CLINICOPATHOLOGICAL CORRELATION OF DRUSEN AND RETINAL-PIGMENT EPITHELIAL ABNORMALITIES IN AGE-RELATED MACULAR DEGENERATION
CLINICOPATHOLOGICAL CORRELATION OF DRUSEN AND RETINAL-PIGMENT EPITHELIAL ABNORMALITIES IN AGE-RELATED MACULAR DEGENERATION
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DOI：
10.1097/00006982-199414020-00006
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发表时间：
1994-01-01
影响因子：
3.3
通讯作者：
GREEN, WR
中科院分区：
文献类型：
--
作者：
BRESSLER, NM;SILVA, JC;GREEN, WR
背景资料：临床病理学研究的眼睛导致更好地了解眼底镜和荧光素血管造影功能的玻璃疣的性质。本研究旨在提供玻璃疣的临床病理学相关性，并根据临床和组织病理学特征提出玻璃疣的分类。方法：对2例患者的3只眼进行连续切片和研究，并将其特征描绘在二维图中，并与临床结果进行比较。所有三种类型都有大玻璃疣（>63 μ m），眼底照片上记录了软形态特征（边界不清）。在一名患者的双眼中，这些大玻璃疣对应于覆盖Bruch膜的局灶性视网膜色素上皮色素减退区域，该区域在整个黄斑中弥漫性增厚。在第二名患者的另一只眼睛中观察到类似的发现，此外，在血管造影片的晚期，大玻璃疣的荧光素染色相对明显，病理相关性表明Bruch膜增厚的内部与Bruch膜的其余部分分离。局灶性色素沉着过度对应的视网膜色素上皮细胞和集群的色素细胞在视网膜下腔和外nuclearareas.Conclusion：弥漫性增厚的内部方面的布鲁赫膜与视网膜色素上皮细胞色素减退，局灶性萎缩，软（大）玻璃疣的形成。
Background: Clinicopathologic studies of eyes lead to a better understanding of the nature of the ophthalmoscopic and fluorescein angiographic features of drusen. A study was conducted to provide clinicopathologic correlation of drusen and present a classification of drusen based on clinical and histopathologic features.Methods: The macular areas of three eyes from two patients were serially sectioned and studied, and features were depicted in a two-dimensional map and compared with clinical findings.Results: All three tyes had large drusen (>63 mum) with soft morphologic characteristics (poorly demarcated borders) documented on fundus photographs. In both eyes from one patient, these large drusen corresponded to areas of focal retinal pigment epithelium hypopigmentation overlying Bruch's membrane, which was diffusely thickened throughout the macula. Similar findings were noted in another eye from a second patient, and additionally, where there was relatively marked fluorescein staining of large drusen on the late phase of an angiogram, the pathologic correlation demonstrated detachment of the thickened inner aspect of Bruch's membrane from the remainder of Bruch's membrane. Focal hyperpigmentation corresponded to areas of hypertrophy of the retinal pigment epithelium and to clusters of pigmented cells in the subretinal space and outer nuclear area.Conclusion: Diffuse thickening of the inner aspect of Bruch's membrane is associated with retinal pigment epithelial hypopigmentation, focal atrophy, and soft (large) drusen formation.