June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Multimodal Imaging and En Face OCT Detection of Calcified Drusen in Eyes with Age-Related Macular Degeneration
Author Affiliations & Notes
  • Jianqing Li
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Jeremy Liu
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Rita Laiginhas
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Mengxi Shen
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Yingying Shi
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Omer Trivizki
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Nadia K Waheed
    New England Eye Center, Boston, Massachusetts, United States
  • Giovanni Gregori
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Philip J Rosenfeld
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Jianqing Li None; Jeremy Liu None; Rita Laiginhas None; Mengxi Shen None; Yingying Shi None; Omer Trivizki None; Nadia Waheed Carl Zeiss Meditec, Code F (Financial Support), Nidek, Code F (Financial Support), Heidelberg Engineering, Code F (Financial Support), Topcon, Code F (Financial Support), Gyroscope Therapeutics , Code S (non-remunerative), Ocudyne, Code S (non-remunerative); Giovanni Gregori Carl Zeiss Meditec, Code F (Financial Support); Philip Rosenfeld Carl Zeiss Meditec, Code C (Consultant/Contractor), Carl Zeiss Meditec, Code F (Financial Support)
  • Footnotes
    Support  Carl Zeiss Meditec, Inc. (Dublin, CA), Salah Foundation (Ft. Lauderdale, FL), National Eye Institute Center Core Grant (P30EY014801), Research to Prevent Blindness (unrestricted Grant)
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 1039 – F0286. doi:
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    • Get Citation

      Jianqing Li, Jeremy Liu, Rita Laiginhas, Mengxi Shen, Yingying Shi, Omer Trivizki, Nadia K Waheed, Giovanni Gregori, Philip J Rosenfeld; Multimodal Imaging and En Face OCT Detection of Calcified Drusen in Eyes with Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1039 – F0286.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : En face optical coherence tomography (OCT) imaging was investigated as a method for the detection and monitoring of calcified drusen in eyes with non-exudative age-related macular degeneration (AMD).

Methods : A retrospective review of a prospective study was performed of same-day color fundus (CF), near infrared (NIR), fundus autofluorescence (FAF), and en face swept-source OCT (SS-OCT) images to identify eyes with non-exudative AMD and calcified drusen. The appearance and subsequent progression of these lesions were compared using the different imaging modalities.

Results : Two hundred twenty eyes from 139 patients with non-exudative AMD were studied with 42.7% of the eyes containing calcified drusen either at baseline or during their follow-up visits. On the en face sub-RPE SS-OCT slabs, calcified drusen appeared as dark focal lesions referred to as choroidal hypo-transmission defects (hypoTDs). The corresponding B-scans showed drusen with heterogenous internal reflectivity and a hyper-reflective cap. In the majority of the calcified drusen, choroidal hyper-transmission defects (hyperTDs) were observed to develop over time around the periphery of the hypoTDs giving them the appearance of a donut lesion on the en face SS-OCT images. These donut lesions were associated with significant attenuation of the overlying retina, and the corresponding FAF images showed hypo-autofluorescence at the location of these lesions. The donut lesions fulfilled the requirement for a persistent hyperTD and is synonymous with complete retinal pigment epithelium and outer retinal atrophy (cRORA). Six eyes displayed regression of their calcified drusen without developing cRORA. B-scans at the location of the regressed calcified drusen showed deposits along the RPE with outer retinal thinning in the regions where the calcified lesions previously existed.

Conclusions : En face rendering of OCT images is a useful method for the detection and monitoring of calcified drusen and future studies will document the evolution of these drusen as they form donut lesions and foci of cRORA.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

Figure 1. Multimodal imaging of the right eye from a 73-year-old woman showing calcified drusen (white arrows). (A) CF. (B) NIR. (C) FAF. (D) Drusen volume map. (E,F) SS-OCT en face sub-RPE slab. (G-I) Color-coded B-scans. The yellow arrow identifies a hyperTD representing atrophy.

Figure 1. Multimodal imaging of the right eye from a 73-year-old woman showing calcified drusen (white arrows). (A) CF. (B) NIR. (C) FAF. (D) Drusen volume map. (E,F) SS-OCT en face sub-RPE slab. (G-I) Color-coded B-scans. The yellow arrow identifies a hyperTD representing atrophy.

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