Casey Eye Institute, Oregon Health & Science University, Portland, 97239, USA.
Am J Ophthalmol. 2011 Jan;151(1):161-9. doi: 10.1016/j.ajo.2010.07.020.
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.
Retrospective, observational case series.
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.
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.
These 3 in situ clinicopathologic correlative studies add new knowledge of the broad clinical spectrum of neovascular age-related macular degeneration.
描述 3 例新生血管性年龄相关性黄斑变性供体眼的组织病理学发现，并与生前进行的临床和荧光素血管造影研究结果相关联。
回顾性、观察性病例系列研究。
在一家三级转诊中心，对 3 例新生血管性年龄相关性黄斑变性患者死后的 3 只眼进行组织病理学检查。对黄斑和视神经的连续切片进行光镜评估。将发现与生前进行的临床评估结果（包括从死亡前 1 周到 5 个月进行的荧光素血管造影检查结果）相关联。
在第 1 例中，组织病理学检查显示在相对完整的视网膜色素上皮下有一层薄的脉络膜新生血管膜（1 型新生血管化）。这与荧光素血管造影上的隐匿性脉络膜新生血管膜相对应，其特征为点状外观，仅有轻微的晚期渗漏，这可能是目前可用于组织病理学相关性的最早的临床可检测到的新生血管膜。在第 2 例中，组织病理学检查显示位于黄斑下的脉络膜新生血管化，明显分为视网膜色素上皮下（1 型）和视网膜下（2 型）两个部分，与荧光素血管造影上的混合性新生血管膜外观相对应，具有相应的隐匿性和经典特征。第 3 例的组织病理学发现显示外视网膜有血管丛，周围环绕着丰富的嗜酸性细胞外基质，并伴有色素上皮脱离。与脉络膜没有相通。这与视网膜血管瘤样增生的临床发现相对应。
这 3 例原位临床病理相关性研究增加了新生血管性年龄相关性黄斑变性广泛临床谱的新知识。
