Ooto Sotaro, Vongkulsiri Sritatath, Sato Taku, Suzuki Mihoko, Curcio Christine A, Spaide Richard F
LuEsther T. Mertz Retinal Research Center, New York, New York2Vitreous Retina Macula Consultants of New York, New York.
EyeSight Foundation of Alabama Vision Research Laboratories, Department of Ophthalmology, University of Alabama School of Medicine, Birmingham.
JAMA Ophthalmol. 2014 Jul;132(7):806-13. doi: 10.1001/jamaophthalmol.2014.1871.
Optical coherence tomography (OCT) abnormalities of age-related macular degeneration (AMD) have not been fully characterized because of the complex morphology and a lack of correlative histologic studies. Expansion of our ability to interpret increasing attributes brings us closer to the goal of in vivo histologic analysis of the eye by OCT.
To describe a new outer retinal finding of AMD using spectral-domain (SD) OCT and suggest histopathologic correlates.
DESIGN, SETTING, AND PARTICIPANTS: Twenty-five eyes of 16 patients with AMD with severe atrophy due to either choroidal neovascularization (CNV) or geographic atrophy (GA) and 53 donor eyes of 53 patients with late AMD were included. Imaging studies were conducted at a referral retinal practice and histopathology was done at a university research laboratory.
Findings in the outer retina were evaluated in SD-OCT images in eyes with atrophy of the retinal pigment epithelium (RPE) and compared with histopathologic findings in eyes with GA or CNV that also showed loss of the RPE.
Spectral-domain OCT and histologic characteristics of the outer retina.
The mean (SD) age of the 16 patients was 82.7 (7.9) years. Twenty eyes had CNV and 5 eyes had GA. The mean best-corrected visual acuity was 0.800 logMAR (interquartile range, 0.350-1.000 logMAR), a Snellen equivalent of 20/126. A curvilinear hyperreflective density was identified above the Bruch membrane line within the atrophic area in the SD-OCT images. At the internal border, the material was contiguous with the outer portion of the RPE band. Below the material was a relatively hyporeflective space. The material was thrown into folds in cases with atrophy following CNV or was seen as a sheet with numerous bumps in eyes with GA. Review of histopathologic findings of eyes with advanced GA and CNV revealed a rippled layer of basal laminar deposits in an area of RPE atrophy that was located in the same level as the curvilinear line seen in the OCT images.
We have described a new entity, termed outer retinal corrugations, which may correspond to histological findings of basal laminar deposits, extracellular deposits that persist in eyes with late AMD. Observation of this undulating band does not necessarily mean there is exudation or leakage; as a consequence, these patients do not need treatment based on this solitary finding.
由于年龄相关性黄斑变性（AMD）的形态复杂且缺乏相关组织学研究，其光学相干断层扫描（OCT）异常尚未得到充分表征。我们解读越来越多特征的能力的扩展使我们更接近通过OCT对眼睛进行体内组织学分析的目标。
使用光谱域（SD）OCT描述AMD一种新的外层视网膜表现，并提出组织病理学相关性。
设计、设置和参与者：纳入16例因脉络膜新生血管（CNV）或地图样萎缩（GA）导致严重萎缩的AMD患者的25只眼，以及53例晚期AMD患者的53只供体眼。在一家转诊视网膜诊所进行影像学研究，在一所大学研究实验室进行组织病理学检查。
在视网膜色素上皮（RPE）萎缩的眼中，评估SD - OCT图像中外层视网膜的表现，并与同样显示RPE缺失的GA或CNV眼中的组织病理学表现进行比较。
外层视网膜的光谱域OCT和组织学特征。
16例患者的平均（标准差）年龄为82.7（7.9）岁。20只眼有CNV，5只眼有GA。平均最佳矫正视力为0.800 logMAR（四分位间距，0.350 - 1.000 logMAR），相当于Snellen视力表的20/126。在SD - OCT图像的萎缩区域内，Bruch膜线以上发现一条曲线状高反射密度。在内部边界，该物质与RPE带的外侧部分连续。该物质下方是一个相对低反射的间隙。在CNV后萎缩的病例中，该物质呈褶皱状，在GA的眼中则表现为有许多隆起的薄片。对晚期GA和CNV眼的组织病理学检查结果进行回顾发现，在RPE萎缩区域有一层波纹状的基底膜沉积物，其位置与OCT图像中看到的曲线位于同一水平。
我们描述了一种新的实体，称为外层视网膜皱褶，它可能与基底膜沉积物的组织学表现相对应，基底膜沉积物是晚期AMD眼中持续存在的细胞外沉积物。观察到这条起伏的带并不一定意味着有渗出或渗漏；因此，仅基于这一单独发现这些患者不需要治疗。
