Gottsch J D, Bynoe L A, Harlan J B, Rencs E V, Green W R
Wilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, Md 21205.
Arch Ophthalmol. 1993 Jan;111(1):126-9. doi: 10.1001/archopht.1993.01090010130039.
Photosensitization of choriocapillary endothelium with blood-borne photosensitizers, such as protoporphyrin IX, has been proposed as a mechanism for the choriocapillary sclerosis and Bruch's membrane deposits seen in age-related macular degeneration. Utilizing a mouse model of protoporphyria with approximately a 10-fold increase in protoporphyrin IX level and exposure to blue light (14 microW/cm2; bandwidth, 390 to 430 nm), a time- and light-dependent increase in choriocapillary and sub-retinal pigment epithelium basal laminar-like deposits could be demonstrated at 7 months by transmission electron microscopy. Thickening of the choriocapillary endothelial basement membrane with a homogeneous electron-dense material was first noted in protoporphyric mice exposed to blue light for 13 weeks. At 28 weeks the experimental animals exhibited a thick band of homogeneous deposits at the level of the choriocapillary basement membrane and electron-dense fibrillogranular deposits of varying sizes along the inner aspect of Bruch's membrane, with fibrils measuring up to 16 nm, with a periodicity of 13 nm. These deposits contributed to an overall thickening of Bruch's membrane with narrowing of the choriocapillaris. The morphologic appearance and localization of these deposits within Bruch's membrane of this animal model are similar to previously described deposits noted in the aging Bruch's membrane prior to the development of age-related macular degeneration.
血源性光敏剂(如原卟啉IX)对脉络膜毛细血管内皮细胞的光致敏作用,被认为是年龄相关性黄斑变性中脉络膜毛细血管硬化和玻璃膜沉积物形成的一种机制。利用原卟啉病小鼠模型,其原卟啉IX水平约增加10倍,并暴露于蓝光(14微瓦/平方厘米;带宽,390至430纳米),通过透射电子显微镜在7个月时可证实脉络膜毛细血管和视网膜色素上皮基底膜样沉积物呈时间和光依赖性增加。在暴露于蓝光13周的原卟啉病小鼠中,首次观察到脉络膜毛细血管内皮基底膜增厚,伴有均匀的电子致密物质。在28周时,实验动物在脉络膜毛细血管基底膜水平呈现出一条均匀沉积物的厚带,以及沿玻璃膜内侧不同大小的电子致密纤维颗粒状沉积物,纤维直径可达16纳米,周期为13纳米。这些沉积物导致玻璃膜整体增厚,脉络膜毛细血管变窄。该动物模型中这些沉积物在玻璃膜内的形态学外观和定位,与年龄相关性黄斑变性发生之前在老化玻璃膜中观察到的先前描述的沉积物相似。