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

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

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

The effect of the Nd:YAG laser on the rabbit retina was evaluated with fundus photography, light microscopy and transmission electron microscopy(TEM), and compared with the effect of the Argon laser. Fundus photography was performed at 2 days, 4 days, 7 days, 14 days, 29 days and 49 days after treatment. The enucleated retina was examined by light microscopy and TEM. In YAG treated eye, laser reaction was not found at 0.5mJ level but laser reaction(G2-3) was found at 1.5mJ level. Laser reaction(G3-4) with expulsive bleeding was found at 2.5 and 3.5mJ level. Bleeding was seemed to be originated from the choroidal layer. 2 days after treatment, hemorrhage was sustained but bleeding was not continued. 7 days after treatment, hemorrhage was completely absorbed. In Argon treated eye, photocoagulation burns was well formed without and bleeding. In pathologic examination of YAG treated eye, full thickness disruption of the retina amd Bruch's membrane and replacement of these layers with fibrous scar tissue were revealed at 2.5 and 3.5mJ level. In 1.5mJ energy level of the YAG laser and Argon laser irradiation, the outer half of the retina, RPE and Bruch's membrane appeared to be pridominantely affected than the inner half of the retina. The extent and character of his to pathology in Argon treated lesion was not so different from that of the YAG laser 1.5mJ lesion.
Argon ; Bruch Membrane ; Burns ; Choroid ; Cicatrix ; Hemorrhage ; Lasers, Solid-State ; Light Coagulation ; Microscopy ; Pathology ; Photography ; Retina*

Sub-retinal pigment epithelial hemorrhage, located between sub-retinal pigment epithelial space and Bruchs membrane, develops from various etiology and usually is associated with subretinal hemorrhage. When sub retinal pigment epithelial hemorrhage occurs with choroidal neovascularization(CNV) within macular area, it generally has a poor visual prognosis. We report the case of a 54-years old man who initially had large sub-retinal pigment epithelial hemorrhage with presumed CNV. Without treatmetn, visual improvement with spontaneous resolution of hemorrhage occured.
Bruch Membrane ; Choroid ; Choroidal Neovascularization ; Hemorrhage* ; Humans ; Middle Aged ; Prognosis ; Retinaldehyde

Changes in the thickness and composition of Bruch's membrane with aging have been described by several observers and related to the development of macular with advancing ageby region, comparing the macular area with more peripheral areas. In the younger (less than. 50 years) eyes we studied, the thickness of macular Bruch's membrane was about equal to that of peripheral Bruch's membrane. With aging, however, the thickness of Bruch's membrane was greater in the periphery than the macula. With increasing age, Bruch's membrane increased in basophilic reaction, PAS positivity and the detectable sialomucin fraction. In the macular region, but not in more peripheral regions, there is a preferential thickening of the interchoriocapillaris "teeth" of Bruch's degeneration by some. Using a combination of histochemical and electronmicroscopic techniques, we have examined the state of Bruch's membrane membrane material. By electronmicroscopy, in older eyes, the elastin layer of Bruch's membrane appears fragmented, while, in the periphery, it is continuous and resembles that of younger eyes. In summary, Bruch's membrane exhibits little regional difference in thickness in younger eyes, but the macular region becomes relatively thinner than more peripheral regions in older eyes. With advancing age, the deposition of extracellular matrix materials in appatite and fragmentation of the elastin layer is dramatically more prominent in the macular region than in the periphery. This regional variation may be related, at least in part, to some aspects of macular degeneration.
Aging ; Basophils ; Bruch Membrane* ; Elastin ; Extracellular Matrix ; Humans* ; Macular Degeneration ; Membranes ; Periodic Acid-Schiff Reaction ; Sialomucins

PURPOSE: To compare the cultured morphology of retinal pigment epithelium (RPE) cells which were transplanted onto the Bruch's membrane (BM) in different tissue types. METHODS: Cultured porcine RPE cells were harvested in three types of transplants: single cell (SC) suspension, cell cluster (CC) suspension and cell sheet (CS). After RPE cell transplants were plated onto the porcine BM explants at three different cell concentrations, they were dissected and examined with a transmission electron microscope and a scanning electron microscope at 1 day, 3 days, and 1, 2 and 4 weeks for morphological study. RESULTS: All types of RPE transplants were grown and proliferated well on BM and required a shorter time to reach confluence with higher cell concentration. Although CC transplants took a little longer to reach confluence on BM than SC transplants, they were nevertheless well grown on BM and showed good cellular morphology in monolayer. The time to confluence was much longer for the CS transplants than for the SC and CC transplants and the proliferated cells tended to be large, flat and to have scanty microvilli on the cell surface with reaching peripheral portion of confluent cell layers. CONCLUSIONS: CC suspension may be a better candidate for RPE transplantation in the case of using cultured RPE cells as transplant.
Bruch Membrane* ; Epithelial Cells* ; Microvilli ; Retinal Pigment Epithelium ; Retinaldehyde* ; Transplantation ; Transplants

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

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

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