title: Photoreceptor layer changes overlying drusen in eyes with age-related macular degeneration associated with vitreomacular traction.
abstract: OBJECTIVE
  To investigate by spectral-domain optical coherence tomography (SD-OCT) changes of photoreceptor layers over drusen in cases of dry type age-related macular degeneration associated with vitreomacular traction (VMT).
  
  
  METHODS
  Clinical examination, fluorescein angiography, fundus photography, and SD-OCT data were retrospectively studied for a consecutive series of 27 patients with drusen, pseudodrusen, and VMT. Control groups of 32 patients with VMT without drusen and 34 patients with drusen and pseudodrusen without VMT were also studied.
  
  
  RESULTS
  The examination revealed disruption of the line corresponding to the inner segment ellipsoid (ISel), previously called inner segment/outer segment junction, of photoreceptor layer, and development of cystoid edema in signiﬁcantly higher incidence in VMT associated with drusen group. 22 out of 32 eyes with VMT and drusen (68.75%) had disrupted ISel, compared to 8 out of 37 (21.6%) control eyes with drusen only and to 12 out of 37 (32.4%) control eyes with VMT only. Chi-square analysis showed significant association between drusen and pseudodrusen on fovea, VMT, and localization of ISel disruption. The changes of the ISel were mainly found in the area that corresponded to VMT. The SD-OCT revealed drusen throughout the macula and discontinuation of ISel only in the fovea in 4 of 32 (12.5%) eyes with VMT, whereas none of 37 control eyes with drusen only had similar appearance.
  
  
  CONCLUSIONS
  The drusen in association with the cystoid macular edema induced by vitreous traction contribute to the photoreceptor layer defect overlying drusen in the fovea. In addition, the number of drusen and pseudodrusen was increased in the area of the vitreous traction compared to the peripheral retina.
authors: 2nd Department of Ophthalmology, "Attikon" University Hospital, University of Athens, Athens - Greece.
authors: Panagiotis G
authors: PG
authors: Theodossiadis
authors: Sofia
authors: S
authors: Theodoropoulou
authors: Polixeni
authors: P
authors: Stamatiou
authors: Ioannis
authors: I
authors: Datseris
authors: George P
authors: GP
authors: Theodossiadis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005451:Fluorescein Angiography; D057092:Geographic Atrophy / Q000150:complications*; D006801:Humans; D008269:Macular Edema / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D020419:Photoreceptor Cells, Vertebrate / Q000473:pathology*; D012164:Retinal Diseases / Q000150:complications*; D015593:Retinal Drusen / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D000267:Tissue Adhesions; D041623:Tomography, Optical Coherence / Q000379:methods; D014822:Vitreous Body / Q000473:pathology*