Histologic Photoreceptor and Retinal Pigment Epithelium Degeneration in an Eye with Clinically Documented Geographic Atrophy of AMD

AI Generated Summary*

One eye of a woman who died at 93 with bilateral multifocal geographic atrophy of AMD underwent electron microscopy and deep-learning OCT segmentation covering five years of imaging that ended six years before death. Reduced photoreceptor segment integrity initially exceeded RPE loss in area, yet RPE loss grew faster (2.432 versus 1.770 mm s per year), converging on it. In the outer junctional zone, ELM to RPE basal lamina distance was halved versus less affected temporal retina; outer segment and interphotoreceptor space volumes fell to about one sixth, myoids to a quarter, ellipsoids to roughly half, while dysmorphic yet continuous RPE retained its volume. Cone inner segments at the descent held fragmented, inwardly moving mitochondria, tentatively linked to hyperreflective thickening.

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