Correlation between Biochemical Composition and Fluorescein Binding of Deposits in Bruch's Membrane

Pauleikhoff, Daniel; Zuels, Sabine; Sheraidah, G; Marshall, John; Wessing, A; Bird, Alan C.

doi:10.1016/s0161-6420(92)31768-3

Cited by 165 publications

(85 citation statements)

References 7 publications

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“…An extensive lipid accumulation in Bruch's membrane as a result of aging (Pauleikhoff et al 1990(Pauleikhoff et al , 1992(Pauleikhoff et al , 1994 could explain the diffuse hyperfluorescence we observed in one-third of SPEDs. The late hyperfluorescence of SPED might hamper the precise detection and delineation of the CNV, some CNVs being lost or incompletely delineated, with the consequence of an inadequate laser treatment.…”

Section: Discussionmentioning

confidence: 69%

Hyperfluorescence associated with serous retinal pigment epithelial detachment on indocyanine green angiography

Parodi

Saviano

Bondel

et al. 2000

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: Indocyanine green angiography has been reported to improve detection and delineation of occult choroidal neovascularisation in serous pigment epithelium detachment in age-related macular degeneration. The study aims to evaluate the visual acuity results of eyes affected by serous pigment epithelium detachment in age-related macular degeneration, having had indocyanine greendirected laser photocoagulation, and to correlate them to the pattern of serous pigment epithelium detachment on indocyanine green angiography. Methods: Thirty-four eyes of 31 patients affected by serous pigment epithelium detachment in age-related macular degeneration were prospectively considered. Each patient underwent an ophthalmological examination including fluorescein and indocyanine green angiography one day before, and 6 weeks, 3 months, 6 months, 9 months, 12 months and 24 months after krypton-laser treatment. The serous pigment epithelium detachment was classified in the late-phases angiograms as either hypofluorescent, isofluorescent or hyperfluorescent comparing the fluorescence of the serous pigment epithelium detachment with the choroidal background fluorescence. Results: The indocyanine green-guided laser treatment was associated with a temporary stabilization and a long-term progressive reduction of visual acuity: after 24 months visual acuity improved in 2.9%, stabilized in 26.5% and worsened in 70.5% of cases. Serous pigment epithelium detachment presenting a pretreatment hyperfluorescence had a final visual acuity of 0.06, with subfoveal choroidal neovascularisation development in 100% of cases, whereas serous pigment epithelium detachment presenting a pretreatment hypofluorescence and isofluorescence showed a final visual acuity of 0.12, with subfoveal choroidal neovascularisation development in 43.5% of eyes, with statistically significant difference. Conclusion: Overall visual acuity decreases with time after indocyanine greenguided laser treatment of choroidal neovascularisation in serous pigment epithelium detachment, and serous pigment epithelium detachment becoming hyperfluorescent in the late-phases of indocyanine green angiography has the worst functional outcome.Key words: indocyanine green angiography -hyperfluorescence -serous retinal pigment epithelial detachment.

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Section: Discussionmentioning

confidence: 69%

Hyperfluorescence associated with serous retinal pigment epithelial detachment on indocyanine green angiography

Parodi

Saviano

Bondel

et al. 2000

Acta Ophthalmologica Scandinavica

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“…9,10 Previous results indicated that some macular drusen did not bind ORO and that basal deposits preferentially bound either ORO or BSBB. 13 Our results with filipin, a specific marker for EC and UC, indicate that this variability was probably due to the lesser sensitivity of traditional lipid stains, without excluding between-lesion differences in non-cholesterol lipid components. It will be interesting to determine whether sub-RPE deposits exhibit a progression in the physical forms of cholesterol like the atherosclerotic intima.…”

Section: Discussionmentioning

confidence: 72%

“…[7][8][9][10] Drusen and basal deposits in aged eyes without ARM contain lipids, including cholesterol, 9 -13 and current evidence suggests that individual sub-RPE deposits are preferentially enriched in either neutral lipids or polar lipids. 13 The source of lipids and mechanisms of deposition are unknown. Analyses of BrM/ choroid lipid composition have implicated both local cells and plasma.…”

mentioning

confidence: 99%

Apolipoprotein B in Cholesterol-Containing Drusen and Basal Deposits of Human Eyes with Age-Related Maculopathy

Malek

Guidry

et al. 2003

The American Journal of Pathology

244

212

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Lipids accumulate in Bruch's membrane (BrM), a specialized vascular intima of the eye, and in extracellular lesions associated with aging and age-related maculopathy (ARM). We tested the hypothesis that ARM and atherosclerotic cardiovascular disease share molecules and mechanisms pertaining to extracellular lipid accumulation by localizing cholesterol and apolipoprotein B (apo B) in BrM, basal deposits, and drusen. Human donor eyes were preserved <4 hours postmortem and cryosectioned. Sections were stained with traditional lipid stains and filipin for esterified and unesterified cholesterol or probed with antibodies to apo B, apo E, and apo C-III. Normal adult retinal pigment epithelium (RPE) was subjected to RT-PCR and Western blot analysis for apolipoprotein mRNA and protein. Esterified and unesterified cholesterol was present in all drusen and basal deposits of ARM and normal eyes. Both apo B and apo E but not apo C-III were found in BrM, drusen, and basal deposits. Age-related maculopathy (ARM) is the leading cause of new, untreatable vision loss in the elderly in Western societies. [1][2][3] As shown in Figure 1A, ARM involves the retinal pigment epithelium (RPE, cells dedicated to sustaining photoreceptor health), the choriocapillaris (the blood supply to photoreceptors and the RPE), and Bruch's membrane (BrM, a thin vascular intima between the RPE and choriocapillaris). 4,5 Early ARM is characterized by moderate vision loss associated with characteristic extracellular lesions. Lesions between the RPE basal lamina and BrM can be focal (drusen) or diffuse (basal linear deposits). A diffuse lesion between the RPE and its basal lamina is basal laminar deposit. The term "sub-RPE deposits" is used for the combination of drusen and basal deposits and "basal deposits" for the combination of basal laminar deposit and basal linear deposit. Late ARM is characterized by severe vision loss associated with extensive RPE atrophy with or without the sequelae of choroidal neovascularization, ie, in-growth of choriocapillaries through BrM and under the RPE in the plane of drusen and basal linear deposits. Because the causes of ARM are obscure, recent studies have sought molecules present in the affected tissues and characteristic lesions to identify biochemical pathways perturbed by disease. 6 An important but incompletely characterized component of BrM and sub-RPE deposits is lipids. Normal BrM accumulates lipids with age, and the accumulation of esterified and unesterified cholesterol (EC and UC)-containing particles is especially prominent in the macula. 7-10 Drusen and basal deposits in aged eyes without ARM contain lipids, including cholesterol, 9 -13 and current evidence suggests that individual sub-RPE deposits are preferentially enriched in either neutral lipids or polar lipids. 13 The source of lipids and mechanisms of deposition are unknown. Analyses of BrM/ choroid lipid composition have implicated both local cells and plasma. 8,9 Atherosclerotic cardiovascular disease (CVD), the leading cause of death in Wester...

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“…58 This conclusion was supported by histological observations in which it was shown that the binding of sodium fluorescein correlated well with the biochemical contents of drusen. 64 It would be predicted that the highest resistance to water flow in Bruch's membrane would be found in eyes destined to suffer tears of the detached RPE in which the concept implies that sufficient tangential stress is induced in the detached tissues to cause them to rupture. The determination that a tear in one eye implied high risk of a similar event occurring in the fellow eye 65 provided the opportunity to test the concept.…”

Section: Bruch's Membranementioning

confidence: 99%

Towards an understanding of age-related macular disease

Bird

2003

Eye

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Correlation between Biochemical Composition and Fluorescein Binding of Deposits in Bruch's Membrane

Cited by 165 publications

References 7 publications

Hyperfluorescence associated with serous retinal pigment epithelial detachment on indocyanine green angiography

Hyperfluorescence associated with serous retinal pigment epithelial detachment on indocyanine green angiography

Apolipoprotein B in Cholesterol-Containing Drusen and Basal Deposits of Human Eyes with Age-Related Maculopathy

Towards an understanding of age-related macular disease

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