Influence of drusenoid pigment epithelial detachments on the progression of age-related macular degeneration and visual acuity

Marlene Hollaus; Johannes Iby; Jonas Brugger; Oliver Leingang; Gregor S Reiter; Ursula Schmidt-Erfurth; Stefan Sacu

doi:10.1016/j.jcjo.2023.12.007

Influence of drusenoid pigment epithelial detachments on the progression of age-related macular degeneration and visual acuity

Can J Ophthalmol. 2024 Jan 11:S0008-4182(23)00386-1. doi: 10.1016/j.jcjo.2023.12.007. Online ahead of print.

Authors

Marlene Hollaus¹, Johannes Iby¹, Jonas Brugger², Oliver Leingang³, Gregor S Reiter³, Ursula Schmidt-Erfurth³, Stefan Sacu⁴

Affiliations

¹ Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria; Vienna Clinical Trial Center, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
² Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
³ Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
⁴ Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria; Vienna Clinical Trial Center, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria. Electronic address: stefan.sacu@meduniwien.ac.at.

PMID: 38219789
DOI: 10.1016/j.jcjo.2023.12.007

Abstract

Objective: To analyze the presence and morphologic characteristics of drusenoid pigment epithelial detachments (DPEDs) in spectral-domain optical coherence tomography (SD-OCT) in Caucasian patients with early and intermediate age-related macular degeneration (AMD) as well as the influence of these characteristics on best-corrected visual acuity (BCVA) and disease progression.

Design: Prospective observational cohort study.

Participants: 89 eyes of 56 patients with early and intermediate AMD.

Methods: Examinations consisted of BCVA, SD-OCT, and indocyanine green angiography. Evaluated parameters included drusen type, mean drusen height and -volume, the presence of DPED, DPED maximum height, -maximum diameter, -volume, topographic location, the rate of DPED collapse, and the development of macular neovascularization (MNV) or geographic atrophy (GA).

Results: DPED maximum height (162.34 µm ± 75.70 μm, p = 0.019) was significantly associated with the development of GA and MNV. For each additional 100 μm in maximum height, the odds of developing any late AMD (GA or MNV) increased by 2.23 (95% CI = 1.14-4.35). The presence of DPED (44 eyes, p = 0.01), its volume (0.20 mm ± 0.20 mm, p = 0.01), maximum diameter (1860.87 μm ± 880.74 μm, p = 0.03), maximum height (p < 0.001) and topographical location in the central millimetre (p = 0.004) of the Early Treatment Diabetic Retinopathy Study (ETDRS)-Grid were significantly correlated with BCVA at the last follow-up (0.15logMAR ± 0.20logMAR; Snellen equivalent approximately 20/28). DPEDs occurred significantly less in the outer quadrants than in the central millimetre and inner quadrants of ETDRS-Grid (all p values < 0.001).

Conclusions: The height of drusen and DPEDs is a biomarker that is significantly associated with the development of late AMD and visual loss. DPEDs affect predominantly the center and inner quadrants of the ETDRS-Grid.