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Changes in Bruch's membrane and related structures with age.
The implant is designed to replace the retinal pigmented epithelium (RPE) and Bruch's membrane which are critical functional elements of the eye that degenerate in dry age-related macular degeneration.
Several hypotheses have been proposed for detachment of RPE resulting from the disintegration of the RPE union with the collagen layer of Bruch's membrane [1, 5], but the most important reason is alternation in choroidal vascular permeability [3].
Laser photocoagulation rupture of Bruch's membrane was used to induce CNV in C57BL/6 as described previously [27, 28].
Similar were the observations in a study on French AMD patients.21 Lipoproteins that pass through and accumulate in RPE and Bruch's membrane provide substrate for initial changes of AMD-like drusen formation.
Whereas AD shows the abundant presence of aggregated A[beta] peptides and hyperphosphorylated tau protein in brain, AMD is characterized by deposition of lipids, lipoproteinaceous debris, and oxidized and damaged extracellular matrix (ECM) components within Bruch's membrane of the eye [5-7].
Dry form of AMD affects approximately 80-90% of individuals with AMD [3] and in this type of macular degeneration, extracellular small white or yellowish deposits (made up of lipids, a type of fatty protein), called drusen, accumulated between the Retinal Pigment Epithelium (RPE) and the inner collagenous layer of Bruch's membrane (vitreous lamina).
In skin lesions, swollen, clumped, and fragmented elastic fibres and calcium deposits are found in the middle and deep reticular dermis with normal morphology in the papillary dermal layers.10 Similar changes occur in elastic fibres of the blood vessels, Bruch's membrane of the eye, endocardium and other organs.
Kawamura et al .,[sup][30] according to spectral domain OCT, found that branching vessels network from feeder vessels may pass through ruptures in Bruch's membrane, spread between the RPE and Bruch's membrane, become deformed polypoidal vessels in Type 1 PCV, which represents the characteristics of CNV beneath the RPE.
Some authors have maintained [112] that the RPE secretes apolipoprotein B particles into Bruch's membrane and that these particles accumulate with age and may in turn form a lipid wall, a precursor of the basal linear deposit.