Binkley Elaine M, Lozano Lola P, Riker Megan J, Pennington Edward C, Tucker Budd A, Stone Edwin M, Boldt H Culver, Mullins Robert F
Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, USA.
Institute for Vision Research, University of Iowa, Iowa City, Iowa, USA.
Case Rep Ophthalmol. 2022 Aug 15;13(2):589-598. doi: 10.1159/000525568. eCollection 2022 May-Aug.
The effects of radiation retinopathy on the retinal vasculature have been well established; however, the literature describing the pathologic changes in the choriocapillaris is relatively lacking. In this report, we describe the histologic findings of a donor eye with a choroidal melanoma with special attention to the choriocapillaris. Clinical and histological findings, including immunohistochemistry and transmission electron microscopy, are described for the retina and choroid of a donor eye affected by radiation retinopathy secondary to treatment of choroidal melanoma. Cells within the tumor exhibited an epithelioid structure and balloon melanosomes. Notable infiltration of macrophages with elongated morphology was also observed. Atrophy of photoreceptors, retinal pigmented epithelium, and choriocapillaris was observed on the inferior edge of the lesion and extending past the tumor. The choriocapillaris endothelium showed more severe dropout at the periphery of the lesion where loss of fenestration, thickened cytosol, and degenerated pericytes were observed. Morphologic analysis revealed choriocapillaris loss with pronounced degeneration of choroidal pericytes. Understanding the differences in sensitivity to radiation injury between different cell types and different patients will provide better insight into radiation retinopathy.
辐射性视网膜病变对视网膜血管系统的影响已得到充分证实；然而，描述脉络膜毛细血管病理变化的文献相对较少。在本报告中，我们描述了一只患有脉络膜黑色素瘤的供体眼的组织学发现，特别关注脉络膜毛细血管。对一只因脉络膜黑色素瘤治疗继发辐射性视网膜病变的供体眼的视网膜和脉络膜进行了临床和组织学检查，包括免疫组织化学和透射电子显微镜检查。肿瘤内的细胞呈现上皮样结构和气球样黑素小体。还观察到形态细长的巨噬细胞显著浸润。在病变下缘及肿瘤以外区域观察到光感受器、视网膜色素上皮和脉络膜毛细血管萎缩。脉络膜毛细血管内皮在病变周边显示更严重的缺失，可见窗孔消失、胞质增厚和周细胞变性。形态学分析显示脉络膜毛细血管丧失，脉络膜周细胞明显变性。了解不同细胞类型和不同患者对辐射损伤的敏感性差异将有助于更好地理解辐射性视网膜病变。
