title: Combined subretinal and sub-retinal pigment epithelium neovascular membranes in age-related macular degeneration: a clinicopathologic study of six cases.
abstract: OBJECTIVE
  Subfoveal neovascular membranes are usually located either in the subsensory retinal space or below the retinal pigment epithelium (RPE). This article describes the clinical and histopathologic features of subfoveal membranes with both subretinal and sub-RPE components (combined membranes).
  
  
  METHODS
  Six surgically excised subfoveal neovascular membranes from six patients were examined histopathologically. Preoperative and postoperative clinical information was obtained from each patient.
  
  
  RESULTS
  Clinically, the combined membranes had no special characteristic features. The most common fluorescein angiographic finding postoperatively was a window defect of the RPE. Visual acuity improved in three patients and became worse in the other three patients.
  
  
  CONCLUSIONS
  All patients with combined subfoveal neovascular membranes had age-related macular degeneration. In this disease, a single subfoveal membrane may extend into both the subretinal and the sub-RPE spaces. Patients may benefit from surgical removal of the membrane.
authors.affiliation: Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston 77030, USA.
authors.forename: H
authors.initials: H
authors.lastname: Mietz
authors.forename: P T
authors.initials: PT
authors.lastname: Merrill
authors.forename: H M
authors.initials: HM
authors.lastname: Lambert
authors.forename: R L
authors.initials: RL
authors.lastname: Font
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000473:pathology; D005260:Female; D005451:Fluorescein Angiography; D005584:Fovea Centralis / Q000473:pathology; D005654:Fundus Oculi; D006801:Humans; D008268:Macular Degeneration / Q000150:complications*; D008297:Male; D010857:Pigment Epithelium of Eye / Q000473:pathology* / Q000601:surgery; D015861:Retinal Neovascularization / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies