title: MORPHOLOGY SCORE AS A MARKER OF RETINAL FUNCTION IN DRUSENOID PIGMENT EPITHELIAL DETACHMENT.
abstract: OBJECTIVE
  To evaluate a morphology score for drusenoid pigment epithelial detachment (dPED) regarding predictability of a decline in retinal function beyond best-corrected visual acuity.
  
  
  METHODS
  Thirteen eyes of 10 patients with dPED due to age-related macular degeneration (AMD) were included (age 72.8 ± 4.2 years). All underwent volume spectral domain optical coherence tomography, fluorescence angiography, and confocal scanning laser ophthalmoscopy infrared imaging as well as multifocal electroretinography and microperimetry. The dPED morphology score suggested consists of five parameters: hyperreflective spots in infrared, lesion diameter, lesion height, presence of vitelliform-like material in the subretinal space or subretinal fluid, and integrity of the ellipsoid zone in spectral domain optical coherence tomography. Subsequently, a score value between 0 and 1 according to the extent of morphologic changes was correlated to foveal multifocal electroretinography and microperimetry measurements.
  
  
  RESULTS
  The mean best-corrected visual acuity was 20/40. The mean height and mean diameter of dPED were 312.2 ± 111 μm and 2,535 ± 805 μm. Two dPED showed no hyperreflective spots in confocal scanning laser ophthalmoscopy infrared images, three displayed a moderate stage of hyperreflective spots, and eight had severe hyperreflective spots. Two eyes showed subretinal fluid, and five patients showed vitelliform-like material in the subretinal space. Eight eyes revealed a severe disruption of the ellipsoid zone. Although no correlation was found between dPED morphology score and best-corrected visual acuity, eyes with a dPED morphology score >0.5 revealed distinctly decreased values in functional measurements compared with those with a score ≤0.5.
  
  
  CONCLUSIONS
  The dPED morphology score aggregates all currently known morphologic changes in dPED and represents a valuable tool for clinical lesion evaluation. Furthermore, it allows for assessing an estimate of functional decline beyond best-corrected visual acuity.
authors: Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany.
authors: Christoph R
authors: CR
authors: Clemens
authors: Florian
authors: F
authors: Alten
authors: Peter
authors: P
authors: Heiduschka
authors: Nicole
authors: N
authors: Eter
mesh_terms: D000368:Aged; D015415:Biomarkers; D004596:Electroretinography; D005260:Female; D005451:Fluorescein Angiography; D057092:Geographic Atrophy / Q000145:classification / Q000503:physiopathology*; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal; D009887:Ophthalmoscopy; D012160:Retina / Q000503:physiopathology*; D012163:Retinal Detachment / Q000145:classification / Q000473:pathology*; D015593:Retinal Drusen / Q000145:classification / Q000473:pathology*; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests
chemical_list: D015415:Biomarkers