September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Ex vivo spectral domain optical coherence tomography (ex-SDOCT) and high-resolution histology of drusenoid pigment epithelial detachment (D-PED) in age-related macular degeneration (AMD)
Author Affiliations & Notes
  • Jeffrey D Messinger
    Ophthalmology, Univ of Alabama at Birmingham, Birmingham, Alabama, United States
  • Chandra Bala
    Vitreous Retina Macula Consultants of New York , New York, New York, United States
    LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York, New York, United States
  • Kenneth R Sloan
    Ophthalmology, Univ of Alabama at Birmingham, Birmingham, Alabama, United States
    Department of Computer and Information Sciences, University of Alabama at Birmingham, Birmingham, Alabama, United States
  • K Bailey Freund
    Vitreous Retina Macula Consultants of New York , New York, New York, United States
    Department of Ophthalmology, New York University School of Medicine, New York, New York, United States
  • Christine A Curcio
    Ophthalmology, Univ of Alabama at Birmingham, Birmingham, Alabama, United States
  • Footnotes
    Commercial Relationships   Jeffrey Messinger, None; Chandra Bala, None; Kenneth Sloan, None; K Bailey Freund, Genentech (R), Heidelberg Engineering (R), Ohr Pharmaceutical (R), Optos (R), Optovue (R), ThromboGenics (R); Christine Curcio, Genentech (C), Janssen Cell Therapy (C), Merck (C), Novartis (C)
  • Footnotes
    Support  Messinger, Curcio: NIH grant EY06019, EyeSight Foundation of Alabama, Research to Prevent Blindness, Ernest N. and Della L. Thome Foundation, International Retinal Research Foundation. Freund; LuEsther T. Mertz Retinal Research Center, The Macula Foundation Inc. Balaratnasingam: The Macula Foundation Inc.
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
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      Jeffrey D Messinger, Chandra Bala, Kenneth R Sloan, K Bailey Freund, Christine A Curcio; Ex vivo spectral domain optical coherence tomography (ex-SDOCT) and high-resolution histology of drusenoid pigment epithelial detachment (D-PED) in age-related macular degeneration (AMD). Invest. Ophthalmol. Vis. Sci. 201657(12):.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To provide histological correlates for SDOCT signatures in D-PED; to specify features to be sought in clinical imaging studies of D-PED.

Methods : Preserved donor eyes with pigmentary change consistent with AMD were subject to ex-SDOCT [1]. The left eye of a 73-year-old white female had exceptionally clear imaging of a 3 mm diameter D-PED centered under the fovea. An 8-mm diameter tissue block was prepared for submicrometer sections [2] at 25-30 µm intervals. At 402 locations in 28 sections chosen by systematic unbiased sampling, retinal pigment epithelium (RPE) phenotypes [2,3] were assessed.

Results : Histologic correlates for ex-SDOCT signatures include (referring to colored arrowheads in the Figure): 1) Small punctate hyperreflective (hyperR) spots (aqua) in the D-PED interior represent calcific nodules. 2) Hypertransmission through the D-PED dome represent dissociated RPE cells atop basal laminar deposit in an atrophic area. 3) Small and large hyperR intraretinal foci represent fully pigmented and nucleated cells, singly or in groups, respectively, located as far inward as the ganglion cell layer. 4) HyperR material rising from the PED like a volcanic plume (red) represent intraretinal pigmented cells tracking among centrifugally traveling Henle fibers. 5) Focal thickening of the RPE band resembling acquired vitelliform lesions (yellow) represent subretinal plaques of numerous RPE granules and some outer segment debris. Vitelliform material was disproportionately associated with intraretinal pigmented cells.

Conclusions : Histology and ex-SDOCT confirmed hypotheses about the reflectivity of calcific nodules, [4] migratory cells of RPE origin, [2] and vitelliform material [5]. HyperR lipid-filled cells associated with PED in neovascular AMD [1] were not seen in this eye. Multiple RPE fates in AMD can be followed quantified followed using eye-tracked serial SDOCT [2,3].

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

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