June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Natural History of Drusen with Heterogenous Internal Reflectivity
Author Affiliations & Notes
  • Ye He
    Doheny Eye Institute, Los Angeles, California, United States
    Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • YU Wakatsuki
    Doheny Eye Institute, Los Angeles, California, United States
    Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Shin Kadomoto
    Doheny Eye Institute, Los Angeles, California, United States
    Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Giulia Corradetti
    Doheny Eye Institute, Los Angeles, California, United States
    Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Charles Clifton Wykoff
    Retina Consultants of Texas, Houston, Texas, United States
  • David Sarraf
    Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
    Jules Stein Eye Institute, Los Angeles, California, United States
  • SriniVas R Sadda
    Doheny Eye Institute, Los Angeles, California, United States
    Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Ye He None; YU Wakatsuki None; Shin Kadomoto None; Giulia Corradetti None; Charles Wykoff None; David Sarraf None; SriniVas Sadda 4DMT, Abbvie/Allergan, Amgen, Apellis, Astellas, Bayer, Biogen, Boerhinger Ingelheim, Centervue, Genentech/Roche, Heidelberg Engineering, Iveric, Nanoscope, Novartis, Optos, Oxurion, Regeneron, Code C (Consultant/Contractor), Carl Zeiss Meditec, Code F (Financial Support), Nidek, Code R (Recipient), Centervue, Heidelberg Engineering, Nidek, Optos, Topcon, Code S (non-remunerative)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2142. doi:
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      Ye He, YU Wakatsuki, Shin Kadomoto, Giulia Corradetti, Charles Clifton Wykoff, David Sarraf, SriniVas R Sadda; Natural History of Drusen with Heterogenous Internal Reflectivity. Invest. Ophthalmol. Vis. Sci. 2023;64(8):2142.

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

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Abstract

Purpose : Drusen with heterogenous internal reflectivity (HD), including those with hyporeflective cores, have been implicated to be independent risk factors for progression of age-related macular degeneration (AMD) in some studies, but not confirmed in others. In this analysis, we sought to quantitatively analyze the reflectivity characteristics of these HD lesions and define their evolution over time

Methods : This retrospective cohort study included 458 intermediate AMD (iAMD) eyes from 458 patients evaluated at the Retina Consultants of Texas. OCT volume scans were collected at baseline (first visit) and subsequently at 12 ± 3 months and 24 ± 3 months. OCTs were evaluated for presence of HD at baseline, and a single HD lesion was randomly chosen in each eye for quantitative reflectivity analysis. The region internal to the RPE above Bruch’s membrane was manually segmented, and within this internal region, the hyporeflective core was also segmented. The intensities of the reflectivity of the drusen interior and core were quantified using Image J, and normalized using the vitreous and nerve fiber layer as dark and bright reference standards. The evolution of the selected HD lesions was evaluated at 12 and 24 months and classified into three groups: Stable (no change in size or internal reflectivity), Progressed (larger lesion and/or more hyporeflective) or Regressed (smaller or absent and/or less hyporeflectivity). The baseline normalized reflectivity (Rn) of the interior and core were compared between groups.

Results : Of the 458 iAMD eyes, 50 eyes had HD at baseline, among which 39 had 12 months of follow-up and 27 had 24 months. At 12 months, 26% of HD lesions had progressed, 26% had regressed, and 26% were stable. Among those that regressed, atrophy was evident in 23%. The baseline Rn of both the drusen interior (p=0.008) and core (p=0.034) in the Progressed group were significantly higher than the Regressed group. There was also a trend for higher Rn in the Progressed group compared to the Stable group. Similar findings were observed at Month 24. (Figure 1)

Conclusions : HD lesions in iAMD may feature a spectrum of internal reflectivity which may predict their evolution over 12 and 24 months. HD lesions that have a more hyporeflective interior and core are more likely to regress or collapse and result in atrophy over this time frame.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

Baseline normalized reflectivity (Rn) of drusen interior and core

Baseline normalized reflectivity (Rn) of drusen interior and core

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