June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Compelling Evidence Of Lymphangiogenesis And Lymphatic Vessels In The Developing And Adult Human Choroid
Tailoi Chan-Ling; Louise Baxter; Ping Hu; Samuel Adamson; Frank Arfuso; Michele Madigan; Mark Koina
Author Affiliations & Notes
  • Tailoi Chan-Ling
    Department of Anatomy & Histology, University of Sydney, Sydney, NSW, Australia
  • Louise Baxter
    Department of Anatomy & Histology, University of Sydney, Sydney, NSW, Australia
  • Ping Hu
    Department of Anatomy & Histology, University of Sydney, Sydney, NSW, Australia
  • Samuel Adamson
    Department of Anatomy & Histology, University of Sydney, Sydney, NSW, Australia
  • Frank Arfuso
    Department of Anatomy & Histology, University of Sydney, Sydney, NSW, Australia
  • Michele Madigan
    School of Optometry, The University of New South Wales, Sydney, NSW, Australia
  • Mark Koina
    ACT Pathology, The Canberra Hospital, Canberra, ACT, Australia
  • Footnotes
    Commercial Relationships Tailoi Chan-Ling, None; Louise Baxter, None; Ping Hu, None; Samuel Adamson, None; Frank Arfuso, None; Michele Madigan, None; Mark Koina, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 312. doi:
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      Tailoi Chan-Ling, Louise Baxter, Ping Hu, Samuel Adamson, Frank Arfuso, Michele Madigan, Mark Koina; Compelling Evidence Of Lymphangiogenesis And Lymphatic Vessels In The Developing And Adult Human Choroid. Invest. Ophthalmol. Vis. Sci. 2013;54(15):312.

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Abstract

Purpose: The lymphatic system plays a key role in maintaining fluid homeostasis, macromolecular (including lipid) absorption, immune surveillance & tumour metastasis. Our aim is to provide definitive evidence for lymphatics in human choroid, and to investigate the cellular mechanisms of lymphatic formation.

Methods: Choroidal wholemounts & sections from 12-20 weeks gestation & young adult choroids (20-40 yrs) were examined with multiple marker immunohistochemistry (IHC) using PROX-1, LYVE-1, Podoplanin, D-240, endomucin, VEGF-C & VEGF-R3 antibodies. CD34 & CD39 antibodies were also used to co-visualise vascular lineage cells. Ultrastructural criteria & frequency of lymphatics relative to the vascular lineage was determined using TEM.

Results: The processes of vasculogenesis & angiogenesis preceded lymphangiogenesis during formation of human choroid. The topography of lymphatic formation was centred around the optic nerve & showed a distinct optic disc to periphery topography. A subset of CD34+ hematopoietic stem cells (HSCs) were PROX-1+/Podoplanin+/D240+/VEGF-R3+ & likely represent lymphatic precursor cells (LPCs). These presumed LPCs were distributed as single cells during embryological development. PROX-1+/LYVE-1+/D-240+/VEGF-R3+ macrophages were frequently associated with forming lymphatic channels. Numerous blind ended lymph sacs just external to the choriocapillaris were evident utilizing VEGFR-3/CD34/D-240/LYVE-1 multiple marker IHC. The presence of mid-sized & larger lymphatic channels was determined using both ultrastructural criteria & IHC on choroidal wholemounts. Ultrastructural features of lymphatics included presence of; anchoring filaments, flocculent protein within lymphatic lumina but absence of RBCs; high endothelial cells; incomplete basal lamina; absence of pericytes and double-layered vessel walls and branch patterns typical of lymphatics. In healthy young adults, the relative frequency of lymphatic channels compared to capillaries, arterioles and arteries was 7%, 1% and 5% respectively based on ultrastructural criteria.

Conclusions: Our finding of a system of blind-ended lymphatic capillaries just external to the choriocapillaris places them in an ideal position to subserve their functions of fluid homeostasis, macromolecular absorption and immune surveillance for the choroid. Their existence in the human choroid has major implications for pathogenesis of ARMD, DR & myopia.

Keywords: 452 choroid • 557 inflammation • 499 diabetic retinopathy  
© 2013, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2025 Association for Research in Vision and Ophthalmology.
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