Hyporeflective Wedge-Shaped Band in Geographic Atrophy Secondary to Age-related Macular Degeneration

Monés, Jordi; Biarnés, Marc; Trindade, Fabio

doi:10.1016/j.ophtha.2012.01.026

Cited by 43 publications

(30 citation statements)

References 30 publications

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“…It should be noted that this description differed markedly from the common “hyporeflective wedge-shaped band” described by Monés et al, 18 which develops in the axonal portion of the OPL (Henle fiber layer) at the junction between normal and atrophic retina. 6,19 The descriptor “hyporeflective wedge” applied to two different structures in GA has caused some confusion in recent literature.…”

mentioning

confidence: 54%

The Evolution of the Plateau, an Optical Coherence Tomography Signature Seen in Geographic Atrophy

Tan

Astroz

Dansingani

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PurposeHistologic details of progression routes to geographic atrophy (GA) in AMD are becoming available through optical coherence tomography (OCT). We studied the origins and evolution of an OCT signature called plateau in eyes with GA and suggested a histologic correlate.MethodsSerial eye-tracked OCT scans and multimodal imaging were acquired from eight eyes of seven patients with GA and plateau signatures over a mean follow-up of 7.7 years (range, 3.7–11.6). The histology of unrelated donor eyes with AMD was reviewed.ResultsDrusenoid pigment epithelial detachment (PED) on OCT imaging progressed into wide-based mound-like signatures with flattened apices characterized by a hyporeflective yet heterogeneous interior and an overlying hyperreflective exterior, similar to outer retinal corrugations previously ascribed to persistent basal laminar deposit (BLamD) but larger. These new signatures are described as “plateaus.” An initial increase of the PED volume and hyporeflectivity of its contents was followed by a decrease in PED volume and thinning of an overlying hyperreflective band attributable to the loss of the overlying RPE leaving persistent BLamD. Both imaging and histology revealed persistent BLamD with defects through which gliotic Müller cell processes pass.ConclusionsPlateaus can be traced back to drusenoid PEDs on OCT imaging. We hypothesize that during progressive RPE atrophy, Müller cell extension through focal defects in the residual persistent BLamD may contribute to the heterogeneous internal reflectivity of these entities. The role of Müller cell activation and extension in the pathogenesis of AMD should be explored in future studies.

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mentioning

confidence: 54%

The Evolution of the Plateau, an Optical Coherence Tomography Signature Seen in Geographic Atrophy

Tan

Astroz

Dansingani

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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“…97,110 Existing histopathology 33,111 shows maintained or increased RPE thickness at the GA border, contrary to a recent SDOCT interpretation. 112 The large size of non-epithelial cells pertains to whether these cells are hyperplastic (i.e., proliferating) or hypertrophic. 113 We favor hypertrophy, as we utilize fine detail of nuclear chromatin to focus images, and no mitotic figures were encountered, suggesting that any cell division occurs rarely.…”

Section: Discussionmentioning

confidence: 99%

The Project MACULA Retinal Pigment Epithelium Grading System for Histology and Optical Coherence Tomography in Age-Related Macular Degeneration

Zanzottera

Messinger

Ach

et al. 2015

Invest. Ophthalmol. Vis. Sci.

134

183

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Retinal pigment epithelium morphology indicates multiple pathways in GA and CNV. Atrophic/scarred areas have numerous cells capable of transcribing genes and generating imaging signals. Shed granule aggregates, possibly apoptotic, are visible in SDOCT, as are 'Dissociated' and 'Sloughed' cells. The significance of RPE phenotypes is addressable in longitudinal, high-resolution imaging in clinic populations. Data can motivate future molecular phenotyping studies.

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“…Several studies reported that the presence of OPL and INL subsidence23 and the development of a hyporeflective wedge-shaped band in OPL24 were SD-OCT features of GA areas. Nevertheless, recently, Wu et al 14 demonstrated that the latter SD-OCT hallmarks were also found in patients with intermediate AMD.…”

Section: Discussionmentioning

confidence: 99%

Association between outer retinal alterations and microvascular changes in intermediate stage age-related macular degeneration: an optical coherence tomography angiography study

et al. 2016

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Hyporeflective Wedge-Shaped Band in Geographic Atrophy Secondary to Age-related Macular Degeneration

Cited by 43 publications

References 30 publications

The Evolution of the Plateau, an Optical Coherence Tomography Signature Seen in Geographic Atrophy

The Evolution of the Plateau, an Optical Coherence Tomography Signature Seen in Geographic Atrophy

The Project MACULA Retinal Pigment Epithelium Grading System for Histology and Optical Coherence Tomography in Age-Related Macular Degeneration

Association between outer retinal alterations and microvascular changes in intermediate stage age-related macular degeneration: an optical coherence tomography angiography study

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