Insight into large colloid drusen: A decade-long follow-up

Abstract

Purpose

To describe the follow-up of large colloid drusen (LCD) through multimodal imaging over a 10-year follow-up period.

Materials and Methods

Medical records of patients with a history of LCD were retrospectively analyzed. Inclusion criteria were the presence of bilateral LCD diagnosed at least 10 years before inclusion, having undergone baseline multimodal imaging, including color fundus photography (CF), fundus autofluorescence (FAF), spectral domain optical coherence tomography (SD-OCT) and indocyanine green angiography (ICGA). Ten-year follow-up multimodal imaging included CF, FAF, SD-OCT and swept-source OCT angiography (SS-OCTA). The 10-year FAF pattern and the presence of macular neovascularization (MNV) and/or atrophy were assessed.

Results

Twelve eyes of 6 patients were included in this study. The mean age at diagnosis was 47.83 +/- 7.8 SD years. Best-corrected visual acuity (BCVA) was 0 log MAR at baseline and 0.05 +/- 0.083 log MAR at 10-year follow-up. BCVA at follow-up was maintained at 20/20 in 6 eyes. On SD-OCT, LCDs resorbed in 6 out of 12 eyes, with the development of outer retinal atrophy in 2 eyes and with no atrophy in 4 eyes. Hyperreflective foci (HRF) were noted in 4 eyes. An increase in the height and reflectivity of LCD were found in 2 eyes and coalesced LCDs in 2 eyes. FAF revealed either the persistence of the same pattern of autofluorescence or a speckled autofluorescence of the surrounding ring of LCD. SS-OCTA analysis revealed the presence of a unique case of nonexudative MNV in one out of 12 eyes (8,3%). No cases of fibrosis were detected.

Conclusion

Over a 10-year multimodal imaging follow-up, LCDs were frequently resorbed. While outer retinal atrophy was occasionally noted, no complete atrophy occurred. Neovascular complications were limited to nonexudative MNV, with no active lesions observed. The 10-year prevalence of nonexudative MNV was 7%. Overall, LCDs showed a more favorable prognosis regarding atrophy and neovascularization compared to other early-onset drusen types.