CLINICOPATHOLOGIC CORRELATION OF GEOGRAPHIC ATROPHY SECONDARY TO AGE-RELATED MACULAR DEGENERATION

Autor: Rosa Dolz-Marco, Daniela Ferrara, Carrie Huisingh, K. Bailey Freund, Richard M. Feist, Christine A. Curcio, Jeffrey D. Messinger, Miaoling Li
Rok vydání: 2019
Předmět:
medicine.medical_specialty
Clinicopathologic Correlation
genetic structures
Infrared Rays
retinal pigment epithelium
basal laminar deposits
Retinal Drusen
subretinal drusenoid deposits
Drusen
Fundus (eye)
histology
Macular Degeneration
Optical coherence tomography
In vivo
Ophthalmology
Geographic Atrophy
medicine
Humans
External limiting membrane
age-related macular degeneration
Aged
80 and over
Müller cells
Retinal pigment epithelium
optical coherence tomography
medicine.diagnostic_test
fundus autofluorescence
business.industry
Optical Imaging
drusen
outer retina
photoreceptors
General Medicine
Macular degeneration
basal linear deposits
medicine.disease
eye diseases
Choroidal Neovascularization
external limiting membrane
complete retinal pigment epithelium and outer retinal atrophy
medicine.anatomical_structure
Female
sense organs
business
Ex vivo
Tomography
Optical Coherence
Zdroj: Retina (Philadelphia, Pa.)
ISSN: 1539-2864
Popis: Supplemental Digital Content is Available in the Text. Direct clinicopathologic correlation of an eye with geographic atrophy secondary to age-related macular degeneration provides histologic correlates of features commonly seen by optical coherence tomography, such as end-stages of drusen, subretinal drusenoid deposit, plaques near the Bruch membrane, and hyporeflective wedge.
Purpose: In an eye with geographic atrophy (GA) secondary to age-related macular degeneration, we correlated ex vivo histologic features with findings recorded in vivo using optical coherence tomography (OCT), near-infrared reflectance imaging, and fundus autofluorescence. Methods: In the left eye of an 86-year-old white woman, in vivo near-infrared reflectance and eye-tracked OCT B-scans at each of 6 clinic visits and a baseline fundus autofluorescence image were correlated with high-resolution histologic images of the preserved donor eye. Results: Clinical imaging showed a small parafoveal multilobular area of GA, subfoveal soft drusen, refractile drusen, hyperreflective lines near the Bruch membrane, subretinal drusenoid deposit (reticular pseudodrusen), and absence of hyperautofluorescent foci at the GA margin. By histology, soft drusen end-stages included avascular fibrosis with highly reflective cholesterol crystals. These accounted for hyperreflective lines near the Bruch membrane in OCT and plaques in near-infrared reflectance imaging. Subretinal drusenoid deposit was thick, continuous, extracellular, extensive outside the fovea, and associated with distinctive retinal pigment epithelium dysmorphia and photoreceptor degeneration. A hyporeflective wedge corresponded to ordered Henle fibers without cellular infiltration. The external limiting membrane descent, which delimits GA, was best visualized in high-quality OCT B-scans. Retinal pigment epithelium and photoreceptor changes at the external limiting membrane descent were consistent with our recent histologic survey of donor eyes. Conclusion: This case informs on the extent, topography, and lifecycle of extracellular deposits. High-quality OCT scans are required to reveal all tissue features relevant to age-related macular degeneration progression to GA, especially the external limiting membrane descent. Histologically validated signatures of structural OCT B-scans can serve as references for other imaging modalities.
Databáze: OpenAIRE
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