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TRANSSCLERAL ALBUMIN DIFFUSION AND SUPRACHOROIDAL ALBUMIN CONCENTRATION IN UVEAL EFFUSION SYNDROME.
MedLine Citation:
PMID:  21811210     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE:: To test the hypothesis that uveal effusion syndrome is caused by reduced transscleral albumin permeability. METHODS:: Surgical scleral specimens were obtained from a 55-year-old patient with nanophthalmic uveal effusion syndrome. Specimens were clamped in a modified Ussing chamber, and the rate of transscleral diffusion of fluorescein isothiocyanate-albumin was measured over 12 hours, using a spectrophotometer and predetermined standard curves. The diffusion coefficient was determined at 20°C, and then adjusted to body temperature using Einstein's equation. Results in 3 scleral samples were compared with 10 age-matched controls. Albumin and total protein concentration were measured in choroidal fluid and serum. RESULTS:: Histologic staining with Alcian blue showed interfibrillary acid mucin deposits. Transmission electron microscopy showed deposits measuring 1 μm to 10 μm and collections of expanded, degenerate collagen fibrils. The mean (±SD) albumin diffusion coefficient was 12% of that in controls (1.22 ± 0.67 × 10 vs. 10.3 ± 7.0 × 10 cm/second) and below the lower 95% confidence limit of the control group. The diffusion coefficient was calculated to increase 53% to 1.87 ± 1.03 × 10 cm/second at 37°C. Choroidal albumin concentration was much higher than physiologic levels, measuring 200 g/L (total protein 321 g/L), 5 times the serum albumin concentration of 42 g/L (total protein 70 g/L). CONCLUSION:: Nanophthalmic uveal effusion syndrome can be associated with reduced scleral permeability to albumin, and a very high concentration of retained suprachoroidal albumin. This will lead to an osmotic gradient that retains fluid and may partly explain the pathogenesis of uveal effusion syndrome in some patients.
Authors:
Timothy L Jackson; Ali Hussain; Jon Salisbury; Roy Sherwood; Paul M Sullivan; John Marshall
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-29
Journal Detail:
Title:  Retina (Philadelphia, Pa.)     Volume:  -     ISSN:  1539-2864     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-8-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309919     Medline TA:  Retina     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the *Department of Ophthalmology, King's College Hospital, London, United Kingdom; †Biomedical Sciences, King's College London, London, United Kingdom; and ‡Vitreoretinal Unit, Moorfields Eye Hospital, London, United Kingdom.
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