The 'system' to be investigated is the layer of light sensitive cells (rods and cones) in the outer retina, the remarkably dense, supporting vascular bed (choriocapillaris
) that lies beneath it and the connective tissue layer known as Bruch's membrane that sits between the choriocapillaris
and the rods and cones.
The primary cause of ICSCR is focal occlusion at the choriocapillaris
level according to the study by Kitaya et al.
The four images are usually termed the superficial capillary plexus, the deep capillary plexus, the outer retina and RPE, and the choriocapillaris
. In normal eyes, only the outer retina with the RPE slab fails to image blood vessels because the photoreceptors and RPE are devoid of blood vessels.
degeneration and related pathologic changes in human diabetic eyes.
Pachychoroid spectrum diseases are characterized by increased choroidal thickness, dilation of the outer choroidal veins (pachy-veins), and thinning of Sattler's and choriocapillaris
Shimoda et al., "Different filling patterns of the choriocapillaris
in fluorescein and indocyanine green angiography in primate eyes under elevated intraocular pressure," Investigative Ophthalmology & Visual Science, vol.
degeneration and related pathologic changes in human diabetic eyes," Archives of Ophthalmology, vol.
The primary tissue involved is thought to be the retinal pigment epithelium (RPE) and/or the choriocapillaris
Rosenberg, "Generalized choriocapillaris
dystrophy, a distinct phenotype in the spectrum of ABCA4-associated retinopathies," Investigative Ophthalmology & Visual Science, vol.
Age-related macular degeneration (AMD) can cause severe central vision loss in patients aged 75 or older, which is initially caused by an age-related, progressive degeneration in the retinal pigment epithelium in the macular area of the retina., RPE cells, located between the neuroretina and the choriocapillaris
, which comprise the outer blood-retinal barrier, participate in the selective transport of metabolites, phagocytose the outer segments that are shed from photoreceptors, and act as antigen-presenting cells.,, A literature review has demonstrated that photoreceptor outer segment phagocytosis, peroxidized lipid membranes, and photo-oxidative reactive oxygen intermediates are endogenous sources of oxidative stress, which can induce damage to the RPE cells.
The small choroidal vessels (mainly capillaries) that perforate the tapetum en route for the choriocapillaris
can be viewed ophthalmoscopically as distinct dark dots the stars of Winslow.
On OCT, acute CSCR appears as an elevation of the full-thickness neurosensory retina from the highly reflective RPE- choriocapillaris
complex separated by an optically empty zone with or without RPE detachments and significantly increased choroidal thickness in patients.