Identity of pigmented subretinal cells in age-related macular degeneration
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We were very interested to read the letter by Curcio and Ach in Graefe’s Archives in response to our manuscript. We are pleased that our work has generated interest by expert investigators in the AMD research community.
The authors question our identification of the pigmented CD163+ cells in the subretinal space of cases with Sarks stage IV (intermediate AMD) to VI (severe) AMD as monocyte-derived. In high-resolution light microscopy studies [1, 2], Curcio and colleagues identified spherical subretinal cells as “sloughed” retinal pigment epithelium (RPE) cells since they contain RPE granules similar in morphology and autofluorescence patterns to granules in the RPE cells. Pathologists often encounter phagocytic cells engulfing melanin pigment (“melanophages”) in the skin  and eye  and have found the morphology of melanosomes and melanin granules to be that of the tissue of provenance. Therefore, extreme caution is required before using pigment granule...
KeywordsRetinal Pigment Epithelium Macular Degeneration Retinal Pigment Epithelium Cell Pigment Cell Melanin Granule
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