The highly effective responses obtained with anti-VEGF injections were attributed to enhanced passage of the bevacizumab through the thinned and degenerated RPE and Bruch's membrane
to the subretinal area, thus increasing the drug's efficacy.
The intracellular lipid accumulation in RPE leads to AMD that appears in the form of Bruch's membrane
deposits and drusen.
10 Similar changes occur in elastic fibres of the blood vessels, Bruch's membrane
of the eye, endocardium and other organs.
choriocapillaris, Bruch's membrane
, RPE, and photoreceptors), and changes in each of these structures may contribute to varying degrees to the onset of AMD (Figure 2).
The presumed pathogenesis is pressure deformity of the border of Bruch's membrane
at the level of the optic nerve head creating a discontinuity of the normal anatomic apposition of the chorioretinal layers.
2) They result from a rupture of the elastic tissue in the Bruch's membrane
of the retina.
Using aged submacular human Bruch's membrane
explants in organ culture, we reproduced the incomplete and aberrant RPE resurfacing seen in AMD patients following CNV excision .
A breakdown in the Bruch's membrane
usually occurs near drusen deposits, and this is where the new blood vessel growth occurs (neovascularization).
Statins may prevent the accumulation of basal linear deposit in Bruch's membrane
, which occurs in patients with high cholesterol levels.
Statins may prevent accumulation of basal linear deposit in Bruch's membrane
, which occurs when cholesterol levels are high.
It has been postulated that in old age, this material is released from the RPE and renders the overlying Bruch's membrane
The TIMP3 mutations may promote excessive growth of blood vessels through Bruch's membrane
, which lies below the retina, they speculate.