Natural course of acquired vitelliform lesions associated with pigment epithelial detachments in dry age related macular degeneration

Abstract

Purpose:

To describe the natural history of acquired vitelliform lesions (AVLs) associated with different types of pigment epithelial detachments (PEDs) in dry age-related macular degeneration.

Methods:

A retrospective review of clinical examination and multimodal imaging data of patients with AVLs associated with PED(s) was performed.

Results:

This study included 25 eyes of 17 patients. The mean age of patients was 67.2 ± 9.7 (47–83) years. The mean follow-up time was 32.6 ± 16.2 (12–66) months, excluding four patients (five eyes) that were lost to follow-up. The mean logMAR BCVA was 0.21 ± 0.16 at baseline and 0.38 ± 0.28 at final visit (p = 0.016). At the end of the follow-up period, PEDs enlarged in eight eyes (40%) and were unchanged in two eyes (10%). Spontaneous resolution of the central PED(s) with AVLs was seen in four (20%) eyes. Rupture of the PED(s) occurred in four eyes (20%), with two developing central foveolar atrophy afterwards. Overall, central foveolar atrophy was seen ultimately in four eyes (20%).

Conclusion:

It seems that high PED size may be a risk factor for PED rupture during follow-up. 1/3 of the eyes ended up with unfavorable anatomical outcome.

Keywords

Get full access to this article

View all access options for this article.

References

Freund

Laud

Lima

, et al. Acquired vitelliform lesions: correlation of clinical findings and multiple imaging analyses. Retina 2011; 31: 13–25.

Lima

Laud

Freund

, et al. Acquired vitelliform lesion associated with large drusen. Retina 2012; 32: 647–651.

Sundelin

Wihlmark

Nilsson

, et al. Lipofuscin accumulation in cultured retinal pigment epithelial cells reduces their phagocytic capacity. Curr Eye Res 1998; 17: 851–857.

Finnemann

Leung

Rodriguez-Boulan

The lipofuscin component A2E selectively inhibits phagolysosomal degradation of photoreceptor phospholipid by the retinal pigment epithelium. Proc Natl Acad Sci U S A 2002; 99: 3842–3847.

Zweifel

Spaide

Yannuzzi

LA.

Acquired vitelliform detachment in patients with subretinal drusenoid deposits (reticular pseudodrusen). Retina 2011; 31: 229–234. DOI: 10.1097/IAE.0b013e3181f049bd.

Morillo

Gonzalez-Escobar

Baquero

, et al. [Bevacizumab treatment for acquired vitelliform detachment in patient with cuticular drusen]. Arch Soc Esp Oftalmol 2014; 89: 165–169.

Ferris

3rd Wilkinson

Bird

, et al. Clinical classification of age-related macular degeneration. Ophthalmology 2013; 120: 844–851.

Boon

van de Ven

Hoyng

, et al. Cuticular drusen: stars in the sky. Prog Retin Eye Res 2013; 37: 90–113.

Rocha Bastos

Ferreira

Brandao

, et al. Multimodal image analysis in acquired vitelliform lesions and adult-onset foveomacular vitelliform dystrophy. J Ophthalmol 2016; 2016: 6037537.

10.

Saito

Iida

Freund

, et al. Clinical findings of acquired vitelliform lesions associated with retinal pigment epithelial detachments. Am J Ophthalmol 2014; 157: 355–365.

11.

Balaratnasingam

Hoang

Inoue

, et al. Clinical characteristics, choroidal neovascularization, and predictors of visual outcomes in acquired vitelliform lesions. Am J Ophthalmol 2016; 172: 28–38.

12.

Agron

Clemons

, et al. Natural history of drusenoid pigment epithelial detachment associated with age-related macular degeneration: age-related eye disease study 2 report no. 17. Ophthalmology 2019; 126: 261–273.

13.

Cukras

Agron

Klein

, et al. Natural history of drusenoid pigment epithelial detachment in age-related macular degeneration: age-related eye disease study report no. 28. Ophthalmology 2010; 117: 489–499.

14.

Curcio

Balaratnasingam

Messinger

, et al. Correlation of type 1 neovascularization associated with acquired vitelliform lesion in the setting of age-related macular degeneration. Am J Ophthalmol 2015; 160: 1024–1033.

15.

Lupidi

Coscas

Cagini

, et al. Optical coherence tomography angiography of a choroidal neovascularization in adult onset foveomacular vitelliform dystrophy: pearls and pitfalls. Invest Ophthalmol Vis Sci 2015; 56: 7638–7645.