Serena Fragiotta1,2,3, Pedro Fernández-Avellaneda1,2,4, Mark P Breazzano1,2,5,6, Christine A Curcio7, Belinda C S Leong1,2, Kenneth Kato1, Lawrence A Yannuzzi1,2,5,6, K Bailey Freund1,2,5,6. 1. Vitreous Retina Macula Consultants of New York, New York, New York, United States. 2. LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York, United States. 3. Department of Medico-Surgical Sciences and Biotechnologies, U.O.S.D. Ophthalmology, Sapienza University of Rome, Rome, Italy. 4. Department of Ophthalmology, Basurto University Hospital, Bilbao, Spain. 5. Department of Ophthalmology, New York University School of Medicine, New York, New York, United States. 6. Columbia University College of Physicians and Surgeons, Harkness Eye Institute, New York, New York, United States. 7. Department of Ophthalmology and Visual Science, University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama, United States.
Abstract
Purpose: To explore patterns of disease progression in nonneovascular age-related macular degeneration (AMD) associated with hyperreflective crystalline deposits (HCDs) in the sub-retinal pigment epithelium-basal laminar space. Methods: Retrospective review of medical records, multimodal imaging, and longitudinal eye-tracked near-infrared reflectance (NIR) and optical coherence tomography (OCT) spanning ≥2 years. NIR/OCT images were analyzed with ImageJ software to identify HCD morphology and location. Associated macular complications were reviewed from the time of HCD detection to the most recent follow-up, using NIR/OCT. Results: Thirty-three eyes with HCDs from 33 patients (mean age: 72 ± 7.5 years) had 46.7 months (95% confidence limits: 33.7, 59.6) of serial eye-tracked NIR/OCT follow-up. Baseline best-corrected visual acuity (BCVA) was 0.44 logMAR (Snellen equivalent 20/55). At a mean of 11.3 months (3.1, 19.6) after HCD detection, 31/33 (93.9%) eyes had developed macular complications including de novo areas of complete retinal pigment epithelium and outer retinal atrophy (cRORA) in 21/33 (64%) eyes, enlargement of preexisting cRORA in 4/33 (12%) eyes, and incident macular neovascularization in 3/33 (9%) eyes. Movement and clearance of HCDs in 9/33 (27%) eyes was associated with enlargement of preexisting cRORA (r = 0.44, P = 0.02). BCVA at the last follow-up visit had decreased to 0.72 logMAR (20/105). Conclusions: Eyes with nonneovascular AMD demonstrating HCDs are at risk for vision loss due to macular complications, particularly when movement and clearance of these structures appear on multimodal imaging. HCD reflectivity and dynamism may be amenable to automated recognition and analysis to assess cellular activity related to drusen end-stages.
Purpose: To explore patterns of disease progression in nonneovascular age-related macular degeneration (AMD) associated with hyperreflective crystalline deposits (HCDs) in the sub-retinal pigment epithelium-basal laminar space. Methods: Retrospective review of medical records, multimodal imaging, and longitudinal eye-tracked near-infrared reflectance (NIR) and optical coherence tomography (OCT) spanning ≥2 years. NIR/OCT images were analyzed with ImageJ software to identify HCD morphology and location. Associated macular complications were reviewed from the time of HCD detection to the most recent follow-up, using NIR/OCT. Results: Thirty-three eyes with HCDs from 33 patients (mean age: 72 ± 7.5 years) had 46.7 months (95% confidence limits: 33.7, 59.6) of serial eye-tracked NIR/OCT follow-up. Baseline best-corrected visual acuity (BCVA) was 0.44 logMAR (Snellen equivalent 20/55). At a mean of 11.3 months (3.1, 19.6) after HCD detection, 31/33 (93.9%) eyes had developed macular complications including de novo areas of complete retinal pigment epithelium and outer retinal atrophy (cRORA) in 21/33 (64%) eyes, enlargement of preexisting cRORA in 4/33 (12%) eyes, and incident macular neovascularization in 3/33 (9%) eyes. Movement and clearance of HCDs in 9/33 (27%) eyes was associated with enlargement of preexisting cRORA (r = 0.44, P = 0.02). BCVA at the last follow-up visit had decreased to 0.72 logMAR (20/105). Conclusions: Eyes with nonneovascular AMD demonstrating HCDs are at risk for vision loss due to macular complications, particularly when movement and clearance of these structures appear on multimodal imaging. HCD reflectivity and dynamism may be amenable to automated recognition and analysis to assess cellular activity related to drusen end-stages.
Authors: Serena Fragiotta; Pedro Fernández-Avellaneda; Mark P Breazzano; Lawrence A Yannuzzi; Christine A Curcio; K Bailey Freund Journal: Graefes Arch Clin Exp Ophthalmol Date: 2019-12-26 Impact factor: 3.117
Authors: Gavin W Roddy; Robert H Rosa; Kimberly B Viker; Bradley H Holman; Cheryl R Hann; Anuradha Krishnan; Gregory J Gores; Sophie J Bakri; Michael P Fautsch Journal: Curr Eye Res Date: 2019-12-02 Impact factor: 2.424
Authors: Serena Fragiotta; Mariacristina Parravano; Riccardo Sacconi; Eliana Costanzo; Daniele De Geronimo; Francesco Prascina; Vittorio Capuano; Eric H Souied; Ian C Han; Robert Mullins; Giuseppe Querques Journal: Sci Rep Date: 2022-09-07 Impact factor: 4.996