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Fluid of choroidal origin
Author(s) -
SOUBRANE G
Publication year - 2013
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2013.3612.x
Subject(s) - retina , sclera , membrane , tight junction , biophysics , permeability (electromagnetism) , chemistry , anatomy , ophthalmology , biology , microbiology and biotechnology , medicine , biochemistry , neuroscience
The choroidal circulation is crucial in supplying nutrients as well as oxygen to the outer retina. The capillaries of the choriocapillaris are fenestrated and have a high protein permeability that allows the establishment of a high oncotic pressure, presumably contributing to movement of fluid out of the retina through the stroma to the sclera. The pores of the choriocapillaris are facing the RPE. Bruchs membrane acts as a sieve depending on the amount and chemical properties of the deposited waste products. The accumulation of fluid under the RPE or within the retina implies a tight Bruchs membrane. Lipids as result of the the outer segment turn over accumulate and decrease the permeability of Bruchs membrane precluding the evacuation of the waste products and initiate a vicious circle. Active transport by the RPE is impaired. The tight junctions of the RPE are ruptured, the fluid irruption into the retina results in the disorganisation of the outer layers of the retina. A progressive breakdown of all defense mechanisms especially the reabsorbtion pump tips over the balance. The mechanismsm of the restauration are partially known. All choroidal diseases can induce these featuree and clinicians may analyze the resulting steps