CHOROIDAL THICKENING IN PATIENTS WITH CUTICULAR DRUSEN COMBINED WITH VITELLIFORM MACULAR DETACHMENT. Issue 6 (June 2016)

• Record Type: Journal Article
• Authors: Mrejen-Uretsky, Sarah; Ayrault, Sandrine; Nghiem-Buffet, Sylvia; Quentel, Gabriel; Cohen, Salomon Y.
• Is Part Of: Retina. Volume 36:Issue 6(2016:Jun.)
• Publication Date: 2016-06
• Subjects: basal laminar drusen -- cuticular drusen -- vitelliform macular detachment -- choroidal thickness -- SD-OCT -- EDI-OCT; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000000831
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To analyze the subfoveal choroidal thickness (SFCT) in patients with cuticular drusen. Methods: Retrospective, monocentric, study of consecutive patients examined with enhanced depth imaging spectral domain optical coherence tomography (EDI SD-OCT, Cirrus, Zeiss) between 2009 and 2014 in a tertiary care center. Measurements of the height of the subfoveal vitelliform detachment and SFCT were manually performed. Results: Thirteen patients, 3 men and 10 women, aged from 35 to 73 (mean: 53.6 years) were selected. For the 24 eyes without macular atrophy at first visit, SFCT ranged from 195 to 559 µ m (mean ± SD = 317.5 ± 93). The SFCT was significantly thicker in 12 eyes with vitelliform macular detachment at presentation (369 ± 96, median = 368.5) than in 12 eyes without (266 ± 58, median = 257.5) ( P = 0.007), whereas the 2 groups did not differ in age ( P = 0.35) or refractive error ( P = 0.56). No correlation was observed between SFCT and the height of the foveal detachment. For 10 eyes followed up longer than 24 months (mean: 38.9 months), the SFCT significantly decreased over time, from 375 ± 96 (median = 368.5) to 303 ± 138 (median = 319) µ m ( P = 0.022). Conclusion: Eyes with cuticular drusen combined with vitelliform macular detachment present with choroidal thickening, suggesting that the choroidal vasculature may play a role in the occurrence of macular detachments in patients with cuticular drusen. The life cycle of these vitelliform lesions evolves from translucent subretinal fluid to the accumulation of yellowish material eventually resolving and leading to atrophy with marked and rapid thinning of the choroid. Abstract : Spectral domain optical coherence tomography analysis of eyes with cuticular drusen showed that the mean thickness of the subfoveal choroid was significantly greater in 12 eyes with vitelliform macular detachment at presentation (mean ± SD = 369 ± 96 µ m, median = 368.5) than in 12 eyes without (mean ± SD = 266 ± 58 µm, median = 257.5) ( P = 0.007), whereas the 2 groups did not differ in age ( P = 0.35) or refractive error ( P = 0.56). These results suggest that choroidal vascular hyperpermeability may modulate the occurrence of macular detachment in patients with cuticular drusen.