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Ferdinand G. Schlanitz, Matthias Bolz, Bernhard Baumann, Maria Platzer, Michael Pircher, Erich Götzinger, Christoph K. Hitzenberger, Ursula Schmidt-Erfurth; The Impact of Drusen Types on their overlying Retinal Pigment Epithelium Investigated with Polarization-Sensitive Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2012;53(14):846.
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To evaluate the impact of drusen on the retinal pigment epithelium (RPE) in eyes with non-advanced age-related macular degeneration (AMD) using polarization sensitive optical coherence tomography (PS-OCT).
24 eyes of 24 patients with non-atrophic and non-neovascular AMD were imaged with PS-OCT using high-resolution macular volume scans. Each druse in the single B-scans was manually graded for 6 drusen characteristics and for the integrity of the drusen's overlying RPE. The central scan of each druse was selected for statistical calculations, as well as its diameter and location within the retina.
5896 single drusen and their connected RPE were evaluated. 41.5% of all drusen had a normal overlying RPE-layer, in 27.7% the layer was irregular, but continuous. In 29.1%, the layer was disrupted, ranging from small lesions (21.9%) to a nearly complete absence (0.7%). The integrity of the RPE was significantly related to the drusen's size (p<0.001), the shape of the druse (p<0.001), the internal reflectivity (p<0.001) and its homogeneity (p<0.001). The presence of overlying foci was also related to an affected RPE (p<0.001). The integrity of the inner segment/ outer segment photoreceptor band was significantly related to the integrity of its underlying RPE (p<0.001).
PS-OCT reveals the characteristic relationship between drusen patterns and the integrity of the overlying RPE-layer. Known risk factors for progression of AMD, such as drusen size and the presence of pigmentary alterations, were indeed related to an affected RPE visualized by PS-OCT.
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