Abstract
Purpose :
Drusen are lipoproteinaceous deposits found in the area between RPE and Bruch’s membrane. They are associated with age, however, in some cases, they may cause of visual symptoms. Drusen is associated with age-related macular degeneration (AMD) and is considered a precursor for this particular disease. The purpose of this study is to evaluate the prevalence of macular and foveal drusen in histopathological sections obtained from enucleated and eviscerated eyes.
Methods :
A total of 143 eyes from 143 patients were examined, from the MUHC – McGill University Ocular Pathology Laboratory (2012-2019). Of the 143 eyes, 71 (49.6%) were enucleated and 72(50.4%) eviscerated. The main histopathological diagnosis of the specimens include: trauma, ocular melanoma, pan-ophthalmitis, longstanding glaucoma, and recurrent uveitis. Of the 143 patients, only those over 50 years of age were selected for the study (n=100). A histopathological review was performed in digitalized H&E slides (Zeiss Axio Scan.Z1) in 52 eyes of the 100 patients. Each case was assessed based on the presence of drusen (yes/no), their size (small = < 75um, large = >75um) and their number (one/multiple). Only drusen composed of eosinophilic proteinaceous material located in the macular area were considered for the study. While the macular area was obvious in enucleation specimens, the identification in evisceration specimens was based on the thickness of the photoreceptor layer of the retina.
Results :
Histopathological review of the 27 eviscerations and 25 enucleations (n=52), 18 cases showed macular drusen (34.6%). Drusen were small and multiple in 73.7% of cases (n=14), whereas 2 cases showed multiple large drusen and 2 cases had a single small druse. The mean age was 70 years-old (st. dev: 12) and there was no correlation between age, size or number of drusen.
Conclusions :
The histopathological identification of drusen in the macular area is feasible in both enucleation and evisceration specimens. Prevalence of macular drusen from enucleated and eviscerated ocular specimens in patients over 50 years-old is comparable to the incidence of age-related macular degeneration in this particular population. An analysis of the clinical characteristics of this cohort of patients, as well as, a large series of enucleation and evisceration specimens is underway.
This is a 2020 ARVO Annual Meeting abstract.