SUBMACULAR SURGERY TRIALS PATHOLOGY CENTER

视网膜相关性黄斑变性（AMD）是美国不可逆失明的主要原因。当AMD的新生血管形式脉络膜新生血管（CNV）发生在中心凹下（中心凹下CNV）时，其导致中心视力丧失和功能性失明。中心凹下CNV也可能发生在眼组织胞浆菌病综合征（OHS）中，导致年轻人残疾。血管造影显示CNV可能有经典和隐匿的模式，每种模式与不同的临床结果相关。组织学研究表明，1型和2型CNV的拓扑结构在手术后具有理论上不同的临床结果。黄斑下手术试验是一项III期随机临床试验，其中外科医生从AMD和OHS患者中取出CNV标本。在这个建议中，从SST获得的CNV标本进行了研究，使用光学和电子显微镜和免疫组化染色，以确定经典和隐匿性荧光素血管造影模式的结构和生化对应物。将检验手术切除的1型CNV与手术切除的2型CNV相比与未手术患者不同的临床结果相关的假设，如果结果存在差异，将确定1型与2型CNV的眼底特征。此外，还将研究入组SST的患者尸检眼睛的病理学与临床结果和结局的相关性。

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.