Artículos de revistas: "Drusen"

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Shchuko, A. G., D. Yu Samsonov, S. I. Zhukova, T. N. Iureva, I. M. Mikhalevich, A. V. Grigorieva, and Yu S. Samsonova. "Differential Change in Retina Structure and Function in Children and Adolescents with Drusens of the Optic Nerve Disk." Ophthalmology in Russia 15, no. 2S (July 28, 2018): 73–81. http://dx.doi.org/10.18008/1816-5095-2018-2s-73-81.

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The first histological and clinical description of the optic nerve drusens was given in the 19th century. Then authors considered drusens as congenital pathologies, and a study of 1999 showed that drusen is not the primary pathology, but the dysplasia of the optic nerve disk and its circulation predisposes to the formation of drusen. Central vision in patients with drusens of the optic nerve disc is reduced rarely, and their diagnosis is reduced to ascertaining of the fact of having drusen without taking into account the structural and functional changes in the visual system.Purpose of the work: to identify the pattern of changes in visual functions in children and adolescents with druses of the optic nerve disk, the development and addition of classification criteria.Patients and methods. 45 children with drusens were examined, a comprehensive analysis of the visual system included a standard ophthalmological examination, a comprehensive study of visual system with ultrasound scanning, OCT and OCTA, standard automated and pulsarperimetry.Based on the results of the cluster analysis, a graph of the distribution of patients into three groups (control group and two clinical groups) was constructed, and the structural and functional state of the visual system was analyzed. Drusens in children in the second group we marked as “peripheral”, and in the third — “central”. The carried out researches have shown, that the revealed disturbances are more expressed in the third clinical group. All this determines the need to complement the clinical classification of drusens and their separation depending on the location relative to the vessels of the optic nerve disk to the central and peripheral. The compression effect of drusen is accompanied with changes in the volume of the optic nerve disc, a violation of retinal hemodynamics, damage to the neuroglia and ganglion cells, which allows treating this pathology as a progressive neuroopticopathy, and the revealed dependence of changes on the localization of druses requires supplementing the existing classification.

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Schlanitz, Ferdinand, Bernhard Baumann, Stefan Sacu, Lukas Baumann, Michael Pircher, Christoph K. Hitzenberger, and Ursula Margarethe Schmidt-Erfurth. "Impact of drusen and drusenoid retinal pigment epithelium elevation size and structure on the integrity of the retinal pigment epithelium layer." British Journal of Ophthalmology 103, no. 2 (April 29, 2018): 227–32. http://dx.doi.org/10.1136/bjophthalmol-2017-311782.

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PurposeTo evaluate the impact of drusen size and structure on retinal pigment epithelium (RPE) and photoreceptor layers in eyes with early to intermediate age-related macular degeneration (AMD) using polarisation-sensitive optical coherence tomography (OCT).DesignRetrospective investigation of an observational cross-sectional study.ParticipantsPatients with early to intermediate AMD.MethodsTwenty-five eyes of 25 patients with drusen were imaged with polarisation-sensitive OCT using macular volume scans. Each scan was manually graded for six distinct drusen characteristics and the integrity of both the overlying RPE and photoreceptor layer. The central scan of each single druse, as well as its diameter and location, were selected for statistical calculations.ResultsA total number of 5933 individual drusen including their adjacent RPE and photoreceptor layer were evaluated. 41.3% of all drusen demonstrated an intact overlying RPE; in 28.1% the RPE layer was irregular, but continuous. In 30.6%, the RPE layer signal was discontinuous above the area of drusen. The level of RPE alteration was significantly related to shape (p<0.001), internal reflectivity (p<0.001) and homogeneity (p<0.001) of the drusen and their diameter, with a higher probability for larger drusen to have a discontinuous RPE (OR 3.2, p<0.001). The number of drusen showing overlying foci or an altered photoreceptor layer was too small to be conclusive, but showed a trend towards an altered RPE if present.ConclusionsPolarisation-sensitive OCT reveals a correlation between specific drusen characteristics and the integrity of the overlying RPE layer. Drusen diameter and configuration were significantly associated with RPE loss.

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Čmelo, Jozef, Jela Valášková, and Vladimír Krásnik. "Optic Disc Drusen and Heamodynamics." Czech and Slovak Ophthalmology 75, no. 5 (October 26, 2019): 252–56. http://dx.doi.org/10.31348/2019/5/2.

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Purpose: The problem of optic disc drusen (ODD) has been described in detail in several publications. However, less attention has been devoted to real haemodynamic parameters (HP) in ODD. It has been clinically demonstrated that the occurrence and progression of changes in the visual field in ODD are closely linked with the haemodynamics of the vascular supply of the eye – the optic nerve. ODD may visually overlap excavation of the disc of the optic nerve, on the basis of which it is more difficult to evaluate changes (scotomas) in the visual field in the case of glaucoma. Methods: Haemodynamic parameters were prospectively evaluated in 54 patients with compensated intraocular pressure and with optic disc drusens. Drusens in the head of the optic nerve were demonstrated by a fundus examination and B-scan ultrasonography (USG). The drusens were divided into 3 groups according to the size of the individual drusens or drusen complex. Group I: area size up to 1.9 mm. Group II: area size: 1.9-3.9 mm. Group III: area size > 4.0 mm. Flow (haemodynamic) parameters – maximum systolic velocity (MSV), minimum diastolic velocity (MDV), and resistivity index (RI) and pulsatility index (PI) were recorded in the central retinal artery (CRA), in the central retinal vein (CRV), in the temporal and nasal ciliares posteriores arteries breves (CPAb) and in the ophthalmic artery (OA). The values were divided into 1. Physiological: CRA: 8.7 ± 0.9 / 2.9 ± 0.6 cm/s, or RI: 0.70 ± 0.05, 2. Slightly impaired: CRA: 6.6 ± 0.8 / 2.0 ± 0.5 cm/s, or RI: 0.75 ± 0.04. 3. Significantly impaired: CRA: 5.2 ± 1.2 / 1.9 ± 0.7 cm/s, or RI: 0.79 ± 0.03. Results: No linear relationship was demonstrated between the size of the drusens and flow parameters. Slight impairment of HP in the CRA was present in 28.6% of drusens in group I, 48.3% in group II and 62.4% in group III. Significant impairment of HP in the CRA was present in 28.6% of drusens in group I, 48.3% in group II and 62.4% in group III. HP in the CPAb and OA were not of significant importance with regard to the presence and size of the drusens. The relationship between the individual variables was evaluated with the aid of a Pearson correlation coefficient: 0.213, group I P: 0.354, group II P: 0.073, group III P: 0.287. Conclusions: HP are more often impaired in “large” optic disc drusens (group III), rarely in group I ODDs – though this is not an absolute rule. It is not possible to predict haemodynamic parameters according to the size of the drusen formation in the optic nerve. It appears that impairment of the haemodynamic parameters is conditioned not only by the size of the ODD, but also by the locality (distance from lamina cribriformis) and also the intrapapillary relationship to the vascular system.

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Muth, Daniel Rudolf, Mario Damiano Toro, Anahita Bajka, Kamil Jonak, Roman Rieder, Myrtha Magdalena Kohler, Jeanne Martine Gunzinger, et al. "Correlation between Macular Neovascularization (MNV) Type and Druse Type in Neovascular Age-Related Macular Degeneration (AMD) Based on the CONAN Classification." Biomedicines 10, no. 10 (September 22, 2022): 2370. http://dx.doi.org/10.3390/biomedicines10102370.

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Background: To investigate associations and predictive factors between macular neovascularization (MNV) lesion variants and drusen types in patients with treatment-naïve neovascular age-related macular degeneration (AMD). Methods: Multimodal imaging was retrospectively reviewed for druse type (soft drusen, subretinal drusenoid deposits (SDDs) or mixed) and MNV type (MNV 1, MNV 2, MNV 1/2 or MNV 3). The Consensus on Neovascular AMD Nomenclature (CONAN) classification was used for characterizing MNV at baseline. Results: One eye of each eligible patient was included (n = 191). Patients with predominant SDDs had an increased adjusted odds ratio (aOR) for MNV 2 (23.4453, p = 0.0025) and any type of MNV 3 (8.7374, p < 0.0001). Patients with MNV 1/2 had an aOR for predominant SDDs (0.3284, p = 0.0084). Patients with MNV1 showed an aOR for SDDs (0.0357, p < 0.0001). Eyes with SDDs only without other drusen types showed an aOR for MNV 2 (9.2945, p < 0.0001). Conclusions: SDDs represent a common phenotypic characteristic in AMD eyes with treatment-naïve MNV. The aOR for eyes with predominant SDDs to develop MNV 2 and MNV 3 was much higher, possibly due to their location in the subretinal space. The predominant druse type may help to predict which type of MNV will develop during the course of AMD.

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Sitaula, S., M. Thapa, and AK Sharma. "Optic disc drusen presenting as papilledema: a case report." Journal of Chitwan Medical College 4, no. 1 (July 30, 2014): 42–44. http://dx.doi.org/10.3126/jcmc.v4i1.10848.

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Optic disc drusens, which are congenital anomalies of optic nerve head, are depositions of mucopolysaccharides and proteinaceous material within the optic nerve head. They are usually bilateral and diagnosed incidentally during routine fundus examination where they may be mistaken for papilledema. We report a case of 63 year old female referred to the neuro-ophthalmology department with the clinical suspicion of disc edema. Simple noninvasive investigations like ultrasound B-scan, fundus autofluorescene along with the newer test like spectral domain optical coherence tomography helped us to diagnose it as a case of pseudopapilledema, as optic disc drusen. Thus, a high index of suspicion along with the ancillary tests is helpful in differentiating optic disc drusen from true papilledema. DOI: http://dx.doi.org/10.3126/jcmc.v4i1.10848 Journal of Chitwan Medical College 2014; 4(1): 42-44

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Gartner, S. "Drusen." Archives of Ophthalmology 103, no. 9 (September 1, 1985): 1283. http://dx.doi.org/10.1001/archopht.1985.01050090035020.

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Belmouhand, Mohamed, Simon P. Rothenbuehler, Sami Dabbah, Jakob Bjerager, Birgit Sander, Jacob B. Hjelmborg, Christine Dalgård, Rasmus Jensen, and Michael Larsen. "Small hard drusen and associated factors in early seniority." PLOS ONE 17, no. 12 (December 22, 2022): e0279279. http://dx.doi.org/10.1371/journal.pone.0279279.

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Purpose The purpose of this study was to examine the ocular and systemic risk profile of the fundus phenotype ≥ 20 small hard (macular) drusen (< 63 μm in diameter). Methods This single-center, cross-sectional study of 176 same-sex twin pairs aged 30 to 80 (median 60) years was a component of a framework study of the transition from not having age-related macular degeneration to having early AMD. Drusen categories assessed using fundus photography and optical coherence tomography included small hard drusen (diameter < 63 μm), intermediate soft drusen (63–125 μm), and large soft drusen (> 125 μm), of which the soft drusen are compatible with a diagnosis of AMD. Results Having ≥ 20 small hard drusen within or outside the macula was associated with increasing age, lower body mass index, shorter axial length, hyperopia, female sex, increasing high-density lipoprotein (HDL), high alcohol consumption, and with the presence of soft drusen. Conclusions Having ≥ 20 small hard drusen was associated with some AMD-related risk factors, but not with smoking, increasing body mass index, and higher blood pressure. Having ≥ 20 small hard drusen was also associated with soft drusen, in agreement with previous studies. These findings suggest that small hard drusen are not an early manifestation of AMD but the product of a distinct process of tissue alteration that promotes the development of AMD or some subtype thereof.

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Ban, Norimitsu, Ari Shinojima, Kazuno Negishi, and Toshihide Kurihara. "Drusen in AMD from the Perspective of Cholesterol Metabolism and Hypoxic Response." Journal of Clinical Medicine 13, no. 9 (April 29, 2024): 2608. http://dx.doi.org/10.3390/jcm13092608.

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Drusen are one of the most characteristic pathologies of precursor lesion of age-related macular degeneration (AMD). Drusen comprise a yellowish white substance that accumulates typically under the retinal pigment epithelium (RPE), and their constituents are lipids, complement, amyloid, crystallin, and others. In the past, many researchers have focused on drusen and tried to elucidate the pathophysiology of AMD because they believed that disease progression from early AMD to advanced AMD might be based on drusen or drusen might cause AMD. In fact, it is well established that drusen are the hallmark of precursor lesion of AMD and a major risk factor for AMD progression mainly based on their size and number. However, the existence of advanced AMD without drusen has long been recognized. For example, polypoidal choroidal vasculopathy (PCV), which comprises the majority of AMD cases in Asians, often lacks drusen. Thus, there is the possibility that drusen might be no more than a biomarker of AMD and not a cause of AMD. Now is the time to reconsider the relationship between AMD and drusen. In this review, we focus on early AMD pathogenesis based on basic research from the perspective of cholesterol metabolism and hypoxic response in the retina, and we discuss the role of drusen.

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D’souza, Yvonne, Carolyn J. P. Jones, and Richard Bonshek. "Glycoproteins of drusen and drusen-like lesions." Journal of Molecular Histology 39, no. 1 (September 11, 2007): 77–86. http://dx.doi.org/10.1007/s10735-007-9130-5.

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BONSHEK, RE, Y. D'SOUZA, and C. JONES. "Glycoproteins of drusen and drusen-like lesions." Acta Ophthalmologica Scandinavica 85 (October 2, 2007): 0. http://dx.doi.org/10.1111/j.1600-0420.2007.01062_3305.x.

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Pham, Quang T. M., Sangil Ahn, Su Jeong Song, and Jitae Shin. "Automatic Drusen Segmentation for Age-Related Macular Degeneration in Fundus Images Using Deep Learning." Electronics 9, no. 10 (October 1, 2020): 1617. http://dx.doi.org/10.3390/electronics9101617.

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Drusen are the main aspect of detecting age-related macular degeneration (AMD). Ophthalmologists can evaluate the condition of AMD based on drusen in fundus images. However, in the early stage of AMD, the drusen areas are usually small and vague. This leads to challenges in the drusen segmentation task. Moreover, due to the high-resolution fundus images, it is hard to accurately predict the drusen areas with deep learning models. In this paper, we propose a multi-scale deep learning model for drusen segmentation. By exploiting both local and global information, we can improve the performance, especially in the early stages of AMD cases.

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Saßmannshausen, Marlene, Leyla Sautbaeva, Leon Alexander von der Emde, Marc Vaisband, Kenneth R. Sloan, Jan Hasenauer, Frank G. Holz, and Thomas Ach. "Retro Mode Imaging for Detection and Quantification of Sub-RPE Drusen and Subretinal Drusenoid Deposits in Age-Related Macular Degeneration." Journal of Clinical Medicine 13, no. 14 (July 15, 2024): 4131. http://dx.doi.org/10.3390/jcm13144131.

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Background: Drusen and drusenoid deposits are a hallmark of age-related macular degeneration (AMD). Nowadays, a multimodal retinal imaging approach enables the detection of these deposits. However, quantitative data on subretinal drusenoid deposits (SDDs) are still missing. Here, we compare the capability of en-face drusen and SDD area detection in eyes with non-exudative AMD using conventional imaging modalities versus Retro mode imaging. We also quantitatively assess the topographic distribution of drusen and SDDs. Methods: In total, 120 eyes of 90 subjects (mean age ± standard deviation = 74.6 ± 8.6 years) were included. Coherent en-face drusen and SDD areas were measured via near-infrared reflectance, green (G-) and blue (B-) fundus autofluorescence (AF), and Retro mode imaging. Drusen phenotypes were classified by correlating en-face drusen areas using structural high-resolution spectral domain optical coherence tomography. The topographic distribution of drusen was analyzed according to a modified ETDRS (Early Treatment of Diabetic Retinopathy Study) grid. Intraclass correlation coefficient (ICC) analysis was applied to determine the inter-reader agreement in the SDD en-face area assessment. Results: The largest coherent en-face drusen area was found using Retro mode imaging with a mean area of 105.2 ± 45.9 mm2 (deviated left mode (DL)) and 105.4 ± 45.5 mm2 (deviated right mode (DR)). The smallest en-face drusen areas were determined by GAF (50.9 ± 42.6 mm2) and BAF imaging (49.1 ± 42.9 mm2) (p < 0.001). The inter-reader agreement for SDD en-face areas ranged from 0.93 (DR) to 0.70 (BAF). The topographic analysis revealed the highest number of SDDs in the superior peripheral retina, whereas sub-retinal pigment epithelium drusen were mostly found in the perifoveal retina. Retro mode imaging further enabled the detection of the earliest SDD stages. Conclusions: Retro mode imaging allows for a detailed detection of drusen phenotypes. While hundreds/thousands of SDDs can be present in one eye, the impact of SDD number or volume on AMD progression still needs to be evaluated. However, this new imaging modality can add important knowledge on drusen development and the pathophysiology of AMD.

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Kamao, Hiroyuki, Katsutoshi Goto, Kento Matsuno, Kenichi Mizukawa, Atsushi Miki, and Junichi Kiryu. "Clinical Characteristics of Neovascular Age-Related Macular Degeneration without Typical Drusen." Journal of Ophthalmology 2021 (April 27, 2021): 1–8. http://dx.doi.org/10.1155/2021/6683532.

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Purpose. To evaluate the clinical characteristics of neovascular age-related macular degeneration (nAMD) patients without typical drusen. Methods. We retrospectively studied 165 eyes in 165 patients with treatment-naïve nAMD, including typical AMD and polypoidal choroidal vasculopathy (PCV). According to the fellow eye condition, the patients were divided into nAMD with and without typical drusen groups. Eyes with soft drusen or subretinal drusenoid deposits were classified into the nAMD with the typical drusen group. Smoking status and diagnoses of hypertension and diabetes were identified from hospital records and patient recall. We assessed best-corrected visual acuity (BCVA), central retinal thickness (CRT) at the fovea, subfoveal choroidal thickness (SFCT), and the number of injections received. Results. The nAMD without typical drusen group was significantly younger (77.9 ± 7.6 vs. 71.8 ± 8.3, P < 0.001 ) and had thicker SFCT at baseline (207.9 ± 99.5 vs. 260.1 ± 113.2 μm, P = 0.007 ) and a higher proportion of PCV (30.6 vs. 63.1%, P < 0.001 ). The proportion of ever-smokers was significantly higher in the nAMD without typical drusen group (54.8 vs. 70.9%, P = 0.036 ). There were no statistically significant differences in the proportion of patients with hypertension or diabetes; BCVA, CRT, or SFCT changes; or the number of injections between the nAMD with and without typical drusen groups. Conclusion. The clinical features of patients in the nAMD without typical drusen group were almost identical to those of pachychoroid-driven choroidal neovascularization (CNV) patients. The nAMD without typical drusen group had a significantly higher proportion of ever-smokers than the nAMD with typical drusen group. Smoking could be a risk factor for the development of pachychoroid-driven CNV.

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Chen, Qing-Shan, Xia Zhao, Miao-Hong Chen, Yu-Hang Yang, and Zhi Li. "Morphological changes of macular soft drusen and drusenoid DPED after subthreshold micropulse laser treatment." International Eye Research 2, no. 2 (June 28, 2021): 95–100. http://dx.doi.org/10.18240/ier.2021.02.07.

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AIM: To analyze the morphological changes of macular soft drusen and drusenoid pigmental epithelium detachment (DPED) after subthreshold micropulse laser treatment (SMLT). METHODS: Fourteen patients (20 affected eyes) with soft drusen and DPED clinically confirmed from August 2016 to October 2018, were included in this study. 577 nm yellow laser of SMLT was applied for soft drusen and DPED. The changes of soft drusen and DPED in best corrected visual acuity (BCVA)(LogMAR)and height, diameter and cross-sessional area according to fundus autofluorescence and SD-OCT examinations were observed after SMLT RESULTS: BCVA was not significant difference after treatment of soft drusen (P=0.260), and the DPED (P=0.736) than that of the baseline. Compared with the baseline values, the height and cross-sessional area of soft drusen were reduced at the 6mo after treatment, and the differences were statistically significant (P=0.008, P=0.034). Compared with the baseline values, the differences were not statistically significant in height, diameter and cross-sectional area of DPED after treatment. CONCLUSION: BCVA was not reduced for drusen and DPED after SMLT, however, the height and cross-sessional area of soft drusen was reduced compared with those before treatment, and the differences were not statistically significant in height, diameter and cross-sectional area of DPED before and after treatment. The results indicated that SMLT was effective for soft drusen, but was not effective for short-term treatment of DPED. SMLT caused no damage to the visual acuity in treatment of soft drusen and DPED, but prospective, controlled, large sample and long-term follow-up studies should be required.

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Suzuki, Mihoko, Christine A. Curcio, Robert F. Mullins, and Richard F. Spaide. "REFRACTILE DRUSEN." Retina 35, no. 5 (May 2015): 859–65. http://dx.doi.org/10.1097/iae.0000000000000503.

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Querques, Giuseppe, and Eric H. Souied. "Vascularized Drusen." Retina 35, no. 12 (December 2015): 2433–39. http://dx.doi.org/10.1097/iae.0000000000000761.

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Balaratnasingam, Chandrakumar, Svetlana Cherepanoff, Rosa Dolz-Marco, Murray Killingsworth, Fred K. Chen, Randev Mendis, Sarah Mrejen, et al. "Cuticular Drusen." Ophthalmology 125, no. 1 (January 2018): 100–118. http://dx.doi.org/10.1016/j.ophtha.2017.08.033.

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Slotnick, Samantha, and Jerome Sherman. "Disc Drusen." Ophthalmology 119, no. 3 (March 2012): 652–652. http://dx.doi.org/10.1016/j.ophtha.2011.11.026.

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Tso, M. O. M., and G. A. Fishman. "Drusen-Reply." Archives of Ophthalmology 103, no. 9 (September 1, 1985): 1283. http://dx.doi.org/10.1001/archopht.1985.01050090035021.

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Sreenivasan, Janani, Praveena Venkatakrishnan, and Charanya Chenthilnathan. "Drusen drizzle." Indian Journal of Ophthalmology 71, no. 8 (2023): 2937. http://dx.doi.org/10.4103/ijo.ijo_3019_22.

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Bennett, Loren Wallace. "Case of Legal Blindness Secondary to Optic Nerve Head Drusen." Canadian Journal of Optometry 84, no. 2 (May 31, 2022): 23–30. http://dx.doi.org/10.15353/cjo.v84i2.1727.

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Optic nerve head drusen are relatively infrequent abnormalities of the optic disc that are usually discovered as incidental findings during a routine eye examination. While typically considered to be benign, visual field loss due to the drusen is not uncommon. Visual field defects are more prevalent in superficial drusen than buried drusen, and can present as nerve fiber bundle defects, generalized concentric constriction, or enlargement of the blind spot. The extent of damage is variable, but it is rare that the degree of field loss leads to substantial functional impairment. This case presents a patient with significant bilateral concentric field loss secondary to optic nerve drusen that caused severe visual impairment and disability.

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Ukalovic, Kresimir, Sijia Cao, Sieun Lee, Qiaoyue Tang, Mirza Faisal Beg, Marinko V. Sarunic, Ging-Yuek R. Hsiung, et al. "Drusen in the Peripheral Retina of the Alzheimer’s Eye." Current Alzheimer Research 15, no. 8 (June 11, 2018): 743–50. http://dx.doi.org/10.2174/1567205015666180123122637.

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Background: Recent work on Alzheimer's disease (AD) diagnosis focuses on neuroimaging modalities; however, these methods are expensive, invasive, and not available to all patients. Ocular imaging of biomarkers, such as drusen in the peripheral retina, could provide an alternative method to diagnose AD. Objective: This study compares macular and peripheral drusen load in control and AD eyes. Methods: Postmortem eye tissues were obtained from donors with a neuropathological diagnosis of AD. Retina from normal donors were processed and categorized into younger (<55 years) and older (>55 years) groups. After fixation and dissection, 3-6 mm punches of RPE/choroid were taken in macular and peripheral (temporal, superior, and inferior) retinal regions. Oil red O positive drusen were counted and grouped into two size categories: small (<63 μm) and intermediate (63-125 μm). Results: There was a significant increase in the total number of macular and peripheral hard drusen in older, compared to younger, normal eyes (p<0.05). Intermediate hard drusen were more commonly found in the temporal region of AD eyes compared to older normal eyes, even after controlling for age (p<0.05). Among the brain and eye tissues from AD donors, there was a significant relationship between cerebral amyloid angiopathy (CAA) severity and number of temporal intermediate hard drusen (r=0.78, p<0.05). Conclusion: Imaging temporal drusen in the eye may have benefit for diagnosing and monitoring progression of AD. Our results on CAA severity and temporal intermediate drusen in the AD eye are novel. Future studies are needed to further understand the interactions among CAA and drusen formation.

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Hristova, Elitsa G., and Zornitsa I. Zlatarova. "Dry Age-Related Macular Degeneration – A New Approach In Optical Coherence Tomography Monitoring And Quantitative Assessment." Journal of Biomedical and Clinical Research 7, no. 2 (December 1, 2014): 148–54. http://dx.doi.org/10.1515/jbcr-2015-0141.

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Summary The purpose of the study was to present the ability of Drusen analysis software tool to measure drusen area and volume in patients with dry age-related macular degeneration (AMD). Eleven patients with confirmed dry AMD aged 59-74 years were scanned with 3D OCT-2000 Topcon 3D Macula scanning protocol by a single operator. All subjects underwent a complete ophthalmologic examination including best corrected visual acuity, indirect biomicroscopy, tonometry, fluorescein angiography and OCT. Drusen analysis was performed on the macula with 6.0 × 6.0 mm volume cube scans and 512×128 pixels scan resolution. The results were presented along with calculated values in two clearly arranged reports. Mean follow-up period was 19 months (6-40). Count, area occupation, volume of the drusen and 3D retinal pigment epithelium (RPE) elevation map were presented in a Macula drusen analysis report. Drusen count and volume in 6 patients were increased at the end of follow-up period. There were 5 patients with regression in drusen count and area and volume of the drusen in 3 of them were higher than on previous examination. Another 2 were with regression not only in drusen count but also in their area and volume. With this software tool the status of RPE can be objectively and automatically examined in detail and can be followed up over time. OCT allows for precise quantitative evaluation and study of microstructural changes in patients with dry AMD and provides three-dimensional information of macular pathology in situ and in real time. This could be useful for determining stages and monitoring the progression of AMD.

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Pedersen, Hilde R., Stuart J. Gilson, Alfredo Dubra, Inger Christine Munch, Michael Larsen, and Rigmor C. Baraas. "Multimodal imaging of small hard retinal drusen in young healthy adults." British Journal of Ophthalmology 102, no. 1 (October 19, 2017): 146–52. http://dx.doi.org/10.1136/bjophthalmol-2017-310719.

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BackgroundSmall hard macular drusen can be observed in the retina of adults as young as 18 years of age. Here, we seek to describe the in vivo topography and geometry of these drusen.MethodsRetinal images were acquired in young, healthy adults using colour fundus photography, spectral domain optic coherence tomography (SD-OCT), reflectance flood-illuminated adaptive optic ophthalmoscopy (AO flood) and reflectance adaptive optic scanning light ophthalmoscopy (AOSLO) in both confocal and non-confocal split-detection modalities. Small bright yellow hard drusen within a 10 degree radius from the foveal centre were characterised.ResultsSmall hard drusen were seen on colour photographs in 21 out of 97 participants and 26 drusen in 12 eyes in 11 participants were imaged using the full protocol. Drusen were easily identifiable in all modalities, except a few very small ones, which were not visible on SD-OCT. On AOSLO images, these drusen appeared as round, oval or lobular areas (up to three lobules) of diameter 22–61 µm where cone photoreceptor reflectivity and density was decreased (p=0.049). This was usually associated with discrete thickening of the retinal pigment epithelium (RPE) complex.ConclusionHigh lateral resolution imaging of small lobular hard retinal drusen suggests formation through the confluence of two or more smaller round lesions. The outline and size of these smaller lesions corresponds to 1–4 RPE cells. Prospective longitudinal studies are needed to determine the ultimate fate of small hard drusen and their potential relation to age-related macular degeneration.

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Kamao, Hiroyuki, Erika Mitsui, Yuto Date, Katsutoshi Goto, Kenichi Mizukawa, and Atsushi Miki. "Clinical Characteristics of Unilateral Macular Neovascularization Patients with Pachydrusen in the Fellow Eye." Journal of Clinical Medicine 13, no. 13 (June 27, 2024): 3757. http://dx.doi.org/10.3390/jcm13133757.

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Background/Objectives: To approach the clinical properties of pachydrusen that differ from conventional drusen, we investigated the incidence of macular neovascularization (MNV) in fellow eyes and the treatment outcomes of intravitreal aflibercept (IVA) in MNV eyes of unilateral MNV patients with pachydrusen in the fellow eye. Methods: We retrospectively studied 261 consecutive patients with treatment-naïve unilateral MNV. Patients were classified into four groups according to the type of drusen in the fellow eye: the pachydrusen group (n = 49), the soft drusen group (n = 63), the subretinal drusenoid deposit (SDD) group (n = 24), and the no drusen group (n = 125). The development of the MNV in the fellow eye was evaluated for five years, and the retreatment proportion after three monthly aflibercept injections was evaluated for one year. Results: The choroidal thickness in the fellow eyes and MNV eyes was the greatest in the pachydrusen group (all p < 0.001). The 5-year incidence of MNV in the pachydrusen group was similar to that in the soft drusen group and no drusen group. The pachydrusen group had a lower retreatment rate than the other groups did (pachydrusen group: 46.4%; soft drusen group: 78.1%; SDDs: 87.5%; no drusen group: 83.3%). Conclusions: Unilateral MNV patients with pachydrusen in the fellow eye had a lower retreatment rate (46.4%/1 year); therefore, aflibercept monotherapy using the PRN regimen is one of the preferred treatment methods for MNV patients with pachydrusen in the fellow eye.

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Danišová, Jana, and Evžen Fric. "Diagnostics of Optic Disc Drusen in Children with Swept Source OCT Imaging." Czech and Slovak Ophthalmology 77, no. 2 (May 1, 2021): 80–86. http://dx.doi.org/10.31348/2021/11.

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Aim: The aim of this retrospective study is to compare two methods of optic disc drusen imaging in pediatric patients – new swept source OCT technology with the B-scan ultrasonography, which has been assumed to be a gold standard in diagnosing optic disc drusen, and to compare pRNFL thickness in children with optic disc drusen and control group. Methods: 14 eyes of 8 pediatric patients in whom optic disc drusen were confirmed by either B-scan ultrasonography, or swept-source OCT, were included in the study. We compared the sensitivity of these two imaging methods. Then we compared an average pRNFL thickness and pRNFL thickness in all four quadrants of our study group with the control group. Two statistical methods were used in data analysis – Mann-Whitney a Kruskal-Wallis test. Results: The difference between SS-OCT and B-scan ultrasonography was not statistically significant in diagnosing optic disc drusen. Average pRNFL thickness was 135.29 ± SD 31.2 μm in eyes with optic disc drusen, which is 24.15 % higher than in control group (p = 0.00214; p = 0.00207). pRNFL thickness of temporal (p = 0.0001; p = 0.0001), superior (p = 0.03486; p = 0.03361) and inferior (p = 0.00652; p = 0.00627) quadrant was statistically significantly higher in comparison with healthy controls, whereas the difference of pRNFL thickness in nasal quadrant was not statistically significant between the study and control group (p = 0.09692; p = 0.0947). Conclusion: Swept source OCT is a promising new "gold standard" in optic disc drusen diagnostics in pediatric patients. An increase in pRNFL thickness values does not always confirm papilloedema as optic disc drusen may be the cause. Direct visualisation of optic disc drusen by swept source OCT can aid in differentiation from true papilloedema.

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Beck, Marco, Devika S. Joshi, Lieselotte Berger, Gerd Klose, Sandro De Zanet, Agata Mosinska, Stefanos Apostolopoulos, et al. "Comparison of Drusen Volume Assessed by Two Different OCT Devices." Journal of Clinical Medicine 9, no. 8 (August 17, 2020): 2657. http://dx.doi.org/10.3390/jcm9082657.

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To compare drusen volume between Heidelberg Spectral Domain (SD-) and Zeiss Swept-Source (SS) PlexElite Optical Coherence Tomography (OCT) determined by manual and automated segmentation methods. Thirty-two eyes of 24 patients with Age-Related Macular Degeneration (AMD) and drusen maculopathy were included. In the central 1 and 3 mm ETDRS circle drusen volumes were calculated and compared. Drusen segmentation was performed using automated manufacturer algorithms of the two OCT devices. Then, the automated segmentation was manually corrected and compared and finally analyzed using customized software. Though on SD-OCT, there was a significant difference of mean drusen volume prior to and after manual correction (mean difference: 0.0188 ± 0.0269 mm3, p < 0.001, corr. p < 0.001, correlation of r = 0.90), there was no difference found on SS-OCT (mean difference: 0.0001 ± 0.0003 mm3, p = 0.262, corr. p = 0.524, r = 1.0). Heidelberg-acquired mean drusen volume after manual correction was significantly different from Zeiss-acquired drusen volume after manual correction (mean difference: 0.1231 ± 0.0371 mm3, p < 0.001, corr. p < 0.001, r = 0.68). Using customized software, the difference of measurements between both devices decreased and correlation among the measurements improved (mean difference: 0.0547 ± 0.0744 mm3, p = 0.02, corr. p = 0.08, r = 0.937). Heidelberg SD-OCT, the Zeiss PlexElite SS-OCT, and customized software all measured significantly different drusen volumes. Therefore, devices/algorithms may not be interchangeable. Third-party customized software helps to minimize differences, which may allow a pooling of data of different devices, e.g., in multicenter trials.

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White, Robert J., Daniel J. Watson, Dara D. Koozekanani, and Sandra R. Montezuma. "Association of Optic Nerve Head Drusen with Best Vitelliform Macular Dystrophy: A Case Series." Case Reports in Ophthalmology 9, no. 1 (January 26, 2018): 82–92. http://dx.doi.org/10.1159/000485963.

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Purpose: To report the association of optic nerve head (ONH) drusen with Best vitelliform macular dystrophy (BVMD). Methods: Chart review. Patients: Five patients from 3 families. Results: Multimodal imaging and ophthalmic examination demonstrated findings consistent with ONH drusen, in association with BVMD, in 5 patients. Conclusion: We report the association of BVMD with ONH drusen in 5 patients. This combination has previously been reported only once. We recommend that patients with a diagnosis of BVMD undergo autofluorescence and ultrasound imaging of the optic nerve to help facilitate this diagnosis, as some ONH drusen can be buried.

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Кабанова, Evgeniya Kabanova, Иойлева, Elena Ioyleva, Котова, and Elena Kotova. "POSSIBILITIES OF MODERN IMAGING TECHNIQUES IN DIAGNOSTICS OF OPTIC NERVE DRUSEN (LITERATURE REVIEW)." Бюллетень Восточно-Сибирского научного центра Сибирского отделения Российской академии медицинских наук 1, no. 6 (December 20, 2016): 206–9. http://dx.doi.org/10.12737/23842.

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With the introduction and development of new diagnostic techniques, the relevance of drusen of the optic nerve di-agnostics is increasing. Existing imaging techniques alone or in their various combinations cannot allow to confirm optic nerve drusen in all clinical cases. The diagnosis of optic nerve drusen causes some difficulties because of absence of clear diagnostic standards and classification. Since the advent of new ophthalmological methods of structural and topographic visual analysis evaluation, such as spectral-domain optical coherence tomography, Heidelberg retina tomography, videooculography, B-scan ultrasonography of the orbits and optic nerve, fluorescent angiography of the retina, computed tomography and magnetic resonance imaging of the brain and orbits, the diagnostics of optic nerve drusen becomes more informative. In this article we review the main current imaging techniques in the diagnostics of the optic nerve drusen.

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Rodríguez, Anabel, Marc Biarnés, Rosa M. Coco-Martin, Anna Sala-Puigdollers, and Jordi Monés. "Early Detection of Incipient Retinal Pigment Epithelium Atrophy Overlying Drusen with Fundus Autofluorescence vs. Spectral Domain Optical Coherence Tomography." Journal of Ophthalmology 2020 (September 16, 2020): 1–8. http://dx.doi.org/10.1155/2020/9457457.

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Purpose. This study aims to find out which tool, fundus autofluorescence (FAF) or spectral domain optical coherence tomography (SD-OCT), is more sensitive in detecting retinal pigment epithelium (RPE) demise overlying drusen and can, therefore, help predict geographic atrophy (GA) appearance in Age-Related Macular Degeneration (AMD). Methods. A single-site, retrospective, observational, longitudinal study was conducted. Patients with intermediate AMD (iAMD) (large (>125 μm) or intermediate (63–125 μm) drusen with hyper/hypopigmentation) with a minimum follow-up of 18 months were included. Drusen with overlying incipient RPE atrophy were identified on SD-OCT defined as choroidal hypertransmission or nascent geographic atrophy (nGA). These selected drusen were, then, traced backwards in time to determine if incipient RPE atrophy overlying drusen was observed on FAF (well-demarcated region of absence of autofluorescence) before, simultaneously, or after having detected the first signs of incipient RPE atrophy on SD-OCT. The number of drusen in which signs of incipient RPE atrophy was detected earlier using FAF or SD-OCT was compared. The time elapsed from the identification with the more sensitive method to the other was recorded and analyzed. Results. One hundred and thirty-three drusen in 22 eyes of 22 patients were included. Of these, 112 (84.2%) drusen showed choroidal hypertransmission and 21(15.8%) nGA. Early signs of atrophy overlying drusen were found simultaneously on SD-OCT and FAF in 52 cases (39.1%, 95% CI 30.8–47.9%), earliest on FAF in 51 (38.3%, 95% CI 30.0–47.2%) and first on SD-OCT in 30 (22.6%, 95% CI 15.8–30.6%; p<0.05). Statistically significant differences were found between both techniques (p=0.005), with FAF detecting it earlier than SD-OCT. When RPE atrophy was found first on FAF, the median time to diagnosis with SD-OCT was 6.6 months (95% CI 5.5 to 8.6), while if detection occurred earlier on SD-OCT, the median time until identification with FAF was 12.6 months (95% CI 6.0 to 23.4; p=0.0003). Conclusions. In iAMD cases in which early atrophy overlying drusen is not detected simultaneously in FAF and SD-OCT, FAF was significantly more sensitive. Nevertheless, a multimodal approach is recommended and required to evaluate these patients.

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López-Cuenca, Inés, Elena Salobrar-García, Inés Gil-Salgado, Lidia Sánchez-Puebla, Lorena Elvira-Hurtado, José A. Fernández-Albarral, Federico Ramírez-Toraño, et al. "Characterization of Retinal Drusen in Subjects at High Genetic Risk of Developing Sporadic Alzheimer’s Disease: An Exploratory Analysis." Journal of Personalized Medicine 12, no. 5 (May 23, 2022): 847. http://dx.doi.org/10.3390/jpm12050847.

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Having a family history (FH+) of Alzheimer’s disease (AD) and being a carrier of at least one ɛ4 allele of the ApoE gene are two of the main risk factors for the development of AD. AD and age-related macular degeneration (AMD) share one of the main risk factors, such as age, and characteristics including the presence of deposits (Aβ plaques in AD and drusen in AMD); however, the role of apolipoprotein E isoforms in both pathologies is controversial. We analyzed and characterized retinal drusen by optical coherence tomography (OCT) in subjects, classifying them by their AD FH (FH- or FH+) and their allelic characterization of ApoE ɛ4 (ApoE ɛ4- or ApoE ɛ4+) and considering cardiovascular risk factors (hypercholesterolemia, hypertension, and diabetes mellitus). In addition, we analyzed the choroidal thickness by OCT and the area of the foveal avascular zone with OCTA. We did not find a relationship between a family history of AD or any of the ApoE isoforms and the presence or absence of drusen. Subjects with drusen show choroidal thinning compared to patients without drusen, and thinning could trigger changes in choroidal perfusion that may give rise to the deposits that generate drusen.

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Parameswarappa, Deepika Chennapura, and Padmaja Kumari Rani. "Utility of pattern recognition and multimodal imaging in the diagnosis and management of doyne honeycomb retinal dystrophy complicated with type one choroidal neovascular membrane." BMJ Case Reports 14, no. 2 (February 2021): e237635. http://dx.doi.org/10.1136/bcr-2020-237635.

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A 44-year-old woman presented with decreased vision in both eyes. The retina in both eyes had drusen distributed along vascular arcades, central macula and in peripapillary region. Macula had pigmented scarring and exudation. Fundus autofluorescence showed drusen. Optical coherence tomography showed drusen, subretinal and intraretinal fluid. Fundus fluorescein and indocyanine green angiography showed drusen, retinal pigment epithelial atrophy and vascular network. Younger age at presentation, bilateral symmetry, typical distribution of drusen along the arcades in a radiating pattern, peripapillary involvement, scarring and atrophy at macula were suggestive of doyne honeycomb retinal dystrophy. The reduced vision was due to macular atrophy and an active choroidal neovascular membrane. The patient was treated with antivascular endothelial growth factor injections for choroidal neovascular membrane. Our case highlights the importance of pattern recognition and multimodal imaging for diagnosing the type of macular dystrophy as doyne honeycomb retinal dystrophy, while simultaneously managing choroidal neovascular membrane.

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Sundari, N. Parvatha, E. Rajeswari, and V. Preethi. "A rare case report of Doyne’s honeycomb retinal dystrophy." Indian Journal of Ophthalmology - Case Reports 4, no. 1 (2024): 202–5. http://dx.doi.org/10.4103/ijo.ijo_1504_23.

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Doyne’s honeycomb dystrophy is a rare hereditary retinal dystrophy where drusens form in the macula and around the optic nerve head, resulting in choroidal neovascularization later. We report the case of a 63-year-old male with metamorphopsia in the right eye (RE) since 6 months. On examination, his visual acuity was 6/6 in both eyes. The anterior segment was normal. Fundus examination showed multiple drusen deposits in the macula and optic nerve head and hyperpigmentation in the macula. OCT showed hyperreflective bumpy retinal pigment epithelial in Bruch’s membrane. Fundus autofluorescence of both showed hyperfluorescence in areas of drusens. Fundus fluorescein angiography of the RE showed hyperfluorescence with central hypofluorescence. The left eye showed areas of blocked hypofluorescence within areas of hyperfluorescence.

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Nittala, Muneeswar G., Federico Corvi, Jyotsna Maram, Swetha B. Velaga, Jonathan Haines, Margaret A. Pericak-Vance, Dwight Stambolian, and SriniVas R. Sadda. "Risk Factors for Progression of Age-Related Macular Degeneration: Population-Based Amish Eye Study." Journal of Clinical Medicine 11, no. 17 (August 30, 2022): 5110. http://dx.doi.org/10.3390/jcm11175110.

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Objective: To evaluate the optical coherence tomography (OCT)-based risk factors for progression to late age-related macular degeneration (AMD) in a population-based study of elderly Amish. Methods: A total of 1332 eyes of 666 consecutive subjects who completed a 2-year follow-up visit were included in this multicenter, prospective, longitudinal, observational study. Imaging features were correlated with 2-year incidence of late AMD development. Odds ratios for imaging features were estimated from logistic regression. Baseline OCT images were reviewed for the presence of drusen volume ≥0.03 mm3 in the central 3 mm ring, intraretinal hyperreflective foci (IHRF), hyporeflective drusen cores (hDC), subretinal drusenoid deposits (SDD), and drusenoid pigment epithelium detachment (PED). Subfoveal choroidal thickness, drusen area, and drusen volume within 3 and 5 mm circles centered on the fovea were also assessed. Results: Twenty-one (1.5%) of 1332 eyes progressed to late AMD by 2 years. The mean age of the study subjects was 65 ± 10.17 (±SD) years and 410 subjects were female. Univariate logistic regression showed that drusen area and volume in both 3 mm and 5 mm circles, subfoveal choroidal thickness, drusen volume ≥ 0.03 mm3 in the 3 mm ring, SDD, IHRF, and hDC were all associated with an increased risk for development of late AMD. The multivariate regression model identified that drusen volume in the 3 mm ring (OR: 2.59, p = 0.049) and presence of IHRF (OR: 57.06, p < 0.001) remained as independent and significant risk factors for progression to late AMD. Conclusions: This population-based study confirms previous findings from clinic-based studies that high central drusen volume and IHRF are associated with an increased risk of progression to late AMD. These findings may be of value in risk-stratifying patients in clinical practice or identifying subjects for early intervention clinical trials.

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Sato, Atsuko, Nami Senda, Emi Fukui, and Kouichi Ohta. "Retinal Angiomatous Proliferation in an Eye with Cuticular Drusen." Case Reports in Ophthalmology 6, no. 1 (April 1, 2015): 127–31. http://dx.doi.org/10.1159/000381616.

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Purpose: To report the presence of retinal angiomatous proliferation (RAP) in an eye with cuticular drusen detected by fluorescein and indocyanine green angiography by confocal scanning laser ophthalmoscopy and by spectral-domain optical coherence tomography (SD-OCT). Methods: Case report of a 65-year-old Japanese woman with cuticular drusen. Results: At her first ophthalmic examination, her visual acuity was 20/20 in both eyes. An ophthalmoscopy showed many small subretinal pigment epithelial deposits in both eyes. These deposits had a ‘saw-tooth pattern' in the SD-OCT images. During the follow-up examination, retinal hemorrhages were observed, and fluorescein angiography showed a ‘stars-in-the-sky' appearance and intraretinal neovascularization. The patient was diagnosed with cuticular drusen associated with RAP. Conclusion: We suggest that the cuticular drusen were associated with RAP, so periodic follow-up examinations are needed for patients with cuticular drusen for the early detection and treatment of RAP.

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Giuffrè, G. "Optic Disc Drusen in Tilted Disc." European Journal of Ophthalmology 15, no. 5 (September 2005): 647–51. http://dx.doi.org/10.1177/112067210501500518.

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Purpose To investigate if a congenital anomaly of the head of the optic nerve like such as tilted disc can be a risk factor for the development of optic disc drusen. Methods The study was performed retrospectively on the files of 47 patients with optic disc drusen. The diagnosis was confirmed by fluorescein angiography and B-scan ultrasonography. The authors examined the fundus photographs and the fluorescein angiographies of these patients looking for the presence of tilted discs. Results Two of the 47 patients with optic nerve drusen had tilted discs as well, about twice the expected rate. Both cases presented a parapapillary hemorrhage. Conclusions The concomitant presence of tilted disc and optic disc drusen can have a cause-effect relationship. The axonal crowding in a scleral canal of reduced size, as seen in tilted disc, can compress the nerve fibers against the stiff lamina cribrosa, producing a chronic optic neuropathy leading to drusen.

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Kim, Sukjin, Jeongjae Oh, and Kiseok Kim. "Morphologic Changes in Patient with Drusen and Drusenoid Pigment Epithelial Detachment after Intravitreal Ranibizumab for Choroidal Neovascular Membrane : A Case Report." Open Ophthalmology Journal 10, no. 1 (February 4, 2016): 1–4. http://dx.doi.org/10.2174/1874364101610010001.

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The authors present a case of morphologic changes of drusen and drusenoid pigment epithelial detachment (DPED) after treating choroidal neovascularization (CNV) using ranibizumab in age-related macular degeneration (AMD). A 71-year-old woman has noticed mild visual acuity deterioration in the right eye for several months. She was presented with some drusen and DPED associated with CNV. This patient was given intravitreal injection of 0.5 mg of ranibizumab five times at monthly intervals for treating CNV. DPED in the temporal and drusen in the superior to macula were diminished, which continued up to 2 months. Intravitreal ranibizumab injection may have influenced with diminishment of drusen and DPED. After 2 months, CNV was recurred.

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L., Jeganson Durai, and Vijayakumar J. "Quantum-Assisted Retinal Drusen Detection Algorithm using Entropy-Based Image Processing Techniques." International Journal of Engineering and Advanced Technology (IJEAT) 9, no. 3 (February 29, 2020): 2251–56. https://doi.org/10.35940/ijeat.C5781.029320.

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Drusen identification is the fundamental operation in the automated diagnosis of eye diseases. Manual and automatic detection of the drusen in the retinal fundus images has been developed recently in the classical manner only. This work provides the quantum-based retinal drusen detection method using entropy-based image processing techniques. This algorithm is the composite system of two channels, classical and quantum channels for the preprocessing and drusen detection respectively. This research work has been evaluated with the databases of DRIVE, STARE, MESSIDOR, E-Optha-Ex and ONH-Hunter. This quantum-based approach will be analyzed with the results of the existing classical methods and proves its efficiency from the calculations of sensitivity, specificity, accuracy and execution time.

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Landa, G., A. Springer, A. Bukelman, and A. Pollack. "The Diagnostic Contribution of Indocyanine Green to Fluorescein Angiography in Fellow Drusen Eyes of Patients with Wet Age-Related Macular Degeneration." European Journal of Ophthalmology 17, no. 4 (July 2007): 615–19. http://dx.doi.org/10.1177/112067210701700421.

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Purpose To assess the contribution of indocyanine green angiography (ICGA) to fluorescein angiography (FA) in evaluating fellow drusen eyes of patients with wet age-related macular degeneration (AMD) in the other eye. Methods The records of paired FA and ICGA of patients with dry AMD in one eye and wet AMD in the other eye were retrospectively reviewed. Based on color fundus photographs, drusen were graded to low, moderate, or high grade of severity on FA. The FA and ICGA findings were compared. Results Fifty-two pairs of eyes were included. Fluorescein angiography showed drusen of low severity in 11 (21.2%) eyes, of moderate severity in 31 (59.6%), and of high severity in 10 (19.2%). Leakage on both FA and ICGA was not demonstrated in any case of drusen of low or moderate severity. Only in 2 out of 10 eyes from the high severity group, 3.8% of the eyes of the whole study population, did ICGA reveal occult choroidal neovascularization (CNV) that was not observed on FA. Conclusions In selected eyes with drusen of high grade severity, ICGA may detect occult CNV, unrecognized clinically or by FA. ICGA had a small contribution to the diagnosis of occult CNV in fellow drusen eyes with any degree of severity.

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Ioyleva, E. E., and S. I. Belianina. "Treatment of the subretinal neovascularization associated with optic nerve head drusen." Russian ophthalmology of children, no. 3 (November 7, 2022): 51–57. http://dx.doi.org/10.25276/2307-6658-2022-3-51-57.

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Purpose. To describe a rare clinical case of bilateral choroidal neovascularization (CNV) associated with optic nerve head (ONH) drusen and to report a positive functional and clinical outcome of intravitreal injections of vascular endothelial growth factor inhibitors (anti-VEGF) in this patient. Material and methods. A 39-year-old man with ONH drusen complained of decreased visual acuity and distortion of objects. During the examination, the bilateral CNV was detected in peripapillary area. The patient received two consecutive intravitreal injections of anti-VEGF in the right eye and one injection in the left eye. Results. After the treatment, reabsorption of subretinal fluid and an increase of visual acuity were observed. There were no complications associated with injections. The best-corrected visual acuity remains stabilized at 20/20 at three years of followup. According to the optical coherence tomography parameters, there was no negative dynamics of CNV. Conclusion. ONH drusen may cause several complications, including the development of CNV and significant decrease in visual acuity, due to the CNV progression. Follow-up of patients with ONH drusen is necessary for early diagnosis and treatment of complications. The differential sign of CNV associated with ONH drusen is a localization in the peripapillary area nasal to the fovea. A search of the literature revealed only a few publications on the use of anti-VEGF in patients with CNV associated with ONH drusen. This method was effective and demonstrated positive functional and clinical outcome in the presented clinical case. Key word: subretinal neovascularization; choroidal neovascularization; optic nerve head drusen; optical coherence tomography; antivascular endothelial growth factor therapy

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Morgan, William H. "Macular drusen quantitation." Ophthalmology 107, no. 6 (June 2000): 1019. http://dx.doi.org/10.1016/s0161-6420(99)00171-2.

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Auw-Haedrich, Claudia, Flemming Staubach, and Heinrich Witschel. "Optic Disk Drusen." Survey of Ophthalmology 47, no. 6 (November 2002): 515–32. http://dx.doi.org/10.1016/s0039-6257(02)00357-0.

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Abeysiri, Poorna, Sobha Sivaprasad, and David Trew. "Optic disc drusen." Lancet 362, no. 9382 (August 2003): 468. http://dx.doi.org/10.1016/s0140-6736(03)14074-3.

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Barondes, M., D. Pauleikhoff, I. C. Chisholm, D. Minassian, and A. C. Bird. "Bilaterality of drusen." British Journal of Ophthalmology 74, no. 3 (March 1, 1990): 180–82. http://dx.doi.org/10.1136/bjo.74.3.180.

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D’souza, Yvonne B., Carolyn J. P. Jones, Colin D. Short, and Richard E. Bonshek. "Basal laminar drusen and soft drusen have similar glycan composition." Canadian Journal of Ophthalmology 45, no. 3 (June 2010): 297–99. http://dx.doi.org/10.3129/i09-232.

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Trenkic-Bozinovic, Marija, Predrag Jovanovic, Gordana Zlatanovic, Dragan Veselinovic, Aleksandra Aracki-Trenkic, and Milan Trenkic. "Retinal hemorrhages as one of complications of optic disc drusen during pregnancy." Medical review 67, no. 5-6 (2014): 185–89. http://dx.doi.org/10.2298/mpns1406185t.

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Introduction. Drusen of the optic nerve head are relatively benign and asymptomatic. They represent retinal hyaline corpuscles resulting from impaired axoplasmic transport of the retinal ganglion cells of optic nerve in front of the lamina cribrosa. They are usually detected accidentally, during a routine ophthalmologic examination. Most patients with optic disc drusen are not aware of the deterioration of their eyesight because of the slow progression of visual field defects. Damage in visual acuity due to optic disc drusen is rare. Case Report. A 27-year-old female patient in the sixth month of pregnancy visited an ophthalmologist because of a visual impairment described as the appearance of mist and shadows over her right eye. When first examined, her visual acuity in both eyes was 20/20. The retinal hemorrhages framing the bottom half of the optic nerve were seen. Complete laboratory and clinical testing as well as specific ophthalmic examinations (photofundus, computerized visual field, optical coherence tomography, and ultrasound) were performed to exclude systemic causes and they presented no risk for the pregnancy. Echosonographic examination confirmed the presence of bilateral optic nerve head drusen. Conclusion. Hemodynamic changes during pregnancy are possible factors for the development of optical disc and retinal hemorrhages. Since treatment of optic disc drusen is limited, recognition of optic nerve drusen as a cause of hemorrhage during pregnancy prevents unnecessary diagnostic and therapeutic interventions.

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Notomi, Shoji, Satomi Shiose, Keijiro Ishikawa, Yosuke Fukuda, Kumiko Kano, Kenichiro Mori, Iori Wada, et al. "Drusen and pigment abnormality predict the development of neovascular age-related macular degeneration in Japanese patients." PLOS ONE 16, no. 7 (July 27, 2021): e0255213. http://dx.doi.org/10.1371/journal.pone.0255213.

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Drusen are known to be the important hallmark to predict the development of age-related macular degeneration (AMD). The prevalence of drusen is lower in Asians compared with Caucasians so that the role of signs constituting early AMD is not well established in Asian populations as in Western countries. In this study, we retrospectively investigated clinical characteristics and 5-year incidence of neovascular AMD (nAMD) in the fellow eye of unilateral nAMD patients. Of 296 consecutive unilateral nAMD patients who had been followed up more than 5 years, 170 typical AMD, 119 polypoidal choroidal vasculopathy, and 7 retinal angiomatous proliferation were included. To examine factors associated with nAMD occurrence in the fellow eye, drusen and pigmentary abnormality in the fellow eye were classified into 4 categories; Category 1: no or small drusen < 63 μm (37.2%), Category 2: 63–125 μm medium drusen or pigmentary abnormality (22.2%), Category 3: large drusen > 125 μm (25.0%), Category P: pachydrusen (15.5%). The mean sub-foveal choroidal thickness (SFCT) was Category 1: 276 μm, Category 2: 308 μm, Category 3: 246 μm, and Category P: 302 μm, respectively. Of note, SFCT in Category 2 and Category P was significantly larger than those of Category 3. Finally, the 5-year incidence of nAMD in the fellow eye was 32/296 (10.8%); Category 1: 0/110 (0%), Category 2: 12/66 (18.2%), Category 3: 20/74 (27.0%), and Category P: 0/46 (0%). Thus, signs of intermediate AMD (large drusen) as well as those of early AMD, especially the pigmentary abnormality, may contribute to development of bilateral nAMD in Japanese patients.

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Ayhan, Ziya, Aylin Yaman, Meltem Söylev Bajin, and A. Osman Saatci. "Unilateral Acute Anterior Ischemic Optic Neuropathy in a Patient with an Already Established Diagnosis of Bilateral Optic Disc Drusen." Case Reports in Ophthalmological Medicine 2015 (2015): 1–4. http://dx.doi.org/10.1155/2015/730606.

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Optic disc drusen (ODD) are calcific deposits that form in the optic nerve head secondary to abnormalities in axonal metabolism and degeneration. Anterior ischemic optic neuropathy, central retinal artery, and vein occlusion are among the rare vascular complications of disc drusen. We reported the clinical course of a 51-year-old patient with a unilateral acute nonarteritic anterior ischemic optic neuropathy (NAION) who received the diagnosis of bilateral optic disc drusen five years earlier and thereby reiterated the association of ODD and acute NAION.

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49

Савина, Yuliya Savina, Юрьева, Tatyana Yureva, Щуко, Andrey Shchuko, Самсонов, and Dmitriy Samsonov. "INFLUENCE OF OPTIC NERVE DRUSEN ON VISUAL FUNCTIONS IN CHILDREN AND ADOLESCENTS WITH ESSENTIAL ARTERIAL HYPERTENSION." Бюллетень Восточно-Сибирского научного центра Сибирского отделения Российской академии медицинских наук 1, no. 6 (December 20, 2016): 148–52. http://dx.doi.org/10.12737/23797.

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The article presents data examination of children and male adolescents, aged 8 to 17years without eye pathologies, with primary hypertension diagnosis – established at the clinic of Scientific Centre for Family Health and Human Re-production Problems. Examination results were: 42patients (84eyes) had primary hypertension with optic disc drusen, 8patients (16eyes) had primary hypertension without optic disc drusen.Characteristics of basic functional changes of patients ophthalmic status with and without optic disc drusen on the basis of data of visometry refractometry, keratometry, computer perimetry, ultrasonic ehobiometry. Doppler angio-graphic examination of ocular vessels, electroretinography (ERG) according to registration standards proposed by the International Society of Clinical electrophysiology of (ISCEV), visual-evoked potentials (VEP), biomicroscopy of the eye, fundus photo registration.To verify and differentiate the prominence of the optic disc drusen in cases of the prominence of stagnant disc with characteristic extension of perineural space, all patients underwent an ultrasound scan procedure of the eyeball. The study obtained data on early pre-clinical manifestations of hypertensive angiohorioretinopaty.The risk factors for the formation of drusen of the optic nerve were identified. We determined that the presence of drusen does not lead to the aggravation of the changes of the visual system, formed under the influence of high blood pressure, affecting only the indicators characterizing ischemic processes in the retina and the optic nerve, which is due to the influence of compression of drusen on glial tissue and the vascular wall.

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50

Bellis, Raymond Matthew, Yang Fei, Brandon Le, Gerardo Ledesma-Gil, Oscar Otero-Marquez, Yuehong Tong, Katy Tai, Richard B. Rosen, Gareth M. C. Lema, and Roland Theodore Smith. "Correlation between ellipsoid zone thickness and the presence of subretinal drusenoid deposits in age-related macular degeneration." BMJ Open Ophthalmology 9, no. 1 (March 2024): e001622. http://dx.doi.org/10.1136/bmjophth-2023-001622.

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PurposeSubretinal drusenoid deposits (SDDs) in age-related macular degeneration (AMD) are associated with systemic vascular diseases that compromise ocular perfusion. We demonstrate that SDDs are associated with decreased ellipsoid zone (EZ) thickness, further evidence of hypoxic damage.MethodsPost hoc analysis of a cross-sectional study. 165 AMD subjects (aged 51–100; 61% women). Spectral-domain optical coherence tomography was obtained in both eyes. Masked readers assigned subjects to three groups: drusen only, SDD+drusen (SDD+D) and SDD only. EZ thickness was measured subfoveally and 2000 µm nasally, temporally, superiorly and inferiorly from the fovea. Univariate testing was performed using two-tailed t-tests with Bonferroni correction.ResultsThe mean EZ thickness differences between the SDD+D and drusen-only groups were (in μm) 1.10, 0.67, 1.21, 1.10 and 0.50 at the foveal, nasal, temporal, superior and inferior locations, respectively (p=0.08 inferiorly, otherwise p≤0.01); between the SDD-only and drusen-only groups, the differences were 3.48, 2.48, 2.42, 2.08 and 1.42 (p≤0.0002). Differences in EZ thicknesses across all subjects and between groups were not significantly different based on gender, race or age.ConclusionSubjects with SDDs (±drusen) had thinner EZs than those with drusen only, and the inferior EZ was least affected. EZs were thinnest in SDD-only subjects. This thinning gradation is consistent with progressive destruction of highly oxygen-sensitive mitochondria in the EZ from hypoxia. These findings support the reduced ophthalmic perfusion hypothesis for the formation of SDDs secondary to high-risk systemic vasculopathy.

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