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Ferdinand Georg Schlanitz, Magdalena Baratsits, Katharina Eibenberger, Alessio Montuoro, Stefan Zotter, Bernhard Baumann, Michael Pircher, Christoph K Hitzenberger, Ursula Schmidt-Erfurth; Investigating the Development of Pseudodrusen in Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3957.
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The aim of this study was to investigate the development of pseudodrusen (PD) in age-related macular degeneration (AMD) longitudinally by three-dimensional segmentation of polarization-sensitive OCT (PS-OCT) volume scans.
109 patients with early AMD were scanned using a wide-field PS-OCT (scanning area 30°x30°, volume scan 1024x250) in a regular follow-up scheme for at least one year. The collective was reviewed and patients with PD were selected for grading. The RPE and drusen were segmented by PS-OCT automatically. Two expert graders segmented manually every PD in the volume scan at baseline and at the one-year follow-up visit. Every hyperreflective matrial above the retinal pigment epithelium (RPE) and below the external limiting membrane (ELM) layer was defined as PD.
14 eyes with PD were segmented manually by the graders. PD did not show distinct borders and therefore differentiating between single entities was difficult. The mean volume at baseline was 0.21 mm3 and at year one 0.27 mm3. At the same time, the drusen volume increased in most eyes. However, in some eyes, spontaneous drusen regression was observed, without correlation to the development of PD at the same time.
Due to the RPE-sensitivity of the PS-OCT, pseudodrusen could be segmented in a more reliable way than in regular SD-OCT scans. By grading the hyperreflective structures located above RPE, a plaque-like deposition was found, as described by histologic investigations. PD did show a steady increase in their volume, and interestingly, their development appeared to be independent from that of classic drusen, and was not affected by a spontaneous regression of the latter.
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