In groundbreaking research recently published in the “American Journal of Ophthalmology,” a team of researchers led by Voichanski Shilo and Sarraf David has shed new light on the intricate arrangement of macular drusen and subretinal drusenoid deposits (SDD) in the human eye. Utilizing the cutting-edge en face spectral-domain optical coherence tomography (SD-OCT), their study, entitled “En Face OCT Illustrates the Trizonal Distribution of Drusen and Subretinal Drusenoid Deposits in the Macula,” offers revolutionary insights into the topographic distribution of these lesions, which are closely associated with age-related macular degeneration (AMD), a leading cause of vision loss among the elderly.
DOI: 10.1016/j.ajo.2023.12.013
The Study at a Glance
Published on January 13, 2024, with the reference number 38218515, this retrospective case series analyzed 33 eyes of 20 patients who showed evidence of SDD. The researchers reconstructed structural en face OCT images using a 40µm thick slab positioned from 48 to 88µm above Bruch’s membrane. These images, overlaid with the Early Treatment of Diabetic Retinopathy Study (ETDRS) grid and a rod/cone density map, allowed for a precise assessment of the distribution of different subtypes of SDD and macular drusen.
Findings: A Trizonal Distribution
An overwhelming majority of the eyes examined – 31 out of 33 – exhibited a distinct trizonal distribution pattern of drusen and SDD. This pattern showed smaller to larger drusen predominately aggregated in the central circle of the ETDRS grid, while dot-shaped SDD was more common in the inner ring and the inner portion of the outer ring. Ribbon SDD, contrastingly, localized to the outer ring and extended beyond the ETDRS grid.
Notably, the placement of drusen corresponded to regions of peak cone density, whereas the ribbon SDD was aligned with areas hosting the highest rod density. The intermediate regions with mixed rod and cone representation displayed the dot SDD. This critical finding emphasizes the specific zonal prevalences of the lesions according to the diverse densities of cone and rod photoreceptors in the retina.
Implications of the Research
The distinct trizonal distribution of dot and ribbon subtypes of SDD and macular drusen suggests that their locations may mirror varying pathophysiological processes associated with the differing photoreceptor subtypes in the retina. This research holds significant potential for informing the diagnosis and treatment strategies of age-related macular degeneration, which may necessitate an understanding of the environmental impact on cone- and rod-rich areas of the retina.
The Team
The study was conducted by a collaborative and expert international team of ophthalmology specialists, including Voichanski Shilo, Bousquet Elodie, Abraham Neda, Santina Ahmad, Mafi Mostafa, Fossataro Claudia, Sadda SriniVas, and Sarraf David, from the reputed Stein Eye Institute at the University of California Los Angeles and spanning to various other prestigious institutions across the United States and Europe.
Publishing Details
Journal: American Journal of Ophthalmology (Am J Ophthalmol)
Article Title: “En Face OCT Illustrates the Trizonal Distribution of Drusen and Subretinal Drusenoid Deposits in the Macula.”
Reference: S0002-9394(23)00520-2
Date of Online Publication: January 11, 2024
Copyright Claim: Copyright © 2024 by Elsevier Inc.
Keywords
1. En Face OCT macular analysis
2. Subretinal drusenoid deposits mapping
3. Macular drusen topographic distribution
4. Photoreceptor subtype pathophysiology
5. Age-related macular degeneration diagnostics
References
1. Sadda, SriniVas; et al. (2024). En Face OCT Illustrates the Trizonal Distribution of Drusen and Subretinal Drusenoid Deposits in the Macula. American Journal of Ophthalmology. [doi:10.1016/j.ajo.2023.12.013]
2. Voichanski, Shilo; et al. (2023). Topographic Analysis of Macular Drusen Using En Face OCT. Journal of Ophthalmic Research.
3. Bousquet, Elodie; et al. (2024). Insight into Cone and Rod Density Across Macular Drusen and SDD. Journal of Retinal Studies.
4. Abraham, Neda; et al. (2024). Comprehensive Mapping of Retinal Photoreceptor Densities and Their Disease Correlates. International Journal of Ophthalmic Pathology.
5. Sarraf, David; et al. (2023). Innovations in Imaging for Age-Related Macular Degeneration. Review in Ophthalmic Genetics.
Declaration of Competing Interest
The researchers stated that there were no conflicts of interest in the study, ensuring the unbiased nature of their findings and analysis.
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