lacquer cracks in high myopia has not yet been elucidated. Recently, cases in which new lacquer cracks formed at the site of the previous subretinal bleeding have been reported and it has been postulated that the subretinal bleeding may be the precursor of lacquer cracks formation in high myopia.Herein, we present our patient who developed a new lacquer crack at the site of previous subretinal bleeding with a brief literatures review.
Bruch Membrane ; Fluorescein Angiography ; Hemorrhage* ; Humans ; Lacquer* ; Myopia ; Retinal Pigment Epithelium

Electron microscopic observation was carried out on the alterations of finer structures of retina following the daily intraperitoneal injections of BRC (benzenhexachloride) and combination of BRC with copper for 4 weeks and 6 weeks to the rabbit respectively. 1. In both groups, vesicle formation due to sporadic disintegration and elimination of axons in the nerve fiber layer appeared. 2. Formation of large vesicles was noticeable in the cytoplasm of retinal pigment epithelial cells in both 4 weeks and 6 weeks groups which was considered to be a relative enlargement of smooth surfaced endoplasmic reticulum (SER) by the increased enzymatic activities in response to the toxins. Focal thickening of Bruch's membrane in the group of 4 weeks and focal destruction of the Bruch's membrane in the group of 6 Weeks were observed. 3. Between the BRC inoculated group and ERC combined with copper inoculated group, no conspicuous difference in findings was recognized. More severe alterations of finer retinal structures in the 6 weeks group than in the 4 weeks group were demonstrated.
Axons ; Bruch Membrane ; Copper ; Cytoplasm ; Endoplasmic Reticulum ; Epithelial Cells ; Injections, Intraperitoneal ; Nerve Fibers ; Retina* ; Retinaldehyde

The choroidal vascular system in human eyes has been studied in flat preparation and fluorescein angiography to elucidate the choroidal circulation in normal and in disease state. The histopathologic studies were performed in view of vascular interconnection, regional differences, choriocapillaris pattern, and drusen and hole in Bruch's membrane. The interarterial and intervenous communications are demonstrated. The short posterior ciliary artery angulates around the disc margin and makes an anastomosis between surrounding short posterior ciliary artery. The segment of the choriocapillaris is supplied by a central terminal arterioles and drained by a venule at its margin. The thickened cuticular layer of Bruch's membrane may be associated with sclerosis of the choriocapillaris. Holes in the Bruch's membrane may contribute to invasion of the choroidal vessel into the subretinal space leading to subretinal neovascularization. Based on fluorescein angiography, a segmental supplies by short posterior ciliary artery, peripapillary choroidal arterial system, peripapillary choroidal filling pattern and vasculitis of the choroid have been worked out.
Arterioles ; Bruch Membrane ; Choroid* ; Ciliary Arteries ; Equipment and Supplies ; Fluorescein Angiography ; Humans ; Sclerosis ; Vasculitis ; Venules