The choroid is a thin layer of highly vascular uveal tissue enclosed externally by sclera and internally by neurosensory retinal tissue. The choroid is a "middle layer" ocular tissue with anatomically challenging surgical access. The primary functional role of the choroid is to provide rapid, oxygenated, and nutrient-rich blood flow to both the highly metabolic retinal pigment epithelium and outer retina (i.e. photoreceptors) while simultaneously removing waste products. Historically, incisional choroidal surgery (ICS) has involved tumor biopsy or excision, removal of choroidal neovascular complex or autologous choroidal translocations; however, ICS also holds unique potential for novel and innovative approaches to address macular pathology. Using large-animal surgical studies, researchers have explored ICS with the objective of finding safer and more effective techniques to reduce surgical risks such as bleeding, tissue contraction, and scar tissue formation. We explore the relevant anatomy and embryology, existing surgical techniques, discuss the implications for retinal drug delivery, define ICS guiding principles, and offer a rationale for implementation of ICS into a vitreoretinal surgical practice. We also identify other future challenges and anticipate future innovations that will advance ICS.
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Incisional choroidal surgery.
Surv Ophthalmol
August 2024
Chair Emeritus, Emory University, Atlanta, GA, Professor & Consultant, Mayo Clinic, Rochester, MN (2017-23), EyeMacular Regeneration, Inc., Rochester, MN, iMacular Regeneration, LLC, Rochester, MN; Mayo Clinic, Rochester Minnesota. Electronic address:
The choroid is a thin layer of highly vascular uveal tissue enclosed externally by sclera and internally by neurosensory retinal tissue. The choroid is a "middle layer" ocular tissue with anatomically challenging surgical access. The primary functional role of the choroid is to provide rapid, oxygenated, and nutrient-rich blood flow to both the highly metabolic retinal pigment epithelium and outer retina (i.
View Article and Find Full Text PDFPREVALENCE, CHARACTERISTICS, AND OUTCOMES OF RHEGMATOGENOUS RETINAL DETACHMENT IN EYES WITH TRABECULECTOMY OR GLAUCOMA DRAINAGE DEVICES.
Retina
November 2022
Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania; and.
Purpose: To describe the prevalence, management, and outcomes of rhegmatogenous retinal detachment (RRD) after incisional glaucoma filtering surgery.
Methods: All patients with a history of trabeculectomy or glaucoma drainage device surgery who were subsequently diagnosed with an RRD from January 1, 2016, to January 1, 2021, at the Wills Eye Hospital were identified.
Results: Forty-six eyes met the inclusion criteria.
[Congenital penile curvature: Guidelines from the Andrology and Sexual Medicine Committee of the French Association of Urology (CAMS-AFU)].
Prog Urol
September 2022
Département d'urologie, transplantation rénale et andrologie, CHU de Toulouse, site de Rangueil, Toulouse, France.
Introduction: Guidelines regarding congenital penile curvature (CPC) are lacking, and this pathology has not been the subject of French recommendations to date. The Andrology and Sexual Medicine Committee (CAMS) of the French Association of Urology (AFU) propose a series of clinical practice recommendations (CPR) by answering five clinical questions concerning the diagnosis and treatment of this pathology.
Materials And Methods: After a bibliographic research between 2000 and 2021, followed by a critical reading according to the CRP method.
Management of primary choroidal lymphoma presenting as extensive serous retinal detachment and salmon patch of bulbar conjunctiva: a case report.
J Med Case Rep
April 2022
Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Background: We describe the outcome of ultra-low-dose radiotherapy plus intravitreal methotrexate and rituximab injections for a patient with primary choroidal lymphoma who presented with nodular conjunctival salmon patches and extensive serous retinal detachment.
Case Presentation: A 34-year-old Iranian man presented with a nodular patch of bulbar conjunctiva in the right eye, and 1+ vitritis. A nearly complete shallow serous retinal detachment, retinal folds, and multifocal yellow choroidal infiltrates were seen during a fundus examination of the right eye.
Iris melanoma with ciliary body infiltration presenting as a presumed chronic unilateral inflammatory glaucoma. The challenges of iris tumor biopsy assessment.
Pol J Pathol
January 2022
Department of Ophthalmology, Poznan University of Medical Sciences, Poznan, Poland.
Article Synopsis
- Uveal melanoma is the most common eye cancer in adults, often affecting the choroid and ciliary body, with rare instances (2-3%) involving the iris.
- A 56-year-old patient presented with ongoing inflammatory glaucoma in one eye for 6 years, leading to suspicion of iris melanoma due to changes in iris color and thickness.
- Despite an inconclusive biopsy, the condition worsened, resulting in the removal of the eye, which revealed a diagnosis of iridociliary melanoma with a specific growth pattern upon further examination.
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