PMID- 23891523
OWN - NLM
STAT- MEDLINE
DCOM- 20140313
LR  - 20220410
IS  - 1549-4713 (Electronic)
IS  - 0161-6420 (Linking)
VI  - 121
IP  - 1
DP  - 2014 Jan
TI  - Appearance of regressing drusen on optical coherence tomography in age-related 
      macular degeneration.
PG  - 173-179
LID - S0161-6420(13)00528-9 [pii]
LID - 10.1016/j.ophtha.2013.06.024 [doi]
AB  - OBJECTIVE: To describe and interpret a multilaminar sub-retinal pigment 
      epithelium (RPE) intense hyper-reflectivity observed in vivo in eyes clinically 
      diagnosed with regressing drusen. DESIGN: Observational case series. 
      PARTICIPANTS: Twenty-three consecutive patients clinically diagnosed with 
      regressing calcific drusen due to nonneovascular age-related macular degeneration 
      (AMD). METHODS: Patients were submitted to confocal scanning laser ophthalmoscopy 
      (cSLO) fundus imaging and "eye-tracked" spectral-domain optical coherence 
      tomography (SD-OCT). MAIN OUTCOME MEASURES: Localization and possible origin and 
      composition of the multilaminar sub-RPE hyperreflectivity. RESULTS: Thirty eyes 
      of 23 consecutive patients (8 male and 15 female; mean age, 82.7+/-10.1 years) 
      showing on SD-OCT an intense multilaminar sub-RPE hyperreflectivity, which 
      matched with regressing calcific drusen as visualized by cSLO infrared (IR) and 
      MultiColor (Heidelberg Engineering, Heidelberg, Germany) images, were included in 
      this study. The multilaminar hyperreflectivity was found to localize to beneath 
      the RPE and above the outer Bruch's membrane (oBM) layer. A mean of 1.2 
      multilaminar sub-RPE hyperreflectivities per SD-OCT scan were identified by 2 
      readers. The SD-OCT analysis allowed the 2 readers to describe 3 different types 
      of sub-RPE hyperreflectivity. "Type 1" laminar/multilaminar hyperreflectivity 
      (found in 24 scans of 12 eyes) was characterized by an intense signal originating 
      from what we interpreted as the inner Bruch's membrane (iBM) layer. "Type 2" 
      multilaminar hyperreflectivity (found in 130 scans of 27 eyes) was characterized 
      by an intense signal originating from the oBM layer. "Type 3" multilaminar 
      fragmented hyperreflectivity (found in 22 scans of 11 eyes) was characterized by 
      an intense signal originating from what we interpreted as both the iBM and the 
      oBM, showing different degrees of fragmentation. CONCLUSIONS: We describe a novel 
      SD-OCT finding appearing as multilaminar sub-RPE intense hyper-reflectivity 
      observed in vivo in eyes with regressing drusen. This multilaminar sub-RPE 
      hyperreflectivity could be interpreted as layers of lipid mineralization 
      (membranous debris also called "lipoprotein-derived debris" developing 
      calcification), internal and external to the basement membrane, with different 
      degrees of fragmentation.
CI  - Copyright (c) 2014 American Academy of Ophthalmology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Querques, Giuseppe
AU  - Querques G
AD  - Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil 
      University Paris Est Creteil, Creteil, France. Electronic address: 
      giuseppe.querques@hotmail.it.
FAU - Georges, Anouk
AU  - Georges A
AD  - Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil 
      University Paris Est Creteil, Creteil, France.
FAU - Ben Moussa, Naima
AU  - Ben Moussa N
AD  - Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil 
      University Paris Est Creteil, Creteil, France.
FAU - Sterkers, Margaret
AU  - Sterkers M
AD  - Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil 
      University Paris Est Creteil, Creteil, France.
FAU - Souied, Eric H
AU  - Souied EH
AD  - Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil 
      University Paris Est Creteil, Creteil, France.
LA  - eng
PT  - Journal Article
DEP - 20130725
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Calcinosis/diagnosis/metabolism
MH  - Female
MH  - Geographic Atrophy/*diagnosis/physiopathology
MH  - Humans
MH  - Lipid Metabolism
MH  - Male
MH  - Ophthalmoscopy
MH  - Retinal Drusen/*diagnosis/physiopathology
MH  - Retinal Pigment Epithelium/*pathology
MH  - *Tomography, Optical Coherence
EDAT- 2013/07/31 06:00
MHDA- 2014/03/14 06:00
CRDT- 2013/07/30 06:00
PHST- 2013/03/04 00:00 [received]
PHST- 2013/06/12 00:00 [revised]
PHST- 2013/06/12 00:00 [accepted]
PHST- 2013/07/30 06:00 [entrez]
PHST- 2013/07/31 06:00 [pubmed]
PHST- 2014/03/14 06:00 [medline]
AID - S0161-6420(13)00528-9 [pii]
AID - 10.1016/j.ophtha.2013.06.024 [doi]
PST - ppublish
SO  - Ophthalmology. 2014 Jan;121(1):173-179. doi: 10.1016/j.ophtha.2013.06.024. Epub 
      2013 Jul 25.