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Drusen in the macula and parapapillary region

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Abstract

Purpose

To examine histological characteristics and differences between drusen beneath the retinal pigment epithelium (small hard drusen) located in the macula and located in the parapapillary region.

Methods

We histomorphometrically examined human eyes enucleated due to uveal melanomas or secondary angle-closure glaucoma.

Results

The study included 106 eyes (age, 62.6 ± 15.2 years) with macular drusen (n = 7 globes) or parapapillary drusen (n = 29 eyes) and 70 eyes without drusen. In all drusen, periodic-acid-Schiff-positive material was located between the RPE basal membrane and the inner collagenous layer of Bruch’s membrane (BM). Macular drusen as compared with parapapillary drusen had lower height (15.2 ± 10.1 µm versus 34.3 ± 19.8 µm; P = 0.003), while both groups did not differ significantly in basal drusen width (74.0 ± 36.3 µm versus 108.7 ± 101.0 µm; P = 0.95). Eyes with macular drusen and eyes without drusen did not differ significantly in BM thickness (2.74 ± 0.44 µm versus 2.55 ± 0.88 µm; P = 0.57) or in RPE cell density (35.4 ± 10.4 cells/480 µm versus 32.8 ± 7.5 cells/480 µm; P = 0.53), neither in the drusen region nor in the drusen vicinity, while BM thickness (4.60 ± 1.490 µm; P < 0.001) and RPE cell density (56.9 ± 26.8 cells/480 µm; P = 0.005) were higher at the parapapillary drusen. Eyes with macular drusen, eyes with parapapillary drusen, and eyes without drusen did not differ significantly in choriocapillaris density (all P > 0.10) and thickness (all P > 0.35). Limitations of the study, among others, were a small number and size of drusen examined, diseases leading to enucleation, lack of serial sections, limited resolution of light microscopy, and enucleation-related and histological preparation-associated artefacts.

Conclusions

The findings of this study, also taking into account its methodological limitations, suggest that macular drusen and parapapillary drusen shared the morphological feature of periodic-acid-Schiff-positive material between the RPE basal membrane and BM and that they did not vary significantly in choriocapillaris thickness and density. RPE cell density and BM thickness were higher in parapapillary drusen than in macular drusen.

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Data availability

All data are available upon reasonable request from the corresponding author.

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Funding

No funding was received for this research.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    Jost B. Jonas

  2. Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland

    Jost B. Jonas

  3. Singapore Eye Research Institute, Singapore, Singapore

    Jost B. Jonas

  4. Privatpraxis Prof Jonas Und Dr Panda-Jonas, Heidelberg, Germany

    Songhomitra Panda-Jonas

  5. Department of Ophthalmology, University of Cologne, Cologne, Germany

    Rahul A. Jonas

Authors
  1. Jost B. Jonas
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  2. Songhomitra Panda-Jonas
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  3. Rahul A. Jonas
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Corresponding author

Correspondence to Jost B. Jonas.

Ethics declarations

Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Medical Ethics Committee II of the Medical Faculty Mannheim of the Heidelberg University which approved the study and confirmed that the study conformed to the regulations formulated in the World Medical Association Declaration of Helsinki.

Consent for publication

The ethics committee waived the necessity of an informed written consent by the patients, since the globes had been enucleated up to 60 years before start of the present investigations, with the enucleation as part of routinely taken clinical care of the patients.

Conflict of interest

Jost B. Jonas, S. Panda-Jonas, Rahul A. Jonas: European patent EP 3 271 392, JP 2021–119187, and US 2021 0340237 A1: Agents for use in the therapeutic or prophylactic treatment of myopia or hyperopia; Patent application: European patent office number: 23170806.6: Jonas JB, Panda-Jonas S, Jonas RA, Jonas SB. Epidermal Growth Factor Inhibition in the Prophylactic or Therapeutic Treatment of Unwanted Proliferation, Migration or Metaplasia of the Retinal Pigment Epithelium.

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Dres. Jost B. Jonas, Songhomitra Panda-Jonas, and Rahul A. Jonas equally contributed and share the first authorship.

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Jonas, J.B., Panda-Jonas, S. & Jonas, R.A. Drusen in the macula and parapapillary region. Graefes Arch Clin Exp Ophthalmol (2024). https://doi.org/10.1007/s00417-024-06438-5

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  • DOI: https://doi.org/10.1007/s00417-024-06438-5

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