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Nancy E. Medeiros, Christine A. Curcio; Preservation of Ganglion Cell Layer Neurons in Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2001;42(3):795-803.
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purpose. To determine the number of neurons remaining in the ganglion cell layer
(GCL) of eyes with nonexudative and exudative age-related macular
degeneration (NEAMD and EXAMD, respectively) in relation to
photoreceptor loss in the same retinas.
methods. The study design was a clinicopathologic correlation. Macular
photoreceptors and GCL neurons were counted in unstained retinal
wholemounts from eyes of patients with NEAMD (n = 6) and
EXAMD (n = 5) and from control patients without grossly
visible drusen or pigmentary change (n = 15; age range,
60–95 years). The authors determined the percentage of counting sites
with significant cell loss relative to control eyes and for
photoreceptors, the percentage of sites where rod or cone loss
predominated. The total numbers of cones, rods, and GCL neurons were
determined within the 6-mm-diameter macula. Fellow eyes were prepared
for light and electron microscopic evaluation of retinal pigment
epithelium and Bruch’s membrane disease.
results. EXAMD eyes had severe photoreceptor loss. The total number of macular
photoreceptors in NEAMD eyes was similar to the number in control eyes,
despite moderate loss in the parafovea. In 9 of 11 AMD eyes, rod loss
was greater than cone loss at the same locations. EXAMD eyes had 47%
fewer GCL neurons than control eyes. GCL neurons in NEAMD eyes did not
differ significantly from control eyes.
conclusions. Interventions targeted at the outer retina early in the progression of
neovascular disease should benefit from the full age-appropriate
complement of GCL neurons.
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