SUBMACULAR SURGERY TRIALS PATHOLOGY CENTER

黄斑下手术试验病理中心

• 批准号: 6635678
• 负责人: Hans E. Grossniklaus
• 金额: $ 8.01万
• 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 2004-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6635678
• 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.

在美国，年龄相关性黄斑变性（AMD）是导致不可逆失明的主要原因。当AMD的新血管形式，脉络膜新生血管（CNV）发生在中央凹下（中央凹下CNV）时，它会导致中央视力丧失和功能性失明。眼组织胞浆菌病综合征（OHS）也可能发生角膜中央凹下CNV，导致年轻人残疾。荧光素血管造影显示CNV可能有典型和隐匿的模式，每一种模式都与不同的临床结果相关。组织学研究表明，1型和2型CNV在手术后理论上具有不同的临床结果。黄斑下手术试验是一项III期随机临床试验，在该试验中，外科医生从AMD和OHS患者身上切除CNV标本。在本研究中，研究人员使用光镜、电镜和免疫组织化学染色对从SST获得的CNV标本进行了研究，以确定其结构和生化特征与经典和隐匿荧光素血管造影模式的对应关系。我们将检验手术切除的1型CNV与手术切除的2型CNV与未手术患者的临床结果相关的假设，如果结果存在差异，将确定1型CNV与2型CNV的眼底特征。此外，将研究SST患者尸检后获得的眼睛与临床表现和结果的病理相关性。