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Associations Between Retinal Pigment Epithelium and Drusen Volume Changes During the Lifecycle of Large Drusenoid Pigment Epithelial Detachments

Identifieur interne : 002325 ( Main/Exploration ); précédent : 002324; suivant : 002326

Associations Between Retinal Pigment Epithelium and Drusen Volume Changes During the Lifecycle of Large Drusenoid Pigment Epithelial Detachments

Auteurs : Chandrakumar Balaratnasingam [États-Unis, Australie] ; Lawrence A. Yannuzzi [États-Unis] ; Christine A. Curcio [États-Unis] ; William H. Morgan [États-Unis] ; Giuseppe Querques [France, Italie] ; Vittorio Capuano [France] ; Eric Souied [France, Italie] ; Jesse Jung [États-Unis] ; K. Bailey Freund [États-Unis]

Source :

RBID : PMC:5072538

Descripteurs français

English descriptors

Abstract

Purpose

Drusenoid pigment epithelial detachments (PEDs) are a defined path to atrophy in age-related macular degeneration (AMD). We analyzed the relationships between retinal pigment epithelium (RPE) and drusen volume changes during the PED lifecycle, using spectral-domain optical coherence tomography (SD-OCT).

Methods

Twenty-one cases of drusenoid PED tracked using SD-OCT through periods of growth and collapse were evaluated. Volumetric calculations and piece-wise linear regression analysis were used to determine the breakpoint between growth and collapse. Spectral-domain OCT scans were independently evaluated for the appearance of intraretinal hyperreflective foci, acquired vitelliform lesions (AVLs), and disruptions to the RPE+basal lamina band. Timing of these events with respect to the breakpoint was statistically evaluated. Morphometric characteristics of drusenoid PEDs were correlated with rate of PED collapse and final visual acuity.

Results

Mean age of subjects was 75.3 years and mean period of follow up was 4.1 years (median 4.5 years; range, 0.6–6.6 years). The lifecycle of drusenoid PEDs was asymmetric, in that the rate of collapse (0.199 mm3/month) is significantly faster (P < 0.001) than the rate of growth (0.022 mm3/month). Appearance of intraretinal hyperreflective foci and AVLs preceded the breakpoint (both P < 0.001). The timing of disruptions to the RPE+basal lamina band did not differ from the breakpoint (P = 0.510). Maximal height, volume, and diameter of drusenoid PEDs were inversely correlated with final visual acuity (all P < 0.001) and positively correlated with the rate of PED collapse (all P < 0.001).

Conclusions

Spectral-domain OCT signatures, plausibly attributable to anteriorly migrated RPE and disintegration of the RPE layer, precede or occur simultaneously with changes in volume of drusenoid PED during the lifecycle of this lesion.


Url:
DOI: 10.1167/iovs.16-19816
PubMed: 27760262
PubMed Central: 5072538


Affiliations:


Links toward previous steps (curation, corpus...)


Le document en format XML

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<term>Follow-Up Studies</term>
<term>Fundus Oculi</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Prognosis</term>
<term>Retinal Detachment (diagnosis)</term>
<term>Retinal Detachment (etiology)</term>
<term>Retinal Drusen (complications)</term>
<term>Retinal Drusen (diagnosis)</term>
<term>Retinal Pigment Epithelium (pathology)</term>
<term>Retrospective Studies</term>
<term>Time Factors</term>
<term>Tomography, Optical Coherence (methods)</term>
<term>Visual Acuity</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr">
<term>Acuité visuelle</term>
<term>Adulte d'âge moyen</term>
<term>Angiographie fluorescéinique</term>
<term>Druses de la rétine ()</term>
<term>Druses de la rétine (diagnostic)</term>
<term>Décollement de la rétine (diagnostic)</term>
<term>Décollement de la rétine (étiologie)</term>
<term>Facteurs temps</term>
<term>Femelle</term>
<term>Fond de l'oeil</term>
<term>Humains</term>
<term>Mâle</term>
<term>Pronostic</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Tomographie par cohérence optique ()</term>
<term>Épithélium pigmentaire de la rétine (anatomopathologie)</term>
<term>Études de suivi</term>
<term>Études rétrospectives</term>
<term>Évolution de la maladie</term>
</keywords>
<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr">
<term>Épithélium pigmentaire de la rétine</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en">
<term>Retinal Drusen</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en">
<term>Retinal Detachment</term>
<term>Retinal Drusen</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr">
<term>Druses de la rétine</term>
<term>Décollement de la rétine</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en">
<term>Retinal Detachment</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en">
<term>Tomography, Optical Coherence</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en">
<term>Retinal Pigment Epithelium</term>
</keywords>
<keywords scheme="MESH" qualifier="étiologie" xml:lang="fr">
<term>Décollement de la rétine</term>
</keywords>
<keywords scheme="MESH" xml:lang="en">
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Disease Progression</term>
<term>Female</term>
<term>Fluorescein Angiography</term>
<term>Follow-Up Studies</term>
<term>Fundus Oculi</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Prognosis</term>
<term>Retrospective Studies</term>
<term>Time Factors</term>
<term>Visual Acuity</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr">
<term>Acuité visuelle</term>
<term>Adulte d'âge moyen</term>
<term>Angiographie fluorescéinique</term>
<term>Druses de la rétine</term>
<term>Facteurs temps</term>
<term>Femelle</term>
<term>Fond de l'oeil</term>
<term>Humains</term>
<term>Mâle</term>
<term>Pronostic</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Tomographie par cohérence optique</term>
<term>Études de suivi</term>
<term>Études rétrospectives</term>
<term>Évolution de la maladie</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<sec id="st1">
<title>Purpose</title>
<p>Drusenoid pigment epithelial detachments (PEDs) are a defined path to atrophy in age-related macular degeneration (AMD). We analyzed the relationships between retinal pigment epithelium (RPE) and drusen volume changes during the PED lifecycle, using spectral-domain optical coherence tomography (SD-OCT).</p>
</sec>
<sec id="st2">
<title>Methods</title>
<p>Twenty-one cases of drusenoid PED tracked using SD-OCT through periods of growth and collapse were evaluated. Volumetric calculations and piece-wise linear regression analysis were used to determine the breakpoint between growth and collapse. Spectral-domain OCT scans were independently evaluated for the appearance of intraretinal hyperreflective foci, acquired vitelliform lesions (AVLs), and disruptions to the RPE+basal lamina band. Timing of these events with respect to the breakpoint was statistically evaluated. Morphometric characteristics of drusenoid PEDs were correlated with rate of PED collapse and final visual acuity.</p>
</sec>
<sec id="st3">
<title>Results</title>
<p>Mean age of subjects was 75.3 years and mean period of follow up was 4.1 years (median 4.5 years; range, 0.6–6.6 years). The lifecycle of drusenoid PEDs was asymmetric, in that the rate of collapse (0.199 mm
<sup>3</sup>
/month) is significantly faster (
<italic>P</italic>
< 0.001) than the rate of growth (0.022 mm
<sup>3</sup>
/month). Appearance of intraretinal hyperreflective foci and AVLs preceded the breakpoint (both
<italic>P</italic>
< 0.001). The timing of disruptions to the RPE+basal lamina band did not differ from the breakpoint (
<italic>P</italic>
= 0.510). Maximal height, volume, and diameter of drusenoid PEDs were inversely correlated with final visual acuity (all
<italic>P</italic>
< 0.001) and positively correlated with the rate of PED collapse (all
<italic>P</italic>
< 0.001).</p>
</sec>
<sec id="st4">
<title>Conclusions</title>
<p>Spectral-domain OCT signatures, plausibly attributable to anteriorly migrated RPE and disintegration of the RPE layer, precede or occur simultaneously with changes in volume of drusenoid PED during the lifecycle of this lesion.</p>
</sec>
</div>
</front>
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<author>
<name sortKey="Fariss, Rn" uniqKey="Fariss R">RN, Fariss</name>
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<name sortKey="Wong, Wt" uniqKey="Wong W">WT. Wong</name>
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<author>
<name sortKey="Van Arnam, Js" uniqKey="Van Arnam J">JS, Van Arnam</name>
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<name sortKey="Proia, Ad" uniqKey="Proia A">AD. Proia</name>
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<name sortKey="Curcio, Ca" uniqKey="Curcio C">CA. Curcio</name>
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<li>Île-de-France</li>
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<name sortKey="Balaratnasingam, Chandrakumar" sort="Balaratnasingam, Chandrakumar" uniqKey="Balaratnasingam C" first="Chandrakumar" last="Balaratnasingam">Chandrakumar Balaratnasingam</name>
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<name sortKey="Jung, Jesse" sort="Jung, Jesse" uniqKey="Jung J" first="Jesse" last="Jung">Jesse Jung</name>
<name sortKey="Jung, Jesse" sort="Jung, Jesse" uniqKey="Jung J" first="Jesse" last="Jung">Jesse Jung</name>
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<name sortKey="Morgan, William H" sort="Morgan, William H" uniqKey="Morgan W" first="William H." last="Morgan">William H. Morgan</name>
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<name sortKey="Yannuzzi, Lawrence A" sort="Yannuzzi, Lawrence A" uniqKey="Yannuzzi L" first="Lawrence A." last="Yannuzzi">Lawrence A. Yannuzzi</name>
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<name sortKey="Querques, Giuseppe" sort="Querques, Giuseppe" uniqKey="Querques G" first="Giuseppe" last="Querques">Giuseppe Querques</name>
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<name sortKey="Capuano, Vittorio" sort="Capuano, Vittorio" uniqKey="Capuano V" first="Vittorio" last="Capuano">Vittorio Capuano</name>
<name sortKey="Souied, Eric" sort="Souied, Eric" uniqKey="Souied E" first="Eric" last="Souied">Eric Souied</name>
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<name sortKey="Souied, Eric" sort="Souied, Eric" uniqKey="Souied E" first="Eric" last="Souied">Eric Souied</name>
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</record>

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