Development and aging of cell topography in the human retinal pigment epithelium.

PURPOSE To determine how regional cell density of this tissue changes with age, the authors examined the topography of the human retinal pigment epithelium (RPE) in wholemounted tissue obtained from eyes aged 12 to 89 years, donated for corneas. METHODS The RPE, with choroid attached, was wholemounted and stained with cresyl violet. From these preparations, the authors analyzed retinal area, RPE cell number, and cell density. RESULTS Retinal pigment epithelial cell number is highly variable between persons but does not appear to be age related. Retinal area increases until approximately 30 years of age, but beyond this age individual variation masks further enlargement. The distinctive topography of the RPE changes markedly with age. There is a modification from the relatively homogeneous cell density distribution in the youngest retinas examined toward a more heterogeneous pattern in older retinas. From mid-adolescence, a band of larger cells appears at the extreme periphery, adjacent to the ora serrata, which gradually widens so that by 90 years of age, it occupies the outermost 30% of the retinal area. Cell density is highest in the central temporal retina, adjacent to the macula in the neural retina, throughout life. Cell density values in this region increase slightly with age, and the difference between this and surrounding regions becomes more marked with age. CONCLUSIONS With no marked change in total cell number, peripheral RPE in humans enlarges in area throughout life, but the RPE in more central regions decreases in area.