MOLECULAR SIEVING IN SUPRACHOROIDAL FLUID FORMATION IN MAN

  • 1 January 1978
    • journal article
    • research article
    • Vol. 17  (5) , 420-427
Abstract
Suprachoroidal fluid (SCF) obtained at the time of the surgical evacuation of a clinically significant choroidal detachment (CD) was analyzed for its chemical and cellular components in 4 distinct subgroups: CD following cataract surgery, CD (nonhemorrhagic) following glaucoma surgery, CD (hemorrhagic) following glaucoma surgery and intraoperative CD during glaucoma surgery in patients with elevated episcleral veous pressure. The fluid obtained in groups 1, 2 and 4 was clear and slightly xanthochromic and contained low-MW substances in concentrations essentially equal to serum. Proteins and other high-MW substances were present in lesser amounts than in serum. Albumin, .alpha.1-antitrypsin and transferrin were present in amounts approximately equal to those in serum; .alpha.2-macroglobulin, Ig[immunoglobulin]M and IgG were decreased. .beta.-Lipoprotein and .beta.-complement were absent. Apparently this distribution of serum proteins is a manifestation of molecular sieving and is consistent with the existence of an isoporous membrane between the intravascular and suprachoroidal space with a pore diameter of 144 .ANG.. In the intraoperative choroidal effusions there was evidence for exclusion of more of the lower, and all of the higher, MW proteins. This suggested that the degree of molecular sieving increased with increasing filtration rate. In the hemorrhagic SCF the distinctive character of the fluid and the protein concentrations indicated that the integrity of the capillary membrane was markedly disrupted, thereby allowing higher-MW proteins and cellular elements to enter the space.

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