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RETINAL PIGMENTED EPITHELIUM

By: Angelic Norefil Padilla



Gross Description
1. Consist of single layer of cells that
extends forward from the margin of the
optic nerve to the ora serrata anteriorly.
2. The cells are narrow and tall in the
posterior pole region and become flattened
near the ora serrata.
3. On tangential section, the cells are
hexagonal.
4. When seen in section, each cell consist of
an outer non-pigmented epithelium part
containing a large oval nucleus and an inner
pigmented portion which extends as a series
of straight thread-like process between the
rods.
Functions:

1. Light absorption - The RPE shields the
retina from excess incoming light. It
supplies omega-3 fatty acids and glucose.

2. Epithelial transport- This epithelial
transport serves to supply nutrients to the
photoreceptors (transport from the blood
to the retinal side), control the ion
homeostasis in the subretinal space and
to eliminate water and metabolites from
retinal tissue (transport from the retinal
to the blood side).


3. Visual cycle- The RPE plays a crucial
role in visual function, in the light
adaptation.
The visual cycle fulfills an essential
task of maintaining visual function
and needs therefore to be adapted to
different visual needs such as vision
in darkness or lightness

4. Phagocytosis- . Has a participation in the
turnover of the outer segments of the
photoreceptors and the formation of the
rhodopsin and iodopsin by storing and
releasing vitamin A.

5. Secretion and immune modulation- It
secretes substances to help build and
sustain the choroid and retina. It secretes
ATP, fibroblast growth factors,
transforming growth factor, insulin-like
growth factor, ciliary neurotrophic factor,
platelet-derived growth factor, vascular
endothelial growth factor, lens
epithelium-derived growth factor, and
pigment epithelium-derived factor.





BLOOD RETINAL BARRIER
By:Patricia Myka Dayap

Blood-Ocular Barrier
The eye has two barriers that prevent the
entry of macromolecules, chiefly proteins,
into the eye:
1. Blood Aqueous Barrier
2. Blood Retinal Barrier
It is a physical barrier between the
local blood vessels and most parts of
the eye itself, and stops many substances
including drugs from traveling across it.
Inflammation can break down this barrier
allowing drugs and large molecules to
penetrate into the eye.


Blood-Retinal Barrier (BRB)

The blood-retina barrier is formed by the
retinal pigment epithelium and the
endothelium of the retinal blood vessels.
Adjacent cells of each are joined by tight
junctions called as zonulae occludentes to
prevent certain substances from entering the
retina.
It consists of non-fenestrated capillaries of
the retinal circulation and tight-
junctions between retinal epithelial
cells preventing passage of large molecules
from choriocapillaris into the retina.
Function:
It regulates fluids and molecular movement
between the ocular vascular beds and retinal
tissues and prevents leakage into the retina
of macromolecules and other potentially
harmful agents.
Structure:
The blood retinal barrier has two components:
Retinal blood vessels maintains the inner
blood-ocular barrier.
The retinal pigment epithelium maintains the
outer bloodretinal barrier


Blood-Retinal Barrier Breakdown
Diabetic retinopathy
- An eye damage that frequently occurs as a result
of diabetes, is related to the breakdown of the
bloodretinal barrier.
- The barrier becomes more leaky in patients with
diabetic retinopathy
Signs and Symptoms:

First stage which is called non-proliferative diabetic
retinopathy (NPDR) there are no symptoms, it is not
visible to the naked eye and patients will have 20/20
vision. The only way to detect NPDR is by fundus
photography.

second stage, as abnormal new blood vessels
(neovascularisation) form at the back of the eye as a
part of proliferative diabetic retinopathy (PDR), they
can burst and bleed (vitreous hemorrhage) and blur
vision, because the new blood vessels are weak.
Treatment:
Scatter (pan-retinal) photocoagulation. Scatter
treatment is used to slow the growth of new abnormal
blood vessels that have developed over a wider area
of the retina.

Diabetic macular edema (DME)

occurs when blood vessels in the retina of
patients with diabetes begin to leak into the
macula, the part of the eye responsible for
detailed central vision.
These leaks cause the macula to thicken and
swell, progressively distorting acute vision.
While the swelling may not lead to
blindness, the effect can cause a severe loss
in central vision.
DME is the major cause of vision loss in
people with diabetic retinopathy.
People with diabetes have a 10 percent risk
of developing the condition during their
lifetime.
Treatment
Laser photocoagulation is a retinal
procedure in which a laser is used to
cauterize leaky blood vessels or to apply a
pattern of burns to reduce edema.



AGE RELATED MACULAR
DEGENERATION (ARMD)
By: Kristine Nicole Ramos

Mainly affects the older generation. It can
affect people over 50years of age.
It is a deterioration or breakdown of the
eye's macula. The macula is a small area in
the retina the light-sensitive tissue lining
the back of the eye.
The macula is the part of the retina that is
responsible for your central vision, allowing
you to see fine details clearly.

2 Types of ARMD:

Dry AMD

The "dry" form of macular degeneration is
characterized by the presence of yellow deposits,
called drusen, in the macula. A few small drusen
may not cause changes in vision; however, as they
grow in size and increase in number, they may lead
to a dimming or distortion of vision that people find
most noticeable when they read.

Wet AMD
In the 'wet' form, abnormal blood vessel growth in
the eye leads to the leaking of blood and proteins
into the sensitive cells (called photoreceptors) in the
macula, damaging them and causing vision loss.
The wet form is the condition in its advanced stage.








Role of RPE in ARMD:
o The RPE is responsible for maintaining the
extracellular matrix and the activity of the
photoreceptors.
o The primary cause of AMD is thought to be
the degeneration of a layer of specialised
cells called retinal pigment epithelium
(RPE)
o The RPE, melanin granules diminish, and
lipofuscin granules form.
o As we age, Bruchs membrane tends to
accumulate debris in the elastin lamina and
also drusen between the collagen layer and
RPE basal lamina.
o This debris accumulation causes a reduction
in the permeability of Bruchs membrane.
o This will hinder the pumping of waste from
inside to outside of the eye by the RPE and
may cause pigment epithelial detachments.

















PARTS OF RETINAL PIGMENTED
EPITHELIUM
By: Aaron Jake De Leon & Charisse Visca

1. Base- adjacent to the curricular portion of
Bruchs Membrane to which its basement
membrane is firmly attached. The base contains
prominent infolding of the basal plasma membrane,
many mitochondria, and a little or no pigment.
It contains:
(Plasma membrane and mitochondria)
2. Body- contains the cell nucleus, many organelles
and lipofuscin. The lipofuscin become prominent in
the retinal pigment epithelium underlying the
central retina in individuals older than 30 years.
It contains:
(Nucleus, endoplasmic reticulum, lipofuscin)
3. Apices-are topped with microvilli in which the
outer segments of the rods and cones are imbedded
in the interphotoreceptor matrix.
There are no specialized attachments
between the photoreceptors and the retinal
pigment epithelium.
The lateral surfaces of the apices of
adjacent cells (but not the microvilli) are
bound together by terminal bars that are
composed of a basilar portion and an apical
portion.
There is no Intracellular space at the level of
these junctions, and together with the non-
fenestrated retinal blood vessels they
constitute the blood-retinal barrier.
Apical portion: It makes contact loosely
with sensory retina through numerous
Microvillus and concentrated with melanin
granules.
Apex(pigmented, ingested outer segment)
It contains:
1. Microvilli
2. Lateral terminal bars
( Zonula Adherens and zonula occludens )
The zonula occludens (ZO) (Tight Junction)
occupied very large, macular gap junctions
occur within the region.
The zonula adherens (ZA) (Intermediate
Junction) in adult chicken retinal pigment
epithelium was examined with cryo-electron
microscopic methods.
Deep-etching of the cross-fractured ZA showed
globules in the intercellular space

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