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Johannes P. van de Ven, Camiel J. Boon, Dzenita Smailhodzic, Yara T. Lechanteur, Anneke I. den Hollander, Carel B. Hoyng, Thomas Theelen; Short-Term Changes of Basal Laminar Drusen on Spectral-Domain Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2899.
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Macular drusen are the hallmark lesions of age-related macular degeneration (AMD). "Basal laminar drusen" (BLD), also named "cuticular drusen", is an early-onset subtype of AMD characterized by innumerable, small hard drusen scattered throughout the retina. The aim of this study is to determine if small hard drusen in patients with BLD show changes during a short follow-up period.
Ten subjects with BLD were longitudinally followed during a period of four months by spectral domain optical coherence tomography. Drusen that showed a spontaneous change in volume were further analyzed according to five morphological parameters: shape, reflectivity, homogeneity, and concurring photoreceptor layer (PRL) / retinal pigment epithelium (RPE) damage. Odds ratios (ORs) and risk for regression and progression of drusen volumes were calculated.
One-hundred and five small hard drusen in 19 eyes showed a spontaneous change in volume over the period of follow-up. Drusen with a "pointed" shape were significantly associated (P = 0.031; OR 4.89; 95% CI 1.16-20.67) with spontaneous progression in drusen volume, with a chance of 0.80 (95% CI 0.55-0.93) to progress. Drusen that showed a decreased reflectivity of overlying PRL (P = 0.041; OR 7.67; 95% CI 1.09-54.24) or RPE (P = 0.030; OR 11.00; 95% CI 1.26-95.77), showed a significant association with spontaneous regression in drusen volume, with chances on regression of 0.86 (95% CI 0.41-0.98) and 0.89 (95% CI 0.49-0.99), respectively.
Small hard drusen in patients with the BLD phenotype are subject to a process of short-term remodeling. The dynamic nature of this disease points to high biochemical activity that may be sensitive to future pharmacological treatment strategies. In addition, these short-term changes of drusen may be a source of misclassification in disease staging.
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