Bruch's membrane or lamina vitrea is the innermost layer of the

choroid The choroid, also known as the choroidea or choroid coat, is a part of the uvea, the vascular layer of the eye. It contains connective tissues, and lies between the retina and the sclera. The human choroid is thickest at the far extreme rear o ...

of the eye. It is also called the ''vitreous lamina'' or ''Membrane vitriae'', because of its glassy microscopic appearance. It is 2–4 μm thick.

Anatomy

Structure

Bruch's membrane consists of five layers (from inside to outside): #the

basement membrane The basement membrane, also known as base membrane, is a thin, pliable sheet-like type of extracellular matrix that provides cell and tissue support and acts as a platform for complex signalling. The basement membrane sits between epithelial tis ...

of the

retinal pigment epithelium The pigmented layer of retina or retinal pigment epithelium (RPE) is the pigment A pigment is a powder used to add or alter color or change visual appearance. Pigments are completely or nearly solubility, insoluble and reactivity (chemistry), ...

#the inner collagenous zone #a central band of elastic fibers #the outer collagenous zone #the

of the choriocapillaris

Development

The membrane grows thicker with age. With age, lipid-containing extracellular deposits may accumulate between the membrane and the basal lamina of the retinal pigmental epithelium, impairing exchange of solutes and contributing to age-related pathology.

Embryology

Bruch's membrane is present by midterm in fetal development as an elastic sheet.

Function

The membrane is involved in the regulation of fluid and solute passage from the choroid to the retina.

Pathology

Bruch's membrane thickens with age, slowing the transport of metabolites. This may lead to the formation of drusen in

age-related macular degeneration Macular degeneration, also known as age-related macular degeneration (AMD or ARMD), is a medical condition which may result in blurred or no vision in the center of the visual field. Early on there are often no symptoms. Some people experien ...

. There is also a buildup of deposits (Basal Linear Deposits or BLinD and Basal Lamellar Deposits BLamD) on and within the membrane, primarily consisting of phospholipids. The accumulation of lipids appears to be greater in the central fundus than in the periphery. This build up seems to fragment the membrane into a lamellar structure more like puff-pastry than a barrier. Inflammatory and neovascular mediators can then invite choroidal vessels to grow into and beyond the fragmented membrane. This neovascular membrane destroys the architecture of the outer retina and leads to sudden loss of central vision – wet age related

macular degeneration Macular degeneration, also known as age-related macular degeneration (AMD or ARMD), is a medical condition which may result in blurred vision, blurred or vision loss, no vision in the center of the visual field. Early on there are often no sym ...

. Pseudoxanthoma elasticum,

myopia Myopia, also known as near-sightedness and short-sightedness, is an eye condition where light from distant objects focuses in front of, instead of on, the retina. As a result, distant objects appear blurry, while close objects appear normal. ...

and trauma can also cause defects in Bruch's membrane which may lead to choroidal neovascularization. Alport's Syndrome, a genetic disorder affecting the alpha(IV) collagen chains, can also lead to defects in the Bruch membrane such as 'dot and fleck' retinopathy. Angioid streaks cause calcification, thickening and breaks in Bruch's membrane.

Eponym

Bruch's membrane was named after the German anatomist Karl Wilhelm Ludwig Bruch.

References

External links

Pictures
at National Eye Institute {{DEFAULTSORT:Bruch's Membrane Human eye anatomy Anatomy named for one who described it