Associations Between Retinal Pigment Epithelium and Drusen Volume Changes During the Lifecycle of Large Drusenoid Pigment Epithelial Detachments
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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.
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Increasing expression of inflammatory complement protein C3 in the aging rodent retina is associated with progressive extracellular deposits between the retinal pigment epithelium (RPE) and Bruch's membrane (BM), which contribute to retinal degeneration.
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- Authors
- Balaratnasingam, C., Yannuzzi, L. A., Curcio, C. A., Morgan, W. H., Querques, G., Capuano, V., Souied, E., Jung, J., & Freund, K. B.
- Affiliations
- Lions Eye Institute (AU)
- Manhattan Eye, Ear and Throat Hospital (US)
- University of Alabama (US)
- New York University (US)
- Vita-Salute San Raffaele University (IT)
- Université Paris-Est Créteil (FR)
- Corresponding author
- Freund, K. Bailey
- ORCID
- Venue
- Investigative Opthalmology & Visual Science
- Published
- 2016-10-19
- Volume
- 57
- Issue
- 13
- Pages
- 5479
- ISSN
- 0146-0404 (ISSN-L)
- 1552-5783
- PMC
- PMC5072538
- OpenAlex
- W2537146178
- Cited by
- 144
- References
- 44
- Citations by year
- 2026: 12 · 2025: 11 · 2024: 14 · 2023: 9 · 2022: 23 · 2021: 20 · 2020: 19 · 2019: 11 · 2018: 16 · 2017: 9
- FWCI
- 12.75
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Investigative Ophthalmology & Visual Science (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- UWA Profiles and Research Repository (UWA) (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- Funders
- National Eye Institute (R01EY006109)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal and Macular Surgery
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
- Keywords
- retinal pigment epithelium, drusen volume, age-related macular degeneration, visual acuity, retinal pigment epithelium atrophy
- MeSH terms
- Aged, Aged, 80 and over, Female, Fluorescein Angiography, Follow-Up Studies, Fundus Oculi, Humans, Male, Middle Aged, Prognosis, Retinal Detachment, Retrospective Studies, Time Factors, Visual Acuity, Retinal Drusen, Disease Progression, Tomography, Optical Coherence, Retinal Pigment Epithelium
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