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C.F. Fernandez, R.F. Spaide, R. Iranmanesh, J. Klancnik, Jr; Circumferential Perimacular Drusen . Invest. Ophthalmol. Vis. Sci. 2005;46(13):193.
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Purpose: To report a particular pattern of nearly confluent drusen forming a discrete ring in the perimacular region. Methods:Three patients with circumferential perimacular drusen had a comprehensive examination including fundus photography, fluorescein angiography, autofluorescence photography and peripheral visual field evaluation. Results: The patients, all women had a mean age of 76 years old. They had bilaterally symmetrical distribution of drusen in a zone from 5 to 8 millimeters from the geometric center of the fovea. The fundus more peripheral to the region of perimacular drusen showed broad, but subtle zones of altered pigmentation. The central macular region was nearly free of significant drusen in all the cases. Autofluorescence photography revealed a posterior pole with normal autofluorescence and markedly hypoautofluorescent areas in the periphery. The drusen were located at the boundary between the normal and abnormal areas of autofluorescence. The patients had mild peripheral constriction of their visual fields. Conclusions: Many forms of drusen formation have been ascribed to "familial drusen" in past reports. Circumferential perimacular drusen appears to be a distinct, newly recognized entity in which drusen form in a nearly confluent pattern at the boundary between abnormal peripheral and normal posterior regions of fundus autofluorescence.
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