Br J Ophthalmol 2000;84:239-243
( March )
Clinicopathological correlation in exudative age related macular
degeneration: histological differentiation between classic and occult
choroidal neovascularisation
B A Lafauta b, K U Bartz-Schmidta, C Vanden Broeckec, S Aisenbreya, J J De Laeyb, K Heimanna
a University Eye
Clinic, Joseph-Stelzmann- Strasse 9, D-50931 Cologne, Germany, b University Hospital Gent,
Ophthalmology, De Pintelaan 185, B-9000 Gent, Belgium, c University Hospital
Gent, Pathology
Correspondence to: B A Lafaut, University Hospital Gent
Accepted for publication 18 November 1999
AIMS To analyse the
histopathology of classic and occult choroidal neovascular membrane
surgical specimens in age related macular degeneration.
METHODS35 membranes,
from a consecutive series of surgically removed choroidal neovascular
membranes in age related macular degeneration, were classified as
classic or occult following the guidelines of the Macular
Photocoagulation Study. Membranes with classic as well as occult
components were considered as mixed membranes. The membranes were
serially sectioned and stained with haematoxylin and eosin, Masson
trichrome, periodic acid-Schiff, and phosphotungstic acid haematoxylin
stain. The correlation has been made in a masked fashion.
RESULTS31 membranes
(19 classic, 10 occult, and two mixed membranes) could be analysed
histologically. 18 classic choroidal neovascular membranes had a major
subretinal fibrovascular component and 10 of these had an additional,
minor fibrovascular component under the retinal pigment epithelium. The
10 occult membranes contained a fibrovascular component under the
retinal pigment epithelium and the two mixed membranes contained
fibrovascular tissue on both sides of the retinal pigment epithelium.
Fibrin and remains of outer segments tended to occur at the lateral
edges of classic membranes and to cover the inner surface of occult membranes.
CONCLUSIONClassic
choroidal neovascularisation in age related macular degeneration is
predominantly composed of subretinal fibrovascular tissue while
occult choroidal neovascularisation is composed of fibrovascular
tissue at the choroidal side of the retinal pigment epithelium.
© 2000 by British Journal of Ophthalmology
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