title: Abnormal cone synapses in human cone-rod dystrophy.
abstract: OBJECTIVE
  Little is known of the cytopathology of photoreceptors in human inherited retinal dystrophies that initially affect the central retina, including the macula. The current study sought to determine the cytologic features of dysfunctional cone and rod photoreceptors, as well as the pattern of degeneration of the cells in representative cases of central retinal dystrophy.
  
  
  METHODS
  Comparative human tissue study.
  
  
  METHODS
  Four human donor eyes with the following forms of central retinal dystrophy: cone-rod dystrophy (CRD), central areolar choroidal dystrophy, Bardet-Biedl syndrome, and cone dystrophy-cerebellar ataxia. The cytologic features of retinal photoreceptors in these eyes were compared with those in an eye with retinitis pigmentosa and six normal human eyes.
  
  
  METHODS
  Immunocytochemistry and electron microscopy were used to evaluate the retinal histopathology in the donor eyes.
  
  
  RESULTS
  Cone numbers were decreased in the case of CRD, particularly in the central and far peripheral retina, and both cone and rod outer segments were slightly shortened. Occasional degenerate cones had dense cytoplasm and pyknotic nuclei dislocated sclerad to the external-limiting membrane. The most prominent alteration in this retina was marked enlargement and distortion of the cone photoreceptor pedicles, which contained reduced numbers of synaptic vesicles. The retina with central areolar choroidal dystrophy contained a few cones with similarly abnormal synapses. However, comparable cone synapse abnormalities were not observed in the cases of Bardet-Biedl syndrome, cone dystrophy-cerebellar ataxia, retinitis pigmentosa, or in the normal retinas.
  
  
  CONCLUSIONS
  The functional consequences of the cone synapse abnormalities in CRD are not known but may correlate with the electroretinographic abnormalities documented in some cases of CRD. To our knowledge, comparable synapse changes have not been noted in either rods or cones in other forms of retinal dystrophy, including retinitis pigmentosa, suggesting that different cytopathologic mechanisms may be involved.
authors.affiliation: Department of Ophthalmology, University of Washington, Seattle, USA.
authors.forename: K
authors.initials: K
authors.lastname: Gregory-Evans
authors.forename: R N
authors.initials: RN
authors.lastname: Fariss
authors.forename: D E
authors.initials: DE
authors.lastname: Possin
authors.forename: C Y
authors.initials: CY
authors.lastname: Gregory-Evans
authors.forename: A H
authors.initials: AH
authors.lastname: Milam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count; D002524:Cerebellar Ataxia / Q000473:pathology; D015862:Choroid Diseases / Q000473:pathology; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007849:Laurence-Moon Syndrome / Q000473:pathology; D008297:Male; D008875:Middle Aged; D020419:Photoreceptor Cells, Vertebrate / Q000648:ultrastructure*; D012162:Retinal Degeneration / Q000473:pathology*; D013569:Synapses / Q000648:ultrastructure*