Abstract

The purpose of this study was to evaluate central and parafoveal inner retinal layer thickness in patients with subretinal drusenoid deposits (SDD) or conventional drusen (CD). Participants underwent comprehensive ophthalmoscopic examination. Evidence of SDD or CD was evaluated with near infrared reflectance and spectral domain optical coherence tomography. Quantification of subfoveal lesions was made through a qualitative analysis of vertical and horizontal SD-OCT scans centered on the fovea. Inner retinal layer macular thickness measurements were obtained for central circles with 1, 3, and 5 mm diameter. Continuous variables were compared by the analysis of covariance (ANCOVA) with post-hoc Tukey HSD correction for multiple comparison analysis. Fifty-five patients were included in the study; 18 eyes with SDD alone, 19 eyes with CD alone, and 18 eyes of healthy age-matched subjects. Eight eyes with SDD (44%) and 13 eyes with CD (68%) had subfoveal lesions. There was significant reduction in the inner retinal layer thickness in the central 1mm area and in the superior 3 mm area in the SDD and CD group compared to controls. In conclusion the inner retinal layer is thinner in the central macula and in the superior parafovea in eyes.

Highlights

  • Late manifestations of age related macular degeneration (AMD) are the primary pathology responsible for irreversible loss of vision in developed countries

  • These deposits are located in the subretinal space, between the photoreceptors and retinal pigment epithelium layer with different retinal topography with respect to drusen as they are localized predominantly in the superior macula outside of the fovea, and to a less extent in the foveal region, whereas soft drusen are characteristically found in the central macula [2,3]

  • Thinning of the inner retinal structures has been reported for the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and ganglion cell complex (GCC) [9,10,11,12]

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Summary

Introduction

Late manifestations of age related macular degeneration (AMD) are the primary pathology responsible for irreversible loss of vision in developed countries. The principal hallmarks of AMD are drusen that are focal deposits of extracellular material beneath the retinal pigment epithelium [1]. Growing evidence shows that subretinal drusenoid deposits (SDD), otherwise called reticular pseudodrusen, are an important phenotype in AMD. These deposits are located in the subretinal space, between the photoreceptors and retinal pigment epithelium layer with different retinal topography with respect to drusen as they are localized predominantly in the superior macula outside of the fovea, and to a less extent in the foveal region, whereas soft drusen are characteristically found in the central macula [2,3]. AMD is characterized by outer retinal involvement [4,5]. Thinning of the inner retinal structures has been reported for the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and ganglion cell complex (GCC) [9,10,11,12]

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