China
Africa
Explore chapters and articles related to this topic
Polypoidal Choroidal Vasculopathy
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
Epidemiological evidence may support pachychoroid being an important risk factor for developing PCV. In population-based studies, the Beijing Eye Study showed that thicker subfoveal and central choroidal thickness was observed in PCV eyes compared with controls.19 In line with this, soft drusen are more infrequent. Pachydrusen,56 or peculiar large drusenoid deposits, which are reportedly associated with pachychoroid, may be found in PCV patients. However, there are no diagnostic criteria for pachychoroid. As such, the experts in this field agree that there is a need to develop multimodal imaging diagnostic criteria for pachychoroid.
Paper 4
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
Drusen are usually small areas of bilateral calcification overlying the optic nerve and are not a unilateral finding, such as in this case. Choroidal osteomas do occur unilaterally and manifest as curvilinear calcification which are usually larger than drusen and normally spare the optic disc.
There is Something Strange and Unusual at the Back of the Eye
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
A naevus is generally relatively well defined and flat, of varying sizes, often with a depigmented halo. Overlying drusen are a reassuring feature (see Figure 12.1). Naevi are present in 5%–10% of Caucasians and rarer in darker skinned individuals. The lifetime risk of malignant transformation is only around 1%, and these can happily be monitored on an annual basis in a community by optometrists with imaging facilities.
Are macular drusen in midlife a marker of accelerated biological ageing?
Published in Clinical and Experimental Optometry, 2023
Graham A Wilson, Kirsten Cheyne, Sandhya Ramrakha, Antony Ambler, Gavin SW Tan, Avshalom Caspi, Ben Williams, Karen Sugden, Renate Houts, Rachael L Niederer, Tien Yin Wong, Terrie E Moffitt, Richie Poulton
The eye is a good model for studying ageing; not just because it can be imaged non-invasively, but because it allows non-invasive imaging of neurological and vascular tissue.8 Macular drusen are yellow deposits deep within the retina that are easily identifiable on clinical examination or retinal photography. Drusen are accumulations of extracellular debris and come in a range of morphologies.9 While the initiation and growth of drusen and the mechanisms underlying drusen remain a key area of research, it is well established that drusen are the hallmark of age-related macular degeneration (AMD), a disease for which age is the strongest risk factor.10,11 Estimated 8.4 million people worldwide have moderate-to-severe vision loss caused by AMD.12
Retinal findings in glomerulonephritis
Published in Clinical and Experimental Optometry, 2022
Heather G Mack, Deborah J Colville, Phillip Harraka, Judith Anne Savige, Alessandro Invernizzi, Samantha Fraser-Bell
Clinical testing for complement abnormalities is not part of routine eye care practice or general medical practice. Optional complement testing by nephrologists includes measurement of C3 and C4 protein levels. Low C3 levels support the concept of complement activation, and normal C4 levels suggest the alternative pathway is not involved. Genetic testing for complement factor H mutations of young patients (< 50 years) with drusen and known renal disease may support a diagnosis of dense deposit disease (which requires renal biopsy for diagnosis), the most visually threatening of the forms of glomerulonephritis,41,52,67,112–115 as well as confirming the mode of inheritance and the likelihood of other family members being affected. Mutations of Complement factor H resulting in dense deposit disease are typically inherited in an autosomal recessive manner. However, the genetics is complex and multifactorial with associations between Complement factor H and Complement factor H receptor 5 genes recognised, and there are rare reports of possible dominant inheritance in C3 glomerulonephritis. Further, polymorphisms in Complement factor H are thought to be common in the general population.116 An ideal biomarker of complement activation and subsequent ocular involvement with visual loss is yet to be identified. At present the closest approximation is identification of retinal abnormalities, particularly drusen.
State-of-the art pharmacotherapy for non-neovascular age-related macular degeneration
Published in Expert Opinion on Pharmacotherapy, 2020
Daniele Veritti, Valentina Sarao, Francesco Samassa, Carla Danese, Anat Löwenstein, Ursula Schmidt-Erfurth, Paolo Lanzetta
Drusen are yellowish-white deposits of extracellular material located between RPE cells and the inner collagenous zone of Bruch’s membrane. The size and density of drusen are determinant factors in the progression of the disease. According to their appearance and size drusen are classified in the two basic categories: hard drusen, that appear as well-demarcated yellow deposits smaller than 63 µm; and soft drusen, that are greater than 63 µm and not sharply defined. Drusen with advancing age usually increase in their amount [32]. Hard drusen are frequently associated with the occurrence of non-neovascular AMD, but they are associated with low risk of progression to late forms of AMD [33]. Instead, soft drusen can coalesce to form drusenoid detachments of the RPE and their presence is an important risk factor for developing advanced forms of AMD. GA is end-stage AMD and it is characterized by well-circumscribed area of RPE atrophy. GA leads to a gradual, progressive visual decline, mostly because of photoreceptor loss.