WordNet

in or relating to the retina of the eye; "retinal cells"
the innermost light-sensitive membrane covering the back wall of the eyeball; it is continuous with the optic nerve
(plural) an eye disease resulting from small accumulations of hyaline bodies underneath the retina

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(目の)網膜

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/12/24 00:51:39」(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. Optical coherence tomography 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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English Journal

Laser Clearance of Drusen Deposit in Patients With Autosomal Dominant Drusen (p.Arg345Trp in EFEMP1).

Lenassi E, Troeger E, Wilke R, Tufail A, Hawlina M, Jeffery G, Webster AR.SourceInstitute of Ophthalmology, University College London, London, United Kingdom; Moorfields Eye Hospital, London, United Kingdom; Eye Hospital, University Medical Centre, Ljubljana, Slovenia.
American journal of ophthalmology.Am J Ophthalmol.2012 Oct 1. pii: S0002-9394(12)00499-0. doi: 10.1016/j.ajo.2012.07.003. [Epub ahead of print]
PURPOSE: To assess whether laser treatment to the retinal pigment epithelium anterior to drusen in eyes of patients with EFEMP1-related maculopathy affects visual acuity, deposit volume, and retinal sensitivity.DESIGN: Prospective, interventional case series.METHODS: In 11 patients with autosomal do
PMID 23036572

Drusen prevalence and pigmentary changes in Caucasians aged 18-54 years.

Silvestri G, Williams MA, McAuley C, Oakes K, Sillery E, Henderson DC, Ferguson S, Silvestri V, Muldrew KA.Source1] Centre for Vision & Vascular Science, Queen's University of Belfast, Royal Victoria Hospital, Belfast, UK [2] Ophthalmology, Belfast Health & Social Care Trust, Belfast, UK.
Eye (London, England).Eye (Lond).2012 Oct;26(10):1357-62. doi: 10.1038/eye.2012.165. Epub 2012 Aug 17.
Aims and PurposeThe aim of this study was to describe the prevalence and characteristics of drusen and pigmentary changes in a middle-aged population.MethodsRetinal images from 500 individuals aged 18-54 years were included. The source of participants was two UK optometry practices. Retinal images w
PMID 22899005

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,今泉寛子,奥芝詩子,木下貴正,宮本寛知
日本眼科學会雜誌 116(7), 635-642, 2012-07-10
NAID 10030791134

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

★リンクテーブル★

リンク元	「網膜ドルーゼン」
関連記事	「retinal」「druse」「drusen」

「網膜ドルーゼン」

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

　　[★]

英: retinal drusen

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網膜ドルーゼン : 43 件
網膜ドルーゼ : 4 件

黄斑変性症の前駆症状として網膜上皮に発生する色素斑

「retinal」

　　[★]

網膜の、(βカロチン誘導体の視物質アルデヒド帯)レチナール

関: 11-cis-retinal、retina、retinae、retinaldehyde, retinol

「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

「drusen」

　　[★]

[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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retinal drusen