Intraretinal Retinal Pigment Epithelium Cells in Age-Related Macular Degeneration

IF 3.2 Q1 OPHTHALMOLOGY Ophthalmology science Pub Date : 2024-09-30 DOI:10.1016/j.xops.2024.100626
Songhomitra Panda-Jonas MD , Rahul A. Jonas MD , Jie Xu MD , Ya Xing Wang MD , Jost B. Jonas MD
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Abstract

Purpose

To examine intraretinally migrated retinal pigment epithelium cells (iRPECs) in enucleated human eyes with various retinal conditions and corresponding intraretinal hyperreflective bodies (iHRBs) in a large cohort of patients with age-related macular degeneration (AMD) in China.

Design

Population-based study and histomorphometric investigation.

Participants

Participants of the population-based Beijing Eye Study and enucleated human eyes.

Methods

OCT-based and fundus photography-based examination of the macula of the Beijing Eye Study participants and light-microscopical histomorphometry of enucleated human eyes.

Main Outcome Measures

Presence and location of iRPECs and iHRBs.

Results

In the Beijing Eye Study (6551 eyes; 3301 participants), the prevalence of intermediate AMD and late AMD was 331 (5.1%) and 44 (0.6%), respectively. All 42 eyes with intermediate AMD and macular hyperpigmentation had iHRBs at locations corresponding spatially with macular hyperpigmentation on the fundus photographs. Among all eyes with intermediate AMD (n = 331), iHRBs were detected in 262 (79.2%) eyes. The most internal location of the iHRBs was at the ellipsoid zone in 46 (13.9%) eyes, at the external limiting membrane (ELM) in 45 (13.6%) eyes, and in the outer nuclear layer in 145 (43.8%) eyes. Out of the 262 eyes with iHRBs, 186 (71.0%) eyes showed a corresponding defect in the ellipsoid zone, and 128 (48.9%) eyes showed a defect in the ELM. The eyes with an iHRB located beneath the ELM did not show an ELM defect. The iHRBs were associated with a plume-like appearance and with a smoke-like appearance in 20 (7.6%) eyes and 137 (52.3%) eyes, respectively. All iHRBs did not have a shadow on the OCT images. Similar findings were obtained in the eyes with late AMD. Among 237 eyes examined histologically, 21 globes showed iRPECs: 8 eyes in parapapillary α zone/β zone; 5 eyes with myopic patchy atrophies, and 3 eyes with AMD. The iRPECs were spatially associated with an ELM defect and were not surrounded by a basal membrane.

Conclusions

Intraretinal hyperreflective bodies can be found in 3 out of 4 eyes with intermediate AMD, correlate histologically with intraretinally located (migrated) retinal pigment epithelium cells, and correspond spatially with localized defects of the ellipsoid zone and ELM.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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老年性黄斑变性中的视网膜内视网膜色素上皮细胞
目的研究中国一大批年龄相关性黄斑变性(AMD)患者的去核人眼中视网膜内移行的视网膜色素上皮细胞(irpecs)以及相应的视网膜内高反射体(iHRBs)。主要结果测量iRPECs和iHRBs的存在和位置。结果在北京眼科研究(6551只眼睛;3301名参与者)中,中期AMD和晚期AMD的患病率分别为331(5.1%)和44(0.6%)。所有 42 只患有中期 AMD 和黄斑色素沉着的眼睛都在眼底照片上与黄斑色素沉着相对应的位置出现了 iHRB。在所有患有中度 AMD 的眼睛(n = 331)中,有 262 只眼睛(79.2%)检测到了 iHRB。46只(13.9%)眼的iHRB位于椭圆形区,45只(13.6%)眼的iHRB位于外缘膜(ELM),145只(43.8%)眼的iHRB位于核外层。在 262 只出现 iHRB 的眼睛中,186 只(71.0%)眼睛的椭圆形区出现了相应的缺损,128 只(48.9%)眼睛的 ELM 出现了缺损。iHRB位于ELM下方的眼球未显示ELM缺损。分别有 20 只(7.6%)眼睛和 137 只(52.3%)眼睛的 iHRB 与羽状外观和烟雾状外观有关。所有 iHRB 在 OCT 图像上都没有阴影。晚期 AMD 患者也有类似的发现。在接受组织学检查的237只眼球中,有21只眼球出现了iRPECs:8只眼球位于毛旁α区/β区;5只眼球患有近视斑片状萎缩;3只眼球患有AMD。iRPECs在空间上与ELM缺损相关,周围没有基底膜。结论在4只患有中度AMD的眼睛中,有3只眼睛可以发现视网膜超反射体,在组织学上与视网膜内定位(移行)的视网膜色素上皮细胞相关,在空间上与椭圆形区和ELM的局部缺损相对应。
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来源期刊
Ophthalmology science
Ophthalmology science Ophthalmology
CiteScore
3.40
自引率
0.00%
发文量
0
审稿时长
89 days
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