老年性黄斑变性光学相干断层扫描观察

目的 观察萎缩型，渗出型老年黄斑变性（Age-related macular degeneration AMD）患者的光学相干断层扫描图像特征。比较光学相干断层扫描（Optical Coherence Tomography OCT）和荧光血管造影（Fluorescein angiography FFA）的特点，对脉络膜新生血管（Choroidal neovascularization CNV）进行OCT分型。方法 经FFA确诊的AMD57例76只眼进行OCT检查。结果 AMD患者色素上皮萎缩，软性玻璃膜疣，神经上皮和色素上皮脱离具有特有的OCT特征，OCT图像中视网膜神经上皮增厚、隆起反映视网膜下，视网膜层间积液。神经上皮或色素上皮（Retinal pigment epithelium，RPE）隆起，其下低反射区反映神经上皮或RPE层脱离。CNV的OCT图像分为边界清晰的CNV，边界模糊的CNV，纤维血管性RPE脱离。FFA中的典型性CNV相当于OCT图像中边界清晰CNV，隐匿性CNV相当于OCT图像中边界模糊CNV和纤维血管性RPE脱离。结论 OCT能特征性显示AMD中视网膜神经上皮隆起，视网膜层间积液，出血，神经上皮和RPE的脱离，且显示不同类型CNV的OCT特征。     

Surgical removal of subfoveal choroidal neovascularization: visual outcome and prognostic value of fluorescein angiography and optical coherence tomography.

PURPOSE: To study the functional results of macular surgery and determine pre-operative features associated with better final visual outcome. METHODS: Forty-two consecutive patients underwent surgical removal of subfoveal choroidal neovascularization (CNV), related to age-related macular degeneration (AMD) in 8 eyes, degenerative myopia in 14 eyes, multifocal choroiditis (MFC) in 10 eyes, idiopathic CNV in 6 eyes and other etiologies in 4 eyes. Mean age was 49 years. Pre-operative visual acuity (VA) was 20/200 or less in 30 eyes (71.4%) and never better than 20/40. Fluorescein angiography was analyzed before and after surgery. Pre-operative optical coherence tomographs (OCT) were studied in a masked fashion. Mean follow-up was 12 months (range 4-48 months). RESULTS: Final VA was 20/200 or less in 25 eyes (60%). According to the CNV etiology, the percentage were 87.5%, 80%, 57.1% and 20% respectively in eyes with AMD, MFC, high myopia, and idiopathic or other diseases. Post-operative VA improved in 21 eyes (50%) but subsequently declined in 7% by the final examination. Patients younger than 50 years had better functional results (p=0.006). Lack of retinal pigment epithelium (RPE) changes on pre-operative angiography was correlated with good visual outcome (p<0.001). The OCT study confirmed some features already described and showed some different CNVpatterns: above and usually separated from the RPE, below and not separated from the RPE, and ungradable. Eyes with the first OCT pattern had the best visual outcome. Main complications included 4 (10%) retinal detachments and 9 (21%) recurrences. OCT was also useful to confirm CNV recurrences post-operatively. CONCLUSIONS: CNV surgical excision results vary depending on the underlying disease, the RPE and choriocapillaris function, and the features observed on pre-operative OCT images.     

RPE tears after pegaptanib treatment in age-related macular degeneration

PURPOSE: To describe retinal pigment epithelial (RPE) tears in patients with age-related macular degeneration (AMD) status post pegaptanib (Macugen) injection. METHODS: Six eyes from six patients who developed RPE tears while undergoing treatment with pegaptanib for AMD-related fibrovascular pigment epithelial detachment (PED) and occult choroidal neovascularization (CNV) were identified retrospectively. Diagnosis of pre-pegaptanib fibrovascular PED and post-pegaptanib RPE tears were made by clinical examination, fluorescein angiography (FA), and optical coherence tomography (OCT) imaging of the macula. RESULTS: Four patients developed an RPE tear within 8 weeks after the first pegaptanib injection, while RPE tears were found in two patients following a second injection. Only one of the patients reported acute vision loss, although three of six eyes had a decrease in objective visual acuity in the affected eye to the count fingers level. All six cases displayed the classic clinical and angiographic appearance of RPE tears. In addition, OCT imaging showed an irregular, hyperreflective RPE layer with a focal defect. CONCLUSIONS: RPE tears are known to occur in the setting of PED spontaneously or after laser treatment, but have only recently been described in association with intravitreal pegaptanib. OCT imaging of eyes status post pegaptanib therapy may be helpful in identifying this complication. Patients with AMD, especially those with occult CNV and fibrovascular PED, receiving pegaptanib therapy should be monitored for RPE tears, which may warrant deferral of further injections.     

Retinal pigment epithelial tears after intravitreal bevacizumab injection for predominantly classic choroidal neovascularization

PURPOSE: To detect retinal pigment epithelium (RPE) tears in predominantly classic choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) treated with intravitreal bevacizumab injections. METHODS: Forty consecutive patients with predominantly classic CNV secondary to AMD were treated with 1.25 mg of intravitreal bevacizumab. Patients were evaluated with visual acuity (VA) measured with Early Treatment Diabetic Retinopathy Study charts, optical coherence tomography, and fluorescein angiography. RESULTS: Three patients developed a RPE tear after the first injection. The first patient had been treated with verteporfin therapy and VA remained unchanged. In the other two cases the CNV was naive and VA improved since the foveal center was not involved by the tear and macular edema was reduced. CONCLUSIONS: RPE tears can occur following intravitreal bevacizumab injections in patients with predominantly classic CNV although VA is not always affected.     

特发性眼底血管样条纹的临床特征

目的分析特发性眼底血管样条纹的临床特征。方法分析13例（26眼）特发性眼底血管样条纹患者的临床表现、荧光素眼底血管造影（FFA）及黄斑区光学相干断层扫描（OCT）表现。结果11眼视力≤0.3,占42.31%。26眼眼底后极部均可见类似血管样的放射状条纹,5眼为斑驳状外观,占19.23%;17眼条纹通过黄斑,占65.38%;1眼（3.8%）合并眼外伤致多发性脉络膜破裂出血。FFA显示26眼血管样条纹均表现为透见荧光,11眼黄斑区可见脉络膜新生血管（CNV）影,其亮度逐渐增强,后期有明显的荧光素渗漏。黄斑区OCT检查发现11眼有CNV表现。Ⅰ型CNV（生长于RPE光带下）：表现为在隆起的视网膜色素上皮（RPE）和脉络膜毛细血管层光带下有不均匀的中或高反射带;混合型CNV：表现为CNV侵入RPE光带及视网膜神经上皮层下空间,RPE光带中断,呈现边界不清的高反射组织。结论眼底、FFA及OCT典型表现的综合分析有助于特发性眼底血管样条纹的诊断、分期及治疗指导。     

Retinal pigment epithelium tears following verteporfin therapy combined with intravitreal triamcinolone

PURPOSE: To detect patients with neovascular age-related macular degeneration (AMD) who experience retinal pigment epithelium tears after initial verteporfin therapy combined with intravitreal triamcinolone during early follow-up. DESIGN: Prospective interventional case series. METHODS: Forty-five consecutive patients with choroidal neovascularization (CNV) in AMD were treated with verteporfin therapy combined with 4 mg of intravitreal triamcinolone. Optical coherence tomography (OCT), visual acuity, and fluorescein angiography were performed. RESULTS: Two eyes with a predominantly classic CNV developed a retinal pigment epithelium tear. An early onset tear could be differentiated from a delayed onset tear. OCT showed an increased depth signal in areas of missing retinal pigment epithelium and a wavy, contracted, and elevated retinal pigment epithelium band. CONCLUSIONS: Retinal pigment epithelium tears can occur despite adding intravitreal triamcinolone to verteporfin therapy. OCT shows characteristic changes in the evolution of retinal pigment epithelium tears after combination therapy.     

Retinal pigment epithelial tear following intravitreal ranibizumab injections for neovascular age-related macular degeneration

Background To report the development of retinal pigment epithelial (RPE) tear after intravitreal injection of ranibizumab (Lucentis, Novartis, Basel, Switzerland). Methods Case report with presentation of the fundus photography, fluorescein angiography (FA) and optical coherence tomography (OCT) findings. Results A 70-year-old man received intravitreal injections of ranibizumab for the treatment of occult choroidal neovascularisation (CNV) with fibrovascular pigment epithelial detachment due to age-related macular degeneration. One day after the third intravitreal ranibizumab injection, fundus examination showed a RPE defect at the foveal region. FA and OCT confirmed the presence of RPE tear sparing the fovea. No further progression of the RPE tear was observed after withholding subsequent ranibizumab injection and his right eye visual acuity remained at 20/100 at 3 months from the last injection. Conclusions As with other anti-vascular endothelial growth factor treatment for CNV, RPE tear might occur after intravitreal ranibizumab injection even after previous uneventful intravitreal injections.     

Autologe RPE-Chorioidea-Translokation bei exsudativer AMD

BACKGROUND: To evaluate the retinal sensitivity and fixation pattern after removal of choroidal neovascularisation (CNV) and autologous retinal pigment epithelium (RPE)-choroid translocation in patients with exudative age-related macular degeneration (AMD). METHODS: The functional and morphologic results of 10 consecutive patients (nine with exudative AMD, one with geographic atrophy) were analysed. The mean follow-up was 16.8 (14-20) months. Functional evaluation was performed with the MP1 microperimeter. RESULTS: Preoperative visual acuity ranged from hand motion to 0.2 (decimal), and postoperative visual acuity ranged from hand motion to 0.4. Fixation on the graft was shown in four patients. Microperimetry proved light increment sensitivity over the graft in five patients. Light increment sensitivity could be kept on a constant level in four of these patients. Postoperative complications included retinal detachment (three), proliferative vitreoretinopathy (one), and development of CNV (one). CONCLUSION: Autologous RPE-choroid sheet translocation is feasible and comparatively safe. Fixation and light perception on the graft proved to be possible. Light increment sensitivity can be kept on a constant level for at least 20 months.     

特发性脉络膜新生血管采用光动力疗法后视网膜色素上皮损伤的研究

目的探讨特发性脉络膜新生血管（CNV）采用光动力疗法（PDT）后视网膜色素上皮（RPE）损伤的原因。方法对43例（45只眼）接受PDT治疗的特发性CNV患者资料进行回顾性分析,以25例（27只眼）CNV膜大小接近的病理性近视合并CNV患者作为对照。分析治疗后4周的荧光素眼底血管造影图像,判断病灶周围色素上皮的透见荧光情况,探讨治疗后8-12周CNV患者的复发原因。结果特发性CNV患者经初次治疗后,PDT光照区内有21只眼的RPE发生改变,二次治疗后又增加了1只眼,RPE改变的发生率约为48．9％,而病理性近视组仅2只眼经PDT治疗后RPE发生改变。随访期内4例特发性CNV患者经PDT治疗后CNV明显扩大。两组CNV患者男女比例基本相同,其男女RPE改变的发生率差异也无统计学意义（P〉0．05）。与病理性近视的CNV患者相比,特发性CNV患者的发病年龄较轻,而病理性近视的CNV患者经治疗后出现RPE改变的2例患者中,1例为37岁,1例为15岁。结论特发性CNV患者经PDT治疗后病灶周围出现RPE损伤,提示年轻患者易出现治疗后的过度反应。     

Retinal pigment epithelium translocation and central visual function in age related macular degeneration: preliminary results

Purpose: To test the feasibility of a new surgical technique, and to assess visual function over the translocated retinal pigment epithelium (RPE) cells in patients operated upon for subfoveal choroidal neovascularization (CNV) secondary to age-related maculardegeneration (AMD).Materials and methods: Six patients presenting previouslyuntreated exudative AMD underwent surgical excision of the subfoveal CNV with RPE translocation and were followed from 1 to 10.5 months. The surgery consisted of a standard three port pars plana vitrectomy (TPPPV), excision of the CNV and RPE translocation. Pre and post-operative ocular examination included best-corrected visual acuity measurement, fundus color stereo photography and fundus fluoresceinangiography. Optical coherence tomography (OCT) and confocal laser scanning ophthalmoscopy (cLSO) were performed post-operatively. A cross fixation target and a single-point flashing light were projected on different areas of the posterior pole using a cLSO. Photopic 10-2 perimetry, photopic fine matrix mapping, cLSO microperimetry were also performed pre and post-operatively in four patients. OCTcross-sectional scans and cLSO RPE autofluorescence were recorded to detect the presence of viable translocated RPE. Visual acuity, fixation, photopic 10-2 perimetry, photopic fine matrix mapping and cLSO microperimetry were tested for the presence of central visual function. Results: RPE could be effectively translocated at thetime of CNV removal from the edge of the RPE defect to a subfoveal location. OCT showed the translocated RPE as an area of increased optical reflectivity with optical shadowing external to it. cLSO showed autofluorescence of the translocated RPE. The cross fixation target was seen when projected on the translocated RPE. During eccentricfixation, the patients could see a flashing point-target projected on the translocated RPE. Photopic 10-2 perimetry, photopic fine matrix mapping and cLSO microperimetry showed presence of central visual function.Conclusions: The authors propose that translocationof RPE at the time of CNV removal, from the edge of the RPE defect to a subfoveal location, may have a role in the surgical management of AMD.     

Retinal pigment epithelial tear after intravitreal ranibizumab

PURPOSE: To report two cases of a retinal pigment epithelial (RPE) tear after intravitreal injection of 0.05 mg ranibizumab. DESIGN: Observational case report. METHODS: Two patients with choroidal neovascularization (CNV) resulting from age-related macular degeneration (AMD) were treated with an intravitreal injection of ranibizumab. RESULTS: Both patients were found to have a RPE tear on follow-up visits at one month, confirmed by optical coherence tomography (OCT) and by fluorescein or indocyanine green angiography. CONCLUSIONS: RPE tears may occur after intravitreal injection of ranibizumab. Further study is needed to determine whether CNV membranes associated with pigment epithelial detachments (PED) are more likely to develop RPE tears after treatment with anti-vascular endothelial growth factor (anti-VEGF) agents.     

Optical coherence tomographic findings of the retinal pigment epithelium tear in macular area preserving good visual acuity

PURPOSE: It has been reported that the visual outcome of retinal pigment epithelial tear (RPE tear) in the fovea is worse than that of RPE tear sparing the fovea. We report optical coherence tomography (OCT) findings of 3 cases with RPE tear in the fovea who preserved good visual acuity. PATIENTS: All patients had serous retinal pigment epithelial detachment involving the macula. The RPE was torn and rolled RPE was observed in the fovea. In OCT findings, a fovea was observed on the RPE flap, and visual acuity was preserved after RPE tear repair. CONCLUSION: We considered that preservation of good visual acuity was due to the presence of a fovea on the RPE flap. We could precisely analyze the location of the fovea and RPE tear using OCT.     

Correlation between components of newly diagnosed exudative age‐related macular degeneration lesion and focal retinal sensitivity

Purpose: To analyse lesion components determining retinal sensitivity in microperimetry in eyes with newly diagnosed exudative age‐related macular degeneration (AMD). Methods: Visual acuity, contrast sensitivity, microperimetry, optical coherence tomography (OCT), and fluorescein (FA) and indocyanine green (ICGA) angiographies of 23 eyes of 23 patients were analysed. Central microperimetry grids with 28 test stimulus sites were automatically aligned with three‐dimensional OCTs and manually aligned with angiographies. Thicknesses of the neuroretina, neuroepithelial detachment (NED), retinal pigment epithelial (RPE) elevation and subretinal tissue were measured under the 644 microperimetry stimulus sites. Areas of classic and occult choroidal neovascularizations (CNVs), subretinal and intraretinal haemorrhage, and late hyperfluorescence in ICGA were identified. The impact of the lesion components on retinal sensitivity was evaluated with correlation analysis and multivariate modelling. Results: Decreased retinal sensitivity correlated significantly with the presence of CNV, haemorrhage, subretinal tissue and RPE elevation. Out of the OCT parameters, the most important determinant of sensitivity was the thickness of RPE elevation (Spearman’s rho, r = ?0.202, p < 0.0001). The thicknesses of subretinal tissue (r = ?0.168, p < 0.0001) and NED had weaker effects (r = ?0.147, p < 0.0001), and the neuroretinal thickness remained nonsignificant. In multivariate modelling, RPE elevation and subretinal tissue in OCT, CNV membranes in angiographies and haemorrhage had the strongest impacts on retinal sensitivity. Conclusion: The most important lesion components affecting retinal function were RPE elevation and subretinal tissue in OCT as well as neovascular membranes and haemorrhage in angiographies. NED and neuroretinal thickening remained less significant.     

Autologous retinal pigment epithelium-choroid sheet transplantation in age related macular degeneration: morphological and functional results

OBJECTIVE: To evaluate the outcome of autologous retinal pigment epithelium (RPE)-choroid sheet transplantation after removal of a subfoveal choroidal neovascularisation (CNV) in patients with age related macular degeneration (AMD). METHODS: RPE-choroid sheet transplantation was performed in 10 consecutive patients with exudative AMD (n = 9) or geographic atrophy (n = 1). After CNV extraction, an autologous RPE-choroid patch was translocated from the midperiphery under the macula. Follow-up was between 6 and 12 months. Visual acuity testing and microperimetry (Nidek-MP1) as well as autofluorescence, fluorescein and indocyanine green (ICG) angiography were performed and the data were analysed retrospectively. RESULTS: Visual acuity (logarithm of minimum angel of resolution) before operation ranged from 0.7 to 1.8 (mean 1.37) and after operation from 0.4 to 1.6 (mean 1.24). Visual acuity after operation improved in seven patients (by a mean of 0.26), remained stable in one patient and decreased in two patients. Microperimetry showed light sensitivity and fixation on the sheet in five cases. ICG angiography demonstrated perfusion through the RPE-choroid graft in nine patients. Postoperative complications included retinal detachment (n = 1) and epiretinal membrane formation (n = 2). The patient with geographic atrophy developed a CNV after surgery. CONCLUSIONS: Autologous RPE-choroid sheet transplantation is feasible and a comparatively safe procedure. Microperimetry showed fixation and light perception over the graft with a moderate increase in mean visual acuity.     

Retinal pigment epithelial tear following photodynamic therapy for choroidal neovascularization secondary to AMD

PURPOSE: To describe retinal pigment epithelial tear following photodynamic therapy (PDT) for subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). DESIGN: Retrospective interventional case series. METHODS: A retrospective study in an institutional practice. We describe seven cases of retinal pigment epithelial (RPE) tear, which developed in seven eyes of seven patients following PDT. All eyes had subfoveal CNV secondary to AMD. RESULTS: Six eyes had occult subfoveal CNV, and one eye had recurrent classic subfoveal CNV. In five patients, the eye that developed the tear was the second eye, whereas the first eye had a disciform scar. In four eyes, the RPE tear developed after one PDT, in one eye the RPE tear developed after the second PDT, and in two eyes the RPE tear developed after the third PDT. In five of seven cases, there was a significant visual deterioration following the RPE tear. CONCLUSIONS: RPE tear is a complication that may occur following PDT in particular when the PDT is applied to an occult subfoveal CNV.     

Photodynamic therapy for bilateral idiopathic detachment of the RPE

BACKGROUND: A bilateral monofocal detachment of the pigment epithelium (RPE) without any signs of ARMD or other retinal pathology represents a therapeutic challenge. PATIENT: An otherwise healthy 51-year-old woman presented first with a monocular, later a binocular decrease of visual acuity and metamorphopsia. Optical coherence tomography (OCT) showed a bilateral dome-shaped detachment of the RPE. Pooling beneath the detachment was documented using fluorescein angiography. A choroidal neovascularisation could be excluded by means of indocyanine green angiography (ICG). Due to the binocular decrease of visual acuity from 20/20 to 20/63 on the right eye and 20/100 on the left eye in spite of intensive systemic acetazolamide therapy both eyes were treated with photodynamic therapy (PDT) using verteporfin. During monthly controls, the visual acuity increased up to 20/20 on the right eye and 20/25 on the left eye. Metamorphopsia was also reduced. CONCLUSION: An idiopathic detachment of the pigment epithelium can effectively be treated using PDT whereas the underlying pathology remains unclear.     

自体带Bruch膜视网膜色素上皮复合体移植治疗渗出性老年黄斑变性近期疗效观察

目的 探讨自体带Bruch膜视网膜色素上皮复合体移植术治疗渗出性老年性黄斑变性近期疗效.方法 回顾性分析30例确诊为渗出性老年性黄斑变性的患者,采用脉络膜新生血管膜切除联合自体带Bruch膜视网膜色素上皮复合体移植手术方法.手术前后行视力、荧光素眼底血管造影、吲哚氰绿眼底血管造影、多焦视网膜电图、光学相干断层扫描检查评价疗效.结果 移植术后随访6个月时,25例(83.33%)患者视力获得提高,2例(6.66%)患者视力不变,3例(10%)患者视力下降;所有患者黄斑区RPE植片平铺在位,未见CNV复发.结论 自体带Bruch膜视网膜色素上皮复合体移植治疗渗出性老年性黄斑变性近期疗效确切,是治疗渗出性老年性黄斑变性安全有效的手段之一.     

Intravitreal bevacizumab for previously treated choroidal neovascularization from age-related macular degeneration

PURPOSE: To report the optical coherence tomography (OCT) findings and visual results in a series of patients treated with intravitreal bevacizumab for choroidal neovascularization (CNV) associated with age-related macular degeneration (AMD), and to determine if a difference in treatment effect exists between previously treated and treatment na?ve patients. METHODS: A retrospective review of all patients treated with intravitreal bevacizumab for CNV from AMD with visual acuity greater than or equal to 20/320 between September 2005 and February 2006 was performed. OCT data recorded included central macular thickness and the presence or absence of cystic intraretinal fluid, subretinal fluid, or pigment epithelial detachment at the time of the initial injection, at 1-week, 1-month, and 3-month intervals, as well as at the end of follow-up. Visual acuity measurements were recorded using Early Treatment Diabetic Retinopathy Study charts. Any ocular or systemic adverse events were recorded. Statistical analysis was performed to determine if OCT and visual acuity results were significant and to determine if a difference in outcomes existed between previously treated patients and treatment na?ve patients. RESULTS: Fifty-four eyes of 51 patients treated with intravitreal bevacizumab for CNV from AMD were identified. A total of 178 injections were performed. Mean number of days of follow-up was 138 with 91% of patients having at least 90 days of follow-up. Seventy percent of patients had undergone previous treatment for CNV. The mean number of intravitreal bevacizumab injections per eye was 3.3. Combined treatment with photodynamic therapy was provided in 20% of cases at the initial intravitreal injection. OCT data for all patients revealed an initial mean thickness of 362 mum, which was decreased at 1 week to 278 microm (P = 0.001), 235 microm at 1 month (P < 0.0001), 238 microm at 3 months (P = 0.0004), and 244 microm for the end of follow-up (P < 0.0001). Cystic retinal edema, subretinal fluid, and pigment epithelial detachment resolved in the majority of cases, but pigment epithelial detachment frequently took longer to resolve. Initial mean visual acuity was 20/125 (logMAR 0.8), and final mean visual acuity was 20/100 (logMAR 0.7) (P = 0.03). There was no difference in OCT or visual acuity outcomes (P = 0.62 and P = 0.28, respectively) between previously treated and treatment na?ve patients. There was no difference in OCT or visual acuity outcomes (P = 0.67 and P = 0.21, respectively) between patients who received combination therapy and those who received monotherapy with intravitreal bevacizumab. No systemic or ocular adverse events were recorded. CONCLUSION: Intravitreal bevacizumab for CNV from AMD results in a rapid decrease in OCT-measured retinal thickness in a majority of cases. Visual acuity also improved in this series, suggesting a potential corresponding visual benefit. This series suggests that previously treated and treatment na?ve patients have similar outcomes.     

自体带Bruch膜视网膜色素上皮复合体移植治疗渗出性老年黄斑变性近期疗效观察

目的 探讨自体带Bruch膜视网膜色素上皮复合体移植术治疗渗出性老年性黄斑变性近期疗效.方法 回顾性分析30例确诊为渗出性老年性黄斑变性的患者,采用脉络膜新生血管膜切除联合自体带Bruch膜视网膜色素上皮复合体移植手术方法.手术前后行视力、荧光素眼底血管造影、吲哚氰绿眼底血管造影、多焦视网膜电图、光学相干断层扫描检查评价疗效.结果 移植术后随访6个月时,25例(83.33%)患者视力获得提高,2例(6.66%)患者视力不变,3例(10%)患者视力下降;所有患者黄斑区RPE植片平铺在位,未见CNV复发.结论 自体带Bruch膜视网膜色素上皮复合体移植治疗渗出性老年性黄斑变性近期疗效确切,是治疗渗出性老年性黄斑变性安全有效的手段之一.     

Systemic Inflammation by Collagen-Induced Arthritis Affects the Progression of Age-Related Macular Degeneration Differently in Two Mouse Models of the Disease

PurposeAge-related macular degeneration (AMD) shares similar risk factors and inflammatory responses with rheumatoid arthritis (RA). Previously, we identified increased risk for dry AMD among patients with RA compared to control subjects, using retrospective data analysis. In this current study, we investigate the role of systemic inflammation triggered in a murine model of arthritis on choroidal neovascularization and retinal pigment epithelium (RPE) degeneration mouse models.MethodsCollagen-induced arthritis (CIA) was induced in C57BL/6J mice prior to laser-induced choroidal neovascularization (CNV; wet AMD model) or sodium iodate–induced retinal degeneration (NaIO₃; dry AMD model). CNV lesion size and retinal thickness were quantified by optical coherence photography (OCT), visual function was analyzed using optokinetic response and electroretinography, RPE morphology was examined by immunohistochemistry, and inflammatory gene expression was analyzed by quantitative PCR.ResultsCIA mice demonstrated decreased spatial acuity and contrast sensitivity, whereas no difference was observed in the RPE-generated c-wave. CNV lesion size was decreased in CIA mice. NaIO₃ decreased c-wave amplitude, as well as retinal thickness, which was augmented by CIA. NaIO₃ treatment resulted in loss of normal RPE hexagonal shape, which was further aggravated by CIA. Increased Cxcl9 expression was observed in the presence of CIA and CIA combined with AMD. Disease severity differences were observed between sexes.ConclusionsOur data suggest systemic inflammation by CIA results in increased pathology in a dry AMD model, whereas it reduces lesions in a wet AMD model. These findings highlight the need for additional investigation into the role of secondary inflammation and sex-based differences on AMD.