Association Between Visual Function and Subretinal Drusenoid Deposits in Normal and Early Age-Related Macular Degeneration Eyes

Abstract

Purpose To examine the association between subretinal drusenoid deposits (SDD) identified by multimodal retinal imaging and visual function in older eyes with normal macular health or in the earliest phases of age-related macular degeneration (AMD). Methods AMD status for each eye was defined according to the AREDS 9-step classification system (normal=step 1, early AMD=steps 2–4) based on color fundus photographs. Visual functions measured were best-corrected photopic visual acuity, contrast sensitivity, and light sensitivity, mesopic visual acuity, low luminance deficit, and rod-mediated dark adaptation. SDD were identified through multi-modal imaging (color fundus photographs, infrared reflectance and fundus autofluorescence images, spectral-domain optical coherence tomography). Results The sample included 1,202 eyes (958 eyes with normal health, 244 eyes with early AMD). In normal eyes SDD were not associated with any visual function evaluated. In eyes with early AMD, dark adaptation was markedly delayed in eyes with SDD versus no SDD (4-minute delay on average), p=0.0213. However this association diminished after age adjustment, p=0.2645. Other visual functions in early AMD eyes were not associated with SDD. Conclusion In a study specifically focused on eyes in normal macular health and in the earliest phases of AMD, early AMD eyes with SDD have slower dark adaptation, largely attributable to the older ages of eyes with SDD; they did not exhibit deficits in other visual functions. SDD in older eyes in normal macular health are not associated with any visual functions evaluated.

Reticular pseudodrusen: current understanding

“…RPD have been observed in all stages of AMD . In the Alabama Study of early AMD, 49 per cent of individuals with early and 79 per cent with intermediate AMD were reported to have RPD; however, as has been noted only one lesion was required to confer RPD diagnosis in this study .…”

Spotlight on reticular pseudodrusen

“…A recent study comparing eyes in normal macular health with and without RPD illustrated no significant difference regarding photopic acuity, mesopic acuity, low-luminance acuity, photopic contrast sensitivity and photopic light sensitivity. 111 In the same study, eyes with RPD exhibited delayed dark adaptation, although significant differences in age between the 2 groups could be imputable for such a difference. 111 …”

“… 111 In the same study, eyes with RPD exhibited delayed dark adaptation, although significant differences in age between the 2 groups could be imputable for such a difference. 111 …”

Longitudinal Assessment of Rod Function in Intermediate Age-Related Macular Degeneration With and Without Reticular Pseudodrusen

“…Many cross-sectional studies have demonstrated that rod function is abnormal early in AMD 3,[8][9][10] and more recently it has been found that AMD cases with the additional phenotype of reticular pseudodrusen (RPD, also known as subretinal drusenoid deposits) have particularly poor rod function. 2,[11][12][13][14][15] This finding is particularly significant as RPD are very common in AMD 16,17 and are highly correlated with disease progression to late AMD; geographic atrophy and neovascular AMD. [18][19][20][21][22][23][24][25] In addition, RPD are more likely distributed at superior perifoveal retina, while the common drusen in AMD are more at central fovea.…”