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 man y natural (e. g. diabetes, hypertension) or iatrogenic (chemotherapy, retinal photocoagulation) conditions which can cause of BOB breakdown, resulting in visual acuity impairment or loss. The authors examined 4 2 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. Des pite normal MRI findings immediately after Gd-DTPA injection, contrast leakage into the vitreous body or into the aqueous fluid was demonstr ated in delayed scans (40-50 min after contrast administration), provi ng the existence of a BOB damage (sensitively 94%). Although FA exam r emains the choice modality in BOB breakdown demonstration, we propose MRI as a useful diagnostic tool when optic media opacity (cataract, ha emovitreous, intraocular silicon oil) occurs, preventing direct retina l fundus imaging and/or an early screening tool.