Appearance of medium-large drusen and reticular pseudodrusen on adaptive optics in age-related macular degeneration

摘要

Purpose: To investigate the appearance of medium-large drusen and reticular pseudodrusen on adaptive optics (AO). Methods: In 14 consecutive patients, AO infrared (IR) images were overlaid with confocal scanning-laserophthalmoscope IR reflectance images and IR-referenced spectral-domain optical coherence tomography. Results In eight eyes of six patients, a total of 19 images of medium-large drusen were investigated by AO imaging. En face AO revealed medium-large drusen as highly hyper-reflective round/oval lesions, always centred and/or surrounded by a continuous/discontinuous hyporeflectivity. Cone photoreceptors were detected overlying drusen, appearing either as continuous 'bright' hyper-reflective dots over a 'dark' hyporeflective background, or as continuous 'dark' hyporeflective dots over a 'bright' hyper-reflective background. In eight eyes from eight patients, a total of 14 images of pseudodrusen were investigated by AO imaging. En face AO revealed reticular pseudodrusen as isoreflective lesions, always surrounded by a continuous/ discontinuous hyporeflectivity. Cone photoreceptors were detected overlying pseudodrusen as 'bright' hyperreflective dots over either a hyporeflective or isoreflective background. No 'dark ' hyporefl ective dots were detected in eyes with reticular pseudodrusen only. Cone photoreceptors were counted on the border of the drusen and pseudodrusen, respectively, and in a visibly healthy zone in its absolute vicinity. A similar decrease in cone appearance was observed for drusen and pseudodrusen (15.7% vs 16.2%). Conclusions: AO allows differences in reflectivity between medium-large drusen and reticular pseudodrusen to be appreciated. The cone mosaics may be detected as continuous ' bright' hyper-reflective dots overlying/on the border of drusen and pseudodrusen deposits, and possibly as continuous 'dark' hyporeflective dots overlying drusen only.