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Julia Steinberg, Jasmin Anke Ilka Auge, Monika Fleckenstein, Frank Holz, Steffen Schmitz-Valckenberg; Longitudinal analysis of reticular drusen associated with age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4172.
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To evaluate longitudinal variations of reticular drusen (RDR) in patients with age-related macular degeneration (AMD) using spectral-domain optical coherence tomography (SD-OCT) imaging.
Simultaneous combined near-infrared confocal scanning laser ophthalmoscopy and SD-OCT imaging was performed in 6 eyes of 4 patients (mean age 83 years, range 80 - 85 years) with RDR associated with AMD. Dense volume scans (11µm between sequential B-scans) were acquired at sites with RDR at baseline and at review examination (mean 6 months, range 5 - 9). For the latter, the AutoRescanTM tool (Heidelberg Engineering, Germany) was applied which allows for automatic alignment of follow-up scans at the same location as set as at baseline examination. The maximum width and the maximum height of 5 pre-selected individual RDR in each eye were quantified by two independent readers. The number of B-scan involvement was counted and the individual B-scan showing the maximum height was identified for each lesion, respectively.
The mean height and width at baseline of 30 included RDR lesions were 99.0µm ± 13.7 (range 69.5-127µm) and 126.3µm ± 35.2 (range 60.5-193µm), respectively. Bland-Altman statistics showed a mean agreement of -0.8µm ± 8.8 (range -27-16µm) for lesion height and of 1.0µm ± 6.6 (range -12-19 µm) for lesion width. Over time, a mean change of 3.8 ± 7.3µm (range -12-14.5 µm) for height and of 15.45µm ± 27.3 (range -40-84µm) for width were determined. An average number of B-scan involvement of 7.5 ± 3.6 (range 1-16) for baseline and of 7.2 ± 3.5 (range 1-17) for follow-up was counted. The individual B-Scan showing the maximum height over time was identical for three lesions and varied in-between ± 6 scans.
Single B-scans may be not adequate for the assessment of dynamic RDR changes over time. Using dense volume SD-OCT imaging with the image analysis software tool applied herein, no complete disappearance of a single lesion was observed during the review period, while there was an overall trend of RDR lesion progression both in height and width. Exact and accurate location of follow-up SD-OCT scans as compared to baseline imaging appears to be crucial for further longitudinal analysis of RDR evolution.
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