Loss of choriocapillaris (CC) in advanced age-related macular degeneration (AMD) is well documented but changes in early AMD have not been quantified. Postmortem eyes from donors with clinically documented early AMD were examined in choroidal whole mounts to determine the area, pattern, and severity of CC loss. Choroids from postmortem human eyes without AMD (n = 7; mean age = 86.1) and from eyes with a Grade 2 clinical classification of early AMD (n = 7; mean age = 87) were immunolabeled with Ulex europaeus agglutinin (UEA) lectin-FITC to stain blood vessels. Whole mounts were imaged using confocal microscopy and image analysis was performed to determine the area of vascular changes and density of vasculature (percent vascular area, %VA). All areas evaluated had a complete RPE monolayer upon gross examination. In age-matched control eyes, the CC had broad lumens and a homogenous pattern of freely interconnecting capillaries. The mean %VA ± standard deviation in submacula of control subjects was 78.1 ± 3.25%. In eyes with early AMD, there was a significant decrease in mean %VA to 60.1 ± 10.4% (p < 0.0001). The paramacular %VA was not significantly different in eyes with or without AMD. The area of submacular choroid affected by CC dropout was 0.04 ± 0.09 mm2 in control eyes. In eyes with early AMD, the mean area affected by CC dropout was significantly increased (10.4 ± 6.1 mm2; p < 0.001). In some cases, incipient neovascular buds were observed at the border of regions with CC dropout in early AMD choroids. In conclusion, UEA lectin-labeled choroidal whole mounts from donors with clinically documented early AMD has provided a unique opportunity to examine regional changes in vascular pathology associated with choriocapillaris. The study demonstrated attenuation of submacular CC in early AMD subjects but no vascular pathology was observed outside the submacular region. While the affected area in some eyes was quite extensive histologically, these changes may not be detectable clinically using standard in vivo imaging.

中文翻译：

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脉络膜毛细血管滤除术在与年龄有关的早期黄斑变性中的作用。

晚期老年性黄斑变性（AMD）中脉络膜毛细血管闭塞（CC）的丢失已有大量文献报道，但早期AMD的变化尚未量化。在脉络膜整个坐骑中检查来自临床记录有早期AMD的捐献者的死后眼睛，以确定CC丢失的面积，模式和严重程度。死后无AMD的人眼的脉络膜（n = 7；平均年龄= 86.1）和早期AMD的2级临床分类的眼球（n = 7；平均年龄= 87）的脉络膜均用Ulex europaeus凝集素（UEA）凝集素进行免疫标记， FITC染色血管。使用共聚焦显微镜对整个坐骑成像，并进行图像分析以确定血管变化的面积和脉管系统的密度（血管面积百分比，％VA）。经粗略检查，所有评估区域均具有完整的RPE单层。在年龄匹配的对照眼中，CC的管腔宽，毛细管的连通性均匀。对照受试者的黄斑部的平均％VA±标准偏差为78.1±3.25％。在患有早期AMD的眼中，平均％VA显着降低至60.1±10.4％（p <0.0001）。在有或没有AMD的情况下，黄斑旁％VA无显着差异。在对照眼中，受CC脱落影响的黄斑下脉络膜面积为0.04±0.09 mm2。在患有早期AMD的眼中，受CC脱落影响的平均面积显着增加（10.4±6.1 mm2; p <0.001）。在某些情况下，在早期AMD脉络膜中CC缺失区域的边界处观察到新生血管芽。结论，UEA凝集素标记的来自供体的脉络膜整个坐骑以及临床记录的早期AMD，为检查与脉络膜毛细血管相关的血管病理学的局部变化提供了独特的机会。该研究证明了早期AMD受试者的黄斑下CC减弱，但是在黄斑下区域之外未观察到血管病理。尽管某些眼睛的受影响区域在组织学上相当广泛，但是使用标准的体内成像在临床上可能无法检测到这些变化。