TY - JOUR
T1 - CLINICOPATHOLOGIC CORRELATION OF GEOGRAPHIC ATROPHY SECONDARY TO AGE-RELATED MACULAR DEGENERATION
AU - Li, Miaoling
AU - Dolz-Marco, Rosa
AU - Huisingh, Carrie
AU - Messinger, Jeffrey D.
AU - Feist, Richard M.
AU - Ferrara, Daniela
AU - Freund, K. Bailey
AU - Curcio, Christine A.
AU - Wilson, David
N1 - Funding Information:
Supported by Hoffman-LaRoche. The Funding Organization had no role in the design and conduct of this study. Purchase of the slide scanner was made possible by the Carl G. and Pauline Buck Trust. R. Dolz-Marco receives research support form Alcon, Genentech, Heidelberg Engineering, Novartis, Roche, and Thea. K.B. Freund is a consultant for Optivue, Heidelberg Engineering, Allergan, Zeiss, Novartis, and Genentech. He receives research support from Genentech/Roche. D. Ferrara is an employee of Gen-entech and has stock/stock options of Roche. C.A. Curcio receives research funding from Heidelberg Engineering.
Publisher Copyright:
© by Ophthalmic Communications Society, Inc.
PY - 2019/4/1
Y1 - 2019/4/1
N2 - 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.
AB - 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.
KW - Müller cells
KW - age-related macular degeneration
KW - basal laminar deposits
KW - basal linear deposits
KW - complete retinal pigment epithelium and outer retinal atrophy
KW - drusen
KW - external limiting membrane
KW - fundus autofluorescence
KW - geographic atrophy
KW - histology
KW - optical coherence tomography
KW - outer retina
KW - photoreceptors
KW - retinal pigment epithelium
KW - subretinal drusenoid deposits
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U2 - 10.1097/IAE.0000000000002461
DO - 10.1097/IAE.0000000000002461
M3 - Article
C2 - 30839495
AN - SCOPUS:85063713430
SN - 0275-004X
VL - 39
SP - 802
EP - 816
JO - Retina
JF - Retina
IS - 4
ER -