title: Outer retinal corrugations in age-related macular degeneration.
abstract: OBJECTIVE
  Optical coherence tomography (OCT) abnormalities of age-related macular degeneration (AMD) have not been fully characterized because of the complex morphology and a lack of correlative histologic studies. Expansion of our ability to interpret increasing attributes brings us closer to the goal of in vivo histologic analysis of the eye by OCT.
  
  
  OBJECTIVE
  To describe a new outer retinal finding of AMD using spectral-domain (SD) OCT and suggest histopathologic correlates.
  
  
  METHODS
  Twenty-five eyes of 16 patients with AMD with severe atrophy due to either choroidal neovascularization (CNV) or geographic atrophy (GA) and 53 donor eyes of 53 patients with late AMD were included. Imaging studies were conducted at a referral retinal practice and histopathology was done at a university research laboratory.
  
  
  METHODS
  Findings in the outer retina were evaluated in SD-OCT images in eyes with atrophy of the retinal pigment epithelium (RPE) and compared with histopathologic findings in eyes with GA or CNV that also showed loss of the RPE.
  
  
  METHODS
  Spectral-domain OCT and histologic characteristics of the outer retina.
  
  
  RESULTS
  The mean (SD) age of the 16 patients was 82.7 (7.9) years. Twenty eyes had CNV and 5 eyes had GA. The mean best-corrected visual acuity was 0.800 logMAR (interquartile range, 0.350-1.000 logMAR), a Snellen equivalent of 20/126. A curvilinear hyperreflective density was identified above the Bruch membrane line within the atrophic area in the SD-OCT images. At the internal border, the material was contiguous with the outer portion of the RPE band. Below the material was a relatively hyporeflective space. The material was thrown into folds in cases with atrophy following CNV or was seen as a sheet with numerous bumps in eyes with GA. Review of histopathologic findings of eyes with advanced GA and CNV revealed a rippled layer of basal laminar deposits in an area of RPE atrophy that was located in the same level as the curvilinear line seen in the OCT images.
  
  
  CONCLUSIONS
  We have described a new entity, termed outer retinal corrugations, which may correspond to histological findings of basal laminar deposits, extracellular deposits that persist in eyes with late AMD. Observation of this undulating band does not necessarily mean there is exudation or leakage; as a consequence, these patients do not need treatment based on this solitary finding.
authors.affiliation: LuEsther T. Mertz Retinal Research Center, New York, New York2Vitreous Retina Macula Consultants of New York, New York.
authors.forename: Sotaro
authors.initials: S
authors.lastname: Ooto
authors.affiliation: LuEsther T. Mertz Retinal Research Center, New York, New York2Vitreous Retina Macula Consultants of New York, New York.
authors.forename: Sritatath
authors.initials: S
authors.lastname: Vongkulsiri
authors.affiliation: LuEsther T. Mertz Retinal Research Center, New York, New York2Vitreous Retina Macula Consultants of New York, New York.
authors.forename: Taku
authors.initials: T
authors.lastname: Sato
authors.affiliation: LuEsther T. Mertz Retinal Research Center, New York, New York2Vitreous Retina Macula Consultants of New York, New York.
authors.forename: Mihoko
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: EyeSight Foundation of Alabama Vision Research Laboratories, Department of Ophthalmology, University of Alabama School of Medicine, Birmingham.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Curcio
authors.affiliation: LuEsther T. Mertz Retinal Research Center, New York, New York2Vitreous Retina Macula Consultants of New York, New York.
authors.forename: Richard F
authors.initials: RF
authors.lastname: Spaide
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D001485:Basement Membrane / Q000473:pathology; D000068258:Bevacizumab; D005260:Female; D057092:Geographic Atrophy / Q000175:diagnosis* / Q000188:drug therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D010778:Photochemotherapy; D000069579:Ranibizumab; D040262:Receptors, Vascular Endothelial Growth Factor / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D012160:Retina / Q000473:pathology*; D012189:Retrospective Studies; D014019:Tissue Donors; D041623:Tomography, Optical Coherence; D014222:Triamcinolone Acetonide / Q000627:therapeutic use; D014792:Visual Acuity; D057135:Wet Macular Degeneration / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D005938:Glucocorticoids; D011993:Recombinant Fusion Proteins; C533178:aflibercept; D000068258:Bevacizumab; D040262:Receptors, Vascular Endothelial Growth Factor; D014222:Triamcinolone Acetonide; D000069579:Ranibizumab