Japanese Journal of Ophthalmology

, Volume 63, Issue 6, pp 448–456 | Cite as

Clinical characteristics of cuticular drusen in the Japanese population

  • Yoichi SakuradaEmail author
  • Koji Tanaka
  • Akiko Miki
  • Hidetaka Matsumoto
  • Akiyuki Kawamura
  • Ryo Mukai
  • Hideo Akiyama
  • Shigeru Honda
  • Ryusaburo Mori
  • Hiroyuki Iijima
Clinical Investigation



To investigate the clinical characteristics of eyes with cuticular drusen in Japanese individuals, while paying special attention to large colloid drusen (LCD).

Study design

Retrospective case series.


Eyes with cuticular drusen, from patients of 4 medical institutes in Japan, were investigated. Multimodal imaging findings were used to diagnose cuticular drusen. LCD was defined as cuticular drusen > 200 µm.


Twenty-four eyes from 12 patients (8 women, 4 men) were diagnosed with cuticular drusen. The mean age of all patients (n = 12) was 60.8 years. The mean age of patients without additional macular pathology (n = 5) was 55.4 years. Of the 7 patients with additional macular pathology, 6 (85.7%) exhibited age-related macular degeneration-associated macular pathology, including drusenoid pigment epithelial detachment (PED) (8 eyes from 4 patients), geographic atrophy (2 eyes from 1 patient), and occult choroidal neovascularization (1 eye). LCD were found in 6 eyes of 3 patients (25%), those with LCD were on average 53.7 ± 8.7 years old and those without 69.9 ± 14.1 years of age (P = 0.064, Mann–Whitney U test).


Cuticular drusen were predominantly seen in females, and drusenoid PED was most frequently seen in eyes with additional macular pathology. LCD were seen in 25% of eyes with cuticular drusen.


Cuticular drusen Age-related macular degeneration Drusenoid pigment epithelial detachment Large colloid drusen 


Conflicts of interest

Y. Sakurada, Lecture fee (Santen, Novartis, Bayer); K. Tanaka, None; A. Miki, None; H. Matsumoto, None; A. Kawamura, None; R. Mukai, None; H. Akiyama, None; S. Honda, None; R. Mori, None; H. Iijima, Lecture fee (Novartis), Speaker fee (Bayer, Novartis, Santen, Shionogi).


  1. 1.
    Khan KN, Mahroo OA, Khan RS, Mohamed MD, McKibbin M, Bird A, et al. Differentiating drusen: drusen and drusen-like appearances associated with ageing, age-related macular degeneration, inherited eye disease and other pathological processes. Prog Retin Eye Res. 2016;53:70–106.CrossRefGoogle Scholar
  2. 2.
    Nozaki M, Raisler BJ, Sakurai E, Sarma JV, Barnum SR, Lambris JD, et al. Drusen complement components C3a and C5a promote choroidal neovascularization. Proc Natl Acad Sci USA. 2006;103:2328–33.CrossRefGoogle Scholar
  3. 3.
    Sakurada Y, Sugiyama A, Kikushima W, Yoneyama S, Tanabe N, Matsubara M, et al. Pseudodrusen pattern and development of late age-related macular degeneration in the fellow eye in the unilateral case. Jpn J Ophthalmol. 2019;63(5):374–81.CrossRefGoogle Scholar
  4. 4.
    Ferris FL, Davis MD, Clemons TE, Lee LY, Chew EY, Lindblad AS, et al. A simplified severity scale for age-related macular degeneration: AREDS report no. 18. Arch Ophthalmol. 2005;123:1570–4.CrossRefGoogle Scholar
  5. 5.
    Gass JD. Stereoscopic atlas of macular diseases; diagnosis and treatments. 2nd ed. St. Louis: Mosby; 1977. p. 46–50.Google Scholar
  6. 6.
    Russell SR, Mullins RF, Schneider BL, Hageman GS. Location, substructure, and composition of basal laminar drusen compared with drusen associated with aging and age-related macular degeneration. Am J Ophthalmol. 2000;129:205–14.CrossRefGoogle Scholar
  7. 7.
    Balaratnasingam C, Cherepanoff S, Dolz-Marco R, Killingsworth M, Chen FK, Mendis R, et al. Cuticular drusen: clinical phenotypes and natural history defined using multimodal imaging. Ophthalmology. 2018;125:100–18.CrossRefGoogle Scholar
  8. 8.
    van de Ven JP, Smailhodzic D, Boon CJ, Fauser S, Groenewoud JM, Chong NV, et al. Association analysis of genetic and environmental risk factors in the cuticular drusen subtype of age-related macular degeneration. Mol Vis. 2012;18:2271–8.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Guigui B, Leveziel N, Martinet V, Massamba N, Sterkers M, Coscas G, et al. Angiography features of early onset drusen. Br J Ophthalmol. 2011;95:238–44.CrossRefGoogle Scholar
  10. 10.
    Roberti NC, Dias JRO, Novais EA, Regatieri CS, Belfort R Jr. Large colloid drusen analyzed with structural en face optical coherence tomography. Arq Bras Oftalmol. 2017;80:122–4.CrossRefGoogle Scholar
  11. 11.
    Veronese C, Maiolo C, Mora LD, Morara M, Armstrong GW, Ciardella AP. Bilateral large colloid drusen in a young adult. Retina. 2017;37:e132–4.CrossRefGoogle Scholar
  12. 12.
    Sakurada Y, Parikh R, Gal-Or O, Balaratnasingam C, Leong BCS, Tanaka K, et al. Cuticular drusen: risk of geographic atrophy and macular neovascularization. Retina. 2018. Scholar
  13. 13.
    Sato A, Senda N, Fukui E, Ohta K. Retinal angiomatous proliferation in an eye with cuticular drusen. Case Rep Ophthalmol. 2015;6:127–31.CrossRefGoogle Scholar
  14. 14.
    Spaide RF, Curcio CA. Drusen characterization with multimodal imaging. Retina. 2010;30:1441–54.CrossRefGoogle Scholar
  15. 15.
    Boon CJ, van de Ven JP, Hoyng CB, den Hollander AI, Klevering BJ. Cuticular drusen: stars in the sky. Prog Retin Eye Res. 2013;37:90–113.CrossRefGoogle Scholar
  16. 16.
    van de Ven JP, Boon CJ, Smailhodzic D, Lechanteur YT, den Hollander AI, Hoyng CB, et al. Short-term changes of Basal laminar drusen on spectral-domain optical coherence tomography. Am J Ophthalmol. 2012;154:560–7.CrossRefGoogle Scholar
  17. 17.
    Cukras C, Agron E, Klein ML, Ferris FL 3rd, Chew EY, Gensler G, et al. Natural history of drusenoid pigment epithelial detachment in age-related macular degeneration: age-related eye disease study report no. 28. Ophthalmology. 2010;117:489–99.CrossRefGoogle Scholar
  18. 18.
    Roquet W, Roudot-Thoraval F, Coscas G, Soubrane G. Clinical features of drusenoid pigment epithelial detachment in age related macular degeneration. Br J Ophthalmol. 2004;88:638–42.CrossRefGoogle Scholar
  19. 19.
    Terao R, Matsuda A, Ogawa A, Shimizu K, Azuma K, Inoue T, et al. Optical coherence tomography angiography study of choroidal neovascularization associated with early-onset drusen. Retin Cases Brief Rep. 2019. Scholar

Copyright information

© Japanese Ophthalmological Society 2019

Authors and Affiliations

  • Yoichi Sakurada
    • 1
    Email author
  • Koji Tanaka
    • 2
  • Akiko Miki
    • 3
  • Hidetaka Matsumoto
    • 4
  • Akiyuki Kawamura
    • 2
  • Ryo Mukai
    • 4
  • Hideo Akiyama
    • 4
  • Shigeru Honda
    • 5
  • Ryusaburo Mori
    • 2
  • Hiroyuki Iijima
    • 1
  1. 1.Department of Ophthalmology, Faculty of MedicineUniversity of YamanashiChuoJapan
  2. 2.Division of Ophthalmology, Department of Visual SciencesNihon University School of MedicineTokyoJapan
  3. 3.Division of Ophthalmology, Department of SurgeryKobe University Graduate School of MedicineHyogoJapan
  4. 4.Department of OphthalmologyGunma University School of MedicineGunmaJapan
  5. 5.Department of Ophthalmology and Visual SciencesOsaka City University, Graduate School of MedicineOsakaJapan

Personalised recommendations