Drusen and Photoreceptor Abnormalities in African-Americans with Intermediate Non-neovascular Age-related Macular Degeneration. (April 2015)

• Record Type: Journal Article
• Authors: Sadigh, Sam; Luo, Xunda; Cideciyan, Artur V.; Sumaroka, Alexander; Boxley, Stacy L.; Hall, Laura M.; Sheplock, Rebecca; Feuer, William J.; Stambolian, Dwight S.; Jacobson, Samuel G.
• Is Part Of: Current eye research. Volume 40:Number 4(2015:Apr.)
• Page Start: 398
• Page End: 406
• Publication Date: 2015-04
• Subjects: Ophthalmology -- Periodicals; Eye -- Diseases -- Periodicals; Ophthalmology -- Periodicals; 573.88
• DOI: 10.3109/02713683.2014.925934
• Languages: English
• ISSNs: 0271-3683

Abstract

<abstract> <title>Abstract</title> <p> <italic>Purpose/Aim</italic>: To investigate the relationship of drusen and photoreceptor abnormalities in African-American (AA) patients with intermediate non-neovascular age-related macular degeneration (AMD).</p> <p> <italic>Materials and methods</italic>: AA patients with intermediate AMD (<italic>n</italic> = 11; age 52–77 years) were studied with spectral-domain optical coherence tomography. Macular location and characteristics of large drusen (≥125 µm) were determined. Thickness of photoreceptor laminae was quantified overlying drusen and in other macular regions. A patient with advanced AMD (age 87) was included to illustrate the disease spectrum.</p> <p> <italic>Results</italic>: In this AA patient cohort, the spectrum of changes known to occur in AMD, including large drusen, sub-retinal drusenoid deposits and geographic atrophy, were identified. In intermediate AMD eyes (<italic>n</italic> = 17), there were 183 large drusen, the majority of which were pericentral in location. Overlying the drusen there was significant thinning of the photoreceptor outer nuclear layer (termed ONL<sup>+</sup>) as well as the inner and outer segments (IS + OS). The reductions in IS + OS thickness were directly related to ONL<sup>+</sup> thickness. In a fraction (∼8%) of paradrusen locations with normal lamination sampled within ∼280 µm of peak drusen height, ONL<sup>+</sup> was significantly thickened compared to age and retinal-location-matched normal values. Topographical maps of the macula confirmed ONL thickening in regions neighboring and distant to large drusen.</p> <p> <italic>Conclusions</italic>: We confirm there is a pericentral distribution of drusen across AA-AMD maculae rather than the central localization in Caucasian AMD. Reductions in the photoreceptor laminae overlying drusen are evident. ONL<sup>+</sup> thickening in some macular areas of AA-AMD eyes may be an early phenotypic marker for photoreceptor stress.</p> </abstract>