Session Title: Quick Fire Free Paper 5
Session Date/Time: Sunday 14/09/2014 | 11:00-13:00
Paper Time: 12:25
Venue: Boulevard B
First Author: : C.Gonzalez FRANCE
Co Author(s): :
To study AMD drusenoid deposits with OCT en Face and see all the input of this technique and software. To individualize several drusenoid deposits morphologic types and consider various etiopathogenic options.
Interventional, non comparative, retrospective case series
208 eyes of 104 patients, 32 men, 72 women, with AMD drusenoid deposits (Cuticular drusen, soft Drusen, Drusenoid PED, Subretinal drusenoid deposits(SDD), Pseudovitelliform AMD). Deposits were evaluated by Ocular Confocal Tomography exam (OCT), notably OCT en Face software (Spectralis HRA-OCT, spectral domain OCT). Autofluorescence, IR imaging, ETDRS visual acuity (VA), complete ophthalmic examination with Fundus exam were added. The characteristics, size, number, topography of the lesions, their growth way were evaluated, as well as their environment above and below (particularly IS-OS, plexiform layer, choriocapillaris structure and thickness). Each element was studied, compared cut to cut, layer to layer and time to time to itself and to each other data, every 4 months, during 2 years.
VA stabilized in 90%. Cuticular drusen appear round, white, uniform, numerous punctate accumulations, under the retinal pigment epithelium (RPE). Soft drusen were roughly homogenous, larger, dark-grey, translucent, 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. OCT, especially OCT en Face software, let individualize subgroups of drusenoid deposits, confirm their diversity. Evolutions change and depend on their characteristics. Overall 2 morphologic types appear: A and B. A: dark, homogeneous, optically empty, lipid type; B: white, heterogeneous, polymorphous, cellular-protein type. Various metabolic defect outcome seem to be involved in, on the whole, 2 etiopathogenic pathways: A: lipid metabolic pathway disorder, B: cellular –protein metabolic pathway dysfunction. Furthermore, drusenoid deposits’ prognostic and predictive value: A: rather evolution to atrophy, B: rather evolution to neovascular complication, would enable to build up their biomarker feature.
OCT en Face contribute to and improve AMD Drusenoid deposits study and knowledge and allow to better understand AMD, its evolution , prognosis, etiopathogenic concept