{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T10:48:46Z","timestamp":1786618126636,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82271086"],"award-info":[{"award-number":["82271086"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To assess the prevalence and associations of external limiting membrane (ELM) defects on optical coherence tomographic (OCT) images in a general population, affected by age\u2010related macular degeneration (AMD) or free of any retinal disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using OCT images, we assessed the ELM defect presence in participants of the population\u2010based Beijing Eye Study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study population consisted of 712 (44.2%) eyes with early AMD, 295 (18.3%) eyes with intermediate AMD, 12 (0.7%) eyes with geographic atrophy and 592 (36.7%) eyes without signs of AMD. ELM defect prevalence increased from 6\/592 (1.0%; 95% CI: 0.0, 2.0) in the normal group to 57\/712 (8.0%; 95% CI: 6.0, 10.0), 117\/295 (39.7%; 95% CI: 34.2, 45.2) and 11\/12 (91.7%; 95% CI: 73.7, 100) in the group with early AMD stage, intermediate AMD and late AMD stage, respectively. Higher ELM defect prevalence was spatially associated with higher prevalence of ellipsoid zone (EZ) defects (OR: 929; 95% CI: 291\u20132964;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In multivariable analysis, higher ELM defect prevalence correlated with higher AMD stage (OR: 2.22; 95% CI: 1.33, 3.71;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), higher prevalence of intraretinal hyperreflective foci (iHRFs) superior to the EZ\/ELM (OR: 29.7; 95% CI: 8.69\u2013102;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), lower prevalence of iHRFs beneath the EZ\/ELM (OR: 0.11; 95% CI: 0.04, 0.35;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and higher prevalence of localized interdigitation zone thinnings (IZTs) (OR: 5.66; 95% CI: 3.14, 10.2;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The spatial correlation between ELM defects and EZ defects, the associations of both defect types with a higher occurrence of iHRFs superior to the ELM, the association between an absence of ELM defects and a higher prevalence of iHRFs located inferior to the ELM, and the association between a higher ELM defect prevalence and higher IZT prevalence may suggest the ELM\/EZ may act as a barrier for RPE cells migrating into the retina.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aos.70015","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T06:41:15Z","timestamp":1759214475000},"page":"314-322","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["External limiting membrane defects in age\u2010related macular degeneration. The Beijing Eye Study"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2972-5227","authenticated-orcid":false,"given":"Jost B.","family":"Jonas","sequence":"first","affiliation":[{"name":"Rothschild Foundation Hospital Institut Fran\u00e7ais de Myopie  Paris France"},{"name":"Singapore National Eye Center Singapore Eye Research Institute  Singapore City Singapore"},{"name":"Privatpraxis Prof Jonas Und Dr. Panda\u2010Jonas  Heidelberg Germany"},{"name":"Beijing Visual Science and Translational Eye Research Institute (BERI), Beijing Tsinghua Changgung Hospital, Tsinghua Medicine Tsinghua University  Beijing China"},{"name":"L V Prasad Eye Institute  Hyderabad Telangana India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songhomitra","family":"Panda\u2010Jonas","sequence":"additional","affiliation":[{"name":"Rothschild Foundation Hospital Institut Fran\u00e7ais de Myopie  Paris France"},{"name":"Privatpraxis Prof Jonas Und Dr. Panda\u2010Jonas  Heidelberg Germany"},{"name":"L V Prasad Eye Institute  Hyderabad Telangana India"},{"name":"Department of Ophthalmology University of Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Xu","sequence":"additional","affiliation":[{"name":"Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5389-3047","authenticated-orcid":false,"given":"Rahul A.","family":"Jonas","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine, University Hospital Cologne University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya Xing","family":"Wang","sequence":"additional","affiliation":[{"name":"Beijing Visual Science and Translational Eye Research Institute (BERI), Beijing Tsinghua Changgung Hospital, Tsinghua Medicine Tsinghua University  Beijing China"},{"name":"Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2024.06.023"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.62.10.34"},{"key":"e_1_2_8_4_1","first-page":"BIO211","article-title":"Activated retinal pigment epithelium, an optical coherence tomography biomarker for progression in age\u2010related macular degeneration","volume":"58","author":"Curcio C.A.","year":"2017","journal-title":"Investigative Ophthalmology and Visual 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