Basal Linear Deposit and Large Drusen Are Specific for Early Age-Related Maculopathy

OBJECTIVE: To determine the distributions of basal laminar and basal linear deposits in Bruch membrane (BM) with respect to age and early age-related maculopathy (ARM). METHODS: The foveas of 41 human eyes ( or =60 years n = 32), preserved no later than 3.5 hours post mortem, were examined using light and electron microscopy. Ten eyes met histopathologic criteria of the Alabama Age-related Macular Degeneration Grading System for early ARM. We calculated the specificity, sensitivity, and odds ratios for the association of basal laminar and basal linear deposits with early ARM. RESULTS: Both deposits occurred only in eyes older than 60 years. The highest specificities and sensitivities for early ARM were attained for eyes that had basal linear deposits or large (>125 microm) drusen, followed by eyes with any quantity of basal laminar deposits that also contained membranous debris. Eyes with ARM were 24 times more likely than age-matched control eyes to have basal linear deposits or large drusen (P = .002). CONCLUSIONS: Basal linear deposits and large drusen with membranous contents constitute different morphologic forms of the same ARM-associated lesion and may be significant for progression to late ARM.