Abstract

DO.18.04

High-resolution optical coherence tomography in pseudovitelliform macular degeneration

Robert P. Finger, Peter Charbel Issa, Monika Fleckenstein, Hendrik P. N. Scholl, Frank G. Holz
Universitäts-Augenklinik Bonn

Objective: Visual prognosis in patients with pseudovitelliform macular degeneration (pv-MD) as a phenotypic variation of basal laminar drusen, pattern dystrophy or age-related macular degeneration is generally good. However, progression with secondary choroidal neovascularization or geographic atrophy can occur. To gain a better understanding of the underlying retinal morphological alterations, we investigated retinal pathology using high resolution (spectral-domain) SDOCT.
Methods: Five patients (10 eyes) with pv-MD were examined clinically as well as imaged using fundus photography (FF450, Zeiss), fluorescein angiography, fundus autofluorescence and SDOCT (HRA Spectralis, Heidelberg Engineering).
Results: Mean age was 70 years (58 - 81 yrs) and mean best-corrected distance visual acuity 0,24. Correlating to the funduscopically visible accumulation of yellow-grey material which showed an increased fundus autofluorescence the neurosensory detachment was filled with an amorphous, homogenously reflective material lacoated between RPE and neurosensory retina in the lower part with the upper part of the lesion being optically empty. The RPE basal membrane/Bruch’s membrane band on SDOCT showed multiple, focal tumescences, in analogy to histological descriptions of BLD.
Conclusions: Visual prognosis of patients with pv-MD is extraordinarily good against the background of extensive morphological alterations. This could be explained by the location of the lesion below an anatomically relatively intact neurosensory retina as well as an intact RPE. Transport and function of cellular elements in the area of the chronic neurosensory detachment and extracellular debris accumulation seems to be functioning near to normal. The observed changes on SDOCT imaging show differences of BLDs compared to other drusen and correlate to described histological findings in eyes with BLDs.

Copyright: 2009 Porstmann Kongresse GmbH. All rights reserved. Impressum, Disclaimer.