Adult Vitelliform Macular Detachment Occurring in Patients with Basal Laminar Drusen

Histology, Dimensions, and Fluorescein Staining Characteristics of Nodular and Cuticular Drusen in Age-Related Macular Degeneration

“…Numerous small yellow dots and corresponding small puncta of hyperfluorescence formed a canonical “starry sky” pattern. 10 By light microscopy, the coloration in Figure 4, C and D differs from that in Figures 2 and 3, because of differences in postfixation and staining. Like nodular drusen in Figures 2 and 3, cuticular drusen in this eye (Figure 4C) are globular and have a solid homogeneous appearance and little overlying BLamD.…”

“…9 Eyes with "starry sky" appearance in FA have numerous small cuticular drusen (originally called basal laminar drusen). 10,11 On OCT, these correspond to low-lying RPE elevations, a saw-toothed pattern, and broad mound-shaped elevations resembling soft drusen, the latter two with internal hyporeflectivity. The same proteins are immunodetected in cuticular drusen as in extramacular nodular drusen 1 12 ; lipids have not yet been assessed.…”

Clinical Manifestations of Cuticular Drusen: Current Perspectives

“…One of the first clinical associations described for cuticular drusen was the vitelliform macular lesion. 2 Patients with the combination of vitelliform macular detachment and cuticular drusen were younger and presented with worse visual acuity when compared with adult-onset vitelliform macular dystrophy. 38 The prevalence of acquired vitelliform lesions in patients with cuticular drusen varied by ethnic group from 1.2% in the Asian population to 24.2% in Caucasians.…”

“…1 These alterations were initially thought to represent nodular thickening of the basement membrane of the retinal pigment epithelium (RPE), and thus named "basal laminar drusen". 2 Later, the histopathological correlation demonstrated that basal laminar drusen share with conventional drusen the localization between RPE-basal lamina (BL) and Bruch's membrane (BrM). 3 Therefore, the term "cuticular" drusen was preferred to connotate a similar ultrastructure to conventional drusen.…”

“…3 Therefore, the term "cuticular" drusen was preferred to connotate a similar ultrastructure to conventional drusen. 2,4,5 Although sharing a similar content with hard drusen, cuticular drusen are numerous and tend to coalescence, resulting in a peculiar diffuse distribution. 6 Major advances in multimodal imaging have permitted an accurate characterization of the cuticular drusen, identifying imaging criteria that allow a distinction with other drusen subtypes.…”