Summary
The submacular choroidal vascular pattern was investigated by experimental occlusion of either one of the temporal short posterior ciliary arteries (SPCAs) or 1, 2, 3 or all of the vortex veins in 87 rhesus monkey eyes and evaluation of their filling defects and anastomoses by fluorescein fundus angiography (FFA). No special artery supplying the submacular choroid was seen. All the temporal SPCAs entered the eyeball in the macular region and each artery supplied a segment of the choroid, with no anastomoses between the adjacent segments. Most of the segments of the choroid supplied by the temporal SPCAs and their watershed zones met in the macular region. Similarly the four quadrants of the uveal tract drained by the four vortex veins and their watershed zones met in the macular region. Since an area where numerous watershed zones meet is most vulnerable to ischaemic disorders, the macular region is likely to show special vulnerability to any generalized chronic ischaemic disorder of the choroid. This, however, would not hold good in occlusion of a single SPCA, because the latter supplies only a small segment of the macular region. It is postulated that senile macular degeneration, senile disciform macular degeneration and allied macular disorders are most probably due to this unusual pattern of the submacular choroid and its special vulnerability to suffer in generalized chronic choroidal ischaemia as compared to the rest of the choroid.
Zusammenfassung
Das Gefäßsystem der Aderhaut unterhalb der Macula lutea wurde experimentell untersucht. In 87 Affenaugen wurden entweder eine der temporalen kurzen hinteren Ciliararterien (KHCA) oder 1, 2, 3, oder alle 4 Vortex- venen unterbunden. Die gestörte Füllung und Anastomosen wurden dann im Fluo-Angiogramm studiert. Alle temporalen KHCA penetrieren den Bulbus in der Makulagegend. Jede dieser Arterien versorgt einen Teil der Aderhaut und benachbarte Segmente anastomosieren nicht. Die 4 Segmente der Aderhaut, die von den jeweiligen Vortexvenen drainiert werden, haben ihre Grenzen auch in der Gegend der Makula. In der Makula treffen sich daher viele Grenzen der Blutversorgung und dies macht dieses Gebiet besonders für allgemeine Gefäßstörungen anfällig. Der Verschluß einer einzigen KHCA würde allerdings nur ein kleines Segment der Makula stören. Wir nehmen daher an, daß die senile Degeneration der Makula (die trockene und die feuchte Form) durch diese eigenartige Gefäßverteilung in der Aderhaut bedingt ist. Die Makulagegend ist daher besonders empfindlich bei diffusen Gefäßstörungen der Aderhaut.
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Singh Hayreh, S. Submacular choroidal vascular pattern. Albrecht von Graefes Arch. Klin. Ophthalmol. 192, 181–196 (1974). https://doi.org/10.1007/BF00416865
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DOI: https://doi.org/10.1007/BF00416865