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Multimodal imaging from a patient with chorioretinal folds secondary to idiopathic intracranial hypertension. MultiColor fundus images (left) of the right (above) and left (below) eyes demonstrate undulations of the retinal pigment epithelium (RPE) within the macula and around the optic nerve. Blue-fundus autofluorescence (BAF) images (middle) show CRFs as alternating hypoautofluorescent and hyperautofluorescent bands. Structural optical coherence tomography (OCT) images (right) confirm undulations of retina, RPE and choroid that are easier to detect in the perpendicular scans.
Source publication
Chorioretinal folds (CRFs) are undulations of the choroid and overlying Bruch's membrane, retinal pigment epithelium and neurosensory retina. CRFs represent a clinical sign that is mandatory to investigate assuming their association with several ocular and extra-ocular disorders. Recent advances in retinal imaging have improved the characterization...
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Citations
... Chorioretinal folds have been associated with scleral diseases, particularly posterior scleritis (Giuffrè & Distefano, 2007), an inflammation of the sclera that is associated with systemic inflammatory conditions as well as infectious disease (Grosso et al., 2020). It has been proposed that chorioretinal folds can occur because of a buckling force that affects the choroid when the sclera thickens or shrinks (Grosso et al., 2020). ...
... Chorioretinal folds have been associated with scleral diseases, particularly posterior scleritis (Giuffrè & Distefano, 2007), an inflammation of the sclera that is associated with systemic inflammatory conditions as well as infectious disease (Grosso et al., 2020). It has been proposed that chorioretinal folds can occur because of a buckling force that affects the choroid when the sclera thickens or shrinks (Grosso et al., 2020). While chorioretinal folds have been described to also potentially occur in a concentric manner in human ocular diseases, we observed the fundus rings in normal healthy spotted wolffish, which argues that they are not related to chorioretinal disease or abnormalities in the sclera. ...
A better understanding of unique anatomical and functional features of the visual systems of teleost fish could provide key knowledge on how these systems influence the health and survival of these animals in both wild and culture environments. We took a systematic approach to assess some of the visual systems of spotted wolffish ( Anarhichas minor ), a species of increasing importance in North Atlantic aquaculture initiatives. The lumpfish ( Cyclopterus lumpus ) was included in these studies in a comparative manner to provide reference. Histology, light and electron microscopy were used to study the spatial distribution and occurrence of cone photoreceptor cells and the nature of the retinal tissues, while immunohistochemistry was used to explore the expression patterns of two photoreceptor markers, XAP‐1 and XAP‐2, in both species. A marine bacterial infection paradigm in lumpfish was used to assess how host–pathogen responses might impact the expression of these photoreceptor markers in these animals. We define a basic photoreceptor mosaic and present an ultrastructural to macroscopic geographical configuration of the retinal pigment tissues in both animals. Photoreceptor markers XAP‐1 and XAP‐2 have novel distribution patterns in spotted wolffish and lumpfish retinas, and exogenous pathogenic influences can affect the normal expression pattern of XAP‐1 in lumpfish. Live tank‐side ophthalmoscopy and spectral domain optical coherence tomography (SD‐OCT) revealed that normal cultured spotted wolffish display novel variations in the shape of the retinal tissue. These two complementary imaging findings suggest that spotted wolffish harbour unique ocular features not yet described in marine teleosts and that visual function might involve specific retinal tissue shape dynamics in these animals. Finally, extensive endogenous biofluorescence is present in the retinal tissues of both animals, which raises questions about how these animals might use retinal tissue in novel ways for visual perception and/or communication. This work advances fundamental knowledge on the visual systems of two economically important but now threatened North Atlantic teleosts and provides a basic foundation for further research on the visual systems of these animals in health versus disease settings. This work could also be useful for understanding and optimizing the health and welfare of lumpfish and spotted wolffish in aquaculture towards a one health or integrative perspective.
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Purpose:
syndrome of acquired hyperopia with choroidal folds is a rare syndrome characterized by flattening of the posterior pole with subsequent hyperopization of the eye and a creation of a space between the optic nerve and its sheath. Though uncommon and more often benign, it represents a diagnostic and therapeutic challenge. Correct diagnosis is helpful to exclude other possible causes of choroidal folds.
Observations:
here we report a case of a 39-year-old woman who presented with sudden monolateral hyperopia and choroidal folds in the affected eye.
Conclusions and importance:
we performed a specific assessment of the thickness of choroid with the purpose to give further information for the understanding of the underlying condition. To date, the aspect and the thickness of the choroid in this condition, has not been evaluated yet.
... Recent developments have improved the characterization of CFs in retinal imaging. The development of choroidal neovascularization is just one of the visual complications that can result from chronic CFs that may be picked up by retinal imaging [25]. ...
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... Recently, OCTA imaging demonstrated linear signal decreases in the choriocapillaris perfusion that are topographically associated with the choroidal folds. Based on these results, it was hypothesized that choroidal swelling may cause a stretching of the choriocapillaris and a consequent reduction in perfusion [117]. ...
Introduction
: Scleritis is a severe, vision-threatening ocular inflammation often associated with systemic diseases that carry high risks of morbidity. Timely diagnosis and management are crucial to prevent sequela.
Areas Covered
: This review encompasses the etiology, pathophysiology, classification, diagnosis, and treatment of scleritis with an emphasis on novel diagnostic and treatment modalities. A review of the literature was performed using the key words ‘scleritis’, ‘autoimmune diseases’, ‘non-steroidal anti-inflammatory drugs’, ‘antimetabolite’, ‘immunomodulatory therapy’, ‘tumor necrosis factor alpha inhibitors’, biologic response modifier’ and ‘optical coherence tomography’.
Expert Opinion
: Scleritis is mainly a clinical diagnosis. Nevertheless, multimodal imaging may be used in diagnostically challenging cases. New approaches such as anterior segment optical coherence tomography (OCT), OCT angiography (OCTA), and ultrasound biomicroscopy (UBM) may serve as more objective measures to diagnose and monitor scleritis patients. The etiology, severity, anatomical location, and associated systemic inflammatory diseases should be considered when determining scleritis treatment. Currently, first line treatment in low grade non-necrotizing anterior scleritis is usually non-steroidal anti-inflammatory drugs (NSAIDs) and/or topical/systemic corticosteroids. In non-responsive cases, systemic immunomodulatory therapy (IMT) is recommended. Novel treatment with biologic response modifiers (BRMs) is promising in refractory scleritis. Further studies are needed to evaluate efficiency and safety of BRMs.
... Während direkte Fisteln häufig posttraumatisch, iatrogen oder nach Ruptur eines Aneurysmas entstehen [3,4], ist die genaue Ätiologie der indirekten Fisteln ungeklärt. Diskutiert wird ein spontanes Auftreten im Bereich von postthrombotischen oder postinfektiösen Umgehungskreisläufen im venösen Abflussweg [5] [6,9] [11]. ...
Zusammenfassung
Hintergrund
Die Symptomatik und klinischen Befunde bei Patienten mit Carotis-Sinus-cavernosus-Fisteln sind spezifisch, können aber sehr mild ausgeprägt sein. Wir wollen das diagnostische Potenzial der Echographie der Orbita näher beleuchten.
Methoden
In die retrospektive Studie wurden 25 Patienten mit angiographisch gesicherten Fisteln eingeschlossen. Symptome, klinische Untersuchungsergebnisse und die Darstellbarkeit der V. ophthalmica superior in der orbitalen Echographie wurden gegenübergestellt.
Ergebnisse
Die häufigsten Befunde waren Hirnnervenparesen, episklerale Venenstauung oder Exophthalmus. Wurde eine orbitale Ultraschalluntersuchung durchgeführt, konnte eine erweiterte V. ophthalmica superior zu 100 % nachgewiesen werden.
Schlussfolgerung
Die schnell durchführbare Ultraschalluntersuchung liefert wertvolle Informationen zur Differenzialdiagnose eines therapieresistenten roten Auges. In Kombination mit den 3 Kardinalsymptomen episklerale Venenstauung, Exophthalmus und Hirnnervenparese lässt sich die Diagnose einer Carotis-Sinus-cavernosus-Fistel durch die Echographie untermauern. Die weiterführende Bildgebung kann schließlich zielgerichtet veranlasst werden.
Importance:
The primary contributing factor for development of chorioretinal folds during spaceflight is unknown. Characterizing fold types that develop and tracking their progression may provide insight into the pathophysiology of spaceflight-associated neuro-ocular syndrome and elucidate the risk of fold progression for future exploration-class missions exceeding 12 months in duration.
Objective:
To determine the incidence and presentation of chorioretinal folds in long-duration International Space Station crew members and objectively quantify the progression of choroidal folds during spaceflight.
Design, setting, and participants:
In this retrospective cohort study, optical coherence tomography scans of the optic nerve head and macula of crew members completing long-duration spaceflight missions were obtained on Earth prior to spaceflight and during flight. A panel of experts examined the scans for the qualitative presence of chorioretinal folds. Peripapillary total retinal thickness was calculated to identify eyes with optic disc edema, and choroidal folds were quantified based on surface roughness within macular and peripapillary regions of interest.
Interventions or exposures:
Spaceflight missions ranging 6 to 12 months.
Main outcomes and measures:
Incidence of peripapillary wrinkles, retinal folds, and choroidal folds; peripapillary total retinal thickness; and Bruch membrane surface roughness.
Results:
A total of 36 crew members were analyzed (mean [SD] age, 46 [6] years; 7 [19%] female). Chorioretinal folds were observed in 12 of 72 eyes (17%; 6 crew members). In eyes with early signs of disc edema, 10 of 42 (24%) had choroidal folds, 4 of 42 (10%) had inner retinal folds, and 2 of 42 (5%) had peripapillary wrinkles. Choroidal folds were observed in all eyes with retinal folds and peripapillary wrinkles. Macular choroidal folds developed in 7 of 12 eyes (4 of 6 crew members) with folds and progressed with mission duration; these folds extended into the fovea in 6 eyes. Circumpapillary choroidal folds developed predominantly superior, nasal, and inferior to the optic nerve head and increased in prevalence and severity with mission duration.
Conclusions and relevance:
Choroidal folds were the most common fold type to develop during spaceflight; this differs from reports in idiopathic intracranial hypertension, suggesting differences in the mechanisms underlying fold formation. Quantitative measures demonstrate the development and progression of choroidal folds during weightlessness, and these metrics may help to assess the efficacy of spaceflight-associated neuro-ocular syndrome countermeasures.
During long-duration spaceflight, astronauts are exposed to various risks including spaceflight-associated neuro-ocular syndrome, which serves as a risk to astronaut vision and a potential physiological barrier to future spaceflight. When considering exploration missions that may expose astronauts to longer periods of microgravity, radiation exposure, and natural aging processes during spaceflight, more severe changes to functional vision may occur. The macula plays a critical role in central vision and disruptions to this key area in the eye may compromise functional vision and mission performance. In this article, we describe the development of a countermeasure technique to digitally suppress monocular central visual distortion with head-mounted display technology. We report early validation studies with this noninvasive countermeasure in individuals with simulated metamorphopsia. When worn by these individuals, this emerging wearable countermeasure technology has demonstrated a suppression of monocular visual distortion. We describe the considerations and further directions of this head-mounted technology for both astronauts and aging individuals on Earth.
Purpose
To evaluate macular and radial peripapillary capillary (RPC) microvascular densities and the thickness of the retinal nerve fiber layer (RNFL) in thyroid-associated ophthalmopathy (TAO) with chorioretinal folds (CRFs) and the associations of these characteristics with visual function.
Method
A cross-sectional study was performed at the Ophthalmology Department of the Sun Yat-sen Memorial Hospital from March 2018 to August 2021. All patients underwent ocular examination, ophthalmic function tests and optical coherence tomography angiography (OCTA). The microvascular densities in the macula and optic papilla in the TAO with CRFs or without CRFs. Correlation analyses were used to examine the association of microvascular density and visual function.
Results
Ten TAO patients with CRFs (CRF group, 20 eyes) and 10 TAO patients without CRFs (NCRF group, 20 eyes) were recruited for the study. Visual function measurements, including best-corrected visual acuity (BCVA), were found to be worse in the CRF group(all p<0.05). The macular whole-image vessel density in the superficial layer (SLR-mwiVD) was significantly decreased in the CRF group(p<0.05). The RPC whole-image vessel density (RPC-wiVD) was significantly decreased in the CRF group(p<0.05), particularly in the temporal subfields. The P100 amplitude of visual evoked potentials (VEPs) was positively associated with SLR-mwiVD and RPC-wiVD. The thickness of RNFL in the CRF group was obviously thicker than that in the NCRF group(p<0.05).
Conclusions
Our study showed decreased microvascular density of the macula and RPC and thicker RNFL in TAO patients with CRFs. CRFs with decreased microvascular density should be regard as an indicator of visually threatening conditions.
