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

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

Folding of the choroid, Bruchs membrane, and the overlying retina may occur in a variety of ocular and orbital diseases and after certain surgical procedures. A 34-year-old man experienced the decreased visual acuity and the protrusion and displacement in the right eye for at least 4 years. The protrusion of the patient was 13mm in the right eye and 6mm in the left eye with the aid of Hertels exophthalmometer. The right eye appeared downward deviation about 15 prism. The tumor located outside the muscle cone in the computed tomography and ultrasonography seemed to make the large choroidal folds involving the macula region. The retinal pigment epithelial atrophy was noted along long-standing choroidal folds. The tumor was removed by the lateral orbitotomy. The size of tumor was 20 x 15x 10mm. The postoperative protrusion was 6mm in the both eye. After removal of tumor, changes in the corneal refraction, visual acuity, and choroidal folds with the retinal pigment epithelial atrophy did not occur in comparison with the preoperative state.
Adult ; Atrophy ; Bruch Membrane ; Choroid* ; Humans ; Orbit* ; Orbital Diseases ; Retina ; Retinaldehyde ; Ultrasonography ; Visual Acuity

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

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

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