Basal Linear Deposit: Normal Physiological Ageing or a Defining Lesion of Age-Related Macular Degeneration?

Autor: Thananjeyan AL; St. Vincent's Hospital, Victoria Street, Darlinghurst, NSW 2010, Australia.; School of Medicine, University of Sydney, Camperdown, NSW 2006, Australia., Arnold J; Marsden Eye Specialists, Parramatta, NSW 2150, Australia., Lee M; School of Clinical Medicine, University of NSW, Sydney, NSW 2052, Australia.; Anatomical Pathology, St Vincent's Hospital, Darlinghurst, NSW 2010, Australia., Au C; Anatomical Pathology, St Vincent's Hospital, Darlinghurst, NSW 2010, Australia.; School of Medicine, University of Notre Dame, Sydney, NSW 2008, Australia., Pye V; School of Clinical Medicine, University of NSW, Sydney, NSW 2052, Australia.; Anatomical Pathology, St Vincent's Hospital, Darlinghurst, NSW 2010, Australia., Madigan MC; Optometry and Vision Science, University of New South Wales (UNSW), Sydney, NSW 2052, Australia.; Save Sight Institute, University of Sydney, Sydney, NSW 2000, Australia., Cherepanoff S; School of Clinical Medicine, University of NSW, Sydney, NSW 2052, Australia.; Anatomical Pathology, St Vincent's Hospital, Darlinghurst, NSW 2010, Australia.; School of Medicine, University of Notre Dame, Sydney, NSW 2008, Australia.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2024 Aug 07; Vol. 13 (16). Date of Electronic Publication: 2024 Aug 07.
DOI: 10.3390/jcm13164611
Abstrakt: Objective: To determine if basal linear deposit (BLinD) is a specific lesion of age-related macular degeneration (AMD). Methods: The cohort was selected from a clinically and histopathologically validated archive (Sarks Archive) and consisted of 10 normal eyes (age 55-80 years) without any macular basal laminar deposit (BLamD) (Sarks Group I) and 16 normal aged eyes (age 57-88 years) with patchy BLamD (Sarks Group II). Only eyes with in vivo fundus assessment and corresponding high-resolution transmission electron microscopy (TEM) micrographs of the macula were included. Semithin sections and fellow-eye paraffin sections were additionally examined. BLinD was defined as a diffuse layer of electron-lucent vesicles external to the retinal pigment epithelium (RPE) basement membrane by TEM and was graded as follows: (i) Grade 0, absence of a continuous layer; (ii) Grade 1, a continuous layer up to three times the thickness of the RPE basement membrane (0.9 µm); (iii) Grade 2, a continuous layer greater than 0.9 µm. Bruch's membrane (BrM) hyalinisation and RPE abnormalities were determined by light microscopic examination of corresponding semithin and paraffin sections. Results: BLinD was identified in both normal (30%) and normal aged (62.5%) eyes. BLinD was thicker in normal aged eyes ( p = 0.045; 95% CI 0.04-3.4). BLinD thickness positively correlated with both the degree of BrM hyalinisation ( p = 0.049; 95% CI 0.05-2.69) and increasing microscopic RPE abnormalities ( p = 0.022; 95% CI 0.188-2.422). RPE abnormalities were more likely to be observed in eyes with increased BrM hyalinisation ( p = 0.044; 95% CI 0.61-4.319). Conclusions: BLinD is most likely an age-related deposit rather than a specific lesion of AMD. Its accumulation is associated with increasing BrM hyalinisation and microscopic RPE abnormalities, suggesting a relationship with dysregulated RPE metabolism and/or transport.
Databáze: MEDLINE
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