Bilateral midperipheral large drusen and retinal pigment epithelial detachments associated with multifocal areas of choroidal neovascularization: a histopathologic study.
OBJECTIVE
The ocular histopathologic features of a patient with bilateral multiple midperipheral areas of choroidal vascularization, large drusen, and detachments of the retinal pigment epithelium (RPE) are presented.


METHODS
The eyes were obtained at autopsy and fixed in 4% buffered formaldehyde. Serial sections through the macula area and inferior segments were prepared. Light as well as electron microscopy was performed.


RESULTS
Microscopic examination disclosed numerous large drusen measuring up to 200 micro m in height and 280 micro m in diameter and areas of serous RPE detachments in the midperiphery of both eyes. Some of the large drusen had choroidal vascularization. Areas of sub-RPE neovascularization that measured up to 6.5 mm in diameter were present in the midperiphery of both eyes. The choroidal origin for neovascularization was evident in 10 areas. A 1-mm area of hemorrhagic detachment of the RPE contiguous with choroidal neovascularization (CNV) was present in the immediate postequatorial area temporally in the left eye. No drusen, basal deposit, or CNV was present in the macular area.


CONCLUSIONS
Multifocal midperipheral RPE detachments and CNV can occur in the absence of significant age-related macular disease.
Tabandeh
Homayoun
H
Eye Pathology Laboratory, Wilmer Eye Institute and Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Dubovy
Sander
S
Green
W Richard
WR
D020256:Choroidal Neovascularization / Q000150:complications / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000473:pathology*; D012163:Retinal Detachment / Q000209:etiology / Q000473:pathology*; D015593:Retinal Drusen / Q000209:etiology / Q000473:pathology*