Journal of Lipid Research Volume 51, 2010 3399 plus glial cells (Müller cells, astrocytes, and microglia).[For an excellent overview of retinal structure and cytoarchitecture, see ( 1 ) and http://webvision.med.utah. edu/]. The neuronal cells are distributed into discrete histological layers in the fully differentiated retina ( Fig. 1 ), with the ganglion cell layer arranged proximal to the vitreous and the photoreceptor cells (rods and cones) residing at the opposite side of the neural retina, just underneath the retinal pigment epithelium (RPE) layer. The RPE is a monolayer of polarized epithelial cells that serves as the interface between the neural retina and the choroid, the blood supply to the outer cell layers of the retina. The apical tips of the photoreceptor outer segments (OS) are adjacent to and invaginate into the apical face of the RPE (one of the few examples of apical-apical cellular contact in the body) ( Fig. 1C ). Bruch's membrane (BrM; Fig. 1B, C ) is not a membrane, per se, but rather a pentalaminar structure that consists of the basement membranes of the RPE cells and the endothelial cells of the choriocapillaris ( Fig. 1C ), plus the extracellular matrix that fi lls the space between these two membranes [reviewed in ( 2, 3 )].The relatively modest compendium of cell types mentioned above, however, belies the amazing, higher order complexity of this sensory tissue. It has been estimated that there are actually about 55 anatomically distinct neuronal cell types in the adult mammalian retina, of which about 22 have been thoroughly characterized with regard to their fi ne structure and functional repertoire [reviewed in ( 4 )]. For example, photoreceptors consist of both rods and cones, with cones being subdivided into two (three in Abstract The vertebrate retina has multiple demands for utilization of cholesterol and must meet those demands either by synthesizing its own supply of cholesterol or by importing cholesterol from extraretinal sources, or both. Unlike the blood-brain barrier, the blood-retina barrier allows uptake of cholesterol from the circulation via a lipoprotein-based/receptor-mediated mechanism. Under normal conditions, cholesterol homeostasis is tightly regulated; also, cholesterol exists in the neural retina overwhelmingly in unesterifi ed form, and sterol intermediates are present in minimal to negligible quantities. However, under certain pathological conditions, either due to an inborn error in cholesterol biosynthesis or as a consequence of exposure to selective inhibitors of enzymes in the cholesterol pathway, the ratio of sterol intermediates to cholesterol in the retina can rise dramatically and persist, in some cases resulting in progressive degeneration that signifi cantly compromises the structure and function of the retina. The mature vertebrate retina is a highly stratifi ed, multicellular tissue classically described as consisting of six fundamental neuronal cell types (photoreceptor, bipolar, ganglion, horizontal, amacrine, and interplexiform cells) the normal...