Clinicopathological correlation of choroidal neovascularization after external beam radiotherapy in age-related macular degeneration.

Autor: S. Aisenbrey, B. A. Lafaut, S. Reynders, P. Szurman, S. Grisanti, C. Vanden Broecke, P. Walter, K. U. Bartz-Schmidt
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Zdroj: Graefe's Archive of Clinical & Experimental Ophthalmology; Apr2003, Vol. 241 Issue 4, p269-276, 8p
Abstrakt: Abstract Purpose. To analyze the histopathology of choroidal neovascularization after external beam radiotherapy in age-related macular degeneration. Methods. A retrospective non-case-matched comparative histopathologic study. The histoarchitecture of nine surgically removed subretinal specimens from nine patients that had undergone external beam radiotherapy for exudative age-related macular degeneration was studied. Seven patients had received 20 Gy in 10 fractions and two 15 Gy in 5 fractions with an average time interval between radiotherapy and surgical extraction of 14 months (range 3-28). A consecutive series of classic, mixed and occult choroidal neovascular membranes served as controls. Results. Clinical findings. Radiation-associated choroidal neovasculopathy was angiographically suspected in four patients: a coarse net of vessels on fluorescein angiography developing at the border of previously irradiated choroidal neovascularization was observed in three patients ; blebs at the margin of a plaque on indocyanine green angiography were observed in two patients. Pathological findings. Diffuse drusen as well as intra-Bruch's fibrovascular tissue was found in all irradiated specimens. In four specimens an edematous vascularized layer was seen between diffuse drusen and normal-appearing intra-Bruch's fibrovascular tissue. This lesion was not found in the control specimens. A particular correlation for the bleb lesion was not recognized. Conclusion. The appearance of an edematous subretinal pigment epithelial vascularized layer between diffuse drusen and normal-appearing fibrovascular tissue in four of nine irradiated membranes may be secondary to previous irradiation. It may correlate with the unusual exudative manifestations observed after external beam radiotherapy. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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