Table 1 This table resumes the exams used by previous authors to describe retinal drusen
Authors, Journal (Year of publication) | Number of cases | Symptoms | Clinical findings | Imaging Findings | Lesions |
|---|---|---|---|---|---|
Savige J et al., Ophthalmic Genet (2016) | 6 | visual acuity normal or near normal initially. First symptom: impaired night vision, progression to loss of peripheral vision | bilateral symmetrical drusen. 2 types: 1. basal laminar drusen = small, numerous, yellow. 2. large soft whitish-yellow. Retinal atrophy after 15 years and choroidal neovascularization | OCT: irregularities in RPE surface, RPE detachments, neovascular membranes. Fluorescein angiography: starry sky appearance of druse, multiple small hyperfluorescent spots throughout retina and complications. Amsler grid:distorsion with late complications multifocal ERG: lower amplitudes and lower peak amplitude with retinal atrophy | typical drusen, PED, CNV and atrophy |
Dalvin LA et al., Retin Cases Brief Rep (2016) | 2 | 1. VA 20/300 in both eyes with eccentric fixation2. VA 20/20 inboth eyes | peripheral drusen, subretinal and RPE fibrosis, RPE hypertrophy, scarring | OCT: drusen Fluorescein angiography: areas of hypofluorescence corresponding to subretinal fibrosis surrounded by leakage, window defects, andmultiple drusen | typical drusen, subretinal fibrosis |
Adhi M et al., Ophthalmic Surg Lasers Imaging Retina (2014) | 1 | progressive loss of vision secondary to CNV in RE, and new distorsion of vision in the LE | hemorrhage and subretinal fluid superonasal to the macula | OCT: RPE detachment, irregular and prominent Bruch’s membrane ICG angiography: no definitive signs of CNV | PED, suspicion of CNV |
Empeslidis T et al., Case Rep Ophthalmol Med (2012) | 1 | problems with near vision tasks | signs consistent with RPE detachments and small drusen-like lesions | OCT: PEDs, intraretinal fluid in a cystoid form of less than 50um in the inner retinal layers. No subretinal fluidFluorescein angiography: early phase: window defect due to basal lamina drusen; late phase: staining of hyperfluorescence. No leakage. RPE layer intact. | typical drusen. PED, intraretinal fluid with no subretinal fluid. No CNV |
Ritter M et al., Br J Ophthalmol (2010) | 3 | VA normal or slightly reduced | drusen: temporal in early cases, and throughout the retina in advanced cases | OCT: RPE elevations, areas of compression of the photoreceptor layer missing of IS/OS and ELM backreflection Microperimetry: reduced sensitivity in areas of high drusen density | typical drusen |
Han et al., Arch Ophthalmol (2009) | 1 | VA normal in LE, and 20/30 in RE | bilateral multifocal, 200-300um yellowish lesions at choroid and subretinal pigment epithelial level | OCT: lucent focal elevations of RPE Fluorescein and indocyanine Angiography: staining of lesions throughout the fundi, more numerous than those observed by ophthalmoscopy | typical drusen |
Amer Awan M et al., Clin Exp Optom (2008) | 1 | blurring vision, micropsia, metamorphopsia | elevated area overlying the macula in both eyes. Multiple pale areas without any drusen. Peripheral retina normal in both eyes. | OCT: tent-shaped RPE detachment with overlying detachment of neurosensory retina and loss of foveolar contour Fluorescein Angiography: early multiple hyperfluorescence areas corresponding to these pale areas. Mid-phase leakage of dye in subretinal space | atypical idiopathic serous central chorioretinopathy with spontaneous resolution at 6 weeks |
Shenoy R et al., Eur J Ophthalmol (2006) | 1 | asymptomatic | multiple drusen-like lesions | Microperimetry: areas of reduced retinal sensitivity in areas which were laden with drusen-like deposits, probably indicating areas of reduced retinal function OCT: drusen Fluorescein Angiography: multiple window defects in the posterior pole of both eyes corresponding to the drusen-like lesions | typical drusen |
Colville D et al., Am J Kidney Dis (2003) | 1 | poor night vision, complications resulted in severe visual loss | occasional drusen, widespread chorioretinal atrophy, macular pigmentation | dark adaption test: uniphasic- > consistent with severe rod dysfunction ERG: delayed rod and delayed combined rod and cone responses EOG: reduced light peak/dark through (or Arden ratio) possibly reflecting an ocbstruction to the passage of metabolites from the choriocapillaris Fluorescein angiography: subfoveal choroidal neovascularization | drusen, CNV and atrophy |
Lahbil D et al., J Fr Ophtalmol (2002) | 1 | important decrease of visual acuity in both eyes | diffuse punctiform yellow subretinal lesions and central serous detachment in both eyes | Fluorescein Angiography: after resorbtion of serous fluid, punctiform hyperfluorescent lesions still staining at late phase. ERG:normal | CRSC- like lesion |
Mullins RF et al., Eye (2001) | 2 | numerous subretinal RPE deposits similar to drusen seen in AMD | histochemistry/ immunohistochemistry: same composition of drusen in AMD | typical drusen | |
Polk T et al., Arch ophthalmol (1997) | 1 | blurred vision in right eye, with visual acuity 20/20 in RE, and 20/200 in LE | fine drusen in both eyes. Neurosensory detachment in the nasal macula of RE, and disciform scar in LE | Fluorescein agiography: multiple discrete hyperfluorescent spots corresponding to drusen, and early and late staining at RPE level in the area of the detachment, with 4 pinpoints sites of late leakage. Minimal pooling of dye in the subretinal space. | neurosensory detachment with spontaneous resolution at 2weeks |
C O’Brien et al., Br J Ophthalmol (1993) | 4 | asymptomatic | multiple, yellow, drusen-like lesions | EOG: abnormal low Arden ratios PERG, flash ERG, and flicker ERG: waveform amplitudes essentially normal for all 4 subjects | typical drusen |
Leys A et al., Graefes Arch Clin Exp Ophthalmol (1991) | 23 | – | small-sized subretinal nodules simulating basal laminar drusen. 4 patients displayed marked retinopathy and3 of them exhibited subretinal neovascularization | EOG: Light Peak/Dark peak ratio reduced in 4 (36%) of the 11 patients with EOG recordings. EOG and visual field: grossly normal in patients who did not exhibit choroidal neovascularization. | Typical drusen, CNV |
Leys A et al., Pediatr Nephrol (1991) | 3 | – | granular retinal changes | Fluorescein angiography: numerous basal laminar drusen | drusen |
Leys A et al., Eur J Ophthalmol (1991) | 4 | decrease of vision | drusenoid lesions | Fluorescein angiography: neovascular membranes | CNV |
Duvall-Young J et al., Br J ophthalmol (1989) | 1 | VA 6/24 in both eyes | normal fundus | Fluorescein angiography: numerous hyperfluorescent discrete foci at posterior pole, becoming more intensely fluorescent with time | typical drusen |
Duvall-Young J et al., Br J ophthalmol (1989) | 11 | asymptomatic | few drusen | Fluorescein angiography: few hyperfluoresent spots corresponding to scattered drusen | typical drusen |
Raines MF et al., Br J Ophthalmol (1989) | 5 | asymptomatic | drusen | Vitreous Fluorophotometry: Breakdown of the blood retinal barrier: vitreous fluorophotometry readings and penetration ratios abnormally high, indicating that the deposits in Bruch’s membrane cause retinal pigment epithelial dysfunction. Fluorescein angiography: normal. | typical drusen |