The Aging of the Choroid

The first section of this chapter describes the anatomy and the physiology of the choroid and the vascular pattern of the choroidal vessels. The choroid is of fundamental importance for nourishment of the retina so that all the alterations of the choroid lead to a disfunction of the retinal pigment epithelium (RPE), Bruch's membrane, and choriocapillary complex. The various methods used to study the choroid and its pathologies in post-mortem studies and in vivo are described—injection of chromopolimer, Indocyanine Green Angiografy, and Doppler flow studies. Age-related changes of choroid are analyzed. Alterations have been described in the various layers of the choroid, which are part of the physiologic aging process. In certain cases, they can cause disease, but sometimes the border between physiologic and pathologic age-related changes is very hard to identify. The choroid represents the preferential target of certain age-related diseases. In particular, we describe the physiopathology of age-related pathologies such as hypertension, diabetes, AMD, and atherosclerosis—so common in the elderly. In particular, diabetes and AMD represent the main causes of blindness in industrialized countries.