title: Short-term changes of Basal laminar drusen on spectral-domain optical coherence tomography.
abstract: OBJECTIVE
  To determine if small hard drusen in patients with basal laminar drusen show short-term changes.
  
  
  METHODS
  Prospective observational case series.
  
  
  METHODS
  Ten subjects with basal laminar drusen were longitudinally followed during a period of 4 months by spectral-domain optical coherence tomography. Drusen that showed a spontaneous change in volume were further analyzed according to 5 morphologic parameters: shape, reflectivity, homogeneity, and concurring photoreceptor layer/retinal pigment epithelium damage. Odds ratios (OR) and risk for regression and progression of drusen volumes were calculated.
  
  
  RESULTS
  One hundred and five small hard drusen in 19 eyes showed a spontaneous change in volume over the period of follow-up. Drusen with a "pointed" shape were significantly associated (P = .031; OR 4.89; 95% confidence interval [CI] 1.16-20.67) with spontaneous progression in drusen volume, with a chance of 0.80 (95% CI 0.55-0.93) to progress. Drusen that showed a decreased reflectivity of overlying photoreceptor layer (P = .041; OR 7.67; 95% CI 1.09-54.24) or retinal pigment epithelium (P = .022; OR 12.38; 95% CI 1.44-106.57), showed a significant association with spontaneous regression in drusen volume, with chances of regression of 0.86 (95% CI 0.41-0.98) and 0.89 (95% CI 0.49-0.99), respectively.
  
  
  CONCLUSIONS
  Small hard drusen in patients with the basal laminar drusen phenotype are subject to a process of short-term remodeling. The dynamic nature of this disease points to high biochemical activity that may be sensitive to future pharmacologic treatment strategies. In addition, these short-term changes of drusen may be a source of misclassification in disease staging.
authors.affiliation: Department of Ophthalmology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. J.vandeVen@ohk.umcn.nl
authors.forename: Johannes P H
authors.initials: JP
authors.lastname: van de Ven
authors.forename: Camiel J F
authors.initials: CJ
authors.lastname: Boon
authors.forename: Dženita
authors.initials: D
authors.lastname: Smailhodzic
authors.forename: Yara T E
authors.initials: YT
authors.lastname: Lechanteur
authors.forename: Anneke I
authors.initials: AI
authors.lastname: den Hollander
authors.forename: Carel B
authors.initials: CB
authors.lastname: Hoyng
authors.forename: Thomas
authors.initials: T
authors.lastname: Theelen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000473:pathology; D016570:Bruch Membrane / Q000473:pathology*; D005109:Extracellular Matrix / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010641:Phenotype; D011446:Prospective Studies; D015593:Retinal Drusen / Q000473:pathology*; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology