Ermilov V V, Vodovozov A M
Vestn Oftalmol. 1995 Oct-Dec;111(4):24-7.
Histological, histochemical, and electron microscopic studies of tissues of the fundus oculi in 111 eyes with senile maculopathy revealed amyloid in the nodules. Bruch's membrane, and between the basal membrane of retinal pigmented epithelium and the internal collagen layer of Bruch's membrane in the center of the fundus oculi. The detected amyloid incorporations are referred to senile amyloidosis and reliably differ from amyloid in generalized amyloidosis. Comparative analysis of morphologic changes in tissues of the macular and paramacular areas of the fundus oculi and of the incidence of amyloid incorporations in them permit us to propose that accumulation of local senile amyloid is conductive to development and aggravation of senile maculopathy. A relationship between the degree of pigmented epithelium degeneration and accumulation of amyloid in the fundus oculi was revealed. The authors put forward a hypothesis of the pathogenesis of some stages of senile maculopathy, in which the principal role in the formation and deposition of abnormal protein, amyloid, is played by degenerative cells of pigmented epithelium. It is followed by amyloid destruction of Bruch's membrane and accumulation of amyloid under it and the basal membrane of pigmented epithelium. this in its turn, promoting neovascularization and formation of fibrovascular membrane.
对111只患有老年性黄斑病变眼睛的眼底组织进行组织学、组织化学和电子显微镜研究，发现结节、布鲁赫膜以及眼底中央视网膜色素上皮基底膜与布鲁赫膜内胶原层之间存在淀粉样物质。检测到的淀粉样物质沉积属于老年性淀粉样变性，与全身性淀粉样变性中的淀粉样物质有可靠的区别。对眼底黄斑和黄斑旁区域组织形态学变化以及其中淀粉样物质沉积发生率的比较分析，使我们能够提出局部老年性淀粉样物质的积累会导致老年性黄斑病变的发生和加重。还揭示了眼底色素上皮变性程度与淀粉样物质积累之间的关系。作者提出了老年性黄斑病变某些阶段发病机制的假说，其中色素上皮的变性细胞在异常蛋白质淀粉样物质的形成和沉积中起主要作用。随后是布鲁赫膜的淀粉样物质破坏及其下方和色素上皮基底膜下淀粉样物质的积累，这反过来又促进了新生血管形成和纤维血管膜的形成。
