Session Title: AMD I
Session Date/Time: Thursday 17/09/2015 | 08:30-10:30
Paper Time: 09:34
First Author: : C.Gonzalez FRANCE
Co Author(s): :
PURPOSE:To study AMD drusenoid deposits, Lipid Type,”L”, their morphotype, their evolution with multimodal imaging. So to consider several etiopathogenic options.
Interventional, non comparative, retrospective case series
124 eyes of 92 patients, 35 men, 57 women, with AMD. AMD drusenoid deposits, Lipid type, ”L” : soft Drusen, Drusenoid PED type ”L”, 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 were evaluated, as well as their environment above and below and their evolution too. Each element was compared cut to cut, layer to layer and time to time to itself and to each other data. Follow-up was done every 4 months during 3 years.
VA stabilized in 90%. Soft drusen appear large, roughly homogenous, translucent, dark-grey, dome-shaped mounds of deposit under the RPE, as oil drops. Drusenoid PED type ”L” were homogeneous, as convergence of soft drusen, optically empty, identical on each/every cut at OCT and en face OCT. Photoreceptors and pigment epithelium above change during evolution in structure, thickness, were more irregular, with anomalies moving forward atrophy. Multimodal imaging, especially OCT, en face OCT, let characterize drusenoid deposits, and individualize those homogeneous, dark-grey, called lipid type “L”. Their particularity, their specific evolution toward atrophy seems involving lipid metabolic malfunction, lipid metabolic pathway disorder, so lipid etiopathogenic pathways. Furthermore, lipid type “L” drusenoid deposits’ prognostic and predictive value enable their biomarker feature.
AMD Drusenoid deposits Lipid type ”L” knowledge, evolution study notably with multimodal imaging contribute to and improve AMD metabolism dysfunction understanding, etiopathogenic concept too.