Choriocapillaris Degeneration in Geographic Atrophy
| Autor: | Young H. Kwon, S. Scott Whitmore, Edwin M. Stone, Grefachew Workalemahu, Michael D. Abràmoff, Miles J. Flamme-Wiese, Robert F. Mullins, Alexander G. Marneros, Kai Wang, Erin A. Boese, Budd A. Tucker, Elliott H. Sohn |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Vascular Endothelial Growth Factor A Pathology medicine.medical_specialty genetic structures Retinal Pigment Epithelium Degeneration (medical) Article Pathology and Forensic Medicine Vascular lumen Stroma Geographic Atrophy Humans Medicine Aged Aged 80 and over Retinal pigment epithelium Choroid business.industry Disease progression Macular degeneration medicine.disease eye diseases Geographic atrophy medicine.anatomical_structure Female sense organs business |
| Zdroj: | Am J Pathol |
| ISSN: | 0002-9440 |
| Popis: | Early age-related macular degeneration (AMD) is characterized by degeneration of the choriocapillaris, the vascular supply of retinal photoreceptor cells. We assessed vascular loss during disease progression in the choriocapillaris and larger vessels in the deeper choroid. Human donor maculae from controls (n = 99), early AMD (n = 35), or clinically diagnosed with geographic atrophy (GA; n = 9, collected from outside the zone of retinal pigment epithelium degeneration) were evaluated using Ulex europaeus agglutinin-I labeling to discriminate between vessels with intact endothelial cells and ghost vessels. Morphometric analyses of choriocapillaris density (cross-sectional area of capillary lumens divided by length) and of vascular lumen/stroma ratio in the outer choroid were performed. Choriocapillaris loss was observed in early AMD (Bonferroni-corrected P = 0.024) with greater loss in GA (Bonferroni-corrected P < 10(−9)), even in areas of intact retinal pigment epithelium. In contrast, changes in lumen/stroma ratio in the outer choroid were not found to differ between controls and AMD or GA eyes (P > 0.05), suggesting choriocapillaris changes are more prevalent in AMD than those in the outer choroid. In addition, vascular endothelial growth factor-A levels were negatively correlated with choriocapillaris vascular density. These findings support the concept that choroidal vascular degeneration, predominantly in the microvasculature, contributes to dry AMD progression. Addressing capillary loss in AMD remains an important translational target. |
| Databáze: | OpenAIRE |
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