Histologic and Morphometric Comparison of Drusen Associated With Chronic Retinal Detachment and Aging-Associated Drusen

TL;DR

This study compares the structure and features of unusual drusen found in a young woman with retinal detachment to typical age-related drusen.

Contribution

The study identifies unique morphometric differences in atypical drusen associated with retinal detachment compared to age-related drusen.

Findings

Atypical drusen from retinal detachment were significantly larger in size than age-related drusen.

Both types of drusen showed similar histochemical staining patterns, suggesting similar composition.

The findings suggest atypical drusen may form in association with retinal detachment.

Abstract

Drusen are subretinal pigment epithelium extracellular matrix deposits. This study compared histomorphometric characteristics of age-related and atypical drusen found in an eye of a young woman with chronic retinal detachment (RD).

We conducted a histomorphometric examination of drusen identified in 3 eyes: an eviscerated eye from a 35-year-old woman with chronic RD, and 2 specimens of 2 patients, aged 91 and 77 years, with typical age-related drusen. Sections of formalin-fixed tissue stained with hematoxylin and eosin (H&E), periodic acid-Schiff (PAS), Masson trichrome, luxol fast blue (LFB), and Von Kossa were evaluated using light microscopy. Drusen dimensions were quantified using Philips Digital Pathology Software.

Atypical drusen identified in the RD eye (n = 25) displayed spheroidal shape with peripherally radiating fibrils. There were foci of dystrophic calcification and localized chronic choroidal inflammation and within some drusen. Age-related drusen (n = 29) had a typical dome-shaped appearance. Atypical drusen had significantly larger (P < 0.001) average circumference (278 vs. 52 µm), diameter (96 vs. 20 µm), and area (0.006 vs. 0.00022 mm2) than age-related drusen, respectively. Both groups stained positively with PAS, negatively with LFB and Von Kossa, and blue on Masson Trichrome.

Atypical drusen found in this RD case display significant differences in morphometric parameters compared to age-related drusen but similar histochemical staining patterns, suggesting a similar macromolecular composition. Further investigations are needed to inform drusen pathogenesis, morphology, and associations with sex, age, or long-standing RD.

This case adds to the limited body of evidence on drusen in younger patients and suggests that atypical drusen may form in association with RD.

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