Multimodal imaging of small hard retinal drusen in young healthy adults

Abstract

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.

Small Hard Macular Drusen and Associations in 11- to 12-Year-Old Children in the Copenhagen Child Cohort 2000 Eye Study

“…1 Small hard drusen within the macula have been observed in 22% of 97 healthy young adults in Norway with a mean age of 23 years. 22 We found that the risk of having small hard drusen outside the macula increased nearly four times when drusen were present in the macula. This is an interesting corollary to studies of early 6 and late 23,24 AMD, which have shown a similar association between macular and extramacular lesions.…”

“…38 The strengths of the present study included its populationbased design, the high number of participants, and the inclusion of OCT, even if it was not invariably applied in a mode that is optimal for the imaging of small hard drusen. Specifically, the scan locations were not customized to the actual small hard drusen seen in a given participant and even if they had been, small hard drusen are not invariably visible on OCT. 22 The examination of the relation between small hard drusen and choroidal thickness was a preplanned but secondary analysis. As such, there is a risk of mass significance resulting from multiple testing and therefore replication in one or more separate studies is desirable.…”

The Cone Photoreceptor Mosaic in Aniridia

“…The Kongsberg AOSLO 27,28 was used to obtain images of the photoreceptor mosaic in five participants with aniridia (4 males, aged 40-66 yrs), and 30 age-matched normal controls including four unaffected family members. Ocular media opacities and nystagmus precluded imaging of the photoreceptor mosaic in participant 5114 and 5135.…”

“…Image analyses and registration was performed as described previously. 28 Registered images from each retinal location were manually stitched together into a montage aligned with the corresponding en-face infrared image acquired by the OCT using selected blood vessel landmarks. These steps ensured that the AOSLO images were correctly scaled and positioned irrespective of the individual subject's fixation skill and uncontrolled eye movements.…”

Characterizing drusen using modern multimodal imaging of the retina

“…W badanym materiale klinicznym druzy twarde rozpoznano u 22,6% chorych.Druzy twarde to najczęściej druzy o średnicy małej (poniżej 63 µm), rzadziej średniej (64-125 µm)(13,14). W obrazie oftalmoskopowym (ryc.…”