Relationship of Basal Laminar Deposit and Membranous Debris to the Clinical Presentation of Early Age-Related Macular Degeneration
Abstract
PURPOSE: To correlate basal laminar deposit (BLamD) and membranous debris, including basal linear deposit (BLinD), with the evolution of early age-related macular degeneration (AMD). METHODS: A clinicopathologic collection of 132 eyes with a continuous layer of BLamD was reviewed. The thickness and type of BLamD and the sites of membranous debris deposition were correlated with the clinical progression of the disease. RESULTS: Two types of BLamD, termed early and late, were identified based on light microscopic appearance by using the picro-Mallory stain. The progressive accumulation of late type BLamD correlated well with increasing BLamD thickness, advancing RPE degeneration, poorer vision, increasing age, and clinically evident pigment changes. Membranous debris initially accumulated diffusely as BLinD, most eyes with BLinD and early BLamD remaining funduscopically normal. However, membranous debris also formed focal collections as basal mounds internal to the RPE basement membrane and as soft drusen external to the basement membrane. Eyes in which membranous debris remained confined to basal mounds belonged to older patients with poorer vision, whereas patients with soft drusen were younger and had better vision. CONCLUSIONS: The presence of BLinD and early BLamD define threshold AMD, which manifests clinically as a normal fundus. Although late BLamD correlates most closely with clinical pigment abnormalities, it is the quantity and sites of membranous debris accumulation that appear to determine whether the disease develops pigment changes only or follows the alternative pathway of soft drusen formation with its attendant greater risk of choroidal neovascularization (CNV).
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Basal deposits in Bruch's membrane are of two distinct types: basal laminar deposits between the RPE and basement membrane, and basal linear deposits.
“These deposits are of two distinct types (59): (a) basal laminar deposits between the RPE and basement membrane, and (b) basal linear deposits, which are composed primarily of membraneous material located external to the RPE basement membrane in Bruch’s membrane and are believed to be more specific to AMD (126).”
From Unraveling a Multifactorial Late-Onset Disease: From Genetic Susceptibility to Disease Mechanisms for Age-Related Macular Degeneration (2009) · cites this paper as [126]
Basal linear deposits are composed primarily of membraneous material located external to the RPE basement membrane in Bruch's membrane and are believed to be more specific to AMD.
“basal linear deposits, which are composed primarily of membraneous material located external to the RPE basement membrane in Bruch’s membrane and are believed to be more specific to AMD (126).”
From Unraveling a Multifactorial Late-Onset Disease: From Genetic Susceptibility to Disease Mechanisms for Age-Related Macular Degeneration (2009) · cites this paper as [126]
Basal linear deposits are more specific for early age-related macular degeneration and are composed mainly of membraneous material located external to the basement membrane of the retinal pigment epithelium in Bruch's membrane.
“basal linear, which is more specific for early age-related macular degeneration and composed mainly of membraneous material located external to the basement membrane of the retinal pigment epithelium in Bruch’s membrane.117”
From Age-related macular degeneration (2008) · cites this paper as [117]
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- Authors
- Sarks, S., Cherepanoff, S., Killingsworth, M., & Sarks, J.
- Affiliations
- Neuroscience Research Australia (AU)
- South Western Area Pathology Services, Sydney, Australia.
- Venue
- Investigative Opthalmology & Visual Science
- Published
- 2007-03-01
- Volume
- 48
- Issue
- 3
- Pages
- 968
- ISSN
- 0146-0404 (ISSN-L)
- 1552-5783
- OpenAlex
- W1994025305
- Cited by
- 244
- References
- 39
- Citations by year
- 2026: 15 · 2025: 18 · 2024: 16 · 2023: 8 · 2022: 17 · 2021: 16 · 2020: 12 · 2019: 10 · 2018: 15 · 2017: 16 · 2016: 4 · 2015: 13 · 2014: 16 · 2013: 7 · 2012: 12
- FWCI
- 10.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Investigative Ophthalmology & Visual Science (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Retinal Development and Disorders
- Keywords
- age-related macular degeneration, basal laminar deposits, soft drusen, retinal pigment epithelium degeneration, choroidal neovascularization, disease progression, clinicopathological correlation
- MeSH terms
- Aged, Aged, 80 and over, Extracellular Matrix, Female, Humans, Macular Degeneration, Male, Pigment Epithelium of Eye, Retinal Drusen, Bruch Membrane, Choroidal Neovascularization
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