Figure 2. Intraretinal retinal pigment epithelium associated with native soft drusen.

A1. Near infrared reflectance (NIR) shows subretinal drusenoid deposits especially in the superior macula, 11 months before death. The green arrow shows the location and orientation of the optical coherence tomography (OCT) B-scans and histology section. A2. The OCT B-scan shows confluent soft drusen with moderately reflective interiors, hyperreflective foci (HRF, brown arrowheads) above a retinal pigment epithelium (RPE) elevation, split RPE/Bruch’s membrane (BrM) complex. The choroid is thinned. B. Panoramic histology view shows atrophy of the outer retina in the center above several RPE elevations. The choroid is atrophic. The retina is artificially detached due to histologic tissue processing. The brown arrowheads correspond to hyperreflective foci (HRF) in panel A2. C1, C2. Magnified histology shows intraretinal RPE (brown arrowhead, C1). One organelle conglomeration (brown arrowhead, C2) is next to a vessel in the inner nuclear layer (INL)/ Henle fiber layer (HFL). It is located above an altered RPE layer, separated by basal laminar deposits (BLamD) from the underlying soft druse (d). Insets show different density, and shape, size of RPE organelles.

BLamD, basal laminar deposit; BrM, Bruch’s membrane; Ch, choroid; ChC, choriocapillaris; ELM, external limiting membrane; GCL, ganglion cell layer; HFL, Henle fiber layer; INL, inner nuclear layer; IPL, inner plexiform layer; IS, inner segments; NIR, near infrared reflectance; OCT, optical coherence tomography; ONL, outer nuclear layer; OPL, outer plexiform layer; OS, outer segments; RPE, retinal pigment epithelium.