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(plural) an eye disease resulting from small accumulations of hyaline bodies underneath the retina

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/06/29 12:29:04」(JST)

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Drusen (singular, "druse") are tiny yellow or white accumulations of extracellular material that build up between Bruch's membrane and the retinal pigment epithelium of the eye. The presence of a few small ("hard") drusen is normal with advancing age, and most people over 40 have some hard drusen. However, the presence of larger and more numerous drusen in the macula is a common early sign of age-related macular degeneration (AMD).

Classification

Drusen are associated with aging and macular degeneration are distinct from another clinical entity, optic disc drusen, which is present on the optic nerve head.^[1] Both age-related drusen and optic disc drusen can be observed by ophthalmoscopy. On CT scans of the orbits or head, calcification at the head of the optic nerve without change in size of globe strongly suggests drusen in a middle-age or elderly patient.

Whether drusen promote AMD or are symptomatic of an underlying process that causes both drusen and AMD is not known, but they are indicators of increased risk of the complications of AMD.^[2]

'Hard drusen' may coalesce into 'soft drusen' which is a manifestation of macular degeneration.^[3]

Pathophysiology

Drusen were initially described by Franciscus Donders^[4] who called them "Colloidkugeln" (colloid spheres). Later, Heinrich Müller named them for the German word for geode, based on their glittering appearance.^[5] In view of their location between the retinal pigment epithelium (RPE) and its vascular supply, the choriocapillaris, it is possible that drusen deprive the RPE and photoreceptor cells of oxygen and nutrients. Interestingly, drusen always develop above the so-called pillars of choriocapillaris that is the area between two microvessels.^[6]

Drusen in Optical Coherence Tomography.

The source of the proteins and lipids in drusen is also not clear, with potential contributions by both the RPE and the choroid. Several trace elements are present in drusen,^[7] probably the most concentrated being zinc.^[8] The protein composition of drusen includes apolipoproteins and members of the complement system. Zinc in drusen have been suggested to play a role in drusen formation by precipitating and inhibiting the elements of the complement cascade, especially complement factor H.^[8]

The presence of molecules that regulate inflammation in drusen has led some investigators to conclude that these deposits are product of the immune system.^[9]

Notes

^ Davis PL, Jay WM (December 2003). "Optic nerve head drusen". Semin Ophthalmol 18 (4): 222–42. doi:10.1080/08820530390895244. PMID 15513010.
^ "Age-Related Macular Degeneration". National Eye Institute. March 2008. Retrieved 2008-05-21.
^ http://www.agingeye.net/maculardegen/maculardegeninformation.php
^ Donders FC (March 1855). "Beitrage zur pathologischen Anatomie des Auges". Graefes Arch Clin Exp Ophthalmol 1 (2): 106–18. doi:10.1007/BF02720791.
^ Müller H (January 1856). "Anatomische Beiträge zur Ophthalmologie - 1) Untersuchungen über die Glashäute des Auges, insbesondere die Glaslamelle der Chorioidea und ihre senilen Veränderungen". Graefes Arch Clin Exp Ophthalmol 2 (2): 1–69. doi:10.1007/BF02720657.
^ Lengyel I, Tufail A, Hosaini HA, Luthert P, Bird AC, Jeffery G (September 2004). "Association of drusen deposition with choroidal intercapillary pillars in the aging human eye". Invest. Ophthalmol. Vis. Sci. 45 (9): 2886–92. doi:10.1167/iovs.03-1083. PMID 15326099.
^ van der Schaft TL, de Bruijn WC, Mooy CM, Ketelaars DA, de Jong PT (March 1992). "Element analysis of the early stages of age-related macular degeneration". Arch. Ophthalmol. 110 (3): 389–94. doi:10.1001/archopht.1992.01080150087034. PMID 1543459.
^ ^a ^b Lengyel I, Flinn JM, Peto T et al. (April 2007). "High concentration of zinc in sub-retinal pigment epithelial deposits". Exp. Eye Res. 84 (4): 772–80. doi:10.1016/j.exer.2006.12.015. PMID 17313944.
^ Hageman GS, Luthert PJ, Victor Chong NH, Johnson LV, Anderson DH, Mullins RF (November 2001). "An integrated hypothesis that considers drusen as biomarkers of immune-mediated processes at the RPE-Bruch's membrane interface in aging and age-related macular degeneration". Prog Retin Eye Res 20 (6): 705–32. doi:10.1016/S1350-9462(01)00010-6. PMID 11587915.

External links

agingeye.com
image from macular.org

UpToDate Contents

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1. 視神経の先天性および後天性異常 congenital anomalies and acquired abnormalities of the optic nerve
2. 加齢黄斑変性：臨床像、病因、および診断 age related macular degeneration clinical presentation etiology and diagnosis
3. 加齢黄斑変性：治療および予防 age related macular degeneration treatment and prevention
4. 乳頭浮腫の概要および鑑別診断 overview and differential diagnosis of papilledema
5. 非動脈炎性前部虚血性視神経症：臨床的特徴および診断 nonarteritic anterior ischemic optic neuropathy clinical features and diagnosis

English Journal

Drusen and Photoreceptor Abnormalities in African-Americans with Intermediate Non-neovascular Age-related Macular Degeneration.

Sadigh S1, Luo X, Cideciyan AV, Sumaroka A, Boxley SL, Hall LM, Sheplock R, Feuer WJ, Stambolian DS, Jacobson SG.
Current eye research.Curr Eye Res.2014 Jun 9:1-9. [Epub ahead of print]
Abstract Purpose/Aim: To investigate the relationship of drusen and photoreceptor abnormalities in African-American (AA) patients with intermediate non-neovascular age-related macular degeneration (AMD). Materials and methods: AA patients with intermediate AMD (n = 11; age 52-77 years) were stud
PMID 24912073

Estrogen Signalling in the Pathogenesis of Age-Related Macular Degeneration.

Kaarniranta K1, Machalińska A, Veréb Z, Salminen A, Petrovski G, Kauppinen A.
Current eye research.Curr Eye Res.2014 Jun 9:1-8. [Epub ahead of print]
Abstract Age-related macular degeneration (AMD) is a multifactorial eye disease that is associated with aging, family history, smoking, obesity, cataract surgery, arteriosclerosis, hypertension, hypercholesterolemia and unhealthy diet. Gender has commonly been classified as a weak or inconsistent ri
PMID 24911983

Visual field loss in optic disc drusen patients correlates with central retinal artery blood velocity patterns.

Abegão Pinto L1, Vandewalle E, Marques-Neves C, Stalmans I.
Acta ophthalmologica.Acta Ophthalmol.2014 Jun;92(4):e286-91. doi: 10.1111/aos.12314. Epub 2014 Jan 23.
PURPOSE: (1) To characterize the retrobulbar circulation in patients with optic disc drusen (ODD) using colour Doppler imaging; (2) to explore the differences in retrobulbar hemodynamics in patients with primary open-angle glaucoma (POAG).METHODS: Retrospective analysis using three diagnostic groups
PMID 24456173

Japanese Journal

走査レーザー検眼鏡のレトロモードによる加齢黄斑変性の僚眼にみられる網膜色素上皮レベル病変の検出

竹田宗泰,佐藤唯,荻野哲男 [他]
日本眼科学会雑誌 116(7), 635-642, 2012-07
NAID 40019382838

加齢黄斑変性と白内障手術(特別講演 IV, 第154回名古屋市立大学医学会例会)

安川力
Nagoya medical journal 51(3), 165-169, 2010-12-01
白内障と加齢黄斑変性は共に加齢性眼科疾患である. 白内障を有する眼では,水晶体混濁のため眼内への「光」の透過が減衰している一方,加齢黄斑変性は「光」に起因して網膜色素上皮下に加齢性に沈着した「脂質」に対する炎症反応に関連した病態であり一種の「眼のメタボリックシンドローム」である. すなわち,危険因子として「光」は「喫煙」に並んで重要であり,白内障手術を行うと光の透過が改善するため,加齢黄斑変性発症 …
NAID 110008151185

Related Pictures

Drusen | definition of drusen by Medical dictionary Macular degeneration - Wikipedia EyeRounds.org: Malattia Leventinese (Familial Dominant Drusen): 30 year-old female Drusen | small deposits in the retina from macular degeneration ドルーゼン: みさき眼科クリニック＠代々木上原 Advanced Family Eye Care: Macular Drusen Drusen Treatment - American Academy of Ophthalmology Dry macular degeneration - Diagnosis and treatment - Mayo Clinic

★リンクテーブル★

リンク元	「ドルーゼン」「晶洞」「集晶」
拡張検索	「optic disk drusen」
関連記事	「druse」

「ドルーゼン」

Drusen
	Macular soft drusen in the right eye of a 70 year old male.
Classification and external resources
ICD-10	H35.3, H47.3
OMIM	126700 126600 611040 603075 134370
DiseasesDB	29371
eMedicine	topic list

　　[★]

英: (np)drusen, (ns)druse ドルーゼ
同: 脈絡膜硝子疣 choroidal verruca
同: 菌塊、硫黄顆粒 sulfur granule
関

[show details]

ドルーゼ : 約 211 件
ドルーゼン : 約 2,410 件

眼科

網膜色素上皮の外側にあるBruch膜の硝子様変性と肥厚。加齢性変化
硝子膜ドルーゼン
軟性ドルーゼン：黄斑部
硬性ドルーゼン：黄斑部、周囲眼底

http://www.1stretinalscreen.com/ra_DR_NonDR.asp

細菌

放線菌属やノカルジア属の感染巣に見られる顆粒状小体

「晶洞」

　　[★]

英: druse、drusen
関: 集晶、硫黄顆粒、ドルーゼン、硝子疣、ドルーゼ

「集晶」

　　[★]

英: druse、drusen
関: 晶洞、硫黄顆粒、ドルーゼン、硝子疣、ドルーゼ

「optic disk drusen」

　　[★]

乳頭ドルーゼン

関: optic disc drusen

「druse」

　　[★]

n.

ドルーゼ、硫黄顆粒、(鉱物)集晶、晶洞

関: drusen

(眼科)眼底に見られる黄白色斑

[pmid15513010-1] Davis PL, Jay WM (December 2003). "Optic nerve head drusen". Semin Ophthalmol 18 (4): 222–42. doi:10.1080/08820530390895244. PMID 15513010.

[2] "Age-Related Macular Degeneration". National Eye Institute. March 2008. Retrieved 2008-05-21.

[3] ttp://www.agingeye.net/maculardegen/maculardegeninformation.php

[4] Donders FC (March 1855). "Beitrage zur pathologischen Anatomie des Auges". Graefes Arch Clin Exp Ophthalmol 1 (2): 106–18. doi:10.1007/BF02720791.

[5] Müller H (January 1856). "Anatomische Beiträge zur Ophthalmologie - 1) Untersuchungen über die Glashäute des Auges, insbesondere die Glaslamelle der Chorioidea und ihre senilen Veränderungen". Graefes Arch Clin Exp Ophthalmol 2 (2): 1–69. doi:10.1007/BF02720657.

[pmid15326099-6] Lengyel I, Tufail A, Hosaini HA, Luthert P, Bird AC, Jeffery G (September 2004). "Association of drusen deposition with choroidal intercapillary pillars in the aging human eye". Invest. Ophthalmol. Vis. Sci. 45 (9): 2886–92. doi:10.1167/iovs.03-1083. PMID 15326099.

[pmid1543459-7] van der Schaft TL, de Bruijn WC, Mooy CM, Ketelaars DA, de Jong PT (March 1992). "Element analysis of the early stages of age-related macular degeneration". Arch. Ophthalmol. 110 (3): 389–94. doi:10.1001/archopht.1992.01080150087034. PMID 1543459.

[pmid17313944-8] Lengyel I, Flinn JM, Peto T et al. (April 2007). "High concentration of zinc in sub-retinal pigment epithelial deposits". Exp. Eye Res. 84 (4): 772–80. doi:10.1016/j.exer.2006.12.015. PMID 17313944.

[pmid11587915-9] Hageman GS, Luthert PJ, Victor Chong NH, Johnson LV, Anderson DH, Mullins RF (November 2001). "An integrated hypothesis that considers drusen as biomarkers of immune-mediated processes at the RPE-Bruch's membrane interface in aging and age-related macular degeneration". Prog Retin Eye Res 20 (6): 705–32. doi:10.1016/S1350-9462(01)00010-6. PMID 11587915.

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drusen