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The Effects of Simultaneous Occlusion of the Posterior Ciliary Artery and Vortex Veins: A Histopathologic Study

The Effects of Simultaneous Occlusion of the Posterior Ciliary Artery and Vortex Veins: A... Abstract Objective: In previous research, experimental occlusion of the posterior ciliary arteries resulted in an infarction of the retinal pigment epithelium and outer retina. A simultaneous occlusion of one or two vortex veins (VVs) appeared to have an ameliorative effect on the retinal infarct based on previous clinical and angiographic observations. The objectives of this report were to evaluate the histopathologic changes of the ischemic retina and to examine the disruption and healing of the blood-retinal barrier under various combinations of ciliary artery and VV occlusions. Methods: Experimental posterior ciliary artery (PCA) occlusion with (n=3) or without (n=3) simultaneous VV occlusion was carried out in six rhesus monkey eyes. The eyes were enucleated over a course of 3 months. The histopathologic changes of the ischemic retina were examined by light and electron microscopy. In addition, the horseradish peroxidase tracer technique was used to study the blood-retinal barrier. Results: Ischemic changes following the occlusion of the PCA consisted of coagulation necrosis of the retinal pigment epithelium and of the outer retinal layers and were less pronounced in eyes with simultaneous VV occlusion. At 6 hours after the insult, the blood-retinal barrier was broken and horseradish peroxidase leaked into the subretinal space (PCA occlusion with one VV occlusion). Three months later, the blood-retinal barrier had re-formed, even in the eyes with severe ischemic injury. Conclusions: The histopathologic changes suggest that the ameliorative effect of simultaneous VV occlusion on the effects of PCA occlusion might be due to reduced perfusion in the choroidal circulation. References 1. Hayreh SS, Baines JAB. Occlusion of the posterior ciliary artery, I: effects on choroidal circulation . Br J Ophthalmol . 1972;56:719-735.Crossref 2. Hayreh SS. Baines JAB. Occlusion of the posterior ciliary artery, II: chorioretinal lesions . Br J Ophthalmol . 1972;56:736-753.Crossref 3. McLeod D, Hayreh SS. Occlusion of posterior ciliary artery, IV: electroretinographic studies . Br J Ophthalmol . 1972;56:765-769.Crossref 4. Uyama M, Koshibu A, Itotagawa S, Ohkuma H, Uraguchi K, Miki K. Pathology of choroidal circulatory disturbance, IV: chorioretinopathy in choroidal circulatory disorders, clinical study . Acta Soc Ophthalmol Jpn . 1980;84:1947-1956. 5. Koshibu A. Itotagawa S. Disruption and repair of blood-retinal barrier at the retinal pigment epithelium after experimentally produced choroidal circulatory disturbance . Acta Soc Ophthalmol Jpn . 1980;84:721-735. 6. Uyama M, Ohkuma H, Itotagawa S, Koshibu A, Uraguchi K, Miki K. Pathology of choroidal circulatory disturbance, I: angioarchitecture of the choroid, observation on plastic cast preparation . Acta Soc Ophthalmol Jpn . 1980;84:1893-1909. 7. Uyama M, Itotagawa S, Uraguchi K, Ohkuma H, Miki K, Koshibu A. Pathology of choroidal circulatory disturbance, II: deprivation of the choroidal blood flow and its recovery, an experimental study . Acta Soc Ophthalmol Jpn . 1980;84:1910-1923. 8. Uyama M, Ohkuma H, Miki K, Koshibu A, Uraguchi K, Itotagawa S. Pathology of choroidal circulatory disturbance, III: experimental choroidal circulatory disturbance, histopathological study of retinochoroidal lesion . Acta Soc Ophthalmol Jpn . 1980;84:1924-1946. 9. Hayreh SS. Occlusion of the posterior ciliary arteries . Trans Am Acad Ophthalmol Otolaryngol . 1973;77:300-309. 10. Hayreh SS. Chopdar A. Occlusion of the posterior ciliary artery, V: protective Influence of simultaneous vortex vein occlusion . Arch Ophthalmol . 1982;40:1481-1491.Crossref 11. Tso MOM, Shih CY, McLean IW. Is there a blood-brain barrier at the optic nerve head? Arch Ophthalmol . 1975;93:815-825.Crossref 12. Richardson RC, Jarett L, Finke EH. Embedding in epoxy resins for ultrathin sectioning in electron microscopy . Stain Technol . 1960;35:313-323. 13. Kishi S, Tso MOM, Hayreh SS. Fundus lesions in malignant hypertension. I: a pathologic study of experimental hypertensive choroidopathy . Arch Ophthalmol. 1985;43:1189-1197.Crossref 14. Yoneya S, Tso MOM. Angioarchitechture of the human choroid . Arch Ophthalmol . 1987;105:681-687.Crossref 15. Hayreh SS. Segmental nature of the choroidal vasculature . Br J Ophthalmol . 1975;59:631-648.Crossref 16. Tso MOM, Torczynski E. Architecture of the choriocapillaris and macular edema: XXIII Concilium Ophthalmologicum . Kyoto. In: Shimizu K, Oosterhuis JA, eds. Excerpta Medica . Amsterdam, the Netherlands: Elsevier Science Publishers; 1978:239-241. 17. Ernest JT, Stern WH, Archer DB. Submacular choroidal circulation . Am J Ophthalmol . 1976;81:574-582. 18. McCord JM. Oxygen-derived free radicals in postischemic tissue injury . N Engl J Med . 1985;312:159-163.Crossref 19. Henkind P. Ischaemia of the posterior pole: angioarchitecture, experimental data, clinical correlations, speculations . Trans Ophthalmol Soc U K . 1971;91:343-354. 20. Milde LN. Pathophysiology of ischemic brain injury . Crit Care Clin . 1989;5:729-753. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

The Effects of Simultaneous Occlusion of the Posterior Ciliary Artery and Vortex Veins: A Histopathologic Study

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Publisher
American Medical Association
Copyright
Copyright © 1994 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1994.01090170118033
Publisher site
See Article on Publisher Site

Abstract

Abstract Objective: In previous research, experimental occlusion of the posterior ciliary arteries resulted in an infarction of the retinal pigment epithelium and outer retina. A simultaneous occlusion of one or two vortex veins (VVs) appeared to have an ameliorative effect on the retinal infarct based on previous clinical and angiographic observations. The objectives of this report were to evaluate the histopathologic changes of the ischemic retina and to examine the disruption and healing of the blood-retinal barrier under various combinations of ciliary artery and VV occlusions. Methods: Experimental posterior ciliary artery (PCA) occlusion with (n=3) or without (n=3) simultaneous VV occlusion was carried out in six rhesus monkey eyes. The eyes were enucleated over a course of 3 months. The histopathologic changes of the ischemic retina were examined by light and electron microscopy. In addition, the horseradish peroxidase tracer technique was used to study the blood-retinal barrier. Results: Ischemic changes following the occlusion of the PCA consisted of coagulation necrosis of the retinal pigment epithelium and of the outer retinal layers and were less pronounced in eyes with simultaneous VV occlusion. At 6 hours after the insult, the blood-retinal barrier was broken and horseradish peroxidase leaked into the subretinal space (PCA occlusion with one VV occlusion). Three months later, the blood-retinal barrier had re-formed, even in the eyes with severe ischemic injury. Conclusions: The histopathologic changes suggest that the ameliorative effect of simultaneous VV occlusion on the effects of PCA occlusion might be due to reduced perfusion in the choroidal circulation. References 1. Hayreh SS, Baines JAB. Occlusion of the posterior ciliary artery, I: effects on choroidal circulation . Br J Ophthalmol . 1972;56:719-735.Crossref 2. Hayreh SS. Baines JAB. Occlusion of the posterior ciliary artery, II: chorioretinal lesions . Br J Ophthalmol . 1972;56:736-753.Crossref 3. McLeod D, Hayreh SS. Occlusion of posterior ciliary artery, IV: electroretinographic studies . Br J Ophthalmol . 1972;56:765-769.Crossref 4. Uyama M, Koshibu A, Itotagawa S, Ohkuma H, Uraguchi K, Miki K. Pathology of choroidal circulatory disturbance, IV: chorioretinopathy in choroidal circulatory disorders, clinical study . Acta Soc Ophthalmol Jpn . 1980;84:1947-1956. 5. Koshibu A. Itotagawa S. Disruption and repair of blood-retinal barrier at the retinal pigment epithelium after experimentally produced choroidal circulatory disturbance . Acta Soc Ophthalmol Jpn . 1980;84:721-735. 6. Uyama M, Ohkuma H, Itotagawa S, Koshibu A, Uraguchi K, Miki K. Pathology of choroidal circulatory disturbance, I: angioarchitecture of the choroid, observation on plastic cast preparation . Acta Soc Ophthalmol Jpn . 1980;84:1893-1909. 7. Uyama M, Itotagawa S, Uraguchi K, Ohkuma H, Miki K, Koshibu A. Pathology of choroidal circulatory disturbance, II: deprivation of the choroidal blood flow and its recovery, an experimental study . Acta Soc Ophthalmol Jpn . 1980;84:1910-1923. 8. Uyama M, Ohkuma H, Miki K, Koshibu A, Uraguchi K, Itotagawa S. Pathology of choroidal circulatory disturbance, III: experimental choroidal circulatory disturbance, histopathological study of retinochoroidal lesion . Acta Soc Ophthalmol Jpn . 1980;84:1924-1946. 9. Hayreh SS. Occlusion of the posterior ciliary arteries . Trans Am Acad Ophthalmol Otolaryngol . 1973;77:300-309. 10. Hayreh SS. Chopdar A. Occlusion of the posterior ciliary artery, V: protective Influence of simultaneous vortex vein occlusion . Arch Ophthalmol . 1982;40:1481-1491.Crossref 11. Tso MOM, Shih CY, McLean IW. Is there a blood-brain barrier at the optic nerve head? Arch Ophthalmol . 1975;93:815-825.Crossref 12. Richardson RC, Jarett L, Finke EH. Embedding in epoxy resins for ultrathin sectioning in electron microscopy . Stain Technol . 1960;35:313-323. 13. Kishi S, Tso MOM, Hayreh SS. Fundus lesions in malignant hypertension. I: a pathologic study of experimental hypertensive choroidopathy . Arch Ophthalmol. 1985;43:1189-1197.Crossref 14. Yoneya S, Tso MOM. Angioarchitechture of the human choroid . Arch Ophthalmol . 1987;105:681-687.Crossref 15. Hayreh SS. Segmental nature of the choroidal vasculature . Br J Ophthalmol . 1975;59:631-648.Crossref 16. Tso MOM, Torczynski E. Architecture of the choriocapillaris and macular edema: XXIII Concilium Ophthalmologicum . Kyoto. In: Shimizu K, Oosterhuis JA, eds. Excerpta Medica . Amsterdam, the Netherlands: Elsevier Science Publishers; 1978:239-241. 17. Ernest JT, Stern WH, Archer DB. Submacular choroidal circulation . Am J Ophthalmol . 1976;81:574-582. 18. McCord JM. Oxygen-derived free radicals in postischemic tissue injury . N Engl J Med . 1985;312:159-163.Crossref 19. Henkind P. Ischaemia of the posterior pole: angioarchitecture, experimental data, clinical correlations, speculations . Trans Ophthalmol Soc U K . 1971;91:343-354. 20. Milde LN. Pathophysiology of ischemic brain injury . Crit Care Clin . 1989;5:729-753.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: May 1, 1994

References