DOCSLIB.ORG

UVEAL MELANOMA? 5-6 Adults Per Million Are If UM Is Suspected, Patients Should Uveal Melanoma (UM) Is a Cancer That Arises in the Uvea

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
UVEAL MELANOMA? 5-6 Adults Per Million Are If UM Is Suspected, Patients Should Uveal Melanoma (UM) Is a Cancer That Arises in the Uvea WHAT IS UM IN NUMBERS DIAGNOSIS UVEAL MELANOMA? 5-6 adults per million are If UM is suspected, patients should Uveal Melanoma (UM) is a cancer that arises in the uvea. diagnosed with UM each year. be referred to an eye cancer specialist, The uvea is a pigmented layer of the eye which includes known as “ocular oncologist”. the choroid, the ciliary body and the iris. UM is often also called ocular melanoma. However, this term includes the even rarer conjunctival melanoma, which is biologically similar to It is important to have skin melanomas and behaves very differently from UM. regular eye exams. Most people show no symptoms at all, CHOROID UM can affect anyone. and detection happens only on routine eye examination, using eye drops to But it is more common in people: UVEA CILIARY BODY dilate the pupil. Diagnosis is confirmed • between 50 and 70 years old with tests, such as ultrasounds, IRIS • that are white, slightly more in men angiograms and biopsies. • with blue or green eyes Disease outside the eye region develops LENS • with moles inside the eye almost exclusively in patients whose CORNEA (uveal nevi, congenital ocular tumour in the eye shows specific melanosis or melanocytoma) melanoma changes in genetic material (loss of a SCLERA OPTIC NERVE • in rare cases, UM is associated with of the iris chromosome 3, and other factors). RETINA the BAP1 predisposition syndrome, CONJUNCTIVA melanoma melanoma where familiar transmission can occur of the ciliary body of the choroid Ask your ocular oncologist how Possible signs and symptoms: a biopsy may influence your Choroid: blood filled layer of pigmented tissue under the retina. • seeing flashes of light care – both from a treatment Ciliary Body: muscular ring, which adjusts the focus of the lens • blurred or distorted vision and follow-up perspective. and pumps fluid into the eye to maintain the shape of the eyeball. • changes in the appearance of the eye Iris: controls the amount of light that enters the eye. • irritation and pain (rare) Lens: focuses light behind the iris onto the retina. TREATMENT OF THE Cornea: transparent “window” at the front of the eye. CANCER IN THE EYE Sclera: leathery white “bag” which holds the eye together. Treatment choice is based on: Retina: light-sensitive “film” at the back of the eye, which provides sight. Up to 50% of • how much the patient’s sight is affected Conjunctiva: transparent “skin” covering the eye and lining UM can grow and UM patients develop • size and location of the tumour the inside of the eyelids. spread to distant organs metastases from • pathology reports Optic Nerve: transmits visual information from the retina to the brain. to form new tumours the time of initial • general health of the patient called metastases. The liver diagnosis to several is a common place but the decades later. lungs, bone, skin and more rarely the brain can also There may be different be involved. treatment choices, typically: If the tumour is small and It is important to discuss a not involving the optic nerve: If the tumour is large: surveillance strategy, namely liver • radiotherapy • enucleation (eye removal) (brachytherapy or proton beam therapy) scans, with your ophthalmologist • rarely, exenteration • local resection (eye and adjacent tissue removal) Deutsch English Español Français Italiano Nederlands Polski Português and/or oncologist to watch for • more rarely, laser treatment Stay up to date and find out more @ umcure2020.org potential metastases. (photodynamic therapy or others) SURVEILLANCE MANAGING GET METASTATIC DISEASE INVOLVED Unfortunately, UM metastases umcure2020.org Patients should discuss with their rarely respond to treatment. specialist what tests would be best for Clinical trials may offer the best Patients can contribute significantly to the them to detect any metastases in other possibility for disease management. understanding of uveal melanoma and the parts of the body, how frequently these should be done and for how long. development of appropriate research models to find new therapies. This surveillance protocol should be adjusted If metastases are suspected, according to the risk of metastatic disease, which a multidisciplinary approach in may be estimated by considering clinical findings as a reference centre specialised HOW? well as pathology and genetic results. in uveal melanoma • By donating part of their biopsy or surgical samples For checking the liver, MRI (Magnetic Resonance to reference centres’ biobanks. Research using these Imaging) is currently thought to be the optimal should be sought. samples can lead to new clinical trials dedicated to choice in many countries. Depending on the features and location of metastatic UM patients. metastases, the patient may be a candidate for targeted therapy, surgery, immunotherapy, • By working with patient organisations, such as radiotherapy and/or liver-directed therapies MPNE (and associated national networks), who (chemosaturation, chemoembolization, radioembolization). partner and have a direct input into research projects and how new clinical trials are designed. In patients with only one or few localized metastases in the liver, surgical resection of the affected areas can be considered. FINDING REFERENCE CENTRES AND ONGOING CLINICAL TRIALS FINDING SUPPORT More about clinical trials at: umcure2020.org/trials UM CURE 2020 reference centres are: • Institut Curie: umcure2020.org/curie • Liverpool Ocular Oncology Centre: umcure2020.org/looc and umcure2020.org/loorg • Melanoma Patient Network Europe (MPNE): • Leiden University Medical Center: umcure2020.org/lumc melanomapatientnetworkeu.org • Jagiellonian University: umcure2020.org/jagiellonian • MPNE Rare Ocular, Mucosal, Acral & Paediatric Discuss with your oncologist if you Facebook Group: umcure2020.org/mpne are eligible for an ongoing clinical trial. version 2, 2019 Stay up to date @ umcure2020.org.
Load more

Recommended publications
  • Permeability of the Retina and RPE-Choroid-Sclera to Three Ophthalmic Drugs and the Associated Factors
    pharmaceutics Article Permeability of the Retina and RPE-Choroid-Sclera to Three Ophthalmic Drugs and the Associated Factors Hyeong Min Kim 1,†, Hyounkoo Han 2,†, Hye Kyoung Hong 1, Ji Hyun Park 1, Kyu Hyung Park 1, Hyuncheol Kim 2,* and Se Joon Woo 1,* 1 Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea; [email protected] (H.M.K.); [email protected] (H.K.H.); [email protected] (J.H.P.); [email protected] (K.H.P.) 2 Department of Chemical and Biomolecular Engineering, Sogang University, Seoul 04107, Korea; [email protected] * Correspondence: [email protected] (H.K.); [email protected] (S.J.W.); Tel.: +82-2-705-8922 (H.K.); +82-31-787-7377 (S.J.W.); Fax: +82-2-3273-0331 (H.K.); +82-31-787-4057 (S.J.W.) † These authors contributed equally to this work. Abstract: In this study, Retina-RPE-Choroid-Sclera (RCS) and RPE-Choroid-Sclera (CS) were prepared by scraping them off neural retina, and using the Ussing chamber we measured the average time– concentration values in the acceptor chamber across five isolated rabbit tissues for each drug molecule. We determined the outward direction permeability of the RCS and CS and calculated the neural retina permeability. The permeability coefficients of RCS and CS were as follows: ganciclovir, 13.78 ± 5.82 and 23.22 ± 9.74; brimonidine, 15.34 ± 7.64 and 31.56 ± 12.46; bevacizumab, 0.0136 ± 0.0059 and 0.0612 ± 0.0264 (×10−6 cm/s).
    [Show full text]
  • The Distribution of Immune Cells in the Uveal Tract of the Normal Eye
    THE DISTRIBUTION OF IMMUNE CELLS IN THE UVEAL TRACT OF THE NORMAL EYE PAUL G. McMENAMIN Perth, Western Australia SUMMARY function of these cells in the normal iris, ciliary body Inflammatory and immune-mediated diseases of the and choroid. The role of such cell types in ocular eye are not purely the consequence of infiltrating inflammation, which will be discussed by other inflammatory cells but may be initiated or propagated authors in this issue, is not the major focus of this by immune cells which are resident or trafficking review; however, a few issues will be briefly through the normal eye. The uveal tract in particular considered where appropriate. is the major site of many such cells, including resident tissue macro phages, dendritic cells and mast cells. This MACRO PHAGES review considers the distribution and location of these and other cells in the iris, ciliary body and choroid in Mononuclear phagocytes arise from bone marrow the normal eye. The uveal tract contains rich networks precursors and after a brief journey in the blood as of both resident macrophages and MHe class 11+ monocytes immigrate into tissues to become macro­ dendritic cells. The latter appear strategically located to phages. In their mature form they are widely act as sentinels for capturing and sampling blood-borne distributed throughout the body. Macrophages are and intraocular antigens. Large numbers of mast cells professional phagocytes and play a pivotal role as are present in the choroid of most species but are effector cells in cell-mediated immunity and inflam­ virtually absent from the anterior uvea in many mation.1 In addition, due to their active secretion of a laboratory animals; however, the human iris does range of important biologically active molecules such contain mast cells.
    [Show full text]
  • The Proteomes of the Human Eye, a Highly Compartmentalized Organ
    Proteomics 17, 1–2, 2017, 1600340 DOI 10.1002/pmic.201600340 (1 of 3) 1600340 The proteomes of the human eye, a highly compartmentalized organ Gilbert S. Omenn Center for Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA Proteomics has now published a series of Dataset Briefs on the EyeOme from the HUPO Received: November 2, 2016 Human Proteome Project with high-quality analyses of the proteomes of these compartments Accepted: November 4, 2016 of the human eye: retina, iris, ciliary body, retinal pigment epithelium/choroid, retrobulbar optic nerve, and sclera, with 3436, 2929, 2867, 2755, 2711, and 1945 proteins, respectively. These proteomics resources represent a useful starting point for a broad range of research aimed at developing preventive and therapeutic interventions for the various causes of blindness. Keywords: Biomedicine / Biology and Disease-driven Human Proteome Project / End Blindness by 2020 / Eye proteome / EyeOme / Human Proteome Project See accompanying articles in the EyeOme series: http://dx.doi.org/10.1002/pmic.201600229; http://dx.doi.org/10.1002/pmic.201500188; http://dx.doi.org/10.1002/pmic.201400397 Proteomics has now published a series of four papers on compartments of the eye as shown in Fig. 1. As was noted [5], the human eye proteome [1–4]. Under the aegis of the Hu- it was not feasible to assess the quality of the data or estimate man Proteome Organization Biology and Disease-driven Hu- numbers of likely false positives in the heterogeneous studies man Proteome Project (HPP), the EyeOme was organized by from which these findings were summarized.
    [Show full text]
  • 98796-Anatomy of the Orbit
    Anatomy of the orbit Prof. Pia C Sundgren MD, PhD Department of Diagnostic Radiology, Clinical Sciences, Lund University, Sweden Lund University / Faculty of Medicine / Inst. Clinical Sciences / Radiology / ECNR Dubrovnik / Oct 2018 Lund University / Faculty of Medicine / Inst. Clinical Sciences / Radiology / ECNR Dubrovnik / Oct 2018 Lay-out • brief overview of the basic anatomy of the orbit and its structures • the orbit is a complicated structure due to its embryological composition • high number of entities, and diseases due to its composition of ectoderm, surface ectoderm and mesoderm Recommend you to read for more details Lund University / Faculty of Medicine / Inst. Clinical Sciences / Radiology / ECNR Dubrovnik / Oct 2018 Lund University / Faculty of Medicine / Inst. Clinical Sciences / Radiology / ECNR Dubrovnik / Oct 2018 3 x 3 Imaging technique 3 layers: - neuroectoderm (retina, iris, optic nerve) - surface ectoderm (lens) • CT and / or MR - mesoderm (vascular structures, sclera, choroid) •IOM plane 3 spaces: - pre-septal •thin slices extraconal - post-septal • axial and coronal projections intraconal • CT: soft tissue and bone windows 3 motor nerves: - occulomotor (III) • MR: T1 pre and post, T2, STIR, fat suppression, DWI (?) - trochlear (IV) - abducens (VI) Lund University / Faculty of Medicine / Inst. Clinical Sciences / Radiology / ECNR Dubrovnik / Oct 2018 Lund University / Faculty of Medicine / Inst. Clinical Sciences / Radiology / ECNR Dubrovnik / Oct 2018 Superior orbital fissure • cranial nerves (CN) III, IV, and VI • lacrimal nerve • frontal nerve • nasociliary nerve • orbital branch of middle meningeal artery • recurrent branch of lacrimal artery • superior orbital vein • superior ophthalmic vein Lund University / Faculty of Medicine / Inst. Clinical Sciences / Radiology / ECNR Dubrovnik / Oct 2018 Lund University / Faculty of Medicine / Inst.
    [Show full text]
  • Case Notes Hernia of the Choroid Treated by Scleral Grafting Followed by Direct Suturing of the Sclera* by P
    Br J Ophthalmol: first published as 10.1136/bjo.38.2.126 on 1 February 1954. Downloaded from Brit. J. Ophihal. (1954) 38, 126. CASE NOTES HERNIA OF THE CHOROID TREATED BY SCLERAL GRAFTING FOLLOWED BY DIRECT SUTURING OF THE SCLERA* BY P. SIVASUBRAMANIAM AND T. HOOLE Eye Clinic, Civil Hospital, Jaffna, Ceylon Case Report A young man aged 18 had had a bluish-black lump on the " white " of the left eye for 8 years. He did not recall any injury to this eye and had had no inflammation. Examination.-A bluish-black sessile swelling was seen on the superonasal side of the left eyeball about 4 mm. from the limbus (Figure). The lump measured 6 x 4 mm., the long axis being more or less tangential to the limbus. The swelling was cystic, tense, slightly reducible, nonpulsatile, and non-transluminant. It was not movable over the globe, the conjunctiva over it was stretched and tenuous. Biomicroscopy revealed a deposit of fine iris pigment on the lens capsule at the lower part. There was no sign of active uveitis. Visual acuity was 6/6 in each eye. Digital tonometry indicated that the tension was equal in both eyes. The fundi were normal. The region of the ectasia was not accessible ophthalmoscopically. Wassermann reaction negative. Operations.-Scleral grafting and direct suturing of the scleral hiatus were performed copyright. at different times. The reports of Lister (1951) on scleral grafting prompted us to try this operation. (1) January 21, 1953.-Under retro-ocular novocaine and local anaesthesia the conjunc- tiva over the lump was neatly dissected and an upper flap was raised.
    [Show full text]
  • Eye External Anatomy of Eye Accessory Structures
    4/22/16 Eye Bio 40B Dr. Kandula External Anatomy of Eye Accessory Structures l Eyebrows l Levator Palpebrae Superioris - opens eye l Eyelashes l Ciliary glands – modified sweat glands l Small sebaceous glands l Sty is inflamed ciliary glands or small sebaceous glands 1 4/22/16 Terms: Lacrimal gland and duct Surface of eye Lacrimal puncta Lacrimal sac Nasolacrimal duct Nasal cavity Tears / Lacrimal fluid l a watery physiologic saline, with a plasma-like consistency, l contains the bactericidal enzyme lysozyme; l it moistens the conjunctiva and cornea, l provides nutrients and dissolved O2 to the cornea. Extrinsic Muscles of the Eye: Lateral/medial rectus Important to know Superior/inferior rectus actions and nerve Superior/inferior oblique supply in table 2 4/22/16 Extrinsic Eye Muscles • Eye movements controlled by six extrinsic eye muscles Four recti muscles § Superior rectus – moves eyeball superiorly supplied by Cranial Nerve III § Inferior rectus - moves eyeball inferiorly supplied by Cranial Nerve III § Lateral rectus - moves eyeball laterally supplied by Cranial Nerve VI § Medial rectus - moves eyeball medially supplied by Cranial Nerve III Extrinsic Eye Muscles Two oblique muscles rotate eyeball on its axis § Superior oblique rotates eyeball inferiorly and laterally and is supplied by Cranial Nerve IV § Inferior oblique rotates superiorly and laterally and is supplied by Cranial Nerve III Convergence of the Eyes l Binocular vision in humans has both eyes looking at the same object l As you look at an object close to your face,
    [Show full text]
  • Anatomy of the Periorbital Region Review Article Anatomia Da Região Periorbital
    RevSurgicalV5N3Inglês_RevistaSurgical&CosmeticDermatol 21/01/14 17:54 Página 245 245 Anatomy of the periorbital region Review article Anatomia da região periorbital Authors: Eliandre Costa Palermo1 ABSTRACT A careful study of the anatomy of the orbit is very important for dermatologists, even for those who do not perform major surgical procedures. This is due to the high complexity of the structures involved in the dermatological procedures performed in this region. A 1 Dermatologist Physician, Lato sensu post- detailed knowledge of facial anatomy is what differentiates a qualified professional— graduate diploma in Dermatologic Surgery from the Faculdade de Medician whether in performing minimally invasive procedures (such as botulinum toxin and der- do ABC - Santo André (SP), Brazil mal fillings) or in conducting excisions of skin lesions—thereby avoiding complications and ensuring the best results, both aesthetically and correctively. The present review article focuses on the anatomy of the orbit and palpebral region and on the important structures related to the execution of dermatological procedures. Keywords: eyelids; anatomy; skin. RESU MO Um estudo cuidadoso da anatomia da órbita é muito importante para os dermatologistas, mesmo para os que não realizam grandes procedimentos cirúrgicos, devido à elevada complexidade de estruturas envolvidas nos procedimentos dermatológicos realizados nesta região. O conhecimento detalhado da anatomia facial é o que diferencia o profissional qualificado, seja na realização de procedimentos mini- mamente invasivos, como toxina botulínica e preenchimentos, seja nas exéreses de lesões dermatoló- Correspondence: Dr. Eliandre Costa Palermo gicas, evitando complicações e assegurando os melhores resultados, tanto estéticos quanto corretivos. Av. São Gualter, 615 Trataremos neste artigo da revisão da anatomia da região órbito-palpebral e das estruturas importan- Cep: 05455 000 Alto de Pinheiros—São tes correlacionadas à realização dos procedimentos dermatológicos.
    [Show full text]
  • Destruction of Localized Lesion of Choroid Reference Number: CP.VP.20 Coding Implications Last Review Date: 12/2020 Revision Log
    Clinical Policy: Destruction of Localized Lesion of Choroid Reference Number: CP.VP.20 Coding Implications Last Review Date: 12/2020 Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. Description: This policy describes the medical necessity requirements for destruction of localized lesion(s) of the choroid. Policy/Criteria I. It is the policy of health plans affiliated with Centene Corporation® (Centene) that the destruction of a localized lesion of the choroid is medically necessary for the following indications: A. Treatment of subretinal neovascular membranes as encountered in “wet” age-related macular degeneration, angioid streaks or other retinal disease processes involving violations of Bruch’s membrane allowing in-growth of abnormal neovascular tissue into the subretinal space. B. Subretinal neovascular membrane recurrences, which are immediately adjacent or contiguous with the first treated lesion, are well-known consequences of treating subretinal neovascular membranes. Background Choroidal neovascularization (CNV) describes the growth of new blood vessels that originate from the choroid through a break in the Bruch membrane into the sub–retinal pigment epithelium (sub-RPE) or subretinal space. Choroidal neovascularization is a major cause of visual loss. Destruction of the localized lesion of the choroid can be accomplished by using a laser or xenon arc. The choroid is a thin, vascular membrane lining the posterior eye between the retina and the sclera. Photocoagulation is performed without entering the posterior chamber. Intentionally destructive light is focused through a contact lens onto the choroidal lesion, which is destroyed in one session or in a series of sessions.
    [Show full text]
  • Download Our Coloboma Factsheet In
    Coloboma Factsheet Contents 3 What is Coloboma? 3 How do we see with our eyes? 3 Which parts of the eye can coloboma affect? 3 Iris 4 Lens zonules 4 Retina and choroid (chorioretinal) 4 Optic disc 4 Eyelids 4 What causes coloboma to form inside the eye? 5 Does coloboma affect vision? 5 Iris coloboma 5 Lens coloboma 5 Chorioretinal coloboma 6 How is coloboma diagnosed? 7 What is the treatment for coloboma? 7 Can coloboma lead to other eye health problems? 7 Glaucoma 8 Retinal detachment 8 Choroidal neovascularisation (new blood vessels) 8 Cataract 9 What other health problems can affect some children with coloboma? 9 Coping with sight problems relating to coloboma 10 Further help and support 10 Sources of support 11 Other useful organisations 12 We value your feedback 2 What is Coloboma? Coloboma means that part of one or more structures Choroid inside an unborn baby’s eye does not fully develop Iris during pregnancy. This underdeveloped tissue is Optic nerve normally in the lower part of the eye and it can be Optic Cornea small or large in size. A coloboma occurs in about 1 in disc 10,000 births and by the eighth week of pregnancy. Macula Lens Coloboma can affect one eye (unilateral) or both eyes zonules Pupil (bilateral) and it can affect different parts of the eye. As coloboma forms during the initial development of Choroid the eye, it is present from birth and into adulthood. Lens Retina How do we see with our eyes? Iris Light enters our eyes by passing through our cornea, our pupil, (the hole in the middle of the iris), and Diagram of cross section of eye (labels cornea, lens, iris, our lens so that it is sharply focused onto the retina vitreous humour, macula, retina, choroid, optic nerve) lining the back of our eye.
    [Show full text]
  • Corneal Anatomy
    FFCCF! • Mantis Shrimp have 16 cone types- we humans have three- essentially Red Green and Blue receptors. Whereas a dog has 2, a butterfly has 5, the Mantis Shrimp may well see the most color of any animal on earth. Functional Morphology of the Vertebrate Eye Christopher J Murphy DVM, PhD, DACVO Schools of Medicine & Veterinary Medicine University of California, Davis With integrated FFCCFs Why Does Knowing the Functional Morphology Matter? • The diagnosis of ocular disease relies predominantly on physical findings by the clinician (maybe more than any other specialty) • The tools we routinely employ to examine the eye of patients provide us with the ability to resolve fine anatomic detail • Advanced imaging tools such as optical coherence tomography (OCT) provide very fine resolution of structures in the living patient using non invasive techniques and are becoming widespread in application http://dogtime.com/trending/17524-organization-to-provide-free-eye-exams-to-service- • The basis of any diagnosis of “abnormal” is animals-in-may rooted in absolute confidence of owning the knowledge of “normal”. • If you don’t “own” the knowledge of the terminology and normal functional morphology of the eye you will not be able to adequately describe your findings Why Does Knowing the Functional Morphology Matter? • The diagnosis of ocular disease relies predominantly on physical findings by the clinician (maybe more than any other specialty) • The tools we routinely employ to examine the eye of patients provide us with the ability to resolve fine anatomic detail http://www.vet.upenn.edu/about/press-room/press-releases/article/ • Advanced imaging tools such as optical penn-vet-ophthalmologists-offer-free-eye-exams-for-service-dogs coherence tomography (OCT) provide very fine resolution of structures in the living patient using non invasive techniques and are becoming widespread in application • The basis of any diagnosis of “abnormal” is rooted in absolute confidence of owning the http://aibolita.com/eye-diseases/37593-direct-ophthalmoscopy.html knowledge of “normal”.
    [Show full text]
  • Eye Anatomy Slides File
    EYE ANATOMY & PHYSIOLOGY Dr. Cesar Carrillo [email protected] Sight For All **Disclaimer** The images contained in this presentaon are not my own, they can be found on the web Eye Anatomy and Physiology A thorough understanding of the anatomy and physiology of the eye, orbit, visual pathways, upper cranial nerves, and central pathways for the control of eye movements is a prerequisite for proper interpretaon of diseases having ocular manifestaons. Furthermore, such anatomic knowledge is essen;al to the proper planning and safe execu;on of ocular and orbital surgery Eye Anatomy and Physiology Objecves: Brief overview of eye anatomy and relevant physiology — Embriology — The Orbit, Cranial Nerves, Blood supply and Venous drainage — The Ocular Adnexa — The Extraocular muscles — The Conjunc;va, Sclera and Cornea — The Uveal tract — The Lens — The Re;na, Vitreous and Op;c Nerve — The Visual Pathway Embryology The eye is derived from three of the primi;ve embryonic layers: — Surface ectoderm, including its derivave the neural crest — Neural ectoderm — Mesoderm — Endoderm does not enter into the formaon of the eye — Mesenchyme is the term for embryonic connecve ssue. Ocular and adnexal connec;ve ;ssues previously were thought to be derived from mesoderm, but it has now been shown that most of the mesenchyme of all of the head and neck region is derived from the cranial neural crest Embryology Development of the structures of the head and neck occurs between 3-8 weeks of gestation — Eye develops as an ectodermal diverticulum from the lateral
    [Show full text]
  • Control of Retinal and Choroidal Blood Flow
    Eye (1990) 4, 319-325 Control of Retinal and Choroidal Blood Flow A. BILL and G. O. SPERBER Uppsala, Sweden Summary Earlier studies on the control of retinal and choroidal blood flow are reviewed and some recent observations on the effectsof light on retinal metabolism and retinal and choroidal blood flow in monkeys (Macaca fascicularis) are reported in preliminary form. The retina is nourished by the retinal blood vessels, where blood flow is auto­ regulated and the choroidal blood vessels where autoregulation is absent. Studies with the deoxygiucose method of Sokoloff indicate that flickering light tends to increase the metabolism of the inner retina, while constant light reduces the metab­ olism in the outer retina. Retinal blood flow in flickering light, 8 Hz, is higher than in constant light. The sympathetic nerves of the choroid are probably involved in a pro­ tective mechanism, preventing overperfusion in fight and flight situations with acute increments in blood pressure. The facial nerve contains parasympathetic vasodilator fibres to the choroid; the physiological significance of these fibres is unknown. The neuropeptides 'NPY, VIP and PHI are likely to be involved in autonomic reflexes in the eye. Choroidal and retinal blood flow choroidal and retinal circulation mainly via In most tissues, the control of the circulation autonomic nerves and report on some recent is complex because of the many factors influ­ observations on effects of light on retinal encing the vascular resistance: local myogenic metabolism and blood flow. responses, endothelium derived substances The blood flow, Q, in the intraocular tissues and local metabolic factors as well as circu­ as in other tissues depends on the local arterial lating substances and the autonomic nerves.
    [Show full text]