期刊
INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE
卷 62, 期 1, 页码 -出版社
ASSOC RESEARCH VISION OPHTHALMOLOGY INC
DOI: 10.1167/iovs.62.1.33
关键词
age-related macular degeneration; basal linear deposit; clinicopathologic correlation; drusen; histopathology; histology; neovascularization; optical coherence tomography; photoreceptors; subretinal drusenoid deposit
资金
- Macula Foundation, New York
- National Institutes of Health [R01EY06019]
- EyeSight Foundation of Alabama
- International Retinal Research Foundation
- Edward N. and Della L. Thome Foundation
- Arnold and Mabel Beckman Initiative for Macular Research
The study revealed that the volume of BLinD may be associated with the progression risk of AMD, with BLinD potentially acting as a precursor to type 1 macular neovascularization. Pre-BLinD is more prevalent in control eyes, while BLinD/soft drusen is more common in AMD eyes.
PURPOSE. Basal linear deposit (BLinD) is a thin layer of soft drusen material. To elucidate the biology of extracellular deposits conferring age-related macular degeneration (AMD) progression risk and inform multimodal clinical imaging based on optical coherence tomography (OCT), we examined lipid content and regional prevalence of BLinD, soft drusen, pre-BLinD, and subretinal drusenoid deposit (SDD) in AMD and non-AMD aged eyes. We estimated BLinD volume and illustrated its relation to type 1 macular neovascularization (MNV). METHODS. Donor eyes were classified as early to intermediate AMD (n = 25) and age-matched controls (n = 54). In high-resolution histology, we assessed BLinD/soft drusen thickness at 836 and 1716 locations in AMD and control eyes, respectively. BLinD volume was estimated using solid geometry in donor eyes, one clinically characterized. RESULTS. BLinD, drusen, type 1 MNV, and fluid occupy the sub-RPE-basal laminar space. BLinD volume in a 3-mm diameter circle may be as much as 0.0315 mm(3). Osmophilic lipid was more concentrated in BLinD/drusen than SDD. In the fovea, BLinD/drusen was prevalent in AMD eyes; pre-BLinD was prevalent in control eyes. SDD was low in the fovea and high in perifovea, especially in AMD eyes. CONCLUSIONS. Although invisible, BLinD may presage type 1 MNV. BLinD volume approaches the criterion OCT drusen volume of 0.03 mm(3) for AMD progression risk. BLinD culminates years of subfoveal lipid accumulation. SDD is detected relatively late in life, with currently unknown precursors. Deposit topography suggests one outer retinal lipid recycling system serving specialized cone and rod physiology, and its dysregulation in AMD is due to impaired transfer to the circulation.
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