Location, ubtructure, and compoition of baal laminar druen compared with druen aociated with aging and age-related macular degeneration

PURPOE: To determine whether baal laminar druen differ in their location, ultratructure, or compoition from druen aociated with aging and age-related macular degeneration. METHOD: A paraffin-embedded block from an eye of a patient with baal laminar druen wa obtained. ection were examined immunohitochemically uing a battery of antibodie and lectin directed againt druen-aociated protein and glycoconjugate, repectively. Thin ection were examined by electron microcopy and compared with eye with age-related macular degeneration. REULT: Druen in the eye with baal laminar druen are located between the baal lamina of the retinal pigment epithelium and the inner collagenou layer of Bruch membrane, jut a they are in age-related macular degeneration. Two ditinct ultratructural phenotype are oberved in the eye with baal laminar druen; their ubtructure i inditinguihable from druen phenotype in age-related macular degeneration. Both baal laminar druen and druen aociated with age-related macular degeneration are bound by the lectin Ricini communi agglutinin and Arachi hypogea agglutinin (after neuraminidae digetion) and by antivitronectin, anti–HLA-DR, anti–erum amyloid P, and anti-C5 antibodie, but not by antibodie directed againt baement membrane–aociated heparan ulfate proteoglycan, laminin, fibrinogen, or collagen type IV. CONCLUION: Thee data upport the notion that cuticular or baal laminar druen are imilar to, and perhap inditinguihable from, druen aociated with age-related macular degeneration and are not nodular or diffue thickening of Bruch membrane, a previouly uggeted. Thu, we ugget baal laminar druen i a minomer. Thi clinical phenotype hould be identified a “early adult onet, grouped druen” or by the eponym “Ga yndrome.” Feature of baal laminar druen, uch a uniform druen ize, clutered ditribution, and angiographic feature, do not appear to be related to difference in druen location, compoition, or ubtructure.