Clinical Manifestations of Cuticular Drusen: Current Perspectives

Serena Fragiotta,1 Pedro Fernández-Avellaneda,2 Mark P Breazzano,3 Gianluca Scuderi1 1NESMOS Department, Ophthalmology Unit, St. Andrea Hospital, University of Rome “La Sapienza”, Rome, Italy; 2Department of Ophthalmology, Basurto University Hospital, Bilbao, Spain; 3Wilmer Eye Institute, Johns Hopk...

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Autores principales:	Fragiotta S, Fernández-Avellaneda P, Breazzano MP, Scuderi G
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	cuticular drusen spectral-domain optical coherence tomography fundus autofluorescence fluorescein angiography multimodal imaging; Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/edddf5cb68d8477eb13a3ef0697bf34c
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spelling	oai:doaj.org-article:edddf5cb68d8477eb13a3ef0697bf34c2021-12-02T18:48:31ZClinical Manifestations of Cuticular Drusen: Current Perspectives1177-5483https://doaj.org/article/edddf5cb68d8477eb13a3ef0697bf34c2021-09-01T00:00:00Zhttps://www.dovepress.com/clinical-manifestations-of-cuticular-drusen-current-perspectives-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Serena Fragiotta,1 Pedro Fernández-Avellaneda,2 Mark P Breazzano,3 Gianluca Scuderi1 1NESMOS Department, Ophthalmology Unit, St. Andrea Hospital, University of Rome “La Sapienza”, Rome, Italy; 2Department of Ophthalmology, Basurto University Hospital, Bilbao, Spain; 3Wilmer Eye Institute, Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD, UACorrespondence: Serena FragiottaNESMOS Department, Ophthalmology Unit, St. Andrea Hospital, University of Rome “La Sapienza”, Via di Grottarossa 1035-1039, Rome, 00189, ItalyTel +39 3293276433Fax +39 0633776628Email s.fragiotta@hotmail.itAbstract: 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 imagingFragiotta SFernández-Avellaneda PBreazzano MPScuderi GDove Medical Pressarticlecuticular drusenspectral-domain optical coherence tomographyfundus autofluorescencefluorescein angiographymultimodal imaging;OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 3877-3887 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cuticular drusen spectral-domain optical coherence tomography fundus autofluorescence fluorescein angiography multimodal imaging; Ophthalmology RE1-994
spellingShingle	cuticular drusen spectral-domain optical coherence tomography fundus autofluorescence fluorescein angiography multimodal imaging; Ophthalmology RE1-994 Fragiotta S Fernández-Avellaneda P Breazzano MP Scuderi G Clinical Manifestations of Cuticular Drusen: Current Perspectives
description	Serena Fragiotta,1 Pedro Fernández-Avellaneda,2 Mark P Breazzano,3 Gianluca Scuderi1 1NESMOS Department, Ophthalmology Unit, St. Andrea Hospital, University of Rome “La Sapienza”, Rome, Italy; 2Department of Ophthalmology, Basurto University Hospital, Bilbao, Spain; 3Wilmer Eye Institute, Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD, UACorrespondence: Serena FragiottaNESMOS Department, Ophthalmology Unit, St. Andrea Hospital, University of Rome “La Sapienza”, Via di Grottarossa 1035-1039, Rome, 00189, ItalyTel +39 3293276433Fax +39 0633776628Email s.fragiotta@hotmail.itAbstract: 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
format	article
author	Fragiotta S Fernández-Avellaneda P Breazzano MP Scuderi G
author_facet	Fragiotta S Fernández-Avellaneda P Breazzano MP Scuderi G
author_sort	Fragiotta S
title	Clinical Manifestations of Cuticular Drusen: Current Perspectives
title_short	Clinical Manifestations of Cuticular Drusen: Current Perspectives
title_full	Clinical Manifestations of Cuticular Drusen: Current Perspectives
title_fullStr	Clinical Manifestations of Cuticular Drusen: Current Perspectives
title_full_unstemmed	Clinical Manifestations of Cuticular Drusen: Current Perspectives
title_sort	clinical manifestations of cuticular drusen: current perspectives
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/edddf5cb68d8477eb13a3ef0697bf34c
work_keys_str_mv	AT fragiottas clinicalmanifestationsofcuticulardrusencurrentperspectives AT fernandezavellanedap clinicalmanifestationsofcuticulardrusencurrentperspectives AT breazzanomp clinicalmanifestationsofcuticulardrusencurrentperspectives AT scuderig clinicalmanifestationsofcuticulardrusencurrentperspectives
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Clinical Manifestations of Cuticular Drusen: Current Perspectives

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