Drusen and pachydrusen: the definition, pathogenesis, and clinical significance

Zhang, Xinyuan; Sivaprasad, Sobha

doi:10.1038/s41433-020-01265-4

Cited by 51 publications

(40 citation statements)

References 105 publications

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“…92 Complement components, the important component of drusen, and inflammasomes are involved in the inflammatory responses in AMD. [93][94][95] The activated complement component C3a was higher in both the blood and drusen of patients with dry AMD, and the inhibitors of complement such as complement factor H (CFH), CD59 and CD46 were reduced, implicating a hyperactive complement system in AMD. [96][97][98] Upon oxidative stress, lysosomal destabilization and P2X7 receptor activation, inflammasomes can be activated by the nucleotide-binding and oligomerization domain-like receptor (NLR) family containing 1 (NLRP1), NLRP3, NLR-family CARD-containing protein 4, absent-in-melanoma 2 or pyrin, ultimately cause pyroptosis.…”

Section: Inflammation and Amdmentioning

confidence: 99%

Long-Chain Polyunsaturated Fatty Acids and Their Metabolites Regulate Inflammation in Age-Related Macular Degeneration

Ren¹,

Ren²,

Deng³

et al. 2022

JIR

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Age-related macular degeneration (AMD) is a blinding eye disease, whose incidence strongly increases with ages. The etiology of AMD is complex, including aging, abnormal lipid metabolism, chronic inflammation and oxidative stress. Long-chain polyunsaturated fatty acids (LCPUFA) are essential for ocular structures and functions. This review summarizes the regulatory effects of LCPUFA on inflammation in AMD. LCPUFA are related to aging, autophagy and chronic inflammation. They are metabolized to pro-and anti-inflammatory metabolites by various enzymes. These metabolites stimulate inflammation in response to oxidative stress, causing innate and acquired immune responses. This review also discusses the possible clinical applications, which provided novel targets for the prevention and treatment of AMD and other age-related diseases.

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Section: Inflammation and Amdmentioning

confidence: 99%

Long-Chain Polyunsaturated Fatty Acids and Their Metabolites Regulate Inflammation in Age-Related Macular Degeneration

Ren¹,

Ren²,

Deng³

et al. 2022

JIR

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“…Low blood oxygen content in collateral vessels further leads to the proliferative senescence and subsequent apoptosis of vascular endothelial and smooth muscle cells in collateral vessels [ 23 ]; this can explain why 36% of chronic CSC will eventually be complicated with type 1 CNV [ 2 ], with an outcome of PCV in many instances (such as pachdrusen) [ 24 ]. The highest proportion of the diffused type of collateral circulation in CSC in our study promoted the investigation of whether CSC is an early stage of PCV; we hypothesized that CSC could eventually progress to PCV when the ability to establish collateral circulation decreases and can no longer compensate for the ischemic state.…”

Section: Discussionmentioning

confidence: 99%

Characterization of Choroidal Morphology and Vasculature in the Phenotype of Pachychoroid Diseases by Swept-Source OCT and OCTA

Qiu

Zhang

et al. 2022

JCM

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The objective of this study was to characterize the choroidal morphology and vasculature in pachychoroid diseases (PCD). A total of 49 eyes with polypoidal choroidal vasculopathy (PCV), 43 eyes with neovascular age-related macular degeneration (nAMD), and 50 eyes with central serous chorioretinopathy (CSC), along with 80 healthy eyes, were enrolled in this nested case-control study. The swept-source optical coherent tomography (OCT), OCT angiography, and En face images were quantitatively analyzed. Multivariate logistic regression models showed that older age and increased vessel density (VD) in the choriocapillaris (CC) layer were independent risk factors for both PCV (page < 0.001, pVD = 0.004), and nAMD (page < 0.001, pVD = 0.005). Decreased VD in the Sattler’s layer was an independent risk factor for PCV (p = 0.014). Increased VD in the Haller’s layer was an independent risk factor for CSC (p = 0.001). The proportion of the diffuse type of collateral circulation in the Sattler’ layer in CSC group was significantly higher than in the other three groups (p < 0.001). We concluded that the involvement of the blood flow in the CC, Haller’s, and Sattler’s layers are differently affected in CSC, nAMD, and PCV eyes, indicating the different pathological mechanism underlying the phenotype of PCD. The age-dependent establishment of collateral circulation in the Sattler’s layer may play a compensatory role regarding ischemic injury in the development of PCD.

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“…Our study showed that the occurrence of pachydrusen was significantly more common in PSD eyes without CNV than in neovascular PSD eyes. To our knowledge, no research thus far has compared these two entities; Zhang et al ( 51 ) presumed that pachydrusen constitutes a precursor of PCV and CSC. Thus, we propose that pachydrusen is an early sign of PSD, similar to variable drusen in AMD.…”

Section: Discussionmentioning

confidence: 99%

Imaging Characteristics of Neovascular and Atrophic Pachychoroidal Spectrum Diseases

Hua

Zhang

2022

Front. Med.

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BackgroundThis study qualitatively and quantitatively compared imaging characteristics between neovascular and atrophic pachychoroid spectrum disease (PSD) by optical coherence tomography (OCT), and OCT angiography (OCTA).MethodsThe subtypes of PSD were identified by multi-modality imaging approaches. Subfoveal choroidal thickness (SFCT), choroidal vascular index (CVI), and vascular density of choroidal neovascularization (CNV) were measured.ResultsThe CVI and SFCT of 174 PSD eyes were 67.6% ± 5.48% and 362.2 ± 131.88 μm, respectively. After adjustment for age, linear regression indicated that SFCT was positively associated with CVI (p < 0.001), and patched hyper-reflective lesions in choriocapillaris layers (p = 0.009). Compared with neovascular PSD eyes, atrophic PSD eyes had similar patient age (57.1 ± 16.72 years, p = 0.639), SFCT (332.0 ± 111.00 μm, p = 0.51), and CVI (67.6% ± 3.94%, p = 0.527). There were no differences between polypoidal choroidal vasculopathy (PCV) eyes with aneurysmal polypoidal lesions and PCV eyes with tangled polypoidal lesions in terms of age, CVI, SFCT, vascular density, or the occurrence of double layer signs (DLSs, all p > 0.05). Logistic regression indicated that age (p = 0.003), SFCT (p = 0.003), patched hyper-reflective lesions in choriocapillaris layers (p = 0.009), and DLSs (p < 0.001) were predictive factors for CNV progression in PSD eyes (all p < 0.05).ConclusionsOur study highlighted the similarities in SFCT and CVI between neovascular and atrophic PSD, both of which were late stage lesions. Besides, age, SFCT, patched hyper-reflective lesions in choriocapillaris layers, and DLSs were risk factors for CNV in PSD. Our results showed that atrophic PSD is an important change in the late stage of PSD disease, which is helpful for in-depth understanding of the pathological mechanism of PSD and corresponding intervention.

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Drusen and pachydrusen: the definition, pathogenesis, and clinical significance

Cited by 51 publications

References 105 publications

Long-Chain Polyunsaturated Fatty Acids and Their Metabolites Regulate Inflammation in Age-Related Macular Degeneration

Long-Chain Polyunsaturated Fatty Acids and Their Metabolites Regulate Inflammation in Age-Related Macular Degeneration

Characterization of Choroidal Morphology and Vasculature in the Phenotype of Pachychoroid Diseases by Swept-Source OCT and OCTA

Imaging Characteristics of Neovascular and Atrophic Pachychoroidal Spectrum Diseases

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