Association of drusen deposition with choroidal intercapillary pillars in the aging human eye.
OBJECTIVE
To determine the pattern of drusen accumulation with age and to investigate the initial sites of deposition and their relationship to choroidal capillaries in human donor eyes from the eye bank of Moorfields Eye Hospital.


METHODS
Wholemounted, hydrated preparations of the choriocapillaris and Bruch's membrane from donor eyes ranging from 42 to 95 years, with or without retinal pigment epithelium (RPE), were examined by conventional and confocal microscopy. Drusen were visualized by their autofluorescence.


RESULTS
In all age groups studied autofluorescent drusen were present at the equator but were not found centrally where the vascular architecture is different, being tubular rather than a honeycomb pattern. Autofluorescing drusen were strongly associated with the lateral walls of the choriocapillaris (an area commonly known as the intercapillary pillars of the choriocapillaris (P = 0.028; Wilcoxon signed ranks test). Nonfluorescing drusen were occasionally seen centrally, but were not easily identified, and because of their large size, their localization with respect to capillary walls was not possible.


CONCLUSIONS
These results strongly support the notion that autofluorescent drusen are not randomly distributed and have a specific spatial relationship to choroidal vessel walls. That equatorial drusen fluoresce, whereas central drusen do not, suggests that they may have different chemical compositions at the two sites and possibly different significance in age-related macular disease.
Experimental Age Related Macular Degeneration Research Group, Institute of Ophthalmology, University College London, London, United Kingdom.
Imre
I
Lengyel
Adnan
A
Tufail
Heba Al
HA
Hosaini
Philip
P
Luthert
Alan C
AC
Bird
Glen
G
Jeffery
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D016570:Bruch Membrane / Q000098:blood supply; D002196:Capillaries / Q000473:pathology; D002829:Choroid / Q000098:blood supply*; D005125:Eye Banks; D005453:Fluorescence; D006801:Humans; D018613:Microscopy, Confocal; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000473:pathology; D015593:Retinal Drusen / Q000473:pathology*; D014019:Tissue Donors