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Michael Larsen, Xiao Qiang Li, Inger Christine Munch; Small hard macular drusen and associations in 11-12 year-old children in the Copenhagen Child Cohort 2000 Study. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5533.
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To assess the prevalence and associations, in a population-based child cohort, of small hard drusen, a sharply demarcated bright retinal pigment epithelium lesion of diameter <66 µm that is common in healthy adults.
The population-based Copenhagen Child Cohort 2000 (CCC2000) Study examined 1406 children aged 11-12 years, including non-cycloplegic refractioning, assessment of best-corrected visual acuity (BCVA), ocular biometry, OCT, and fundus photography. Fovea-centred 45-degree digital color images of both eyes were graded for small hard drusen within 3000 μm of the center of the macula. Subfoveal choroidal thickness, axial length, and BCVA were measured in right eyes.
Gradable fundus images from both eyes were available from 1333 children (48 % boys, 52 % girls) aged 11.7±0.40 years (mean ± SD). Small hard macular drusen were present in 6.15 (CI95 4.86-7.44) % of right eyes and 6.23 (CI95 4.93-7.53) % of left eyes. Drusen in one or both eyes was found in 11.1 (CI95 9.41-12.8) % of children and drusen in both eyes in 1.28 (CI95 0.67-1.88) % of children. Nine children (0.68%) had 5 or more drusen in one or both eyes, and 4 children (0.30%) had 20 or more drusen in one or both eyes. All drusen prevalences were comparable (p>0.11) between boys and girls. In logistic regression analyses, the odds for having ≥1 druse increased with the thickness of the subfoveal choroid (odds ratio 1.14 (CI95 1.02-1.28, p=0.020, adjusted for age, gender, and axial length) per 50 µm increase in choroidal thickness. When dividing participants into choroidal thickness quartiles, the prevalence of having ≥ 1 druse was 15.1% in the uppermost quartile compared with 10.2% in the lowest quartile (p=0.067, χ2-test crude analysis, p=0.13 when adjusting for age, gender, and axial length using logistic regression analysis). We found no associations between having ≥1 druse and ocular axial length, peripapillary retinal nerve fiber layer thickness, center-field retinal thickness or BCVA.
Eleven percent of 11-12 year old children in a suburban part of Denmark had at least one small hard macular druse. An association of such drusen with a thicker subfoveal choroid could not definitively be ruled out. Small hard drusen are not only found in adults.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Fundus photograph from the left eye of an 11-year old healthy child showing a single small hard druse temporal of the fovea (arrow)
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