Skip to main content
. 2023 Feb 10;3(3):100280. doi: 10.1016/j.xops.2023.100280

Figure 13.

Figure 13

Retinal pigment epithelium (RPE) complex associated with deep retinal age-related microvascular anomaly (DRAMA), left eye (OS) 3. A, A “hand”-shaped complex consisting of RPE cells surrounds the vessel extending downward from the deep capillary plexus (DCP). Electron microscopy of the area in the dotted fuchsia box is shown in Figure S14. B, The RPE complex extends upward to the inner nuclear layer (INL). On either side of this complex, there is no subsidence of the outer plexiform layer (OPL) or external limiting membrane (ELM), and the outer nuclear layer (ONL) is thinned. The complex emanates from a continuous RPE layer over the basal laminar deposit (BLamD) and a soft druse. The druse is artifactually detached from Bruch's membrane (BrM). C–E, Endothelial cell (EC) ultrastructure in DRAMA and comparison vessels are shown. The vascular lumen is at the bottom of all panels. C, No fenestrations are visible in the DRAMA (red blood cell [RBC]). D, No fenestrations were visible in the DCP (pericyte [P]). E, Fenestrations are visible in the choriocapillaris endothelium (orange arrowheads; white blood cell [WBC]). Ch = choroid; GCL = ganglion cell layer; HFL = Henle fiber layer; ICP = intermediate capillary plexus; IPL = inner plexiform layer; IS = inner segment.