Author: Cumali De_irmenci (Turkey)
Co-authors: Filiz Afrashi, Semir Yarımada, Serap Bilge Çeper, Serhad Nalcaci, Cezmi Akkin, Jale Menteş
Purpose
Age related macular degeneration is the leading cause of the blindness among older people in developed countries. It was divided into neovascular and non-neovascular age related macular degeneration. The clinical hallmark of the non neovascular age related macular degeneration is accumulation of the extracellular material under retinal pigment epithelium called drusen. Drusen are subdivided into hard drusen, soft drusen, cuticuler drusen, autosomal dominant drusen and reticular pseudodrusen. The aim of this study was to compare choroidal thickness, luminal area, stromal area and choroidal vascularity index in patients with reticular pseudodrusen and drusen.
Setting/Venue
The study was conducted at Ege University School of Medicine Department of Ophthalmology. It was approved by local ethic committee of Ege University School of Medicine and adhered to the tenets of the Declaration of Helsinki.
Methods
This retrospective analysis was performed among patients with reticular pseudodrusen and drusen who presented at our Retina subdivision. Inclusion criteria were age ≥55 years, the presence of five or more medium-large drusen, reticular pseudodrusen which detected on both infrared imaging and OCT in 2 or more quadrant. Exclusion criteria were neovascular age related macular degeneration, scar, hemorrhage, geographic atrophy, previous treatment including anti vascular endothelial growth factor, photodynamic therapy, or laser photocoagulation. After a detailed ophthalmic examination, infrared reflectance images and optical coherence tomography with enhanced depth imaging mode obtained from all patients. Images were evaluated by 2 independent retina specialist. Image binarization and stromal area, luminal area and choroidal vascularity index were obtained by Image J program. Statistical analysis was performed using SPSS software(version 20; SPSS Inc, Chicago, Illinois, USA). Demographic characteristics were evaluated by chi square test and intergroup evaluations performed by student t test. A p-value less than 0.05 (typically ≤ 0.05) is considered as statistically significant.
Results
A total of 100 eyes of 100 patients with non neovascular age related macular degeneration recruited to the study (48 eyes of 48 patients with reticular pseudodrusen (Group 1) and 52 eyes of the 52 patients with drusen (Group 2)). Female/Male ratio was 56/44. The mean age of the Group 1 patients 73.63±6.14 (61-91) years; 69.43± 6.97 (59-87) in Group 2 patients. The difference was statistically significant (p=0.005). Choroidal thickness, total choroidal area, stromal area and luminal area was significantly lower in Group 1 patients (p values <0,001 Respectively) and choroidal vascularity index, foveal thicknesses was not statistically significant between groups.(p values 0,214 and 0,384 respectively). Reticular pseudodrusen was detected in 48/48 (100%) of the patients in superior quadrant, in 41/48 (85.4%) of the patients in temporal quadrant in 36/48 (75%) of the patients in nasal quadrant and in 34/48 (70.8%) of the patients in inferior quadrant.
Conlusions
Total choroidal area, stromal area and luminal area which reflecting choroidal vasculature were decreased in patients with reticular pseudodrusen. These results may lead to obtain valuable data to detect pathophysiology of the disease.
Financial Disclosure
No financial interest for all authors
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