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Christine A. Curcio, Jeffrey D. Messinger, Kenneth R. Sloan, Richard F. Spaide; Ex Vivo Optical Coherence Tomography (OCT) And Macula-wide High-resolution Histological Sections In Eyes With Age-related Macular Degeneration (AMD). Invest. Ophthalmol. Vis. Sci. 2011;52(14):148.
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To help interpretation of clinical OCT by providing high-resolution images of human macular cross-sections, delineating/ measuring chorioretinal layers, and creating an online library of AMD eyes, using a research collection of donor eyes (Project MACULA); to identify challenges to accurate layer definitions by ex vivo OCT and histology (Figure).
From donor eyes preserved in 2.5% glutaraldehyde/ 1% paraformaldehyde <6 post-mortem, maculas with pigmentary disturbances and/or drusen were excised for spectral domain (SD)-OCT and reflectance imaging. To accentuate AMD-characteristic lesions, tissues were post-fixed by the OTAP method, sectioned at 0.8 µm, and stained with toluidine blue. Foveolar sections were assessed for AMD status using histological criteria. Thicknesses of 21 chorioretinal layers were determined.
Of 18 donor eyes (68-96 yr, mean 82.9 yr; 13/5 F/M), 8 had early AMD, 2 geographic atrophy, and 8 neovascular AMD (6 with AMD history). 1) Ex vivo SD-OCT quality varies between specimens. Not all layers are visible in all eyes, as noted by others. A reflective band representing elevated or thickened RPE was reliably detected. 2) A range of AMD histopathology (drusen, basal laminar/ linear deposits, serous RPE detachment, sub-retinal drusenoid debris, RPE leafleting/ anterior migration, sub-RPE and sub-retinal neovascularization, outer retinal tubulations) can be accommodated in an annotated 21-layer data structure for thicknesses.
Ex vivo OCT can be used to identify disturbances in the RPE-Bruch’s membrane complex of donor eyes prior to histopathologic characterization. Histological layers, including details of sub-RPE deposits, are recognizable and permit both delineation and thickness measurements.
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