September 12, 2014
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Regression in drusen volume predictive of disease progression

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LONDON — Spectral-domain optical coherence tomography measures drusen volume and area, not only at one time point but also over time, so that progression can be tracked and doubling time can be predicted, according to a speaker here.

Ursula M. Schmidt-Erfurth, MD, told colleagues at the Euretina Congress that such analysis is a precise prognostic indicator of whether advanced stage disease will develop.

Ursula M. Schmidt-Erfurth

“We have a very precise idea about the sequence of changes and about the timing of changes, but what does it mean?” Schmidt-Erfurth said. “Drusen alone is not such a dilemma, but advanced-stage, like [choroidal neovascularization] and geographic atrophy, is a dilemma.”

Schmidt-Erfurth said she and colleagues followed the progression of drusen volume in a recent study and found that, in patients with sudden regression in drusen volume, advanced-stage disease was more likely to develop.

“This regression is the most important sequence in progression from drusen to advanced stages, because what is following the regression is the development of either CNV or geographic atrophy,” she said.

Among the patients in the study, only those who show an acute, intensive regression in drusen load will go on to develop CNV, according to Schmidt-Erfurth.

“If the drusen volume just continues, these patients will not develop an advanced stage,” she said.

Disclosure: Schmidt-Erfurth has no relevant financial disclosures.