Purchase this article with an account.
P.E. Stanga, P. Hiscott, E. Lancaster, D. Wong; Histopathological Correlation of Choroidal Neovascular Membranes (CNV) Secondary to Age-related Macular Degeneration(AMD)Excised During Macular Relocation Surgery (MRS) with Pre-operative Fluorescein Angiography and Visual Outcome . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1778.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To correlate the histopathological findings in choroidal neovascular membranes (CNV) secondary to age-related macular degeneration (AMD) excised during macular relocation surgery (MRS) with the pre- and post-operative logMAR visual acuities. Methods: Twenty-nine patients with a mean age of 75.8 years (SD 6.6, range 59-89) and a mean duration of symptoms of 5.5 months (SD 4.3, range 2 to 21 months) underwent pre- and post-operative protocol refraction, logMAR visual acuity measurements, and fundus fluorescein angiography (FA), phacoemulsification, vitrectomy, 360-degree retinotomy, excision of CNV and MRS. The histological specimens were stained with H&E; and DPAS and examined with light microscopy. The FA were analysed by 2 masked readers and classified as either predominantly classic, occult or submacular haemorrhage. Results: Bruch's membrane elements (BM) were present in 25 of 29 (86%) specimens. The specimen was classified as Sub-RPE when the BM was situated between the fibrovascular complex and the retinal pigment epithelium (RPE). It was classified as Sub-RETINAL when the RPE was situated between the fibrovascular complex and the BM. The pathological classification was made independently and masked to the FA classification and visual outcome. The correlation of Sub-RETINAL and predominantly classic FA was r=0.56, with p<0.01 and between Sub-RPE and occult was r=0.8, p<0.0001. Patients with predominantly classic FA tended to have greater likelihood of visual improvement (not significant). Patients with Sub-RETINAL fibrovascular complexes was significantly correlated with visual improvement r=0.48, p<0.02. Photoreceptor elements were seen at the edge of the specimens and were not correlated with visual outcome. Conclusions: There is good agreement between the histopathological and the FA appearance. Visual acuity improvement is correlated with a subretinal location of the fibrovascular complex. Histological studies of excised membranes may provide prognostic information to the patient.
This PDF is available to Subscribers Only