Macular Degeneration: Ultrastructural Age-Related Changes

  • Illes Kovacs
  • Janos Feher
  • Carlo A. P. Cavallotti
Part of the Aging Medicine book series (AGME)


The aim of this chapter is to reveal the contribution of mitochondria and peroxisomes to the turnover of the photoreceptor outer segment and to describe the subsequent alteration of the retinal pigment epithelium and Bruch's membrane in normal aging and in age-related macular degeneration (AMD). Fifty-two surgically removed human eyes were involved in these histo-pathologic studies (25 female and 27 male, aged 56 to 87 years—mean age 68 years). Twenty-six of them were affected by early AMD, and 26 eyes were used as age-matched normal controls. For better visualization of lipids, osmium tetroxid postfixation was added to the standard electron microscopic technique. Polarization microscopy was also applied for the study of extracellular matrix components. Age-related changes of anisotropy were statistically analyzed using linear regression, and Fisher's transformation in both control and early AMD groups. Electron microscopy of retinal pigment epithelium both aged and early AMD showed a) accumulation of lipofuscin in the cytoplasm, b) focal or rarely diffuse alterations of mitochondrial cristae and matrix, and (c) accumulation of peroxisomes of variable size and electron density distributed throughout the cytoplasm. Electron and polarization microscopy of extracellular matrix showed a) an accumulation of amorphous, vacuolated and granular material in the collageneous layers of Bruch's membrane, b) the appearance of soft (rarely hard) Drusens, and c) a thickening of the basement membrane of retinal pigment epithelium (RPE) and choriocapillaries due to addition of axiparallel-oriented glycated fibrils and transversally oriented lipids. Although these processes were observed in both normal aging and early AMD, statistical analysis of anisotropy suggested that deposition of lipids and glycated fibrils was significantly different in AMD compared to normal aging.


mitochondria peroxisomes age-related macular degeneration retinal pigment epithelium basement membrane 



Acknowledgements The authors thank Ida Bozso for her excellent technical assistance, and Livia Feher and Alessandro Mariani for their contribution to this chapter.


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Copyright information

© Humana Press, a part of Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Illes Kovacs
    • 1
  • Janos Feher
    • 2
  • Carlo A. P. Cavallotti
    • 3
  1. 1.Department of OphthalmologySemmelweis UniversityBudapestHungary
  2. 2.Nutripharma Hungaria Ltd.BudapestHungary
  3. 3.European Ophthalmic Neuroscience Program (Local Research Unit)University of RomeLa Sapienza, RomeItaly

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