Clinicopathological correlation in exudative age-related macular degeneration: recurrent choroidal neovascularization

Lafaut, B. A.; Aisenbrey, S.; Broecke, C. Vanden; Tizio, Federico Di; Bartz‐Schmidt, Karl Ulrich

doi:10.1007/s004170000224

Cited by 10 publications

(4 citation statements)

References 21 publications

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“…Indeed, this phenomenon of macular neovessel recurrence is frequently observed after CNVM treatment modalities. 85,86 We conclude that the quantitatively distinct features of the EL may help to explain the enhanced susceptibility of the macula to degeneration in AMD and other diseases characterized by neovascularization in the macular region.…”

Section: Discussionmentioning

confidence: 87%

Decreased Thickness and Integrity of the Macular Elastic Layer of Bruch's Membrane Correspond to the Distribution of Lesions Associated with Age-Related Macular Degeneration

Chong

Keonin

Luthert

et al. 2005

The American Journal of Pathology

188

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Age-related macular degeneration (AMD) is a leading cause of blindness in the elderly. In its severest form, choroidal neovessels breach the macular Bruch's membrane, an extracellular matrix compartment comprised of elastin and collagen laminae, and grow into the retina. We sought to determine whether structural properties of the elastic lamina (EL) correspond to the region of the macula that is predilected toward degeneration in AMD. Morphometric assessment of the macular and extramacular regions of 121 human donor eyes, with and without AMD, revealed a statistically significant difference in both the integrity (P < 0.0001) and thickness (P < 0.0001) of the EL between the macular and extramacular regions in donors of all ages. The EL was three to six times thinner and two to five times less abundant in the macula than in the periphery. The integrity of the macular EL was significantly lower in donors with early-stage AMD (P = 0.028), active choroidal neovascularization (P = 0.020), and disciform scars (P = 0.003), as compared to unaffected, age-matched controls. EL thickness was significantly lower only in individuals with disciform scars (P = 0.008). The largest gaps in macular EL integrity were significantly larger in all categories of AMD (each P < 0.0001), as compared to controls. EL integrity, thickness, and gap length in donors with geographic atrophy did not differ from those of controls. These structural properties of the macular EL correspond spatially to the distribution of macular lesions associated with AMD and may help to explain why the macula is more susceptible to degenerative events that occur in this disease.

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Section: Discussionmentioning

confidence: 87%

Decreased Thickness and Integrity of the Macular Elastic Layer of Bruch's Membrane Correspond to the Distribution of Lesions Associated with Age-Related Macular Degeneration

Chong

Keonin

Luthert

et al. 2005

The American Journal of Pathology

188

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“…Typischerweise ist eine subretinale CNV von einem fibrinhaltigen Rand umgeben [1,12]. Die Membran vergrößert sich in ihren Randbereichen durch Aussprossung von Gefäßen in die fibrinö-se Matrix.…”

Section: » Neuerdings Wird Die Injektion Von Anti-vegf Gleichzeitig Munclassified

Intravitreale Injektionen

Hesse

2012

Ophthalmologe

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Since 1996 acute subretinal hemorrhages have been treated by intravitreal injections. Large proteins injected into the vitreous cavity can cross the retina as well as the underlying retinal pigment epithelium. After intravitreal injection of tissue plasminogen activator (TPA), plasminogen, which is part of a subretinal clot, is converted to plasmin in the presence of fibrin. Plasmin is a relatively unspecific protease that liquefies a formed fibrin clot. Simultaneous intravitreal injection causes an inferior displacement of the liquefied hemorrhage. Beside mechanical effects on subretinal clots plasmin inhibits choroidal neovascularization by hydrolysis of the extracellular matrix as well as growth factors. After successful displacement of a subretinal hemorrhage an additional anti-VEGF (vascular endothelial growth factor) therapy is required.

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“…Several authors have studied the pathology of exudative AMD [6,7,8,9,10,11,13,14,15,16,17,18,23,24,25,26,27,28,29,31,32,33,36,37,38,40,42]. Some authors have reported the pathology of massive intraocular hemorrhage complicating age-related macular degeneration in enucleated eyes [10,31].…”

Section: Introductionmentioning

confidence: 99%

“…A series of surgically extracted specimens in hemorrhagic AMD have been studied for the Submacular Surgery Trial, but no separate analysis of these specimens is available [18]. More recently, the histopathological appearance in AMD has been correlated with angiographic characteristics [6,7,23,24,25,26,27,28,29,36,40,42]. In this study the pathologic characteristics of a relatively large series of hemorrhagic maculopathy surgical specimens is reported and compared with those of classic, mixed and occult CNV.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathologic correlation in hemorrhagic age-related macular degeneration

Reynders

Lafaut

Aisenbrey

et al. 2002

Graefe's Arch Clin Exp Ophthalmol

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Clinicopathological correlation in exudative age-related macular degeneration: recurrent choroidal neovascularization

Abstract: A subretinal fibrovascular membrane corresponded with the classic recurrent choroidal neovascularization.

Cited by 10 publications

References 21 publications

Decreased Thickness and Integrity of the Macular Elastic Layer of Bruch's Membrane Correspond to the Distribution of Lesions Associated with Age-Related Macular Degeneration

Decreased Thickness and Integrity of the Macular Elastic Layer of Bruch's Membrane Correspond to the Distribution of Lesions Associated with Age-Related Macular Degeneration

Intravitreale Injektionen

Clinicopathologic correlation in hemorrhagic age-related macular degeneration

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