Diagnosis and histopathological evaluation of soft drusen in patients that underwent evisceration and enucleation

Drusen are yellow deposits between the basal lamina of the retinal pigment epithelium and the inner collagenous layer of Bruch’s membrane. Soft drusen, generally characterized by a medium to large size and poorly demarcated boundaries, increases the risk for advanced age-related macular degeneration (AMD). The prevalence of soft drusen in histopathological sections of the macular region, obtained from enucleated and eviscerated eyes, will be correlated in this study. This is a prospective cross-sectional study performed at the MUHC-McGill University Ocular Pathology and Translational Research Laboratory (McGill University, Montreal, Canada). A total of 158 eyes were evaluated between 2011 and 2019. Of these, 50% were enucleated and 50% eviscerated eyes. Cases were divided by age in decades into both groups, eviscerated and enucleated eyes. Inclusion criteria were patients aged 50 years or older, identification by histological criteria of macular area, histopathologically preserved macular area, presence of sufficient residual tissue for additional sections, and concrete patient data. The histopathological review was performed in digitized H and E slides (ZEISS Axio Scan.Z1) to assess the presence of soft drusen. The results in both groups, enucleated and eviscerated eyes, were similar, as well as the histopathological criteria used in the analysis of soft drusen. Prevalence of AMD in the referred population was comparable to that described in both studied groups.