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Zhang, Yuhua, PhD*; Wang, Xiaolin, MS*; Godara, Pooja, MD*; Zhang, Tianjiao, BS; Clark, Mark, E., BS*; Witherspoon, C., Douglas, MD*; Spaide, Richard, F., MD; Owsley, Cynthia, PhD*; Curcio, Christine, A., PhD*

doi: 10.1097/IAE.0000000000001504
Original Study

Purpose: To investigate the natural history of dot subretinal drusenoid deposits (SDD) in age-related macular degeneration, using high-resolution adaptive optics scanning laser ophthalmoscopy.

Methods: Six eyes of four patients with intermediate age-related macular degeneration were studied at baseline and 1 year later. Individual dot SDD within the central 30° retina were examined with adaptive optics scanning laser ophthalmoscopy and optical coherence tomography.

Results: A total of 269 solitary SDD were identified at baseline. Over 12.25 ± 1.18 months, all 35 Stage 1 SDD progressed to advanced stages. Eighteen (60%) Stage 2 lesions progressed to Stage 3 and 12 (40%) remained at Stage 2. Of 204 Stage 3 SDD, 12 (6.4%) disappeared and the rest remained. Twelve new SDD were identified, including 6 (50%) at Stage 1, 2 (16.7%) at Stage 2, and 4 (33.3%) at Stage 3. The mean percentage of the retina affected by dot SDD, measured by the adaptive optics scanning laser ophthalmoscopy, increased in 5/6 eyes (from 2.31% to 5.08% in the most changed eye) and decreased slightly in 1/6 eye (from 10.67% to 10.54%). Dynamism, the absolute value of the areas affected by new and regressed lesions, ranged from 0.7% to 9.3%.

Conclusion: Adaptive optics scanning laser ophthalmoscopy reveals that dot SDD, like drusen, are dynamic.

The authors used multimodal retinal imaging featuring adaptive optics scanning laser ophthalmoscopy to assess the natural history of subretinal drusenoid deposits at the level of individual lesions. The data demonstrate that subretinal drusenoid deposits, like drusen, are dynamic and exhibit both growth and regression.

*Department of Ophthalmology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama;

Department of Bioengineering, University of California, Berkeley, California; and

Vitreous-Retina-Macula Consultants of New York, New York, New York.

Reprint requests: Yuhua Zhang, PhD, Department of Ophthalmology, University of Alabama at Birmingham School of Medicine, Volker Hall 390C, 1670 University Boulevard, Birmingham, AL 35294; e-mail:

Supported in part by EY021903, EY024378, AG04212, and EY06109 and institutional support from Research to Prevent Blindness, EyeSight Foundation of Alabama, Buck Trust of Alabama, the Dorsett Davis Discovery Fund.

R. F. Spaide receives consultant and royalty payment from Topcon Inc, Tokyo, Japan; Bausch and Lomb, Rochester, NY. The remaining authors have no financial/conflicting interests to disclose.

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© 2018 by Ophthalmic Communications Society, Inc.