[The Bruch membrane and choroid. Angiography and functional characteristics in age-related changes]

Age-related changes in the retinal pigment epithelium and Bruch's membrane are believed to play an important role in the pathogenesis of age-related macular degeneration. Ophthalmoscopically visible drusen in the macular area may precede the complications causing visual loss. In addition to these localized depositions of debris in Bruch's membrane, histological methods could demonstrate linear deposits in Bruch's membrane which may also profoundly influence the development of complicated macular aging changes. It is difficult to identify linear deposits clinically, but as an indirect criterion for diffuse thickening and linear deposits in Bruch's membrane regression of the choriocapillaris with consequent prolongation of the choroidal filling phase in fluorescein angiography is suggested. This feature was observed in 26% of elderly patient. In association with these areas of regressed choroidal capillaries, loss of visual function was found in fine matrix perimetry.