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In-vivo mapping of drusen by fundus autofluorescence and spectral-domain optical coherence tomography imaging

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To determine fundus autofluorescence (FAF) signal variations and corresponding microstructural alterations on spectral-domain optical coherence tomography (SD-OCT) in areas of funduscopically visible drusen associated with age-related macular degeneration (AMD).

Methods

Thirty eyes from 22 patients with geographic atrophy (GA) secondary to AMD (median age 74, range 64–87 years), who had undergone retinal imaging including color fundus photography (CFP), FAF and SD-OCT (Spectralis HRA+OCT; Heidelberg Engineering GmbH, Heidelberg, Germany) were retrospectively analyzed. In each eye, at least one druse (≥63 μm) in the perilesional zone of GA recorded on CFP was analyzed. Relative FAF intensities and alterations in SD-OCT bands at the site of each druse were evaluated.

Results

A total of 73 drusen were analyzed, which were associated with heterogeneous corresponding alterations on FAF and SD-OCT. The FAF signal was normal, increased, decreased or not evaluable in 32 (44 %), 27 (37 %), 12 (16 %), and 2 (3 %) drusen, respectively. Focal hyperreflectivity overlying drusen was most frequently spatially confined to increased FAF (present in 9 (33 %) of 27 drusen with increased FAF). Outer nuclear layer thinning and choroidal hyperreflectivity were associated with decreased FAF (present in 7 [58 %] of 12 and 6 [50 %] of 12 drusen with decreased FAF, respectively).

Conclusions

The appearance of soft drusen on CFP does not allow for differentiation between preserved and markedly compromised outer retinal integrity, including incipient atrophy and focal neurosensory alterations of reflectivity overlying extracellular sub-retinal pigment epithelium (RPE) deposits. Multimodal imaging reveals a broad spectrum of microstructural changes, which may reflect different stages in the evolution of drusen.

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Acknowledgments

The Department of Ophthalmology, University of Bonn, has received research material from Carl Zeiss Meditec, Heidelberg Engineering, and Optos PLC.

Monika Fleckenstein has received honoraria from Heidelberg Engineering and is the inventor designated on a patent application (US2012029299 ‘Methods of Diagnosis and Treating Vascular Associated Maculopathy and Symptoms Thereof’)

Frank G. Holz receives compensation as a consultant for Heidelberg Engineering and Optos.

Steffen Schmitz-Valckenberg has received honoraria from Heidelberg Engineering and Optos PLC.

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Authors and Affiliations

  1. Department of Ophthalmology, University of Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Germany

    Arno P. Göbel, Monika Fleckenstein, Tjebo F. C. Heeren, Frank G. Holz & Steffen Schmitz-Valckenberg

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  1. Arno P. Göbel
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  2. Monika Fleckenstein
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  3. Tjebo F. C. Heeren
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Correspondence to Steffen Schmitz-Valckenberg.

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Göbel, A.P., Fleckenstein, M., Heeren, T.F.C. et al. In-vivo mapping of drusen by fundus autofluorescence and spectral-domain optical coherence tomography imaging. Graefes Arch Clin Exp Ophthalmol 254, 59–67 (2016). https://doi.org/10.1007/s00417-015-3012-4

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  • DOI: https://doi.org/10.1007/s00417-015-3012-4

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