AMD Drusenoid deposits “Lipid Type” characteristics and evolution. Multimodal imaging evaluation

Abstract

AbstractPurpose To study AMD drusenoid deposits “Lipid Type” evolution with multimodal imaging. To individualize their evolution and complication and to consider various etiopathogenic AMD optionsMethods 98 eyes of 49 patients, 18 men, 31 women, with AMD. AMD drusenoid deposits, “Lipid type”: soft Drusen, Drusenoid PED (lipid type), were evaluated by Autofluorescence, IR imaging, ETDRS visual acuity (VA), ocular Fundus examination, Ocular Confocal Tomography exam (OCT), OCT en Face software (Spectralis HRA‐OCT). Size, characteristics, number, topography of the lesions, growth were evaluated, as well as their environment above and below. With OCT, each element was studied, compared cut to cut, layer to layer and time to time to itself and to each other data. Follow‐up was done every 4 months during 2 yearsResults Soft drusen were larger, roughly homogenous, dark‐grey, translucent, dome‐shaped mounds of deposit under the RPE; Drusenoid PED, lipid type, were homogeneous, as convergence of soft drusen, dark‐grey. Multimodal imaging, especially OCT, OCT en Face features let individualize “lipid type” drusenoid deposits: morphologic types appearing homogeneous, dark, optically empty, fatty. Evolution change, depend on those characteristics, rather to IS/OS impairment, photoreceptor disappearance, RPE involution, and so atrophy. They seem result from a specific metabolic defect outcome, peculiar etiopathogenic pathways: lipid metabolic pathway disorder with particular metabolic dysfunctions inrolled. Furthermore, lipid type drusenoid deposits’ prognostic, predictive value allow to designate them for biomarker featureConclusion AMD Drusenoid deposits “lipid type” knowledge, evolution allow better AMD metabolism dysfunction understanding and etiopathogenic concept