Prevalence of Reticular Pseudodrusen in Eyes with Newly Presenting Neovascular Age-Related Macular Degeneration

Wilde, Craig; Patel, Moneesh; Lakshmanan, Arun; Morales, Marco U; Dhar-Munshi, Sushma; Amoaku, Winfried

doi:10.5301/ejo.5000661

Cited by 20 publications

(18 citation statements)

References 33 publications

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“…Overall, use of at least two modalities may be recommended to detect and confirm the diagnosis of reticular lesions. 5,[9][10][11]13,[15][16][17]29,30 In the Beaver Dam Study, drusen type was related to the 15-year incidence of RPD (OR per more severe drusen type [hard distinct < soft distinct < soft indistinct]: 1.37) but not to drusen location or area. In the Blue Mountains Eye Study, 10 the location of any soft drusen at close proximity to the fovea (OR: 2.2) and an area of soft drusen between 375 lm and 0.5 disc area in diameter (OR: 3.2) were significantly associated with a greater risk of reticular drusen.…”

Section: Discussion Prevalencementioning

confidence: 99%

Multimodal Imaging of Reticular Pseudodrusen in a Population-Based Setting: The Alienor Study

Chan

Cougnard‐Grégoire

Delyfer

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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57:3058-3065. DOI:10.1167/ iovs.16-19487 PURPOSE. To document reticular pseudodrusen (RPD) using multimodal imaging in French elderly subjects. METHODS.A total of 494 subjects (970 eyes) aged 77 years or more, from the Alienor study, were examined in 2011 and 2012. Reticular pseudodrusen were defined as definite if they were present with at least two imaging methods among color retinal photographs, macular cube (208 3 158) of spectral-domain optical coherence tomography (SD-OCT), fundus autofluorescence (FAF), and infrared reflectance (IR). The Youden index was calculated as specificity þ sensitivity À 1.RESULTS. The prevalence of definite RPD was 13.4% and was higher among women (15.6%) than men (10.2%). It increased with age and reached almost 50% in subjects over 85 years. Infrared reflectance was the most sensitive technique (100%) and color fundus photography the least sensitive (34.5% at left eyes and 48.1% at right eyes). The best Youden index was obtained with IR (0.96 at both eyes) followed by SD-OCT (0.87 at right eye and 0.78 at left eye). Reticular pseudodrusen were present in 4.6% of eyes without AMD, 13.0% with early AMD1, 62.6% with early AMD2, 34.6% with atrophic AMD, and 8.1% with neovascular AMD. Reticular pseudodrusen were significantly associated with central and pericentral intermediate soft drusen (odds ratio [OR]: 2.14; 95% confidence interval [CI] ¼ 1.11-4.14 and OR: 1.49; 95% CI ¼ 1.16-1.90, respectively) and central large soft drusen (OR: 1.67; 95% CI ¼ 1.16-2.42).CONCLUSIONS. Using multimodal imaging, the prevalence of RPD appears higher than previously reported in studies based on retinal photography only. Reticular pseudodrusen frequently accompany other signs of AMD. Infrared reflectance and SD-OCT appear to be particularly relevant methods to diagnose RPD.

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Section: Discussion Prevalencementioning

confidence: 99%

Multimodal Imaging of Reticular Pseudodrusen in a Population-Based Setting: The Alienor Study

Chan

Cougnard‐Grégoire

Delyfer

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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“…In individuals with newly diagnosed choroidal neovascularisation 17–58 per cent have been found to have RPD . Care needs to be taken when considering RPD presence in the context of choroidal neovascularisation as development of choroidal neovascularisation has been observed to result in RPD fading …”

Section: Clinical Implications and Relationship With Amdmentioning

confidence: 99%

“…Multiple‐subtypes of choroidal neovascularisation have been described in association with RPD including types 1, 2 and 3 choroidal neovascularisation, vascularised pigment epithelial detachment, and haemorrhagic and fibrotic scarring . Type 3 choroidal neovascular membranes, also referred to as retinal angiomatous proliferation and retinal choroidal anastomosis, have been shown to have particular association with RPD, occurring more frequently with RPD than without …”

Section: Clinical Implications and Relationship With Amdmentioning

confidence: 99%

Reticular pseudodrusen: current understanding

Wightman

Guymer

2019

Clinical and Experimental Optometry

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Reticular pseudodrusen (RPD), also known as subretinal drusenoid deposits, represent a morphological change to the retina distinct from other subtypes of drusen by being located above the level of the retinal pigment epithelium. Although they can infrequently appear in individuals with no other apparent pathology, their highest rates of occurrence are in association with age-related macular degeneration (AMD), for which they hold clinical significance by being highly correlated with end-stage disease sub-types, choroidal neovascularisation and geographic atrophy. Reticular pseudodrusen are also found in other diseases, most notably Sorsby's fundus dystrophy, pseudoxanthoma elasticum and acquired vitelliform lesions. They are found more frequently in females, with increased age and more commonly bilaterally than unilaterally. Increased risk of RPD formation is conveyed by genetic variants known to increase risk of AMD development, including complement factor H, age-related maculopathy susceptibility 2, and high-temperature requirement A serine peptidase 1; however, to date, no genetic factor has been found to predispose to RPD independent of those that carry risks for AMD. They have typical features visible on multimodal imaging, identifiable either as single lesions or more commonly in yellowishwhite net-like patterns on colour fundus photography and are particularly distinguishable using spectral domain optical coherence tomography, fundus auto-fluorescence, and near infrared reflectance imaging. On histological examination, RPD have been shown to have distinct compositions in comparison to typical drusen, suggesting different pathways of pathogenesis. Although their aetiology remains unclear, presence of opsin within lesions, a high topographic association with areas of highest rod-photoreceptor concentration and functional deficits most pronounced within the scotopic range, has implicated rod photoreceptor dysfunction as a component of RPD.

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“…When adjusted for age, their 15-year cumulative incidence has been shown within the BMES to be twice more likely in females compared to males (5.6 vs 2.2%). 2,3,7,8,33 Arnold et al 2 reported 87% of patients with RPD were female, and Klein et al 9 demonstrated that the prevalence of RPD to be 2.5 times higher in woman within normal subjects. Similarly, in the BMES, after adjusting for age, Joachim et al 8 demonstrated the 15-year cumulative incidence of RPD was twice as likely in females.…”

Section: Discussionmentioning

confidence: 99%

“…Since then several groups have reported a high prevalence of RPD in eyes with both geographic atrophy (GA) and nAMD. [3][4][5][6][7] It has been shown that 30-50% of eyes with RPD will progress to AMD within 5 years 4,8 and RPD have been shown to increase the risk for the development of AMD four-to sixfold when compared to eyes with other stages of age-related maculopathy only. 8,9 In the Beaver Dam Eye Study (BDES), RPD were demonstrated to confer a higher risk of visual impairment.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of reticular pseudodrusen in newly presenting adult onset foveomacular vitelliform dystrophy

Wilde

Lakshmanan

Patel³

et al. 2016

Eye

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Purpose To report the association and prevalence of reticular pseudodrusen (RPD) in eyes with newly presenting adult onset foveomacular vitelliform dystrophy (AFVD). To compare the strength of association with other pathologies resulting from dysfunction of the choroid-Bruch's membrane-retinal pigment epithelium (RPE) complex, including eyes with geographic atrophy (GA) and angioid streaks. Methods Retrospective single-centre review of all consecutive newly presenting AFVD. Multimodal imaging with spectral domain optical coherence tomography, fundus photographs, red-free/blue light images, and fundus fluorescein angiograms were graded for the presence of RPD. For comparison, all consecutive newly presenting cases of GA and eyes with angioid streaks were studied. Results Fifteen (15) patients were identified with AFVD (mean age of 77.3 years; 73.3% female). Mean age of patients with AFVD and RPD was 80.5 years (SD 3.7), whereas that of patients with AFVD without RPD was 75.1 years (SD 7.0). This age difference did not reach statistical significance, P = 0.1. Six (40%) had identifiable RPD; being a bilateral finding in 100% of patients. No males with AFVD and RPD were identified. A total of 92 eyes presented with GA. Twenty-three (23) of these (25.0%) had RPD. Twelve (12) patients presented with identifiable angioid streaks, with 4 (36.4%) having RPD. Conclusion RPD are a frequent finding in eyes with newly presenting AFVD; not being restricted to AMD, but a finding common among diseases where pathophysiological mechanisms involve damage to Bruch's membrane and the RPE, whether genetic or degenerative. Our study supports the concept that they occur with high but variable frequencies in eyes with various pathologies.

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Prevalence of Reticular Pseudodrusen in Eyes with Newly Presenting Neovascular Age-Related Macular Degeneration

Cited by 20 publications

References 33 publications

Multimodal Imaging of Reticular Pseudodrusen in a Population-Based Setting: The Alienor Study

Multimodal Imaging of Reticular Pseudodrusen in a Population-Based Setting: The Alienor Study

Reticular pseudodrusen: current understanding

Prevalence of reticular pseudodrusen in newly presenting adult onset foveomacular vitelliform dystrophy

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