Relationship between RPE and choriocapillaris in age-related macular degeneration.
Relationship between RPE and choriocapillaris in age-related macular degeneration.
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DOI：
10.1167/iovs.09-3639
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发表时间：
2009-10
影响因子：
4.4
通讯作者：
Lutty GA
中科院分区：
文献类型：
--
作者：
McLeod DS;Grebe R;Bhutto I;Merges C;Baba T;Lutty GA
本研究的目的是探讨年龄相关性黄斑变性 (AMD) 中脉络膜毛细血管 (CC) 和视网膜色素上皮 (RPE) 变化之间的关系。对干性和湿性 AMD 中 RPE/脉络膜毛细血管复合体的形态变化进行了量化，并将结果与没有黄斑病的老年对照眼睛进行了比较。使用半定量计算机辅助形态测量技术对 3 名老年对照受试者、5 名地理萎缩 (GA) 受试者和 3 名湿性 AMD 受试者的死后脉络膜进行了分析，该技术是为了测量在碱性磷酸酶活性下孵育的脉络膜整体中的 RPE 和 CC 面积百分比而开发的。随后将组织包埋在甲基丙烯酸酯中并切片以检查结构变化。 GA中RPE和CC的损失之间存在线性关系。在 RPE 完全萎缩的区域，血管面积减少了 50%。在没有 RPE 的区域发现剩余的存活毛细血管极度收缩。与湿性 AMD 中的活动性脉络膜新生血管 (CNV) 相邻，在没有 RPE 萎缩的情况下，CC 脱落很明显，导致血管面积减少 50%。湿 AMD 眼中剩余毛细血管的管腔直径与对照相似。 GA 的主要损伤似乎是在 RPE 水平，并且 RPE 萎缩和继发性 CC 变性之间存在密切关系。 CC 变性发生在湿性 AMD 中存在活 RPE 的情况下。血管脱落区域的 RPE 可能缺氧，这可能导致 RPE 产生的 VEGF 增加并刺激 CNV。
The purpose of this study was to examine the relationships between choriocapillaris (CC) and retinal pigment epithelial (RPE) changes in age-related macular degeneration (AMD). Morphological changes in the RPE/choriocapillaris complex were quantified in dry and wet forms of AMD and the results compared to with aged control eyes without maculopathy. Postmortem choroids from 3 aged control subjects, 5 geographic atrophy (GA) subjects and 3 wet AMD subjects were analyzed using a semi-quantitative computer-assisted morphometric technique developed to measure percent RPE and CC areas in choroidal whole mounts incubated for alkaline phosphatase activity. The tissues were subsequently embedded in methacrylate and sectioned to examine structural changes. There was a linear relationship between the loss of RPE and CC in GA. A 50% reduction in vascular area was found in regions of complete RPE atrophy. Extreme constriction of remaining viable capillaries was found in areas devoid of RPE. Adjacent to active choroidal neovascularization (CNV) in wet AMD, CC dropout was evident in the absence of RPE atrophy resulting in a 50% decrease in vascular area. Lumenal diameters of the remaining capillaries in wet AMD eyes were similar to controls. The primary insult in GA appears to be at the level of the RPE and there is an intimate relationship between RPE atrophy and secondary CC degeneration. CC degeneration occurs in the presence of viable RPE in wet AMD. The RPE in regions of vascular dropout are presumably hypoxic, which may result in an increase in VEGF production by the RPE and stimulation of CNV.