TY - JOUR
T1 - Clinical manifestations of cuticular drusen
T2 - Current perspectives
AU - Fragiotta, Serena
AU - Fernández-Avellaneda, Pedro
AU - Breazzano, Mark P.
AU - Scuderi, Gianluca
N1 - Publisher Copyright:
© 2021 Fragiotta et al.
PY - 2021
Y1 - 2021
N2 - Cuticular drusen are part of the spectrum of age-related macular degeneration (AMD) with particular clinical and multimodal imaging characteristics. This drusen sub-population 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 consid-ered 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.
AB - Cuticular drusen are part of the spectrum of age-related macular degeneration (AMD) with particular clinical and multimodal imaging characteristics. This drusen sub-population 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 consid-ered 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.
KW - Cuticular drusen
KW - Fluorescein angiography
KW - Fundus autofluorescence
KW - Multimodal imaging
KW - Spectral-domain optical coherence tomography
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U2 - 10.2147/OPTH.S272345
DO - 10.2147/OPTH.S272345
M3 - Review article
C2 - 34584401
AN - SCOPUS:85115772913
SN - 1177-5467
VL - 15
SP - 3877
EP - 3887
JO - Clinical Ophthalmology
JF - Clinical Ophthalmology
ER -