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François C. Delori, Douglas G. Goger, C. Kathleen Dorey; Age-Related Accumulation and Spatial Distribution of Lipofuscin in RPE of Normal Subjects. Invest. Ophthalmol. Vis. Sci. 2001;42(8):1855-1866. doi: https://doi.org/.
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purpose. To characterize the age-related accumulation of lipofuscin in a
population of normal subjects, resolve differences in estimated
accumulation rates obtained in previous studies, and characterize the
spatial distribution of lipofuscin in the normal fundus.
methods. Spectrophotometric measurements were made at the fovea and 7°
temporal to the fovea in 145 normal subjects (age range, 15–80 years).
Spatial distribution along the four cardinal meridians was measured in
selected subjects by both spectrophotometry and autofluorescence
imaging. To minimize contributions of extraneous fluorophores, macular
pigment, and melanin, all measurements used excitation at 550 nm,
integrating emission between 650 and 750 nm.
results. Lipofuscin fluorescence increased linearly until age 70, then declined.
The rate of accumulation was significantly slower in the fovea than at
the temporal site; accumulation rates in vivo were greater than
previously observed in microscopic studies. Fluorescence was ∼40%
lower in the fovea than at 7° eccentricity and was asymmetrically
distributed around the fovea. The fluorescence was maximal at ≈11°
temporally, ≈7° nasally, ≈13° superiorly, and ≈9°
inferiorly. At the same eccentricity, fluorescence was always less
along the inferior meridian than along any other.
conclusions. Light absorption by RPE melanin can explain differences between the in
vivo and ex vivo estimates of the rate of lipofuscin accumulation.
Declining fluorescence at old age may represent removal of atrophic RPE
cells. The spatial distribution of lipofuscin generally matches that of
rods and reflects, rather than predicts, the pattern of age-related
loss of rod photoreceptors.
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