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Corinne Gonzalez; AMD Drusenoid deposits. Characterization with and Interest of multimodal imaging and OCT, OCT en Face.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5226.
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© ARVO (1962-2015); The Authors (2016-present)
To study AMD drusenoid deposits with multimodal imaging and OCT, OCT en Face. To individualize several drusenoid deposits morphologic types and to consider various etiopathogenic options.
228 eyes of 114 patients, 38 men, 76 women, with AMD. AMD drusenoid deposits: Cuticular drusen, soft Drusen, Drusenoid PED, Subretinal drusenoid deposits (SDD), Pseudovitellifom AMD, were evaluated by Autofluorescence, IR imaging, ETDRS visual acuity (VA), complete ophthalmic examination with Ocular Fundus. Ocular Confocal Tomography exam (OCT),notably OCT en Face software (Spectralis HRA-OCT,spectral domain OCT) were added. The size, characteristics, number, topography of the lesions, their growth way were evaluated, as well as their environment above and below. With OCT, each element was studied, compared cut to cut, layer to layer and time to time to itself and to each other data. Follow-up was done every 4 months during 2 years.
VA stabilized in 90%. Cuticular drusen appear uniform, round, white, numerous punctate accumulations, under the retinal pigment epithelium (RPE). Soft drusen were larger, roughly homogenous, dark-grey, translucent, dome-shaped mounds of deposit under the RPE. Drusenoid PED were 2 sorts: homogeneous, as convergence of soft drusen, less even and/or heterogeneous, white, dense. Pseudovitelliform AMD are little drusenoid PED with irregular upper limit, more retinal anomalies above. Subretinal drusenoid deposits are interconnected accumulations above the RPE, polymorphous. Multimodal imaging, especially OCT, OCT en Face features let individualize subgroups of drusenoid deposits. Evolutions change and depend on their characteristics. Overall 2 morphologic types appear: A and B. A: homogeneous , dark, optically empty, lipid type; B: heterogeneous, white, polymorphous, cellular-protein type. They seem result from various metabolic defect outcome, on the whole, 2 etiopathogenic pathways: A: lipid metabolic pathway disorder, B: cellular -protein metabolic pathway dysfunction. Furthermore, drusenoid deposits’ prognostic and predictive value: A: rather evolution to atrophy, B: rather evolution to neovascular complication, would build up their biomarker feature.
AMD Drusenoid deposits study and knowledge, notably with multimodal imaging , OCT, OCT en Face contribute to and improve AMD understanding, and its evolution , prognosis , etiopathogic concept.
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