Abstract
Purpose :
Drusen has been reported in adolescents and in children at ARVO 2015 This study assesses the appearance of drusen on both OCT and fundus photos in Asian pediatric patients.
Methods :
Using EHR, eClinicalWorks, from a retina practice from 1/2013-11/2015, pts were identified with CPT code 92250 and 92134 with Va=20/15-20/30. Inclusion criteria: no macular disease, best corrected visual acuity 20/15-20/30. Age range 6-18 years. Exclusion criteria: poor quality fundus photos, macular disease, inability to cooperate with OCT exam. TRC-50EX Topcon camera was used to examine color and red-free photos. OIS Winstation AREDS retinal grid was used to identify drusen and measure drusen size. The grid was superimposed on the fundus photo, centered at the fovea. Using the OIS Topcon software 3x zoom feature, all subfields, para and perifoveal regions were inspected for drusen. A subset of pts were evaluated by using OCT (20x20 volume, density 240um, 8.8frames/sec, Heidelberg Engineering Spectralis HRA+OCT), and fundus photos. The Brightness & Contrast tab was used and was decreased to 0, (default setting=12).
Results :
60 pts: 41 were Asian. Avg age=12.59yrs, sd=4.12, range=6-18. Males=20, avg age=12.15yrs, sd=4.43; Females n=21, avg age=13.00yrs, sd=3.86.
76 fundus photos of 41 pts were examined. No drusen (D) in 29/76 (38%) eyes. The remaining 47/76 (62%) eyes had D from 31 pts. 20 pts (49%) had D in both eyes.
Average number of D per eye OD=2.20 ± 2.59 and OS=1.78 ± 2.27. In total, 163 D were counted, all less than 65um in diameter (C0 on the AREDS grid). 134 of 163 D appeared in the outer subfields vs. 29 found in the inner subfields. 90 D (55%) appeared in right eyes vs 73 D (45%) in left eyes (p=ns). 43% of D were temporal, 10% were nasal (p=0.005). 28% were superior, 19% were inferior (p=0.04).
21 of 41 Asian pts had both OCT and fundus photos. Avg age=14.62yrs, sd=3.58, range=6-18. Males n=10, avg age=14.00yrs, sd=3.71, Females n=11, avg age=15.18yrs, sd=3.54. 42 OCT images were examined and 38 OCT images (90.5%) correlated with photos. With Brightness & Contrast, 37/42 (88.1%) correlated with photos.
Conclusions :
Drusen can be found in Asian children as early as age 6. A majority of drusen were found in the perifoveal subfields and OCT correlation was found in majority of study patients. This small study suggests that drusen may be seen in children age 6-18yrs.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.