Blood-ocular barrier damage: use of contrast-enhanced MRI.
The blood-ocular barrier (BOB) shares similar neuroepithelial origin, microanatomy and functions with the blood-brain barrier. There are many natural (e. g. diabetes, hypertension) or iatrogenic (chemotherapy, retinal photocoagulation) conditions which can cause a BOB breakdown, resulting in visual acuity impairment or loss. The authors examined 42 patients affected by BOB damage in different pathological conditions. All patients previously underwent a conventional fluoroangiographic (FA) study. Nine patients with normal FA exam were evaluated also. Despite normal MRI findings immediately after Gd-DTPA injection, contrast leakage into the vitreous body or into the aqueous fluid was demonstrated in delayed scans (40-50 min after contrast administration), proving the existence of a BOB damage (sensitively 94 %). Although FA exam remains the choice modality in BOB breakdown demonstration, we propose MRI as a useful diagnostic tool when optic media opacity (cataract, haemovitreous, intraocular silicon oil) occurs, preventing direct retinal fundus imaging and/or an early screening tool.
Manfré
L
L
Department of Radiology, "P. Cignolini", University of Palermo, v. del Vespro 127, I-90127 Palermo, Italy.
Midiri
M
M
Giuffré
G
G
Mangiameli
A
A
Cardella
G
G
Ponte
F
F
De Maria
M
M
Lagalla
R
R
D000328:Adult; D000368:Aged; D001082:Aqueous Humor; D018916:Blood-Aqueous Barrier; D001813:Blood-Retinal Barrier; D002199:Capillary Permeability; D003287:Contrast Media; D005128:Eye Diseases / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D005682:Gadolinium; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives*; D014822:Vitreous Body / Q000473:pathology
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA