Neovascular age-related macular degeneration: advancement in retinal imaging builds a bridge between histopathology and clinical findings

Abstract

Purpose: To provide a review of the salient histological and imaging features in neovascular age-related macular degeneration (AMD) that will be integrated in order to have a better comprehension of the pathogenesis and clinical aspects of this disease.

Methods: A literature review of histology and imaging features in neovascular AMD was conducted.

Results: Histology has granted a detailed characterization of neovascular AMD ex vivo. In details, histological features in these eyes have offered important insights into the pathogenesis of neovascular AMD. In addition, histology donated a detailed characterization of the different types of macular neovascularization (MNV) that may complicate AMD. The introduction of optical coherence tomography angiography (OCTA) has enormously amplified our knowledge of neovascular AMD through in vivo assessment of the anatomical and pathological characteristics of this disease. New insights elucidating the morphological features of the choriocapillaris confirmed that this vascular structure plays a crucial role in the pathogenesis of neovascular AMD. OCTA also offered a detailed visualization of MNV complicating neovascular AMD.

Conclusions: New imaging technologies offer a remarkable chance to build a bridge between histology and clinical findings in neovascular AMD.

Keywords: Age-related macular degeneration; Drusen; Geographic atrophy; Histology; Imaging; Macular neovascularization; Optical coherence tomography; Optical coherence tomography angiography.