En face optical coherence tomography (OCT) imaging can diagnose and monitor calcified drusen in patients with age-related macular degeneration (AMD), according to a study published in Ophthalmology Science. This method can also be used to document lesions as they progress to complete retinal pigment epithelium and outer retinal atrophy (cRORA), the researchers note.   

Researchers retroscopically reviewed the records of 220 eyes of 139 patients (median age 78 years, 65.5% women) with non-exudative AMD from June 2016 to November 2021. They obtained same-day color fundus (CF), fundus autofluorescence (FAF), near infrared (NIR), and en face swept-source OCT (SS-OCT) images. The team used the images to identify eyes with non-exudative AMD and calcified drusen, and compared the appearance and progression of these lesions using the different imaging modalities. The main outcome objective was to compare the ability of CF to detect calcified drusen with the ability of FAF, NIR, and en face SS-OCT imaging to identify these lesions.

Investigator noted that 94 eyes (42.7%) contained calcified drusen either at baseline or during the study period. Additionally, they observed a regression of calcified drusen in 6 eyes which never progressed to cRORA. The team determined that NIR and FAF images alone were not reliable with respect to identifying calcified drusen. They highlighted the simplicity of en face OCT and stated that when combined with B-scans, it could sufficiently detect and monitor calcified drusen without other imaging methods, according to the report.


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“Regardless of whether calcified drusen have reached the point of no return in the progression from drusen to cRORA, we propose that the use of en face OCT imaging to identify and monitor calcified drusen will be a valuable strategy for assessing the overall risk of disease progression and for managing expectations of patients with AMD,” according to the researchers. 

The study is limited by its relatively small sample size, single center design, and retrospective nature. 

Disclosure: This research was supported by Carl Zeiss Meditech, Inc. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.  

Reference

Liu J, Laiginhas R, Shen M, et al. Multimodal imaging and en face OCT detection of calcified drusen in eyes with age-related macular degeneration. Ophthalmol Sci. Published online April 20, 2022. doi:10.1016/j.xops.2022.100162