SUBMACULAR SURGERY TRIALS PATHOLOGY CENTER

黄斑下手术试验病理中心

• 批准号: 2883919
• 负责人: Hans E. Grossniklaus
• 金额: $ 22.81万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-08-01 至 2004-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2883919
• 关键词: clinical research; cooperative study; electron microscopy; eye fundus photography; eye infections; eye surgery; fluorescein angiography; fovea centralis retinae; histoplasmosis; human subject; human therapy evaluation; human tissue; immunocytochemistry; light microscopy; longitudinal human study; macular degeneration; outcomes research; pathology; photocoagulation therapy; vision tests

Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in the United States. When the neovascular form of AMD, choroidal neovascularization (CNV), occurs under the fovea (subfoveal CNV), it leads to central vision loss and functional blindness. Subfoveal CNV may also occur in the ocular histoplasmosis syndrome (OHS), leading to disability in young adults. Fluorescein angiography has shown that CNV may have classic and occult patterns, each of which correlates with a different clinical outcome. Histologic studies have shown type l and type 2 topographies of CNV with theoretically differing clinical outcomes after surgery. The Submacular Surgery Trials is a phase III randomized clinical trials in which surgeons remove CNV specimens from patients with AMD and OHS. In this proposal, CNV specimens obtained from the SST are studied using light and electron microscopy and immunohistochemical stains to determine the structural and biochemical counterparts to classic and occult fluorescein angiographic patterns. The hypothesis that surgically removed type 1 CNV correlates with different clinical outcome than surgically removed type2 CNV compared with unoperated patients will be tested, and if there is a difference in outcome, fundus features of type 1 versus type2 CNV will be determined. Additionally, eyes obtained post-mortem from patients enrolled in the SST will be studied for pathologic correlation with clinical findings and outcomes.

老年性黄斑变性(AMD)是美国不可逆性失明的主要原因。当AMD的新生血管形式脉络膜新生血管(CNV)发生在中心凹(中心凹下)时，会导致中心视力丧失和功能性失明。黄斑下CNV也可发生在眼组织胞浆病综合征(OHS)中，导致年轻人残疾。荧光素血管造影术显示，CNV可能有典型的和隐蔽的模式，每种模式都与不同的临床结果相关。组织学研究显示L型和2型CNV术后临床转归在理论上有所不同。黄斑下手术试验是外科医生从AMD和OHS患者身上取出CNV标本的第三阶段随机临床试验。在这个方案中，从SST获得的CNV标本被用光学、电子显微镜和免疫组织化学染色来研究，以确定与经典和隐蔽的荧光素血管造影模式的结构和生化对应。手术切除的1型CNV与手术切除的2型CNV与未手术患者相比临床结果不同的假设将得到检验，如果结果有差异，将确定1型CNV和2型CNV的眼底特征。此外，从SST患者的尸检中获得的眼睛将被研究与临床结果和结果的病理相关性。