Anatomy
The Choroid: The Eye's Vascular Supply Layer
The choroid is a thin layer of blood vessels and connective tissue sandwiched between the retina and the sclera. It is the primary blood supply for the outer retina, including the photoreceptors (rods and cones). Choroidal health is essential for retinal function and is involved in conditions like AMD and central serous retinopathy.
Anatomy Overview
The Choroid: The Eye's Vascular Supply Layer
Structure & Components
Central serous retinopathy: blurred central vision from fluid under retina
Choroidal neovascularization (wet AMD): new vessels growing under macula
Choroidal melanoma: enlarged blind spot or peripheral vision loss
Choroidal rupture from blunt trauma causing permanent vision loss
Polypoidal choroidal vasculopathy: reddish-orange lesions with haemorrhage
Pachychoroid disease spectrum: thickened choroid causing recurrent fluid
Functions & Physiology
Choroid thickness varies 200-300 micrometers, thicker at the posterior pole
Haller's, Sattler's, and choriocapillaris layers form the choroidal architecture
Choriocapillaris provides 90% of oxygen to photoreceptors
Bruch's membrane separates choroid from retinal pigment epithelium
AMD involves breakdown of Bruch's membrane allowing choroidal invasion
Uveal melanoma most commonly arises from choroidal melanocytes
Key Points
Anti-VEGF injections for choroidal neovascularization
Photodynamic therapy for polypoidal vasculopathy and central serous
Observation for small uveal melanoma; radiation or enucleation for large
OCT and OCT-angiography to image choroidal layers
Laser photocoagulation for central serous retinopathy if persistent
Reduce stress, stop steroids (including nasal sprays) for central serous
Fluorescein and indocyanine green angiography for diagnosis
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