Multimodal imaging of small hard retinal drusen in young healthy adults

Hilde R Pedersen; Stuart J Gilson; Alfredo Dubra; Inger Christine Munch; Michael Larsen; Rigmor C Baraas

doi:10.1136/bjophthalmol-2017-310719

Multimodal imaging of small hard retinal drusen in young healthy adults

Hilde R Pedersen, Stuart J Gilson, Alfredo Dubra, Inger Christine Munch, Michael Larsen, Rigmor C Baraas

Department of Clinical Medicine

9 Citations (Scopus)

60 Downloads (Pure)

Abstract

BACKGROUND: Small 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.

METHODS: Retinal 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.

RESULTS: Small 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.

CONCLUSION: High 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.

Original language	English
Journal	British Journal of Ophthalmology
Volume	102
Issue number	1
Pages (from-to)	146-152
ISSN	0007-1161
DOIs	https://doi.org/10.1136/bjophthalmol-2017-310719
Publication status	Published - 1 Jan 2018

Keywords

Adult
Female
Fluorescein Angiography/methods
Fundus Oculi
Humans
Male
Multimodal Imaging/methods
Ophthalmoscopy/methods
Prospective Studies
Reference Values
Reproducibility of Results
Retinal Cone Photoreceptor Cells/pathology
Retinal Drusen/diagnosis
Retinal Pigment Epithelium/pathology
Tomography, Optical Coherence/methods
Visual Acuity
Young Adult

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Multimodal imaging of small hard retinal drusen in young healthy adultsFinal published version, 1.09 MBLicence: CC BY-NC

Cite this

@article{3a10122c11714b67a889ee2f4cea30e3,

title = "Multimodal imaging of small hard retinal drusen in young healthy adults",

abstract = "BACKGROUND: Small 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.METHODS: Retinal 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.RESULTS: Small 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.CONCLUSION: High 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.",

keywords = "Adult, Female, Fluorescein Angiography/methods, Fundus Oculi, Humans, Male, Multimodal Imaging/methods, Ophthalmoscopy/methods, Prospective Studies, Reference Values, Reproducibility of Results, Retinal Cone Photoreceptor Cells/pathology, Retinal Drusen/diagnosis, Retinal Pigment Epithelium/pathology, Tomography, Optical Coherence/methods, Visual Acuity, Young Adult",

author = "Pedersen, {Hilde R} and Gilson, {Stuart J} and Alfredo Dubra and Munch, {Inger Christine} and Michael Larsen and Baraas, {Rigmor C}",

note = "{\textcopyright} Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.",

year = "2018",

month = jan,

day = "1",

doi = "10.1136/bjophthalmol-2017-310719",

language = "English",

volume = "102",

pages = "146--152",

journal = "British Journal of Ophthalmology",

issn = "0007-1161",

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T1 - Multimodal imaging of small hard retinal drusen in young healthy adults

AU - Pedersen, Hilde R

AU - Gilson, Stuart J

AU - Dubra, Alfredo

AU - Munch, Inger Christine

AU - Larsen, Michael

AU - Baraas, Rigmor C

PY - 2018/1/1

Y1 - 2018/1/1

N2 - BACKGROUND: Small 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.METHODS: Retinal 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.RESULTS: Small 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.CONCLUSION: High 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.

AB - BACKGROUND: Small 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.METHODS: Retinal 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.RESULTS: Small 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.CONCLUSION: High 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.

KW - Adult

KW - Female

KW - Fluorescein Angiography/methods

KW - Fundus Oculi

KW - Humans

KW - Male

KW - Multimodal Imaging/methods

KW - Ophthalmoscopy/methods

KW - Prospective Studies

KW - Reference Values

KW - Reproducibility of Results

KW - Retinal Cone Photoreceptor Cells/pathology

KW - Retinal Drusen/diagnosis

KW - Retinal Pigment Epithelium/pathology

KW - Tomography, Optical Coherence/methods

KW - Visual Acuity

KW - Young Adult

U2 - 10.1136/bjophthalmol-2017-310719

DO - 10.1136/bjophthalmol-2017-310719

M3 - Journal article

C2 - 29051326

SN - 0007-1161

VL - 102

SP - 146

EP - 152

JO - British Journal of Ophthalmology

JF - British Journal of Ophthalmology

IS - 1

ER -

Multimodal imaging of small hard retinal drusen in young healthy adults

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