Histologic study of a shielded macula

Purpose: To illustrate the histologic changes at the macula of an eye shielded from focused light for 76 years. Age-related macular degeneration with a central, subretinal, fibrous scar was present in the fellow eye. Methods: Autopsy examination of both eyes of a 91-year-old man was performed. The superior half of the macular area of the shielded eye was studied by light microscopy, and the inferior half was studied by electron microscopy. Serial sections through the macular area of the fellow eye were prepared and studied. Results: The shielded eye contained basal laminar deposits up to 6.0 μm in thickness and basal linear deposits up to 1.0 μm in thickness in the macular area. The photoreceptor outer and inner segments of the outer nuclear layer were intact. The macular area of the fellow eye contained a two- component, vascularized, disciform scar that measured up to 250 μm in one area, with retinal pigment epithelial tears at the nasal and temporal margins. Extensive photoreceptor layer atrophy was present. Conclusions: Such marked asymmetry of macular degeneration in this case may be further evidence of the role of light exposure in the development of age related macular degeneration.