Blood-retina barrier permeability is independent of trace substance lipid solubility in retinitis pigmentosa and in the healthy eye

Differential ocular spectrofluorometry was used toassess the passive permeability of the blood-retinabarrier in healthy subjects and in patients withretinitis pigmentosa by determination of the rate ofinward leakage of fluorescein and fluoresceinglucuronide after intravenous injection offluorescein.In five healthy subjects we found permeabilities of1.3 (0.6–2.8) nm/s [log-mean (range)] for fluoresceinand 1.3 (0.6–3.1) nm/s for fluorescein glucuronide.Six patients with retinitis pigmentosa all had amarkedly increased blood-retina barrier leakage, withinward permeabilities of 8.2 (3.4–25) nm/s forfluorescein and 8.2 (5.6–27) nm/s for fluoresceinglucuronide.Since no detectable difference was found between thepermeabilities of the two tracers the passive permeability of the blood-retina barrier appears to beindependent of the 18-fold difference in lipidsolubility between the two tracers, both in retinitispigmentosa and in healthy subjects. Presumably, thestructural substrate for leakage of small hydrophilicmolecules through the blood-retina barrier is awater-filled pore, since diffusion through lipidcellular membranes would favor fluorescein over itsmore water soluble glucuronide.