title: Correlation of Type 1 Neovascularization Associated With Acquired Vitelliform Lesion in the Setting of Age-Related Macular Degeneration.
abstract: OBJECTIVE
  To correlate postmortem histology with previously recorded multimodal imaging from a patient with type 1 neovascularization (NV) associated with an acquired vitelliform lesion in the setting of age-related macular degeneration (AMD).
  
  
  METHODS
  Case study.
  
  
  METHODS
  Multimodal imaging that was obtained antemortem was matched with ex vivo and high-resolution histologic images of the preserved donor macula. Anatomic correlates for multimodal imaging findings were then defined.
  
  
  RESULTS
  Spectral-domain optical coherence tomography (OCT) revealed a split in the retinal pigment epithelium-Bruch membrane band. Type 1 NV in this case was composed of 6 layered components: (1) retinal pigment epithelium, (2) basal laminar deposits, (3) fibrovascular membrane, (4) fibrocellular scar, (5) hemorrhage, and (6) Bruch membrane. The anatomic correlates for the hyporeflective band on spectral-domain OCT included a thick basal laminar deposit. Not all structures could be readily separated on the basis of their reflectivity patterns.
  
  
  CONCLUSIONS
  This is an important clinicopathologic correlation of NV secondary to AMD in the spectral-domain OCT era. Our findings of 6 layers include and extend the anatomic framework encapsulated by the double-layer and triple-layer signs. The resolution of current devices does not always permit distinction of the different layers of NV tissue. Thick basal laminar deposits may appear hyporeflective on spectral-domain OCT and may be confused with fluid from a neovascular process. It will be important to perform a larger clinicopathologic series to aid our anatomic interpretation of spectral-domain OCT images.
authors.affiliation: Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, Alabama.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Curcio
authors.affiliation: LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York; Vitreous-Retina-Macula Consultants of New York, New York, New York; Department of Physiology and Pharmacology, Centre for Ophthalmology and Visual Sciences, Lions Eye Institute, The University of Western Australia, Perth, Australia.
authors.forename: Chandrakumar
authors.initials: C
authors.lastname: Balaratnasingam
authors.affiliation: Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, Alabama.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Messinger
authors.affiliation: LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York; Vitreous-Retina-Macula Consultants of New York, New York, New York.
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Yannuzzi
authors.affiliation: LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York; Vitreous-Retina-Macula Consultants of New York, New York, New York; Department of Ophthalmology, New York University School of Medicine, New York, New York. Electronic address: kbfnyf@aol.com.
authors.forename: K Bailey
authors.initials: KB
authors.lastname: Freund
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016570:Bruch Membrane / Q000473:pathology; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D008268:Macular Degeneration / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000379:methods*