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Magdalena Baratsits, Ferdinand Georg Schlanitz, Katharina Eibenberger, Bernhard Baumann, Urike Scheschy, Alessio Montuoro, Stefan Zotter, Michael Pircher, Christoph K Hitzenberger, Ursula Schmidt-Erfurth; Characteristics of Pseudodrusen investigated using Multi-Modal Imaging including PS-OCT. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5144. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
The aim of this study was to investigate the characteristics of pseudodrusen (PD) and their organization within the retina in patients with early age-related macular degeneration (AMD) by evaluating and cross-linking different imaging techniques with three-dimensional delineation of polarization- sensitive optical coherence tomography (PS-OCT) volume scans.
109 patients with early AMD were examined using SD-OCT, IR-reflectance imaging, and autofluorescence imaging. Furthermore, patients were scanned with a wide-field PS-OCT (scanning area 30°x30°, volume scan 1024x250). The RPE-layer and drusen were segmented by an automated computer algorithm utilizing the polarization-senstive information. Afterwards, the PS-OCT datasets were delineated manually for pseudodrusen. The 3D-map of pseudodrusen was compared with the 3D-map of the RPE layer and drusen, and furthermore to the autofluorescence and IR-reflectance images in order to investigate the structural characteristics at the level of RPE in early AMD.
14 eyes were segmented manually for PD and the imaging characteristics were evaluated by cross-linking the three-dimensional map to autofluorescence and IR-reflectance images. In the three-dimensional images, PD did not show distinct borders but rather a plaque-like spreading between the RPE and the photoreceptor layers. Therefore, distinction between certain types of PD was difficult, and most PD seemed to be influenced in their form by other microstructural alterations at the level of the RPE, such as drusen. The combination of drusen- and pseudodrusenmap could explain some imaging characteristics seen in the en-face autofluorescence and reflectance images.
Due to the ability of the PS-OCT to detect and segment the RPE layer, grading of pseudodrusen could be done in a more reliable way than before. Certain PD-types were evaluated in their three-dimensional nature for the first time. By segmenting the hyperreflective structures located above RPE a plaque-like deposition found. This matches findings by histologic investigations, and may be caused by the loose-fitting structures between RPE and photoreceptors. The combination of the en-face images extracted from OCT volumes, i.e. RPE layer, drusen- and pseudodrusen maps, could explain the imaging characteristics of early AMD in en-face images such as autofluorescence and IR-reflectance in more detail.
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