Morphologic changes in age-related maculopathy.

Age-related maculopathy (ARM) is a degenerative disorder of the central part of the retina with a rising prevalence in patients 50 years of age and older, and comprises different histopathological changes. The morphologic changes in ARM are described and illustrated with light-microscopical, electron microscopical, and fundus pictures. Furthermore, the most important biochemical data are given.

Increased prevalence of disciform macular degeneration after cataract extraction with implantation of an intraocular lens.

After cataract extraction with implantation of an intraocular lens the increased transmission of ultraviolet and blue light may accelerate the development of age-related macular degeneration by producing free radicals in the retina. The maculae of 82 randomly selected postmortem human pseudophakic eyes and 16 fellow phakic eyes were examined by light microscopy. The presence of a basal laminar deposit, hard and soft drusen, thickening and calcification of Bruch's membrane, geographic atrophy, subretinal neovascularisation, and disciform scars was assessed in a standardised way.

Morphometric analysis of Bruch's membrane, the choriocapillaris, and the choroid in aging.

Purpose: To quantify changes in choriocapillary density and in thickness of Bruch's membrane, the choriocapillaris, and the choroid in 95 unpaired, histologically normal human maculae aged 6 to 100 years and in 25 maculae with advanced age-related macular degeneration.

Methods: Light microscopic, computer-aided, morphometric quantitative analysis.

Results: In ten decades, Bruch's membrane thickness increased by 135%, from 2.

Immunohistochemical light and electron microscopy of basal laminar deposit.

The formation of basal laminar deposit (BLD) is one of the histopathologic changes in the aging human macula. BLD is assumed to be an early stage of age-related macular degeneration. The location of BLD, between the RPE plasma membrane and its basement membrane and in the outer collagenous zone of Bruch's membrane, and its ultrastructure suggest that it is composed of excessive amounts of basement membrane material.

Early stages of age-related macular degeneration: an immunofluorescence and electron microscopy study.

In subretinal neovascularisation capillaries originating from the choriocapillaris must cross Bruch's membrane to reach the subretinal pigment epithelial space. Thus gaps in Bruch's membrane have to be formed before subretinal neovascularisation. Histological examination of eyes with subretinal neovascularisation or disciform scars has shown macrophages adjacent to thin areas and ruptures in Bruch's membrane.

Basal laminar deposit in the aging peripheral human retina.

A basal laminar deposit (BLD) in the human macula has been described as an early sign of age-related macular degeneration. In some eyes with a BLD in the macula, light microscopic sections of the peripheral retina revealed almost similar deposits between the retinal pigment epithelium and Bruch's membrane. Because the exact pathogenesis of age-related macular degeneration and the origin of the BLD are unknown, we studied the ultrastructure of these peripheral sub-RPE deposits.

Element analysis of the early stages of age-related macular degeneration.

The accumulation of basal laminar deposit (BLD) in the macula is considered to be a precursor of age-related macular degeneration. To learn more about the composition of BLD and the role of zinc in age-related macular degeneration, we investigated the elements in BLD, as well as in surrounding structures in 38 postmortem human maculae by electron-probe x-ray microanalysis. Basal laminar deposit and capillary vessel walls of the choriocapillaris appeared to contain no typical elements.

Histologic features of the early stages of age-related macular degeneration. A statistical analysis.

The age distribution, frequency, and correlation among histologic macular changes, including formation of a basal laminar deposit, drusen, and thickening and calcification of Bruch's membrane, were studied by light microscopy. The authors studied 182 unpaired postmortem human maculae from patients between 8 and 100 years of age. In addition, 45 maculae of contralateral eyes and the peripheral retina of 50 eyes were studied.

Is basal laminar deposit unique for age-related macular degeneration?

The ultrastructural nature and distribution of basal laminar deposit, considered to be a precursor of age-related macular degeneration, were studied in 42 human maculae. Basal laminar deposit was found from age 19 years on, not only between the retinal pigment epithelial cells and their basement membrane but also more often on the choriocapillary side of Bruch's membrane. No direct relationship was found with other aging changes, such as calcifications in Bruch's membrane, accumulation of lipofuscin granules, or drusen in the macular area.

Results of penetrating keratoplasty for pseudophakic bullous keratopathy with the exchange of an intraocular lens.

We report on 29 consecutive patients with pseudophakic bullous keratopathy who underwent in one eye penetrating keratoplasty with an exchange of the original intraocular lens for a Pearce tripod posterior chamber lens, and who were available for a follow up of at least 12 months. The average interval between cataract extraction with lens implantation and the appearance of bullous keratopathy was five and a half years (range 10 months to 16 years). The mean follow-up period after penetrating keratoplasty was 36 months (range 12 to 56 months).