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High-resolution optical coherence tomography of subpigment epithelial structures in patients with pigment epithelium detachment secondary to age-related macular degeneration
  1. Christoph R Clemens1,2,
  2. Tim U Krohne2,
  3. Peter Charbel Issa2,
  4. Hans-Martin Helb2,
  5. Nina Kosanetzky2,
  6. Albrecht Lommatzsch3,
  7. Frank G Holz2,
  8. Nicole Eter1,2
  1. 1Department of Ophthalmology, University of Muenster, Muenster, Germany
  2. 2Department of Ophthalmology, University of Bonn, Bonn, Germany
  3. 3Department of Ophthalmology, St. Franziskus Hospital, Muenster, Germany
  1. Correspondence to Professor Nicole Eter, Department of Ophthalmology, University of Muenster Domagkstr. 15, D-48149 Muenster, Germany; eter{at}


Background The pathophysiology of pigment epithelial detachment (PED) secondary to age-related macular degeneration (AMD) is as yet incompletely understood and treatment remains challenging. Spectral domain optical coherence tomography (SD-OCT) allows for improved morphological characterisation of the space underneath the retinal pigment epithelium (RPE).

Objective To investigate eyes with PED for structures underneath the detached RPE cell layer.

Methods In a retrospective observational case study, SD-OCT scans of AMD-related PEDs were assessed for the presence of distinctive morphological features in the space between the detached RPE and inner Bruch's membrane.

Results Structures present in the space between the detached RPE and Bruch's membrane were found in 14 of 90 eyes with AMD-related PED. Each of these eyes shows hyper-reflective material underneath the PED, presenting as highly reflective, multilayered, laminar structures, usually orientated parallel to Bruch's membrane.

Conclusions The findings indicate that SD-OCT may be useful for a more refined phenotypic stratification of AMD-associated PED. Further studies are warranted to explore the correlates on other imaging modalities, to investigate the composition of this material and to assess the potential prognostic relevance of this new finding.

  • Age-related macular degeneration
  • pigment epithelial detachment
  • optical coherence tomography
  • phenotype

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  • CRC and TUK contributed equally to this study.

  • Competing interests None.

  • Patient consent We conducted a retrospective study.

  • Ethics approval The examination procedure in the outpatient clinic and the examination of documents are within the routine work for patients in the outpatient clinic. No specific approval was obtained for this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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