Age-related macular degeneration : a light and electron microscopical study

In the preceding chapters, current knowledge on the normal histology, agerelated changes in the human macula and ARMD is summarized. However, this knowledge is frequently based on one single or only a few observations and it is often mainly descriptive without quantification and/or statistical analysis. Moreover, the results of different investigations are often controversial or even contradictory. Considerable research has been performed in the field of biochemistry, cell biology, histology, clinical evaluation and epidemiology, but several alternatives have remained unexplored or unquantified. The primary aim of this study was to gain more information about the basal laminar deposit, a substance which until now was relatively unknown, but was thought to be associated with the development of age-related macular degeneration. Because experimental animal models in which ARMD can be induced are not known, we chose for a deductive method in which a large series of postmortem human eyes of all ages were studied. Special attention was directed to the morphology, compos1t1on and age-distribution of BLD in the population (chapters 5,6,7,8,9). In addition the histological and morphometrical age-related changes in the maculae (chapter 5). the peripheral retina (chapter 1 0) and the choriocapillaris (chapter 11) of these eyes were quantified and analyzed statistically. We also investigated the histology of human pseudophakic eyes with and without an UV-filter in comparison to normal phakic eyes (chapter 12). For this thesis various techniques have been used such as light microscopical histology, immunohistochemistry, immunofluorescence, transmission electron microscopy, immunoelectron microscopy, electron probe X-ray microanalysis and image analysis. In addition various computerized statistical procedures were applied.