Abstract
Purpose :
Age-related macular degeneration(AMD) is a disease that affects central vision and is the leading cause of blindness in the developed world. Despite the lack of a clear understanding of AMD pathogenesis, growing evidence suggests a link between photooxidative stress caused by short-wavelength(blue) light and subretinal drusen accumulation. This study examines the relationship between blue-light filtering intraocular lens(IOL) implants and drusen development through the histopathology of post-mortem eyes.
Methods :
A total of eighty donor eyes with IOL implants(Forty with clear IOL and 40 with yellow IOL) were obtained from the Minnesota Lions Eye Bank and examined at the MUHC-McGill University Ocular Pathology Lab. The age, sex, ocular history, clinical history, time from IOL implantation(cataract surgery) to enucleation, and lens model type were obtained for each eye. Eyes were sectioned in their sagittal axis, and formalin-fixed paraffin embedded macular cross sections were obtained H&E stained sections were digitalized using the Zeiss Axio Scan.Z1 scanner.Drusen were identified and classified according to the following criteria: type (soft, cuticular, hard), size (small, medium, large, flat ovoid), and quantity (none, few, multiple, zonal, multiple zonal or extensive).
Results :
The presence of soft drusen is observed in 51.32% (n=39) of our samples, while cuticular is observed in 10.53% (n=8) of cases and hard drusen in 14.47% (n=11). The remaining 23.68% does not show macular drusen (n=18). The presence of soft drusen is greater in the group implanted with a clear IOL implant (61.5%, n=24) when compared to the yellow IOL implant. In addition, the number of eyes without apparent drusen is greater in the yellow IOL implant group.The ratio of soft drusen for clear vs yellow IOL is 16:9 for the initial five years after implantation and 22:15 for a ten-year period. Soft drusen accounts for 80% of the aggregate in the 90-99 years old group, while only 42.31% of the drusen in the 70-79 years old group are categorized as soft drusen.
Conclusions :
We observe a lesser presence of drusen of all groups of patients with a yellow IOL implant. The presence of soft drusen, which is known for its relationship with macular disease, is also markedly less in patients with yellow blue-light filtering IOL implant when compared to the clear one. This effect is observed across all age groups.
This is a 2021 ARVO Annual Meeting abstract.