Purpose
To describe the multimodal imaging features of drusen-like lesions identified in areas of geographic atrophy (GA) in age-related macular degeneration (AMD) patients.
Methods
This is a retrospective case series of GA patients harboring lesions in atrophic areas. Multimodal imaging examination including infrared (IR) reflectance, fundus autofluorescence (FAF) and spectral-domain optical coherence tomography (SD-OCT) was performed for each patient. IR and FAF appearance and mean SD-OCT height of the structures in GA were analyzed.
Results
A total of 36 eyes of 25 patients (20 women; mean age 82.3±5.9 years, range 73-92 years) with GA were included. In all eyes, on IR reflectance images, drusen in GA appeared as hypereflective lesions surrounded by hyporeflective halos, within an area of background hypereflectivity due to GA. On FAF, drusen in GA appeared as hypoautofluorescent in most cases in 20/36 eyes (55.5%). On SD-OCT, drusen in GA appeared as hypereflective pyramidal structures (HPS). In 35/36 eyes (97.2%) the center was heterogeneously hypereflective, whereas the peripheral part of the HPS was hypereflective in all eyes (100%).
Conclusions
We describe a multimodal imaging of distinctive lesions. Because these HPS appear in GA areas, and because of their pyramidal or dome-shaped aspect on SD-OCT, we suggest the term of “macular ghosts”
Keywords: 412 age-related macular degeneration •
550 imaging/image analysis: clinical •
504 drusen