Appearance of medium–large drusen and reticular pseudodrusen on adaptive optics in age-related macular degeneration

Abstract

AO allows differences in reflectivity between medium-large drusen and reticular pseudodrusen to be appreciated. The cone mosaics may be detected as continuous 'bright' hyper-reflective dots overlying/on the border of drusen and pseudodrusen deposits, and possibly as continuous 'dark' hyporeflective dots overlying drusen only.

Current knowledge on reticular pseudodrusen in age-related macular degeneration

“…This suggests that eyes with RPD may experience decreased retinal function independent of the presence of CNV or GA and confirms findings in recent functional studies 58. In AO en face imaging, soft drusen appear as highly hyper-reflective lesions, centred and/or surrounded by a hyporeflectivity, whereas RPD appear as isoreflective lesions, surrounded by a hyporeflective halo 59. Defined stages of RPD could be correlated to reflectivity changes in AO-SLO consistent with perturbed surrounding photoreceptors.…”

Pilot evaluation of short-term changes in macular pigment and retinal sensitivity in different phenotypes of early age-related macular degeneration after carotenoid supplementation

“…Using adaptive optics, Mrejen et al 25 investigated the cone photoreceptor mosaic in eyes with RPD and compared the cone density with eyes with soft drusen, showing a reduction in cone density over RPD lesions possibly due to a change in their orientation, alteration of their cellular architecture or even absence of the cones themselves. Similar results have been found by Querques et al 26 in eyes with RPD, even though no differences were detected in areas between RPD deposits as compared with areas between drusen. This suggests that eyes with RPD may experience decreased retinal function independent of the presence of choroidal neovascularization or GA and confirms findings in recent functional studies 27.…”

Prevalence of Subtypes of Reticular Pseudodrusen in Newly Diagnosed Exudative Age-Related Macular Degeneration and Polypoidal Choroidal Vasculopathy in Korean Patients

“…Recent studies using adaptive optics technology revealed markedly decreased cone density over pseudodrusen deposits 31 as well as at the border of pseudodrusen. 32 Although the reticular pseudodrusen may not markedly affect visual acuity, 19 more subtle retinal function measured using a low-luminance acuity test 19 and microperimetry 33 has been found to be decreased in eyes with reticular pseudodrusen. In addition, continuous decline of visual function over time was noted in eyes with progressive reticular pseudodrusen.…”