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Abstract
Abstract
Ophthalmopathological Aspects of the Retinal Pigment Epithelium
Agostini H. T.
Universitäts-Augenklinik Freiburg, Germany
The retinal pigment epithelium (RPE) develops from the outer sheet of the optic cup and forms a cubic epithelium between the choroid and the sensory retina. It regulates the nutrition of the photoreceptors and is responsible for the phagozytosis of the discs shedded by the rods and cones. Zonulae occludentes located at the apical part of the RPE contribute to the blood-retina barrier as do basal parts of the RPE in the Bruch membrane. The physiological RPE plays a key role in maintaining the functional and morphological stability of the posterior pole. Hypertrophic changes of the RPE in one eye are relatively common and harmless. Less frequent are primarily hyperplastic lesions like the adenoma or adenocarcinoma of the RPE.
However, if something disturbes the homeostasis of the retina-RPE-choroid complex, the RPE can demonstrate an amazing plasticity. A proliferative vitreoretinopathy for example develops in 10-15% of eyes after trauma to the retina such as rhegmatous retinal detachment and involves proliferation and transdifferentiation of the RPE activated by the disruption of the physiological environment of the RPE cell layer. The morphology of the RPE changes into fibroblast- or macrophage-like cells and can even result in the formation of bone-like tissue. The transdifferentiation is regulated by growth factors some of which are produced by the RPE itself. It should be a major objective in ophthalmopathological research to link the changes in RPE morph