Long-term Choroidal Thickness Changes in Eyes With Drusenoid Pigment Epithelium Detachment

Dolz-Marco, Rosa; Balaratnasingam, Chandrakumar; Gattoussi, Sarra; Ahn, Seungjun; Yannuzzi, Lawrence A.; Freund, K. Bailey

doi:10.1016/j.ajo.2018.03.038

Cited by 15 publications

(14 citation statements)

References 31 publications

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“…Yellow subretinal deposits called drusen, or extracellular protein aggregates of retinal pigment epithelial (RPE) cells [ 7 ], as well as the accumulation of intracellular lipofuscin [ 8 ], can be found under an ophthalmoscope. Larger drusen may become confluent and evolve into drusenoid RPE detachments [ 9 ], which often progress to geographic atrophy and less frequently to neovascular AMD. Geographic atrophy is the main pathological feature of dry AMD and can lead to severe visual loss when involving the center of the macula [ 10 ].…”

Section: Age-related Macular Degenerationmentioning

confidence: 99%

Autophagy in Age-Related Macular Degeneration: A Regulatory Mechanism of Oxidative Stress

Zhang

Bao

Cong

et al. 2020

Oxidative Medicine and Cellular Longevity

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Age-related macular degeneration (AMD) is a leading cause of severe visual loss and irreversible blindness in the elderly population worldwide. Retinal pigment epithelial (RPE) cells are the major site of pathological alterations in AMD. They are responsible for the phagocytosis of shed photoreceptor outer segments (POSs) and clearance of cellular waste under physiological conditions. Age-related, cumulative oxidative stimuli contribute to the pathogenesis of AMD. Excessive oxidative stress induces RPE cell degeneration and incomplete digestion of POSs, leading to the continuous accumulation of cellular waste (such as lipofuscin). Autophagy is a major system of degradation of damaged or unnecessary proteins. However, degenerative RPE cells in AMD patients cannot perform autophagy sufficiently to resist oxidative damage. Increasing evidence supports the idea that enhancing the autophagic process can properly alleviate oxidative injury in AMD and protect RPE and photoreceptor cells from degeneration and death, although overactivated autophagy may lead to cell death at early stages of retinal degenerative diseases. The crosstalk among the NFE2L2, PGC-1, p62, AMPK, and PI3K/Akt/mTOR pathways may play a crucial role in improving disturbed autophagy and mitigating the progression of AMD. In this review, we discuss how autophagy prevents oxidative damage in AMD, summarize potential neuroprotective strategies for therapeutic interventions, and provide an overview of these neuroprotective mechanisms.

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Section: Age-related Macular Degenerationmentioning

confidence: 99%

Autophagy in Age-Related Macular Degeneration: A Regulatory Mechanism of Oxidative Stress

Zhang

Bao

Cong

et al. 2020

Oxidative Medicine and Cellular Longevity

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“…These parameters include choroidal thickness and the newer CVI, which has demonstrated high reproducibility and validity in estimating pathophysiological variations of the human choroid. 50 – 52 …”

Section: Discussionmentioning

confidence: 99%

Functional Correlates of Outer Retina Remodeling in Intermediate Age-Related Macular Degeneration Using Microperimetry

Fragiotta

Costanzo

Viggiano

et al. 2022

Invest. Ophthalmol. Vis. Sci.

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Purpose To assess the effect of drusen morphometric changes and choroidal vascular modifications on retinal sensitivity (RS) evaluated through microperimetry in intermediate age-related macular degeneration (iAMD). Methods A retrospective review of 18 iAMD patients (18 eyes) with a 12-month follow-up was performed. Eye-tracked spectral-domain optical coherence tomography was obtained, with automatic segmentation of the outer retinal layer (ORL) delineating the drusen area from the external limiting membrane to Bruch's membrane and outer nuclear layer (ONL) thickness maps adjusted manually, as needed. Advanced retinal pigment epithelium analysis was also performed with a ZEISS PLEX Elite 900. Microperimetry obtained under mesopic conditions was overlaid with the corresponding thickness maps with Fiji software. The choroidal vascularity index (CVI) was calculated in the subfoveal b-scan and volumetric in the central 1-mm subfield. Results A reduced central ONL thickness was strongly associated with RS decline at the same region ( r = 0.69, P = 0.002) and globally ( r = 0.80, P < 0.001) at baseline, but also at 1 year in the central subfield (central: r = 0.70, P = 0.001). One-year subfoveal CVI variation, differently from volumetric CVI, directly influenced the central ( r = 0.64, P = 0.004) and global RS ( r = 0.59, P = 0.009), indicating that a CVI reduction negatively affected RS. A greater volumetric CVI within central 1-mm was associated with ORL thickening at 1 year ( r = 0.61, P = 0.008). Conclusions Progressive degeneration of the ONL is related to irreversible photoreceptor dysfunction in iAMD. Likewise, choroidal vascular modifications are associated with a significant functional decline in the central region and diffusely.

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“…4 However, there have been no reports regarding the prevalence of drusenoid PED in epidemiological studies except AREDS, and there are a few studies investigating the natural history of drusenoid PED using SD-OCT in clinic-based studies. 5,8,9 Balaratnasigam et al conducted a longitudinal study investigating 21 eyes with large drusenoid PED (mean PED width:2427µm) using SD-OCT and demonstrated that baseline PED volume was associated with PED collapse leading to GA. 5 On the other hand, Fragiotta et al studied the risk factors for neovascular AMD using 73 eyes with intermediate AMD and revealed that the presence of drusenoid PED increased the risk for neovascular AMD and the PED width, but not height, which was associated with the development of neovascular AMD. 8 The results are consistent with the results of the present study.…”

Section: Discussionmentioning

confidence: 99%

“…However, we could not nd any association between baseline subfoveal choroidal thickness and GA development. 9 Several studies in Asia have studied the 5-year incidence of second eye involvement in contralateral eyes with MNV. [10][11][12][13][14][15] In eyes with unilateral PCV and unilateral neovascular AMD, the 5-year incidence of second eye MNV involvement was 9.3% and 11.3%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Incidence and risk of advanced age-related macular degeneration in eyes with drusenoid pigment epithelial detachment

Shijo

Sakurada

Takada

et al. 2022

Preprint

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Purpose To investigate the incidence and risk of advanced age-related macular degeneration (AMD), including geographic atrophy (GA) and macular neovascularization (MNV), in eyes with drusenoid pigment epithelial detachment (PED). Methods Eighty-five eyes with drusenoid PED from 85 patients (77.2 ± 7.0 years, male/female:44/41) were included in this study. Patients were followed up every 1–3 months via spectral-domain optical coherence tomography (SD-OCT) and color fundus photography. If exudation was observed on SD-OCT, fluorescein and indocyanine green angiography were performed to confirm the MNV subtype accordingly. The maximum follow-up period was 60 months. Results During the study period, GA developed in 8 eyes while MNV also developed in 8 eyes. The Kaplan-Meier estimator revealed that the cumulative incidence for 60 months was 17.9% and 12.2% for GA and MNV, respectively. In eyes developing MNV, retinal angiomatous proliferation (type 3 neovascularization) was the most common. Cox regression analysis revealed that baseline PED width was the only factor associated with advanced AMD. (p = 0.006, Cox regression analysis). Conclusions The five-year cumulative incidence of advanced AMD, including GA and MNV, was approximately 30% in eyes with drusenoid PED among the Japanese elderly. A larger baseline PED width was the only risk factor for advanced AMD.

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Long-term Choroidal Thickness Changes in Eyes With Drusenoid Pigment Epithelium Detachment

Cited by 15 publications

References 31 publications

Autophagy in Age-Related Macular Degeneration: A Regulatory Mechanism of Oxidative Stress

Autophagy in Age-Related Macular Degeneration: A Regulatory Mechanism of Oxidative Stress

Functional Correlates of Outer Retina Remodeling in Intermediate Age-Related Macular Degeneration Using Microperimetry

Incidence and risk of advanced age-related macular degeneration in eyes with drusenoid pigment epithelial detachment

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