Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\24626824
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 JAMA+Ophthalmol
2014 ; 132
(3
): 338-45
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Geographic atrophy: a histopathological assessment
#MMPMID24626824
Bird AC
; Phillips RL
; Hageman GS
JAMA Ophthalmol
2014[Mar]; 132
(3
): 338-45
PMID24626824
show ga
IMPORTANCE: Geographic atrophy (GA) is the major cause of blind registration in
Western communities, although, with few exceptions, it is less common than
choroidal neovascular disease. The variation of phenotype implies that
age-related macular degeneration (AMD) does not follow the same course from one
case to another and that phenotyping may be important before initiating a
therapeutic trial. OBJECTIVE: To document photoreceptor and retinal pigment
epithelium (RPE) cell loss and other changes at the RPE-choroid interface in
donated human eyes in which visual loss was deemed to be due to GA. DESIGN,
SETTING, AND PARTICIPANTS: Histological study of a consecutive series of eyes
donated by individuals previously diagnosed clinically as having GA. Donors were
chosen on the basis of available clinical records (from MidAmerica Transplant
Services, St Louis, Missouri; the Iowa Lions Eye Bank, Iowa City; and the Utah
Lions Eye Bank, Salt Lake City) and selected were those considered to have GA due
to AMD. Tissues in the regions of atrophy were examined with light, electron, and
autofluorescence microscopy. RESULTS: In most of the 37 donors examined, there
was marked loss of photoreceptor cells for variable distances distal from the
edge of the GA. Rod loss was greater than cone loss. An inverse relationship
existed between the quantity of autofluorescent inclusions in the RPE and the
thickness of sub-RPE basal laminar deposit. Integrity of the choroid varied from
one eye to another and was not related strictly to photoreceptor survival. In
some eyes, photoreceptor loss existed in the absence of obvious morphological
changes in the Bruch membrane or RPE. CONCLUSIONS AND RELEVANCE: The findings
support the view that photoreceptor loss occurs early in AMD in a proportion of
cases and imply that photoreceptor-cell loss may contribute to the functional
loss recorded in early stages of AMD at least in part. The variation of changes
from one eye to another implies that patients selected for a specific
prophylactic therapy for early AMD should be chosen on the basis of the
characteristics of their disease.
free
free
free
