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Clinicopathological correlation of choroidal neovascularization after external beam radiotherapy in age-related macular degeneration

  • Clinical Investigation
  • Published:
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Abstract

Purpose

To analyze the histopathology of choroidal neovascularization after external beam radiotherapy in age-related macular degeneration.

Methods

A retrospective non-case-matched comparative histopathologic study. The histoarchitecture of nine surgically removed subretinal specimens from nine patients that had undergone external beam radiotherapy for exudative age-related macular degeneration was studied. Seven patients had received 20 Gy in 10 fractions and two 15 Gy in 5 fractions with an average time interval between radiotherapy and surgical extraction of 14 months (range 3–28). A consecutive series of classic, mixed and occult choroidal neovascular membranes served as controls.

Results

Clinical findings. Radiation-associated choroidal neovasculopathy was angiographically suspected in four patients: a coarse net of vessels on fluorescein angiography developing at the border of previously irradiated choroidal neovascularization was observed in three patients ; blebs at the margin of a plaque on indocyanine green angiography were observed in two patients. Pathological findings. Diffuse drusen as well as intra-Bruch's fibrovascular tissue was found in all irradiated specimens. In four specimens an edematous vascularized layer was seen between diffuse drusen and normal-appearing intra-Bruch's fibrovascular tissue. This lesion was not found in the control specimens. A particular correlation for the bleb lesion was not recognized.

Conclusion

The appearance of an edematous subretinal pigment epithelial vascularized layer between diffuse drusen and normal-appearing fibrovascular tissue in four of nine irradiated membranes may be secondary to previous irradiation. It may correlate with the unusual exudative manifestations observed after external beam radiotherapy.

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Fig. 1A–D.
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Fig. 5. A

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Author information

Authors and Affiliations

  1. Department of Vitreo-Retinal Surgery, Center of Ophthalmology, University of Cologne, Cologne, Germany

    S. Aisenbrey & P. Walter

  2. Department of Ophthalmology, A.Z. St.-Jan Ruddershove, Ruddershove 10, 8000 , Bruges, Belgium

    B. A. Lafaut

  3. Department of Ophthalmology, University Hospital Ghent, Ghent, Belgium

    B. A. Lafaut & S. Reynders

  4. Department of Ophthalmology, University Hospital Tübingen, Tübingen, Germany

    P. Szurman, S. Grisanti & K. U. Bartz-Schmidt

  5. Department of Pathology, University Hospital Ghent, Ghent, Belgium

    C. Vanden Broecke

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  1. S. Aisenbrey
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  2. B. A. Lafaut
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  8. K. U. Bartz-Schmidt
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Correspondence to B. A. Lafaut.

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Aisenbrey, S., Lafaut, B.A., Reynders, S. et al. Clinicopathological correlation of choroidal neovascularization after external beam radiotherapy in age-related macular degeneration. Graefe's Arch Clin Exp Ophthalmol 241, 269–276 (2003). https://doi.org/10.1007/s00417-003-0634-8

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  • DOI: https://doi.org/10.1007/s00417-003-0634-8

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