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If the cells are in S or G2 phase of the cell cycle, then the cell repairs the DSB by the homology-directed repair mechanism (37)
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It could also be that the RPE stress itself may be subsequent to other disease progression mechanisms such as the “oil spill model” (Curcio et al., 2011) where cholesterol-rich lipoproteins needed by photoreceptors are taken up by the RPE via plasma, then exported to Bruch’s membrane which, over time accumulates and becomes cross-linked, effectively fixing them in place, building up into drusen that itself becomes cytotoxic and proinflammatory
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