ABUNDANCE AND MULTIMODAL VISIBILITY OF SOFT DRUSEN IN EARLY AGE-RELATED MACULAR DEGENERATION: A Clinicopathologic Correlation. Issue 8 (August 2020)

• Record Type: Journal Article
• Authors: Chen, Ling; Messinger, Jeffrey D.; Sloan, Kenneth R.; Wong, Jessica; Roorda, Austin; Duncan, Jacque L.; Curcio, Christine A.
• Other Names: Wilson David section editor.
• Is Part Of: Retina. Volume 40:Issue 8(2020)
• Publication Date: 2020-08
• Subjects: age-related macular degeneration -- autofluorescence -- basal linear deposit -- clinicopathologic correlation -- color fundus photography -- drusen -- histology -- optical coherence tomography; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000002893
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To determine the abundance and multimodal visibility of drusen and basal linear deposit (BLinD) in early age-related macular degeneration. Methods: A 69-year-old white man was imaged by color fundus photography and red free photography, fundus autofluorescence, and optical coherence tomography. From en face images, we determined the drusen field, drusen area, and equivalent diameters of individual drusen. From high-resolution light-microscopic histology (6 months after the last clinic visit), we determined the area of drusen, BLinD, and pre-BLinD in a subretinal pigment epithelium-basal lamina lipid field. Results: In right and left eyes, respectively, BLinD covered 40% and 46% of the lipid field, versus 21% and 14% covered by drusen. The lipid field was covered 60% to 61% by Drusen + BLinD and 65% to 72% by BLinD + pre-BLinD. In the left eye, the drusen area on color fundus photography (0.18 mm 2 ) and red free (0.28 mm 2 ) was smaller than the drusen area on histology (1.16 mm 2 ). Among drusen confirmed by optical coherence tomography, 55.1% and 56.6% were observed on red free and fundus autofluorescence, respectively. Conclusion: Basal linear deposit covered 1.9 and 3.4-fold more fundus area than soft drusen, silently increasing progression risk. Improved visualization of BLinD and readouts of the retinal pigment epithelium health over lipid will assist population surveillance, early detection, and trial outcome measures. Abstract : Supplemental Digital Content is Available in the Text. In a clinicopathologic correlation, basal linear deposit covered 1.9 to 3.4-fold more fundus area than soft drusen, potentially increasing progression risk. Improved visualization of this deposit and readouts of the retinal pigment epithelium health over it will assist population surveillance, early detection, and trial outcome measures.