Decreased thickness and integrity of the macular elastic layer of Bruch's membrane correspond to the distribution of lesions associated with age-related macular degeneration
Decreased thickness and integrity of the macular elastic layer of Bruch's membrane correspond to the distribution of lesions associated with age-related macular degeneration
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DOI：
10.1016/s0002-9440(10)62248-1
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发表时间：
2005-01-01
影响因子：
6
通讯作者：
Hageman, GS
中科院分区：
文献类型：
--
作者：
Chong, NHV;Keonin, J;Hageman, GS
视网膜相关性黄斑变性（AMD）是老年人失明的主要原因。脉络膜新生血管在其最原始的形式中，突破黄斑布鲁赫膜（macularBruch’s membrane），并生长到视网膜中，所述膜是由弹性蛋白和胶原层组成的细胞外基质隔室。我们试图确定弹性膜（EL）的结构特性是否对应于黄斑区的偏爱。AMD的退化。对121只患有和不患有AMD的人类供体眼睛的黄斑和黄斑外区域的形态测量评估显示，在所有年龄段的供体中，黄斑和黄斑外区域之间的EL的完整性（P < 0.0001）和厚度（P < 0.0001）在统计学上均存在显著差异。与周边相比，黄斑区的EL薄三到六倍，丰富度低二到五倍。与未受影响的年龄匹配的对照组相比，患有早期AMD（P = 0.028）、活动性脉络膜新生血管（P = 0.020）和瘢痕（P = 0.003）的供体的黄斑EL的完整性显著较低。EL厚度显着较低，只有在个人与ESTA形式。瘢痕（P = 0.008）。与对照组相比，所有类型的AMD中黄斑EL完整性的最大间隙均显著更大（均P < 0.0001）。地图状萎缩供体的EL完整性、厚度和间隙长度与对照组无差异。黄斑EL的这些结构特性在空间上对应于与AMD相关的黄斑病变的分布，并且可能有助于解释为什么黄斑更容易受到这种疾病中发生的退行性事件的影响。
Age-related macular degeneration (AMD) is a leading cause of blindness in the elderly. in its severest form, choroidal neovessels breach the macular Bruch's membrane, an extracellular matrix compartment comprised of elastin and collagen laminae, and grow into the retina. We sought to determine whether structural properties of the elastic lamina (EL) correspond to the region of the macula that is predilected. toward degeneration in AMD. Morphometric assessment of the macular and extramacular regions of 121 human donor eyes, with and without AMD, revealed a statistically significant difference in both the integrity (P < 0.0001) and thickness (P < 0.0001) of the EL between the macular and extramacular regions in donors of all ages. The EL was three to six times thinner and two to five times less abundant in the macula than in the periphery. The integrity of the macular EL was significantly lower in donors with early-stage AMD (P = 0.028), active choroidal neovascularization (P = 0.020), and disciform scars (P = 0.003), as compared to unaffected, age-matched controls. EL thickness was significantly lower only in individuals with disciform. scars (P = 0.008). The largest gaps in macular EL integrity were significantly larger in all categories of AMD (each P < 0.0001), as compared to controls. EL integrity, thickness, and gap length in donors with geographic atrophy did not differ from those of controls. These structural properties of the macular EL correspond spatially to the distribution of macular lesions associated with AMD and may help to explain why the macula is more susceptible to degenerative events that occur in this disease.