Imaging of reticular drusen by multi-spectral confocal scanning laser ophthalmoscopy imaging

Abstract

Purpose: To describe detection, appearance and characteristic signal distribution of reticular drusen (RDR) associated with age-related macular degeneration (AMD) in multispectral confocal scanning laser Ophthalmoscopy (cSLO) images.

Methods: Conventional color fundus photography and multi-spectral cSLO (λ = 488 nm, λ = 514 nm, λ = 820 nm; MultiColor Spectralis, Heidelberg Engineering, Germany) imaging were performed in 25 eyes of 14 patients (mean age 75 years, range 53 - 87 years) with RDR detected by near-infrared cSLO and SD-OCT imaging. Signal alterations and the RDR area involvement in different modalities at the site of RDR were analysed and compared.

Results: RDR were detectable in 25 of 25 cSLO multi-spectral images showing an irregular pattern of small roundish lesions with a greenish center that corresponded to the halo-like appearance by cSLO near-infrared reflectance. In the blue and green reflectance modes alone, the center of single RDR lesions was characterized by a strong hyperreflectivity, surrounded by a weak interlacing pattern of hyper- and hyporeflectivity. The RDR area involvement and its boundaries varied between different cSLO reflectance modes and were best visible by near-infrared reflectance. No RDR lesions were detectable by blue reflectance in the center of the macula. Conventional fundus photography showed RDR in 11 of 25 eyes.

Conclusions: Multi-spectral cSLO imaging allows for the detection of a characteristic pattern of RDR. The signal distribution is dependent on different reflectance modes. Analysis of different image modalities may be helpful for the further characterization of RDR and the implementation in future natural history, epidemiological, genetic and interventional trials in AMD.

Keywords: 412 age-related macular degeneration • 504 drusen • 461 clinical (human) or epidemiologic studies: natural history