Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland.
Acta Ophthalmol. 2024 May;102(3):342-348. doi: 10.1111/aos.15741. Epub 2023 Aug 22.
To describe the occurrence, morphology and associations of parapapillary drusen of the retinal pigment epithelium (RPE-drusen).
Using light microscopy, we histomorphometrically examined enucleated human eyes.
The study included 83 eyes (axial length: 25.9 ± 3.2 mm; range: 20.0-35.0 mm). Eyes with parapapillary RPE-drusen (n = 29 (35%) eyes) as compared to those without drusen had a significantly shorter axial length (24.0 ± 1.8 mm vs 27.0 ± 3.3 mm; p < 0.001), higher prevalence (27/29 vs 12/54; p < 0.001) and longer width (213 ± 125 μm vs 96 ± 282 μm; p < 0.0001) of parapapillary alpha zone, and thicker BM in parapapillary beta zone (8.4 ± 2.7 μm vs 3.9 ± 2.0 μm; p < 0.001) and alpha zone (6.6 ± 3.9 μm vs 4.4 ± 1.5 μm; p = 0.02). Prevalence of parapapillary RPE-drusen was 27 (69%) out of 39 eyes with alpha zone. Beneath the RPE-drusen and in total alpha zone, choriocapillaris was open, while it was closed in the central part of parapapillary beta zone. BM thickness was thicker (p = 0.001) in alpha zone than beta zone, where it was thicker (p < 0.001) than in the region outside of alpha/beta zone. BM thickness outside of alpha/beta zone was not correlated with prevalence of parapapillary RPE-drusen (p = 0.47) or axial length (p = 0.31). RPE cell density was higher in alpha zone than in the region adjacent to alpha zone (22.7 ± 7.3 cells/240 μm vs 18.3 ± 4.1 cells/240 μm; p < 0.001). In the parapapillary RPE-drusen, RPE cells were connected with a PAS-positive basal membrane.
Parapapillary RPE-drusen as fibrous pseudo-metaplasia of the RPE were associated with shorter axial length, higher prevalence and larger size of alpha zone, and thicker BM in alpha zone and beta zone. The RPE-drusen may be helpful to differentiate glaucomatous parapapillary beta zone from myopic beta zone.
描述视网膜色素上皮（RPE）下的脉络膜旁玻璃膜疣（RPE 玻璃膜疣）的发生、形态和相关性。
使用光镜，我们对眼球进行了组织形态计量学检查。
本研究共纳入 83 只眼（眼轴长度：25.9±3.2mm；范围：20.0-35.0mm）。与无玻璃膜疣的眼相比，有脉络膜旁 RPE 玻璃膜疣（n=29（35%）眼）的眼轴长度明显更短（24.0±1.8mm 比 27.0±3.3mm；p<0.001），患病率更高（27/29 比 12/54；p<0.001），玻璃膜疣旁 alpha 区的宽度更长（213±125μm 比 96±282μm；p<0.0001），玻璃膜疣旁 beta 区（8.4±2.7μm 比 3.9±2.0μm；p<0.001）和 alpha 区（6.6±3.9μm 比 4.4±1.5μm；p=0.02）的 BM 更厚。在有 alpha 区的 39 只眼中，有 27 只（69%）出现了脉络膜旁 RPE 玻璃膜疣。玻璃膜疣下方和整个 alpha 区的脉络膜毛细血管是开放的，而在脉络膜旁 beta 区的中心部分则是闭合的。BM 厚度在 alpha 区比 beta 区更厚（p=0.001），在 beta 区比 alpha/β 区以外的区域更厚（p<0.001）。alpha/β 区以外的 BM 厚度与脉络膜旁 RPE 玻璃膜疣的患病率（p=0.47）或眼轴长度（p=0.31）无关。alpha 区的 RPE 细胞密度高于紧邻 alpha 区的区域（22.7±7.3 个细胞/240μm 比 18.3±4.1 个细胞/240μm；p<0.001）。在脉络膜旁 RPE 玻璃膜疣中，RPE 细胞与 PAS 阳性的基膜相连。
脉络膜旁 RPE 玻璃膜疣是 RPE 的纤维假性化生，与较短的眼轴长度、更高的 alpha 区患病率和更大的 alpha 区和 beta 区尺寸以及 alpha 区和 beta 区的 BM 增厚有关。RPE 玻璃膜疣可能有助于区分青光眼性脉络膜旁 beta 区和近视性 beta 区。
