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Kathrin I. Hartmann, Maria L. Gomez, Dirk-Uwe Bartsch, William R. Freeman; Effect of Spontaneous Drusen Regression on the Photoreceptor Inner Segment/Outer Segment Junction. Invest. Ophthalmol. Vis. Sci. 2011;52(14):120.
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To evaluate the integrity of photoreceptor inner segment/outer segment (IS/OS) junction after spontaneous drusen regression in age-related macular degeneration (AMD) using spectral domain optical coherence tomography (SD-OCT).
Drusen volume raster scans were performed with the Spectralis SD-OCT (Heildelberg Engineering) through 2624 drusen in 15 eyes with clinically dry AMD who had been longitudinally followed between 12-16 months without intervention (mean time of 24 months). All eyes had EDTRS visual acuity followed by a standardized raster spectral domain optical coherence tomography (SD-OCT), fluorescein angiography (FA) and colour fundus photography. A total of 2624 drusen were analyzed.
82 out of 2624 drusen (3%) were found to be regressed spontaneously by 40 to 100% and were further evaluated. Initial drusen height ranged from 28 to 203 microns (mean 76 microns). Of the 82 drusen with significant regression (> 40% regression in height), 27 drusen (33%) partially regressed (mean regression was 75%) and 55 drusen (67%) completely regressed. The grading of the IS/OS-junction in the location of all regressed drusen showed predominantly intact photoreceptor integrity. After regression we did not find a strong relation in restoration of the IS/OS-junction regarding drusen size.
After spontaneous drusen regression, outer retinal layers appear normal in SD-OCT with an intact IS/OS-junction photoreceptor integrity. We conclude that the IS/OS-junction integrity is either able to restore as drusen regress or was artifactitiously compressed and not initially visible due to the initial drusen compression of the IS/OS junctional line.
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