49
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Pachychoroid disease

      review-article

      Read this article at

      ScienceOpenPublisherPMC
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Pachychoroid is a relatively novel concept describing a phenotype characterized by attenuation of the choriocapillaris overlying dilated choroidal veins, and associated with progressive retinal pigment epithelium dysfunction and neovascularization. The emphasis in defining pachychoroid-related disorders has shifted away from simply an abnormally thick choroid (pachychoroid) toward a detailed morphological definition of a pathologic state (pachychoroid disease) with functional implications, which will be discussed in this review. Several clinical manifestations have been described to reside within the pachychoroid disease spectrum, including central serous chorioretinopathy, pachychoroid pigment epitheliopathy, pachychoroid neovasculopathy, polypoidal choroidal vasculopathy/aneurysmal type 1 neovascularization, focal choroidal excavation, peripapillary pachychoroid syndrome. These conditions all exhibit the characteristic choroidal alterations and are believed to represent different manifestations of a common pathogenic process. This review is based on both the current literature and the clinical experience of our individual authors, with an emphasis on the clinical and imaging features, management considerations, as well as current understanding of pathogenesis of these disorders within the context of the recent findings related to pachychoroid disease.

          摘要

          肥厚型脉络膜疾病是近年来提出的新概念, 其描述了一类特征为脉络膜毛细血管层的静脉扩张, 并且与进行性视网膜色素上皮功能障碍和新生血管的形成有关的一类疾病。定义肥厚型脉络膜相关疾病的重点已经从简单的脉络膜厚度异常 (脉络膜肥厚) 转向影响功能的病理状态 (“肥厚型脉络膜疾病”) 的详细形态学定义, 这将在本综述中详细讨论。属于肥厚型脉络膜疾病谱的疾病, 包括中心性浆液性脉络膜视网膜病变, 肥厚型脉络膜色素上皮病变, 肥厚型脉络膜新生血管病变, 息肉状脉络膜血管病变/1型动脉瘤新生血管, 局灶性脉络膜凹陷, 视盘周围毛细脉络膜肥厚综合症。这些病症都表现出特征性的脉络膜改变, 并且被认为代表了常见致病过程的不同临床表现。 本综述基于目前已发表的文献和作者自身的临床经验以及最近在肥厚型脉络疾病的相关研究结果, 重点强调了临床表现、影像学特征、治疗要点以及目前对这些疾病发病机制的探讨。

          Related collections

          Most cited references106

          • Record: found
          • Abstract: found
          • Article: not found

          A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes.

          To measure macular choroidal thickness in normal eyes at different points using enhanced depth imaging (EDI) optical coherence tomography (OCT) and to evaluate the association of choroidal thickness and age. Retrospective, observational case series. EDI OCT images were obtained in patients without significant retinal or choroidal pathologic features. The images were obtained by positioning a spectral-domain OCT device close enough to the eye to acquire an inverted image. Seven sections were obtained within a 5 x 30-degree area centered at the fovea, with 100 scans averaged for each section. The choroid was measured from the outer border of the retinal pigment epithelium to the inner scleral border at 500-microm intervals of a horizontal section from 3 mm temporal to the fovea to 3 mm nasal to the fovea. Statistical analysis was performed to evaluate variations of choroidal thickness at each location and to correlate choroidal thickness and patient age. The mean age of the 30 patients (54 eyes) was 50.4 years (range, 19 to 85 years), and 14 patients (46.7%) were female. The choroid was thickest underneath the fovea (mean, 287 microm; standard deviation, +/- 76 microm). Choroidal thickness decreased rapidly in the nasal direction and averaged 145 microm (+/- 57 microm) at 3 mm nasal to the fovea. Increasing age was correlated significantly with decreasing choroidal thickness at all points measured. Regression analysis suggested that the subfoveal choroidal thickness decreased by 15.6 microm for each decade of life. Choroidal thickness seems to vary topographically within the posterior pole. The thickness of the choroid showed a negative correlation with age. The decrease in the thickness of the choroid may play a role in the pathophysiologic features of various age-related ocular conditions.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Central serous chorioretinopathy: Recent findings and new physiopathology hypothesis.

            Central serous chorioretinopathy (CSCR) is a major cause of vision threat among middle-aged male individuals. Multimodal imaging led to the description of a wide range of CSCR manifestations, and highlighted the contribution of the choroid and pigment epithelium in CSCR pathogenesis. However, the exact molecular mechanisms of CSCR have remained uncertain. The aim of this review is to recapitulate the clinical understanding of CSCR, with an emphasis on the most recent findings on epidemiology, risk factors, clinical and imaging diagnosis, and treatments options. It also gives an overview of the novel mineralocorticoid pathway hypothesis, from animal data to clinical evidences of the biological efficacy of oral mineralocorticoid antagonists in acute and chronic CSCR patients. In rodents, activation of the mineralocorticoid pathway in ocular cells either by intravitreous injection of its specific ligand, aldosterone, or by over-expression of the receptor specifically in the vascular endothelium, induced ocular phenotypes carrying many features of acute CSCR. Molecular mechanisms include expression of the calcium-dependent potassium channel (KCa2.3) in the endothelium of choroidal vessels, inducing subsequent vasodilation. Inappropriate or over-activation of the mineralocorticoid receptor in ocular cells and other tissues (such as brain, vessels) could link CSCR with the known co-morbidities observed in CSCR patients, including hypertension, coronary disease and psychological stress.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy.

              The purpose of the study was to evaluate the choroidal thickness in patients with central serous chorioretinopathy, a disease attributed to increased choroidal vascular hyperpermeability. Patients with central serous chorioretinopathy underwent enhanced depth imaging spectral-domain optical coherence tomography, which was obtained by positioning a spectral-domain optical coherence tomography device close enough to the eye to acquire an inverted image. Seven sections, each comprising 100 averaged scans, were obtained within a 5 degrees x 30 degrees rectangle to encompass the macula. The subfoveal choroidal thickness was measured from the outer border of the retinal pigment epithelium to the inner scleral border. The mean age of subjects undergoing enhanced depth imaging spectral-domain optical coherence tomography was 59.3 years (standard deviation, 15.8 years). Seventeen of 19 patients (89.5%) were men, and 12 (63.2%) patients had bilateral clinical disease. The choroidal thickness measured in 28 eligible eyes of the 19 patients was 505 microm (standard deviation, 124 microm), which was significantly greater than the choroidal thickness in normal eyes (P < or = 0.001). Enhanced depth imaging spectral-domain optical coherence tomography demonstrated a very thick choroid in patients with central serous chorioretinopathy. This finding provides additional evidence that central serous chorioretinopathy may be caused by increased hydrostatic pressure in the choroid.
                Bookmark

                Author and article information

                Contributors
                gemmy.cheung.c.m@snec.com.sg
                Journal
                Eye (Lond)
                Eye (Lond)
                Eye
                Nature Publishing Group UK (London )
                0950-222X
                1476-5454
                11 July 2018
                January 2019
                : 33
                : 1
                : 14-33
                Affiliations
                [1 ] ISNI 0000 0000 9960 1711, GRID grid.419272.b, Singapore National Eye Center, ; Singapore, Singapore
                [2 ] ISNI 0000 0001 0706 4670, GRID grid.272555.2, Singapore Eye Research Institute, ; Singapore, Singapore
                [3 ] ISNI 0000 0004 0385 0924, GRID grid.428397.3, Duke-NUS Medical School, ; Singapore, Singapore
                [4 ] ISNI 0000 0004 0470 4224, GRID grid.411947.e, Department of Ophthalmology, Seoul St. Mary’s Hospital, College of Medicine, , The Catholic University of Korea, ; Seoul, South Korea
                [5 ] ISNI 0000 0001 0685 5104, GRID grid.267625.2, Department of Ophthalmology, Graduate School of Medicine, , University of the Ryukyus, ; Nishihara, Japan
                [6 ] ISNI 0000 0001 0650 7433, GRID grid.412689.0, Department of Ophthalmology, , University of Pittsburgh Medical Center, ; Pittsburgh, PA USA
                [7 ] ISNI 0000 0004 1937 0482, GRID grid.10784.3a, Department of Ophthalmology and Visual Sciences, , The Chinese University of Hong Kong, ; Shatin, Hong Kong
                [8 ] GRID grid.497655.c, Vitreous Retina Macula Consultants of New York, ; New York, NY USA
                [9 ]The LuEsther T. Mertz Retinal Research Center, New York, NY USA
                [10 ] ISNI 0000 0004 1936 8753, GRID grid.137628.9, Department of Ophthalmology, , New York University School of Medicine, ; New York, NY USA
                Author information
                http://orcid.org/0000-0003-3358-3516
                http://orcid.org/0000-0002-7430-8601
                Article
                PMC6328576 PMC6328576 6328576 158
                10.1038/s41433-018-0158-4
                6328576
                29995841
                05e83111-cdfe-46b1-b6c7-db669428d6e0
                © The Royal College of Ophthalmologists 2018
                History
                : 29 March 2018
                : 24 April 2018
                : 14 May 2018
                Categories
                Review Article
                Custom metadata
                © The Royal College of Ophthalmologists 2019

                Outcomes research,Macular degeneration
                Outcomes research, Macular degeneration

                Comments

                Comment on this article

                scite_
                0
                0
                0
                0
                Smart Citations
                0
                0
                0
                0
                Citing PublicationsSupportingMentioningContrasting
                View Citations

                See how this article has been cited at scite.ai

                scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.

                Similar content636

                Cited by215

                Most referenced authors1,139