Adult vitelliform macular degeneration: a clinicopathological study
Adult vitelliform macular degeneration: a clinicopathological study
复制标题
DOI：
10.1038/sj.eye.6700460
复制
发表时间：
2003-08-01
期刊：
影响因子：
3.9
通讯作者：
Sarks, SH
中科院分区：
文献类型：
--
作者：
Arnold, JJ;Sarks, JP;Sarks, SH
目的/背景成人卵黄样黄斑变性(AVMD)的黄色病变缓慢消退，进展为色素沉着或萎缩。本研究旨在对卵黄状物的位置和性质提供进一步的观察。方法描述4只眼的临床病理对照。对526只老年性黄斑变性(AMD)的老年眼进行了回顾性的组织病理学研究，发现另有10只眼有类似的病理改变。这种物质内部来自感光细胞外节，外部来自视网膜色素上皮(RPE)，后者首先经历肥大，然后破裂和衰减。黄斑中心凹视锥散落在这些病变上，内视网膜变薄，这可能解释了这种情况下黄斑裂孔的形成。所有受累的眼均有AMD的组织病理学证据。结论本研究证实AVMD的卵黄样病变位于感觉性视网膜下。然而，与以前的报道相反，有人认为损伤主要由光感受器碎片组成的细胞外物质组成，可能是RPE吞噬错误的结果，与RPE经历破坏时释放的色素混合在一起。因此，卵黄样病变是视网膜色素上皮损伤最严重区域的标志。
Aims/background The yellow lesions of adult vitelliform macular degeneration (AVMD) slowly fade, progressing to hyperpigmentation or atrophy. This study aims to provide further observations on the location and nature of the vitelliform material.Methods This report describes the clinicopathological correlation of four eyes with AVMD. A retrospective histopathological study of a further 526 aged eyes previously graded for the stage of age-related macular degeneration (AMD) found another 10 eyes with similar pathology.Results The predominant finding was a collection of extracellular material beneath the sensory retina at the fovea. This material was derived internally from photoreceptor outer segments and externally from the retinal pigment epithelium (RPE), the latter first undergoing hypertrophy and then disruption and attenuation. Fallout of foveal cones occurred over these lesions and the inner retina was thinned, which may explain macular hole formation in this condition. All affected eyes showed histopathological evidence of AMD.Conclusions This study confirms that the vitelliform lesions of AVMD lie beneath the sensory retina. In contrast to previous reports, however, it is proposed that the lesions comprise mainly extracellular material consisting of photoreceptor debris, possibly the result of faulty phagocytosis by the RPE, mixed with pigment liberated as the RPE undergoes disruption. The vitelliform lesions therefore are a marker for the area of maximal RPE disturbance.