SUBMACULAR SURGERY TRIALS PATHOLOGY CENTER

Emory University, Atlanta GA

Investigators

Linked publications & trials

Abstract

Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in the United States. When the neovascular form of AMD, choroidal neovascularization (CNV), occurs under the fovea (subfoveal CNV), it leads to central vision loss and functional blindness. Subfoveal CNV may also occur in the ocular histoplasmosis syndrome (OHS), leading to disability in young adults. Fluorescein angiography has shown that CNV may have classic and occult patterns, each of which correlates with a different clinical outcome. Histologic studies have shown type l and type 2 topographies of CNV with theoretically differing clinical outcomes after surgery. The Submacular Surgery Trials is a phase III randomized clinical trials in which surgeons remove CNV specimens from patients with AMD and OHS. In this proposal, CNV specimens obtained from the SST are studied using light and electron microscopy and immunohistochemical stains to determine the structural and biochemical counterparts to classic and occult fluorescein angiographic patterns. The hypothesis that surgically removed type 1 CNV correlates with different clinical outcome than surgically removed type2 CNV compared with unoperated patients will be tested, and if there is a difference in outcome, fundus features of type 1 versus type2 CNV will be determined. Additionally, eyes obtained post-mortem from patients enrolled in the SST will be studied for pathologic correlation with clinical findings and outcomes.