gms | German Medical Science

23rd Annual Meeting of the German Retina Society

German Retina Society

24.09. - 25.09.2010, Freiburg

Cellular Phenomena in the Transition Zone of Geographic Atrophy due to ARMD

Meeting Abstract

  • Martin Rudolf - University Eye Clinic Lübeck
  • A. Wagner - University Eye Clinic Lübeck
  • J. Torrent Despouy - University Eye Clinic Lübeck
  • S. Grisanti - University Eye Clinic Lübeck
  • C. Curcio - University Eye Center Birmingham, AL

German Retina Society. 23rd Annual Conference of the German Retina Society. Freiburg i. Br., 24.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc10rg04

doi: 10.3205/10rg04, urn:nbn:de:0183-10rg043

This is the translated version of the article.
The original version can be found at:

Published: September 21, 2010

© 2010 Rudolf et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: New clinical high resolution imaging technologies like spectral domain OCT and Fundusautofluorescence are useful tools in the evaluation of GA due to ARMD. The GA junctional zone includes changes in RPE-Bruch’s membrane (BrM) complex that are difficult to interpret. We measured and evaluated characteristic RPE cell changes in histological sections of GA eyes to provide a better basis for interpreting clinical GA imaging data.

Methods: In 7 GA eyes, 3 complete section sets through GA atrophy were analyzed in RPE morphology zones: 0/1 = uniform/ non-uniform morphology and pigmentation; 2A = heaped RPE; 2B = RPE posterior migration into basal deposits; 2L = RPE leaflets; 3 = RPE migration into retina; 4/5 = loss of pigmentation with/ without persisting basal deposits. Within zones, parameters were assigned semi-quantitative descriptors. The sum of AF intensity along lines perpendicular to BrM, measured with laser confocal microscopy, served as a surrogate for fundus AF.

Results: From the outer macula towards the central atrophic area we defined zones in which the RPE grades passed almost steadily upward, indicating increased pathology. AF sum intensity was both highest and most variable in grades 2A,B, and L. Sharp increases in AF sum intensity in grades 2–3, near atrophy, were frequently due to vertical superimposition of orthotopic and ectopic RPE.

Conclusions: Our histological measurements provide information about GA typical alterations of the RPE-Bruch’s membrane complex and are useful for interpreting clinical imaging data. High AF at GA borders is not reliably attributable to increased lipofuscin within individual cells, casting doubt on lipofuscin’s cytotoxicity in vivo.