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Author Spotlight: Ex Vivo OCT-Based Multimodal Imaging of Human Donor Eyes for Research into Age-Related Macular Degeneration
Published on: May 26, 2023
Cuticular Drusen: Clinical Phenotypes and Natural History Defined Using Multimodal Imaging
Chandrakumar Balaratnasingam1, Svetlana Cherepanoff2, Rosa Dolz-Marco3
1LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York; Vitreous Retina Macula Consultants of New York, New York, New York; Department of Ophthalmology, New York University School of Medicine, New York, New York; Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia; Lions Eye Institute, Nedlands, Western Australia, Australia; Department of Ophthalmology, Sir Charles Gairdner Hospital, Western Australia, Australia.
Cuticular drusen share ultrastructural similarities with hard drusen but exhibit a life cycle and macular complications akin to soft drusen, potentially increasing risk for geographic atrophy and neovascularization.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Medical Imaging
Background:
- Cuticular drusen are a subtype of drusen, commonly associated with age-related macular degeneration (AMD).
- Understanding their unique characteristics is crucial for predicting disease progression and visual outcomes.
Purpose of the Study:
- To define the range and life cycles of cuticular drusen phenotypes using multimodal imaging.
- To review the histologic characteristics of cuticular drusen.
Main Methods:
- Retrospective observational cohort study of 240 eyes with cuticular drusen phenotype.
- Multimodal imaging including OCT, fluorescein angiography, and autofluorescence.
- Histologic examination of human donor eyes.
Main Results:
- Cuticular drusen and RPE changes were observed in the peripheral retina.
- Over 5 years, 58.3% of drusen disappeared, 70.8% coalesced, and 56.2% developed new RPE changes.
- Retinal pigment epithelium abnormalities, acquired vitelliform lesions, neovascularization, and geographic atrophy occurred more frequently in patients over 60.
Conclusions:
- Cuticular drusen's ultrastructure resembles hard drusen, but their life cycle and complications align more with soft drusen.
- The cuticular drusen phenotype may uniquely increase the risk of geographic atrophy and neovascularization.
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