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Age macular degeneration- drusenoid deposits. Multimodal imaging and its interest for their characterization

Session Details

Session Title: Quick Fire Free Paper 5

Session Date/Time: Sunday 14/09/2014 | 11:00-13:00

Paper Time: 12:20

Venue: Boulevard B

First Author: : C.Gonzalez FRANCE

Co Author(s): :                  

Abstract Details

Purpose:

To study AMD drusenoid deposits with multimodal imaging. To individualize and consider several drusenoid deposits morphologic types and various etiopathogenic options.

Setting:

Interventional, non comparative, retrospective case series

Methods:

238 eyes of 124 patients, 42 men, 82 women, with AMD. AMD drusenoid deposits included Cuticular drusen, soft Drusen, Drusenoid PED, Subretinal drusenoid deposits (SDD), Pseudovitellifom AMD. They were evaluated by ETDRS visual acuity (VA), complete ophthalmic examination with Ocular Fundus, Autofluorescence, IR imaging, Ocular Confocal Tomography exam (OCT) (Spectralis HRA-OCT, spectral domain OCT). The characteristics, number, size, topography of the lesions, their growth way was evaluated, as well as their environment above and below. Each element was compared cut to cut, layer to layer and time to time to itself and to each other data with OCT. Follow-up was done every 4 months during 2 years.

Results:

VA stabilized in 90%. Cuticular drusen appear round, white, uniform, numerous punctate accumulations, under the retinal pigment epithelium (RPE). Soft drusen were larger, roughly homogenous,translucent, dark-grey, dome-shaped mounds of deposit under the RPE. Drusenoid PED were 2 sorts: homogeneous, as convergence of soft drusen; less even and/or heterogeneous, white, dense. Subretinal drusenoid deposits are interconnected accumulations above the RPE, polymorphous. Pseudovitelliform AMD are little drusenoid PED with irregular upper limit, more retinal anomalies above. Multimodal imaging, especially OCT, let specifically individualize subgroups of drusenoid deposits, confirm their diversity. Overall 2 morphologic types appear: A and B. A: homogeneous, dark, lipid type; B: heterogeneous, white, cellular-protein type and by the way, 2 etiopathogenic, metabolic disorder pathways. Furthermore, drusenoid deposits’ prognostic and predictive value enable their biomarker feature.

Conclusions:

AMD Drusenoid deposits study and knowledge, notably with multimodal imaging contribute to and improve AMD understanding, and its evolution , prognosis , etiopathogenic concept.

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