Multimodal Imaging and En Face OCT Detection of Calcified Drusen in Eyes with Age-Related Macular Degeneration.

Content Provider	Europe PMC
Author	Liu, Jeremy Laiginhas, Rita Shen, Mengxi Shi, Yingying Li, Jianqing Trivizki, Omer Waheed, Nadia K. Gregori, Giovanni Rosenfeld, Philip J.
Copyright Year	2022
Abstract	PurposeEn face OCT imaging was investigated as a method for the detection and monitoring of calcified drusen in eyes with nonexudative age-related macular degeneration (AMD).DesignRetrospective case series of a prospective study.ParticipantsPatients with nonexudative AMD.MethodsA retrospective review was performed of same-day color fundus (CF), fundus autofluorescence (FAF), near-infrared (NIR), and en face swept-source (SS) OCT images to identify eyes with nonexudative AMD and calcified drusen. The appearance and progression of these lesions were compared using the different imaging methods.Main Outcome MeasuresComparison between the presence of calcified drusen observed on CF images with the detection of these lesions on FAF, NIR, and en face SS OCT images.ResultsTwo hundred twenty eyes from 139 patients with nonexudative AMD were studied, with 42.7% of eyes containing calcified drusen either at baseline or during follow-up visits. On the en face SS OCT images, calcified drusen appeared as dark focal lesions referred to as choroidal hypotransmission defects (hypoTDs) that were detected in the choroid using a sub–retinal pigment epithelium (RPE) slab. The corresponding B-scans showed drusen with heterogenous internal reflectivity, hyporeflective cores, and hyperreflective caps. In most calcified drusen, choroidal hypertransmission defects (hyperTDs) were observed to develop over time around the periphery of the hypoTDs, giving them the appearance of a donut lesion on the en face SS OCT images. These donut lesions were associated with significant attenuation of the overlying retina, and the corresponding FAF images showed hypoautofluorescence at the location of these lesions. The donut lesions fulfilled the requirement for a persistent hyperTD, which is synonymous with complete RPE and outer retinal atrophy (cRORA). Six eyes displayed regression of the calcified drusen without cRORA developing. B-scans at the location of these regressed calcified drusen showed deposits along the RPE, with outer retinal thinning in the regions where the calcified lesions previously existed.ConclusionsEn face OCT imaging is a useful method for the detection and monitoring of calcified drusen and can be used to document the evolution of these drusen as they form donut lesions or foci of cRORA.
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Journal	Ophthalmology Science [Ophthalmol Sci]
Volume Number	2
DOI	10.1016/j.xops.2022.100162
PubMed Central reference number	PMC9354070
Issue Number	2
PubMed reference number	35935092
e-ISSN	26669145
Language	English
Publisher	Elsevier
Publisher Date	2022-04-20
Access Restriction	Open
Rights License	This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). © 2022 by the American Academy of Ophthalmology.
Subject Keyword	Age-related macular degeneration Calcified drusen En face OCT Geographic atrophy AMD, age-related macular degeneration CF, color fundus cRORA, complete retinal pigment epithelium and outer retinal atrophy FAF, fundus autofluorescence GA, geographic atrophy hyperTD, hypertransmission defect hypoTD, hypotransmission defect NIR, near-infrared RPE, retinal pigment epithelium SS, swept-source
Content Type	Text
Resource Type	Article
Subject	Ophthalmology