title: Appearance of medium-large drusen and reticular pseudodrusen on adaptive optics in age-related macular degeneration.
abstract: OBJECTIVE
  To investigate the appearance of medium-large drusen and reticular pseudodrusen on adaptive optics (AO).
  
  
  METHODS
  In 14 consecutive patients, AO infrared (IR) images were overlaid with confocal scanning-laser-ophthalmoscope IR reflectance images and IR-referenced spectral-domain optical coherence tomography.
  
  
  RESULTS
  In eight eyes of six patients, a total of 19 images of medium-large drusen were investigated by AO imaging. En face AO revealed medium-large drusen as highly hyper-reflective round/oval lesions, always centred and/or surrounded by a continuous/discontinuous hyporeflectivity. Cone photoreceptors were detected overlying drusen, appearing either as continuous 'bright' hyper-reflective dots over a 'dark' hyporeflective background, or as continuous 'dark' hyporeflective dots over a 'bright' hyper-reflective background. In eight eyes from eight patients, a total of 14 images of pseudodrusen were investigated by AO imaging. En face AO revealed reticular pseudodrusen as isoreflective lesions, always surrounded by a continuous/discontinuous hyporeflectivity. Cone photoreceptors were detected overlying pseudodrusen as 'bright' hyper-reflective dots over either a hyporeflective or isoreflective background. No 'dark' hyporeflective dots were detected in eyes with reticular pseudodrusen only. Cone photoreceptors were counted on the border of the drusen and pseudodrusen, respectively, and in a visibly healthy zone in its absolute vicinity. A similar decrease in cone appearance was observed for drusen and pseudodrusen (15.7% vs 16.2%).
  
  
  CONCLUSIONS
  AO allows differences in reflectivity between medium-large drusen and reticular pseudodrusen to be appreciated. The cone mosaics may be detected as continuous 'bright' hyper-reflective dots overlying/on the border of drusen and pseudodrusen deposits, and possibly as continuous 'dark' hyporeflective dots overlying drusen only.
authors.affiliation: Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, Creteil, France.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Querques
authors.affiliation: Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, Creteil, France.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Kamami-Levy
authors.affiliation: Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, Creteil, France.
authors.forename: Rocio
authors.initials: R
authors.lastname: Blanco-Garavito
authors.affiliation: Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, Creteil, France.
authors.forename: Anouk
authors.initials: A
authors.lastname: Georges
authors.affiliation: Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, Creteil, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Pedinielli
authors.affiliation: Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, Creteil, France.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Capuano
authors.affiliation: Institut d'Optique Graduate School, Palaiseau, France.
authors.forename: Fanny
authors.initials: F
authors.lastname: Poulon
authors.affiliation: Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, Creteil, France.
authors.forename: Eric H
authors.initials: EH
authors.lastname: Souied
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D005451:Fluorescein Angiography; D057092:Geographic Atrophy / Q000175:diagnosis*; D006801:Humans; D007259:Infrared Rays; D008297:Male; D009887:Ophthalmoscopy; D017949:Retinal Cone Photoreceptor Cells / Q000473:pathology; D015593:Retinal Drusen / Q000175:diagnosis*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
keywords: Imaging; Retina