April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Relationship Between Drusen Accumulation and Cone Structure in a Patient with Dry Age-Related Macular Degeneration
Author Affiliations & Notes
  • K A. Woo
    New York Medical College, Valhalla, New York
    Ophthalmology, Univ of California San Francisco, San Francisco, California
  • K Ratnam
    Ophthalmology, Univ of California San Francisco, San Francisco, California
  • D Merino
    Ophthalmology, Univ of California San Francisco, San Francisco, California
    School of Optometry, Univ of California Berkeley, Berkeley, California
  • G Hughes
    Shiley Eye Center, Univ of California San Diego, San Diego, California
  • K Zhang
    Shiley Eye Center, Univ of California San Diego, San Diego, California
  • A Roorda
    School of Optometry, Univ of California Berkeley, Berkeley, California
  • J L. Duncan
    Ophthalmology, Univ of California San Francisco, San Francisco, California
  • Footnotes
    Commercial Relationships  K. A. Woo, None; K. Ratnam, None; D. Merino, None; G. Hughes, None; K. Zhang, None; A. Roorda, University of Houston (P), University of Rochester (P); J. L. Duncan, None
  • Footnotes
    Support  NIH Grants EY002162, EY014375, Research to Prevent Blindness, Foundation Fighting Blindness, That Man May See, Inc., Hope for Vision, RPB, Burroughs Wellcome Fund, RO1EY14428, RO1EY14448, RO1EY18660
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 1672. doi:
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    • Get Citation

      K A. Woo, K Ratnam, D Merino, G Hughes, K Zhang, A Roorda, J L. Duncan; Relationship Between Drusen Accumulation and Cone Structure in a Patient with Dry Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1672.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To study the effects of drusen accumulation on cone photoreceptors in a subject with dry age-related macular degeneration (AMD).

Methods: : Adaptive optics scanning laser ophthalmoscopy (AOSLO) and spectral domain optical coherence tomography (SD-OCT) were used to image macular cones in a subject with AMD at two time points (at baseline and 2-years later) and compared with normal values. Digital color fundus photography and infrared and autofluorescent fundus photos were obtained. Visual acuity (VA) and color vision were also measured. Coding sequences of the complement factor H (CFH) gene were bidirectionally sequenced in the subject with AMD.

Results: : Molecular analysis revealed homozygous risk factor polymorphisms in the CFH gene (CC at rs2274700 and CC rs1061170) in a 64 year-old man with dry AMD. Numerous drusen were present in the macula. VA was 20/16, and color vision was normal. SD-OCT showed macular drusen as elevations beneath the RPE-outer segment junction with protrusion into the photoreceptor outer segment and outer nuclear layer. In the subject with AMD, AOSLO showed contiguous patches of cones interspersed with areas where cone structure was poorly resolved. Localized increases in cone spacing were seen in areas overlying drusen and between drusen, when compared with 9 age-similar normal subjects aged 50-79. In areas directly overlying drusen, there was a decrease in the number of regions with normal cone spacing over 2 years.

Conclusions: : AOSLO revealed increased cone spacing in macular areas directly overlying drusen, suggesting the cytotoxic effects of lipofuscin deposits are associated with localized cone loss.

Keywords: age-related macular degeneration • imaging/image analysis: clinical • macula/fovea 
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