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Retinal thickness changes through history of drusen in AMD

24/10/2018By Myles Hume
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Australian researchers have examined how the natural history of drusen affects retinal thickness, providing important insight for future studies of age-related macular degeneration (AMD).

Researchers from University of New South Wales School of Optometry and Vision Science (SOVS), and the Centre for Eye Health hope grasping the full breadth of retinal changes associated with drusen will improve understanding of disease pathogenesis.

Drusen are associated with retinal thinning in AMD. However, these changes have mostly been examined at single time points, ignoring the evolution of drusen from emergence to regression.

Working with the Department of Ophthalmology at Sydney’s Prince of Wales Hospital, the researchers aimed to assess how the natural history of drusen affected retinal thickness, focusing on the photoreceptor and retinal pigment epithelium (RPE) layers. They found before drusen emergence, the RPE was significantly thicker at the drusen site compared with neighbouring drusen-free areas.

There was a 71% sensitivity of RPE thickening predicting drusen emergence. Once drusen emerged, significant thinning of all outer retinal layers was observed, which was consistent with previous studies.

They said drusen growth was “significantly correlated” with thinning of the outer retina. Drusen regression resulted in outer retinal layers returning to thicknesses not significantly different from baseline.

The researchers concluded the natural history of drusen was associated with RPE thickening before drusen emergence, thinning of the outer nuclear layer as well as photoreceptor and RPE layers proportional to drusen growth, and return to baseline thickness after drusen regression.

“These findings have useful clinical applications, providing a potential marker for predicting drusen emergence for AMD prognostic and intervention studies and highlighting that areas of normal retinal thickness in AMD may be former sites of regressed drusen,” the research authors said.

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