April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Effect of Spontaneous Drusen Regression on the Photoreceptor Inner Segment/Outer Segment Junction
Author Affiliations & Notes
  • Kathrin I. Hartmann
    Jacobs Retina Center, University of San Diego, La Jolla, California
  • Maria L. Gomez
    Jacobs Retina Center, University of San Diego, La Jolla, California
  • Dirk-Uwe Bartsch
    Jacobs Retina Center, University of San Diego, La Jolla, California
  • William R. Freeman
    Jacobs Retina Center, University of San Diego, La Jolla, California
  • Footnotes
    Commercial Relationships  Kathrin I. Hartmann, None; Maria L. Gomez, None; Dirk-Uwe Bartsch, None; William R. Freeman, None
  • Footnotes
    Support  NIH Grant NEI EY 07366 (WRF), EY 016323 (DUB) and Foundation for fighting blindness
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 120. doi:
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      Kathrin I. Hartmann, Maria L. Gomez, Dirk-Uwe Bartsch, William R. Freeman; Effect of Spontaneous Drusen Regression on the Photoreceptor Inner Segment/Outer Segment Junction. Invest. Ophthalmol. Vis. Sci. 2011;52(14):120.

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Abstract

Purpose: : To evaluate the integrity of photoreceptor inner segment/outer segment (IS/OS) junction after spontaneous drusen regression in age-related macular degeneration (AMD) using spectral domain optical coherence tomography (SD-OCT).

Methods: : Drusen volume raster scans were performed with the Spectralis SD-OCT (Heildelberg Engineering) through 2624 drusen in 15 eyes with clinically dry AMD who had been longitudinally followed between 12-16 months without intervention (mean time of 24 months). All eyes had EDTRS visual acuity followed by a standardized raster spectral domain optical coherence tomography (SD-OCT), fluorescein angiography (FA) and colour fundus photography. A total of 2624 drusen were analyzed.

Results: : 82 out of 2624 drusen (3%) were found to be regressed spontaneously by 40 to 100% and were further evaluated. Initial drusen height ranged from 28 to 203 microns (mean 76 microns). Of the 82 drusen with significant regression (> 40% regression in height), 27 drusen (33%) partially regressed (mean regression was 75%) and 55 drusen (67%) completely regressed. The grading of the IS/OS-junction in the location of all regressed drusen showed predominantly intact photoreceptor integrity. After regression we did not find a strong relation in restoration of the IS/OS-junction regarding drusen size.

Conclusions: : After spontaneous drusen regression, outer retinal layers appear normal in SD-OCT with an intact IS/OS-junction photoreceptor integrity. We conclude that the IS/OS-junction integrity is either able to restore as drusen regress or was artifactitiously compressed and not initially visible due to the initial drusen compression of the IS/OS junctional line.

Keywords: age-related macular degeneration • drusen • photoreceptors 
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