Purpose:
To describe the association of acquired vitelliform lesion (AVL) and large drusen in patients with non-neovascular age-related macular degeneration (AMD)
Methods:
A retrospective review of clinical examination and multimodal imaging data of patients with AVL and large drusen seen over a 12-month period was performed. AVL was defined as subretinal accretion of yellowish material within the macular region. Large drusen was diagnosed by the presence of mounded deposits in the sub-retinal pigment epithelium (RPE) space between the RPE and the Bruch's membrane using multimodal imaging analysis (color photography, autofluorescence and spectral domain optical coherence tomography)
Results:
Thirteen eyes of 9 Caucasian patients with a mean age of 74 years were observed to have AVL associated with large drusen. The median visual acuity was 20/60. All AVL's were hyperautofluorescent and were located in the subretinal space between the RPE and the photoreceptor inner segment/outer segment junction. The AVL's in this series had similar color, autofluorescence, and optical coherence tomographic findings as the AVL`s seen in association with cuticular drusen and subretinal drusenoid deposits
Conclusions:
AVLs, which have previously been related to cuticular drusen and subretinal drusenoid deposits, can occur in association with large drusen. Formation of drusen has been related to a complex interplay between RPE function, lipid transport, and inflammation. Abnormalities leading to drusen formation or processes that function in parallel to these may be causative in AVL formation
Keywords: age-related macular degeneration • imaging/image analysis: clinical • drusen