Abnormal thickening as well as thinning of the photoreceptor layer in intermediate age-related macular degeneration.
OBJECTIVE
To investigate the relationship between photoreceptor layers overlying and adjacent to large drusen in intermediate nonneovascular AMD.


METHODS
Patients with AMD (n = 41; aged 53-83 years) and elderly control subjects without eye disease (n = 10; aged 51-79 years) were studied with spectral-domain optical coherence tomography. Characteristics of large drusen (≥125 μm) were measured and the thickness of photoreceptor laminae overlying drusen and in retinal regions neighboring the drusen were quantified.


RESULTS
There were 750 large drusen in 63 intermediate AMD eyes studied. The width of the drusen sampled averaged 352 μm (SD = 153) and the height averaged 78 μm (SD = 31). There was significant reduction of the photoreceptor outer nuclear layer (ONL) thickness overlying 92% of the drusen. The thickness of the layer corresponding to photoreceptor inner and outer segments above drusen was also reduced, and the reduction was proportional to ONL thickness. In a substantial fraction (~20%) of normally laminated paradrusen locations sampled within ~300 μm of peak drusen height, ONL thickness was significantly increased compared with age and retinal location-matched normal values. Topographical analyses of the macula showed ONL thickening occurring in paradrusen regions as well as retinal locations distant from drusen.


CONCLUSIONS
Reductions in the photoreceptor laminae overlying drusen were detectable and this is consistent with histological studies revealing neuronal degeneration in AMD. ONL thickening in some macular areas of AMD eyes has not been previously reported and may be an early phenotypic marker for photoreceptor stress, as it has been speculated to be in hereditary retinal degenerations.
Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Sam
S
Sadigh
Artur V
AV
Cideciyan
Alexander
A
Sumaroka
Wei Chieh
WC
Huang
Xunda
X
Luo
Malgorzata
M
Swider
Janet D
JD
Steinberg
Dwight
D
Stambolian
Samuel G
SG
Jacobson
D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D006801:Humans; D008266:Macula Lutea / Q000473:pathology; D008268:Macular Degeneration / Q000473:pathology*; D008875:Middle Aged; D020419:Photoreceptor Cells, Vertebrate / Q000473:pathology*; D015593:Retinal Drusen / Q000473:pathology; D055214:Retinal Photoreceptor Cell Outer Segment / Q000473:pathology; D041623:Tomography, Optical Coherence