Clinical Manifestations of Cuticular Drusen: Current Perspectives

Cuticular drusen are part of the spectrum of age-related macular degeneration (AMD) with particular clinical and multimodal imaging characteristics. This drusen subpopulation shares several high-risk single nucleotide polymorphisms with AMD. Despite this feature, they can manifest at a relatively yo...

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Bibliographic Details
Published in:Clinical ophthalmology (Auckland, N.Z.) N.Z.), 2021-01, Vol.15, p.3877-3887
Main Authors: Fragiotta, Serena, Fernandez-Avellaneda, Pedro, Breazzano, Mark P, Scuderi, Gianluca
Format: Article
Language:English
Subjects:
cuticular drusen
Fluorescein
fluorescein angiography
Fluorescence
fundus autofluorescence
Genetic aspects
Genetic polymorphisms
Genotype & phenotype
Macular degeneration
Medical imaging
multimodal imaging
Neovascularization
Pathogenesis
Population
Retina
Review
spectral-domain optical coherence tomography
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Summary:Cuticular drusen are part of the spectrum of age-related macular degeneration (AMD) with particular clinical and multimodal imaging characteristics. This drusen subpopulation shares several high-risk single nucleotide polymorphisms with AMD. Despite this feature, they can manifest at a relatively young age, presenting with a female preponderance. Multimodal imaging is essential for characterizing such lesions, using a combination of color fundus photographs, optical coherence tomography (OCT), fluorescein angiography (FA), and fundus autofluorescence (FAF). The classic starry-sky pattern visible on FA and the typical central hypoautofluorescent lesion with hyperautofluorescent rim on FAF is considered the result of a central retinal pigment epithelium (RPE) erosion from these triangular elevations of the RPE-basal lamina. This finding may also be responsible for the typical choroidal hypertransmission appreciated through OCT. The clinical course of cuticular drusen may be relatively benign at early stages, with small drusen presenting at a young age. However, the presence of clinical phenotypes characterized by diffuse involvement and/ or accompanying large drusen in patients older than 60 years may confer a significant risk for either macular neovascularization or geographic atrophy. Keywords: cuticular drusen, spectral-domain optical coherence tomography, fundus autofluorescence, fluorescein angiography, multimodal imaging
ISSN:1177-5483
1177-5467
1177-5483
DOI:10.2147/OPTH.S272345