Evolution of geographic atrophy of the retinal pigment epithelium

The aim of this study was to trace the evolution of geographic atrophy (GA) by clinical documentation and by clinico-morphological correlation in representative eyes. Geographic atrophy commonly commenced within a parafoveal band of incipient atrophy of varying width, characterised by semisolid drusen and a microreticular pigment pattern. Progession of atrophy mostly skirted fixation and visual acuity was a poor guide to the functional impact, an estimate of the percentage of fovea involved proving a more useful clinical parameter. The rate of progression slowed once GA had involved all the retina affected by incipient atrophy and the risk of choroidal neovascularization appeared to decline.An earlier histological classification of the evolution of GA is revised according to the ultras- tructural findings. Membranous debris was not previously recognised and its contribution to the findings in incipient atrophy and to dot-like drusen is described.

[1]  J. Gass,et al.  Adult vitelliform macular detachment occurring in patients with basal laminar drusen. , 1985, American journal of ophthalmology.

[2]  W R Green,et al.  Senile macular degeneration: a histopathologic study. , 1977, Transactions of the American Ophthalmological Society.

[3]  B. Straatsma,et al.  Chorioretinal juncture. Multiple extramacular drusen. , 1986, Ophthalmology.

[4]  M. Hogan.  Role of the retinal pigment epithelium in macular disease. , 1972, Transactions - American Academy of Ophthalmology and Otolaryngology. American Academy of Ophthalmology and Otolaryngology.

[5]  P. Henkind,et al.  The relationship between retinal pigment epithelium and the choriocapillaris. , 1983, Transactions of the ophthalmological societies of the United Kingdom.

[6]  T. Dawber,et al.  The Framingham Eye Study monograph: An ophthalmological and epidemiological study of cataract, glaucoma, diabetic retinopathy, macular degeneration, and visual acuity in a general population of 2631 adults, 1973-1975. , 1980, Survey of ophthalmology.

[7]  K R Kenyon,et al.  Diffuse drusen and associated complications. , 1985, American journal of ophthalmology.

[8]  M. Mainster,et al.  Visual acuity related to retinal distance from the fovea in macular disease. , 1984, Annals of ophthalmology.

[9]  L. Feeney-Burns,et al.  Clinico-morphologic correlations of drusen of Bruch's membrane. , 1980, Transactions of the American Ophthalmological Society.

[10]  P. Maguire,et al.  Geographic atrophy of the retinal pigment epithelium. , 1986, American journal of ophthalmology.

[11]  J D Gass,et al.  Drusen and disciform macular detachment and degeneration. , 1973, A M A Archives of Ophthalmology.

[12]  C. Grindle,et al.  Ageing changes in Bruch's membrane and their functional implications. , 1978, Transactions of the ophthalmological societies of the United Kingdom.

[13]  A. Wyllie,et al.  Apoptosis: A Basic Biological Phenomenon with Wide-ranging Implications in Tissue Kinetics , 1972, British Journal of Cancer.

[14]  S. Sarks,et al.  Drusen patterns predisposing to geographic atrophy of the retinal pigment epithelium. , 1982, Australian journal of ophthalmology.

[15]  F L Ferris,et al.  Senile macular degeneration: a case-control study. , 1983, American journal of epidemiology.

[16]  D L Guyton,et al.  Eccentric visual acuity in patients with macular disease. , 1985, Ophthalmology.

[17]  J. G. Marshall,et al.  Effects of increasing numbers of phagocytic inclusions on human retinal pigment epithelial cells in culture: a model for aging. , 1986, The British journal of ophthalmology.

[18]  B S Fine,et al.  A histologic study of regional choroidal dystrophy. , 1977, American journal of ophthalmology.

[19]  S. Sarks,et al.  Ageing and degeneration in the macular region: a clinico-pathological study. , 1976, The British journal of ophthalmology.

[20]  M. Killingsworth,et al.  Softening of drusen and subretinal neovascularization. , 1980, Transactions of the ophthalmological societies of the United Kingdom.

[21]  D. Burgess,et al.  Macular disease resembling adult foveomacular vitelliform dystrophy in older adults. , 1987, Ophthalmology.

[22]  P. Penfold,et al.  Senile macular degeneration. The involvement of giant cells in atrophy of the retinal pigment epithelium. , 1986, Investigative ophthalmology & visual science.

[23]  A. Bird,et al.  Retinal pigment epithelial detachments in the elderly. , 1986, Transactions of the ophthalmological societies of the United Kingdom.

[24]  S. Sarks,et al.  DRUSEN AND THEIR RELATIONSHIP TO SENILE MACULAR DEGENERATION , 1980 .

[25]  R W Young,et al.  Pathophysiology of age-related macular degeneration. , 1987, Survey of ophthalmology.

[26]  W R Green,et al.  Pathologic Features of Senile Macular Degeneration , 1985, Ophthalmology.

[27]  L. Feeney-Burns,et al.  Aging human RPE: morphometric analysis of macular, equatorial, and peripheral cells. , 1984, Investigative ophthalmology & visual science.

[28]  L. Feeney-Burns,et al.  Lysosomal enzyme cytochemistry of human RPE, Bruch's membrane and drusen. , 1987, Investigative ophthalmology & visual science.

[29]  W. Green,et al.  Retinal pigment epithelial window defect. , 1978, A M A Archives of Ophthalmology.

[30]  M. Ellersieck,et al.  Age-related changes in the ultrastructure of Bruch's membrane. , 1985, American journal of ophthalmology.

[31]  T. Ishibashi,et al.  Aging changes in Bruch's membrane of monkeys: an electron microscopic study. , 1986, Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde.

[32]  D. Taylor,et al.  Histopathology of mitochondrial cytopathy and the Laurence-Moon-Biedl syndrome. , 1986, The British journal of ophthalmology.

[33]  M. Tso,et al.  Pathogenetic factors of aging macular degeneration. , 1985, Ophthalmology.

[34]  J. Weiter,et al.  The topography and age relationship of lipofuscin concentration in the retinal pigment epithelium. , 1978, Investigative ophthalmology & visual science.