Measuring the Contributions of Basal Laminar Deposit and Bruch’s Membrane in Age-Related Macular Degeneration
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Purpose: Basal laminar deposit (BLamD) is a consistent finding in age-related macular degeneration (AMD). We quantified BLamD thickness, appearance, and topography in eyes of aged donors with and without AMD and evaluated its relationship to other components of the retinal pigment epithelium-basal lamina/Bruch's membrane (RPE-BL-BrM) complex. Methods: Donor eyes (n = 132) were classified as normal (n = 54), early to intermediate AMD (n = 24), geographic atrophy (GA; n = 13), and neovascular AMD (NV; n = 41). In high-resolution histology, we assessed RPE, BLamD, and BrM thicknesses and phenotypes at 3309 predefined locations in the central (foveal and perifovea) and superior (perifoveal) sections. Pre-mortem optical coherence tomography (OCT) imaging of a 90-year-old woman was compared to postmortem histopathology. Results: In non-atrophic areas of AMD eyes, the RPE-BLamD is thick (normal = 13.7 µm, early-intermediate = 16.8 µm, GA = 17.4 µm, NV = 18.7 µm), because the BLamD is thick (normal = 0.3 µm, early-intermediate = 5.5 µm, GA = 4.1 µm, NV = 5.3 µm). RPE layer thickness is similar across these stages. Disease-associated variants of BLamD (thick, late, basal mounds) cluster subfoveally. A thick BLamD is visible on OCT as a hyporeflective split in the RPE-BL-BrM complex. BrM is thin (3.5 µm) in NV (normal = 4.2 µm, early to intermediate = 4.4 µm, and GA = 4.2 µm). Conclusions: The RPE-BL-BrM complex is thick in AMD, driven by the accumulation and expansion of BLamD rather than expansion of either three-layer BrM, RPE-BL, or RPE. BLamD is clinically appreciable by OCT in some patients as a non-neovascular "split RPE-BL-BrM complex" or "double-layer sign." BLamD may contribute toward the formation and progression of high-risk drusen yet also exhibit protective properties.
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Recent data suggest that the thickening of the RPE-BrM complex in AMD eyes is mainly due to the accumulation of BLamDs and extracellular matrix material between the basal lamina and plasma membrane of the RPE, rather than accumulation within the RPE or BrM itself.
“Recent data suggest that the thickening of the RPE–BrM complex in AMD eyes is mainly due to the accumulation of BLamDs and extracellular matrix material between the basal lamina and plasma membrane of the RPE, rather than accumulation within the RPE or BrM itself [69].”
From Bruch’s Membrane: A Key Consideration with Complement-Based Therapies for Age-Related Macular Degeneration (2023) · cites this paper as [69]
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Self-citationPathophysiology of Secondary Macular Hole in Rhegmatogenous Retinal Detachment
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Self-citationChoriocapillaris Flow Imbalance in Fellow Eyes in Age-Related Macular Degeneration
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Spectral Analysis of Human Retinal Pigment Epithelium Cells in Healthy and AMD Eyes
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Exploring ocular fibulin-3 (EFEMP1): Anatomical, age-related, and species perspectives
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Imaging Histology Correlations of Intraretinal Fluid in Neovascular Age-Related Macular Degeneration
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Age-Related Macular Degeneration
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Self-citationBreaking Bruch's: How changes in Bruch's membrane influence retinal homeostasis
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Genetic Associations of Rod- and Cone-Mediated Vision in Aging and Age-Related Macular Degeneration
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En Face OCT and the Phenotype Characterization of Drusen
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GSK3 inhibition reduces ECM production and prevents age-related macular degeneration–like pathology
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Photoreceptor Density–Dependent Kinetics of Geographic Atrophy Progression
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Retinal pigment epithelium–Bruch’s membrane volume in grading of age-related macular degeneration
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BASAL LAMINAR DEPOSITS AND PSEUDODRUSEN
Fragiotta, S., Sacconi, R., Beretta, F., & Querques, G. (2025) · Retina · doi:10.1097/iae.0000000000004683 · Cited by 3 · see citing works
- Authors
- Sura, A. A., Chen, L., Messinger, J. D., Swain, T. A., McGwin, G., Freund, K. B., & Curcio, C. A.
- Affiliations
- University of Alabama at Birmingham (US)
- University of Tsukuba (JP)
- Corresponding author
- Curcio, Christine A.
- ORCID
- Venue
- Investigative Opthalmology & Visual Science
- Published
- 2020-11-13
- Volume
- 61
- Issue
- 13
- Pages
- 19
- ISSN
- 0146-0404 (ISSN-L)
- 1552-5783
- PMC
- PMC7671869
- OpenAlex
- W3104313195
- Cited by
- 148
- References
- 118
- Citations by year
- 2026: 28 · 2025: 28 · 2024: 32 · 2023: 21 · 2022: 24 · 2021: 15
- FWCI
- 11.89
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Investigative Ophthalmology & Visual Science (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (P30AG022838)
- National Eye Institute (P30EY003039)
- 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
- basal laminar deposits, Bruch's membrane, age-related macular degeneration, retinal pigment epithelium, geographic atrophy, neovascular AMD, double-layer sign, optical coherence tomography, postmortem histopathology, retinal thickness, choroidal neovascularization, retinal pigment epithelium thickening
- MeSH terms
- Aged, Aged, 80 and over, Basement Membrane, Female, Humans, Macular Degeneration, Male, Phenotype, Visual Acuity, Bruch Membrane, Tomography, Optical Coherence, Retinal Pigment Epithelium
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