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The homogeneous appearance of the normal fundus of the eye depends in part upon the integrity of the retinal pigment epithelium, which acts as a turbid medium obscuring the structures behind it. Whenever these cells contain no pigment, or less than the usual amount, the choroidal vessels become visible, as in albinos and often in myopic eyes. In the present paper, however, I propose to consider not the absence of pigment, but the appearance due to its irregular distribution.
Structural changes in the retinal epithelium have been demonstrated anatomically by Donders, H. Mueller, Leber, Goldzieher and Fuchs, and were attributed by them to the influence of globular hypertrophies (" Drusenbildung") of the vitreous lamella of the choroid. According to Rosa Kerschbaumer (v. Graefe's Arch. f. Ophth., Vol. 38, I., p. 217) anomalies are found in the pigment epithelium in three-fourths of all eyes of persons over 50 years of age, but
GRADLE H. ANOMALIES OF THE RETINAL PIGMENT EPITHELIUM AND THEIR CLINICAL SIGNIFICANCE. JAMA. 1898;XXX(5):248–250. doi:10.1001/jama.1898.72440570016001i
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