Moderne bildgebende Verfahren zur Darstellung der Morphologie und Funktion der Aderhaut

Zusammenfassung

Die Aderhaut oder Choroidea liegt direkt außerhalb der Netzhaut an und besteht aus einem dichten Gefäßnetz, das die äußere Netzhaut versorgt. Pathologien im Bereich der Aderhaut können zu Veränderungen des retinalen Pigmentepithels (RPE) und der äußeren Netzhautschichten führen. Die Aderhaut spielt somit eine entscheidende Rolle bei der Entstehung von Netzhauterkrankungen wie der altersabhängigen Makuladegeneration (AMD), der Chorioretinopathia centralis serosa (CRCS, CSCR, RCS), der pathologischen Myopie und bei inflammatorischen Erkrankungen wie dem Vogt-Koyanagi-Harada-Syndrom (VKH). Die grundlegende Kenntnis des Aufbaus und der Physiologie der Aderhaut sowie der diagnostischen Optionen zur Darstellung von choroidalen Veränderungen ermöglicht ein besseres Verständnis der Physiologie und Pathologie choroidaler Prozesse. Diese Arbeit bietet einen Überblick der Anatomie und Funktion der Choroidea und beschreibt die aktuell verfügbaren diagnostischen Verfahren zur Charakterisierung und Darstellung der Aderhaut. Anschließend werden verschiedene Krankheitsbilder, die mit choroidalen Veränderungen assoziiert sind, beleuchtet.

Schlüsselwörter

Choroidea - Choriokapillaris - okuläre Bildgebung - Choroidopathie - chorioretinale Pathologie

Publication History

Received: 06 July 2021

Accepted: 30 July 2021

Article published online:
07 September 2021

• References/Literatur

• 1 Nickla DL, Wallman J. The multifunctional choroid. Prog Retin Eye Res 2010; 29: 144-168 DOI: 10.1016/j.preteyeres.2009.12.002.
• 2 Ramrattan RS, van der Schaft TL, Mooy CM. et al. Morphometric analysis of Bruchʼs membrane, the choriocapillaris, and the choroid in aging. Invest Ophthalmol Vis Sci 1994; 35: 2857-2864
• 3 Zhao J, Wang YX, Zhang Q. et al. Macular Choroidal Small-Vessel Layer, Sattlerʼs Layer and Hallerʼs Layer Thicknesses: The Beijing Eye Study. Sci Rep 2018; 8: 4411 DOI: 10.1038/s41598-018-22745-4.
• 4 Pichi F, Aggarwal K, Neri P. et al. Choroidal biomarkers. Indian J Ophthalmol 2018; 66: 1716-1726 DOI: 10.4103/ijo.IJO_893_18.
• 5 Alm A, Nilsson SF. Uveoscleral outflow–a review. Exp Eye Res 2009; 88: 760-768 DOI: 10.1016/j.exer.2008.12.012.
• 6 Kinoshita T, Mitamura Y, Shinomiya K. et al. Diurnal variations in luminal and stromal areas of choroid in normal eyes. Br J Ophthalmol 2017; 101: 360-364 DOI: 10.1136/bjophthalmol-2016-308594.
• 7 Sarfare S, Yang J, Nickla DL. The effects of brief high intensity light on ocular growth in chicks developing myopia vary with time of day. Exp Eye Res 2020; 195: 108039 DOI: 10.1016/j.exer.2020.108039.
• 8 Mrejen S, Spaide RF. Imaging the choroid in uveitis. Int Ophthalmol Clin 2012; 52: 67-81 DOI: 10.1097/IIO.0b013e318265f676.
• 9 Invernizzi A, Pellegrini M, Cornish E. et al. Imaging the Choroid: From Indocyanine Green Angiography to Optical Coherence Tomography Angiography. Asia Pac J Ophthalmol (Phila) 2020; 9: 335-348 DOI: 10.1097/APO.0000000000000307.
• 10 Godel V, Baruch E, Lazar M. Late development of chorioretinal lesions in birdshot retinochoroidopathy. Ann Ophthalmol 1989; 21: 49-52
• 11 Shah KH, Levinson RD, Yu F. et al. Birdshot chorioretinopathy. Surv Ophthalmol 2005; 50: 519-541 DOI: 10.1016/j.survophthal.2005.08.004.
• 12 Soubrane G, Bokobza R, Coscas G. Late developing lesions in birdshot retinochoroidopathy. Am J Ophthalmol 1990; 109: 204-210 DOI: 10.1016/s0002-9394(14)75988-4.
• 13 Copete S, Flores-Moreno I, Montero JA. et al. Direct comparison of spectral-domain and swept-source OCT in the measurement of choroidal thickness in normal eyes. Br J Ophthalmol 2014; 98: 334-338 DOI: 10.1136/bjophthalmol-2013-303904.
• 14 Chee SP, Chan SN, Jap A. Comparison of Enhanced Depth Imaging and Swept Source Optical Coherence Tomography in Assessment of Choroidal Thickness in Vogt-Koyanagi-Harada Disease. Ocul Immunol Inflamm 2017; 25: 528-532 DOI: 10.3109/09273948.2016.1151896.
• 15 Gal-Or O, Dansingani KK, Sebrow D. et al. Inner Choroidal Flow Signal Attenuation in Pachychoroid Disease: Optical Coherence Tomography Angiography. Retina 2018; 38: 1984-1992 DOI: 10.1097/IAE.0000000000002051.
• 16 Siedlecki J, Schworm B, Priglinger SG. The Pachychoroid Disease Spectrum-and the Need for a Uniform Classification System. Ophthalmol Retina 2019; 3: 1013-1015 DOI: 10.1016/j.oret.2019.08.002.
• 17 Munk MR, Shah R, Pappas F. et al. Multimodal Imaging and Choroidal Volumetric Changes After Half-fluence PDT in Central Serous Chorioretinopathy. Curr Eye Res 2016; 41: 97-106 DOI: 10.3109/02713683.2014.1002047.
• 18 Romdhane K, Mantel I. Choroidal Neovascularisation Complicating Chronic Central Serous Chorioretinopathy: The Discovery Rate on Multimodal Imaging. Klin Monbl Augenheilkd 2019; 236: 536-541 DOI: 10.1055/a-0834-6118.
• 19 [Anonym] Argon laser photocoagulation for neovascular maculopathy. Three-year results from randomized clinical trials. Macular Photocoagulation Study Group. Arch Ophthal 1986; 104: 694-701
• 20 [Anonym] Laser photocoagulation for juxtafoveal choroidal neovascularization. Five-year results from randomized clinical trials. Macular Photocoagulation Study Group. Arch Ophthal 1994; 112: 500-509
• 21 [Anonym] Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: one-year results of 2 randomized clinical trials–TAP report. Treatment of age-related macular degeneration with photodynamic therapy (TAP) Study Group. Arch Ophthal 1999; 117: 1329-1345
• 22 Spaide RF, Jaffe GJ, Sarraf D. et al. Consensus Nomenclature for Reporting Neovascular Age-Related Macular Degeneration Data: Consensus on Neovascular Age-Related Macular Degeneration Nomenclature Study Group. Ophthalmology 2020; 127: 616-636 DOI: 10.1016/j.ophtha.2019.11.004.
• 23 Sadda SR, Guymer R, Holz FG. et al. Consensus Definition for Atrophy Associated with Age-Related Macular Degeneration on OCT: Classification of Atrophy Report 3. Ophthalmology 2018; 125: 537-548 DOI: 10.1016/j.ophtha.2017.09.028.
• 24 Gaucher D, Sebah C, Erginay A. et al. Optical coherence tomography features during the evolution of serous retinal detachment in patients with diabetic macular edema. Am J Ophthalmol 2008; 145: 289-296 DOI: 10.1016/j.ajo.2007.09.029.
• 25 Munk MR, Bolz M, Huf W. et al. Morphologic and functional evaluations during development, resolution, and relapse of uveitis-associated cystoid macular edema. Retina 2013; 33: 1673-1683 DOI: 10.1097/IAE.0b013e318285cc52.
• 26 Giocanti-Auregan A, Hrarat L, Qu LM. et al. Functional and Anatomical Outcomes in Patients With Serous Retinal Detachment in Diabetic Macular Edema Treated With Ranibizumab. Invest Ophthalmol Vis Sci 2017; 58: 797-800 DOI: 10.1167/iovs.16-20855.