TY - JOUR
T1 - Clinicopathologic correlation of choroidal and retinal neovascular lesions in age-related macular degeneration
AU - Klein, Michael L.
AU - Wilson, David J.
N1 - Funding Information:
Publication of this article was supported by an unrestricted grant to the Casey Eye Institute from Research to Prevent Blindness, Inc , New York, New York, and by the Macular Degeneration Center Research Fund at the Casey Eye Institute, Portland, Oregon. The authors indicate no financial conflict of interest. Involved in Design and conduct of the study (M.L.K., D.J.W.); Collection, management, analysis, and interpretation of the data (M.L.K., D.J.W.); and Preparation, review, or approval of the manuscript (M.L.K., D.J.W.). The Oregon Health & Science University Institutional Review Board determined that human subjects approval was not necessary for this study, because it does not meet the definition of human subjects per 45 CFR 46.102(e). The Institutional Review Board determined that the research does meet the requirements of the Health Insurance Portability and Accountability Act Privacy Rule. The study was in compliance with the tenets of the Declaration of Helsinki and all federal and state laws. The authors thank Susan Nolte, who administered the Retina Eye Donor Program and was responsible for obtaining these donor eyes; the Oregon Lions Eye Bank, which collected the postmortem specimens; and Genevieve J. Long, who edited the manuscript for publication.
PY - 2011/1
Y1 - 2011/1
N2 - Purpose To describe histopathologic findings in donor eyes of 3 individuals with neovascular age-related macular degeneration and to correlate with results of clinical and fluorescein angiographic studies performed before death. Design Retrospective, observational case series. Methods Three eyes of 3 individuals with neovascular age-related macular degeneration were obtained after death and were prepared for histopathologic examination at a tertiary care referral center. Serial sections through the macula and optic nerve were evaluated with light microscopy. Findings were correlated with results of clinical evaluation, including findings of fluorescein angiography performed from 1 week to 5 months before death. Results In Case 1, histopathologic examination revealed a thin choroidal neovascular membrane beneath a relatively intact retinal pigment epithelium (type 1 neovascularization). This correlated with an occult choroidal neovascular membrane on fluorescein angiography characterized by a stippled appearance with minimal late leakage, representing possibly the earliest clinically detectable neovascular membrane for which histopathologic correlation is available. In Case 2, histopathologic examination demonstrated subfoveal choroidal neovascularization with distinctly separate subretinal pigment epithelial (type 1) and subretinal (type 2) components, correlating to fluorescein angiographic appearance of a mixed neovascular membrane with corresponding occult and classic features. The histopathologic findings in Case 3 revealed a plexus of blood vessels in the outer retina surrounded by an abundant eosinophiolic extracellular matrix and associated with a pigment epithelial detachment. There was no communication with the choroid. This correlated with clinical findings of retinal angiomatous proliferation. Conclusions These 3 in situ clinicopathologic correlative studies add new knowledge of the broad clinical spectrum of neovascular age-related macular degeneration.
AB - Purpose To describe histopathologic findings in donor eyes of 3 individuals with neovascular age-related macular degeneration and to correlate with results of clinical and fluorescein angiographic studies performed before death. Design Retrospective, observational case series. Methods Three eyes of 3 individuals with neovascular age-related macular degeneration were obtained after death and were prepared for histopathologic examination at a tertiary care referral center. Serial sections through the macula and optic nerve were evaluated with light microscopy. Findings were correlated with results of clinical evaluation, including findings of fluorescein angiography performed from 1 week to 5 months before death. Results In Case 1, histopathologic examination revealed a thin choroidal neovascular membrane beneath a relatively intact retinal pigment epithelium (type 1 neovascularization). This correlated with an occult choroidal neovascular membrane on fluorescein angiography characterized by a stippled appearance with minimal late leakage, representing possibly the earliest clinically detectable neovascular membrane for which histopathologic correlation is available. In Case 2, histopathologic examination demonstrated subfoveal choroidal neovascularization with distinctly separate subretinal pigment epithelial (type 1) and subretinal (type 2) components, correlating to fluorescein angiographic appearance of a mixed neovascular membrane with corresponding occult and classic features. The histopathologic findings in Case 3 revealed a plexus of blood vessels in the outer retina surrounded by an abundant eosinophiolic extracellular matrix and associated with a pigment epithelial detachment. There was no communication with the choroid. This correlated with clinical findings of retinal angiomatous proliferation. Conclusions These 3 in situ clinicopathologic correlative studies add new knowledge of the broad clinical spectrum of neovascular age-related macular degeneration.
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U2 - 10.1016/j.ajo.2010.07.020
DO - 10.1016/j.ajo.2010.07.020
M3 - Article
C2 - 20970772
AN - SCOPUS:78650511882
SN - 0002-9394
VL - 151
SP - 161
EP - 169
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 1
ER -