Figure 4.
Localization of the MAC in the choriocapillaris of eyes with geographic atrophy. The choroid is thinner in eyes with advanced dry AMD than in control eyes.16 Shown are areas outside (A–C), within (D and F), and at the junction (E) of the central atrophy. A: Drusen deposits (asterisks), extensive MAC in the choriocapillaris layer, and vascular atrophy with loss of endothelium (ghost vessels) in an 83-year-old donor eye. B: Choriocapillaris atrophy, with nonreactive basal deposits, in an 82-year-old donor eye. C: An area of atrophy in an 89-year-old donor eye, with some thinning and attenuation of the ONL and shortening of the inner–outer segment. D: An area of central atrophy, with loss of the RPE, in an 87-year-old donor eye. Note the modest amount of RPE lipofuscin in a gliotic scar. MAC immunoreactivity was still present in the largely atrophied choriocapillaris. E and F: The atrophic interface (E) and the central atrophic zone (F) of an eye from a 68-year-old donor homozygous for the high-risk Y402H allele. Note localization of MAC to RPE cells near the interface (E, arrow) and persistence of MAC in the degenerated choroid in the area of central atrophy. Scale bar = 100 μm. CC, choriocapillaris; CH, outer choroid; GCL, ganglion cell layer; INL, inner nuclear layer; ONL, outer nuclear layer; RPE, retinal pigment epithelium.