Prevalence of reticular pseudodrusen in age-related macular degeneration with newly diagnosed choroidal neovascularisation

Abstract

Aim: To investigate the prevalence of reticular pseudodrusen (RPD) in eyes of patients presenting with newly diagnosed choroidal neovascularisation (CNV) in age-related macular degeneration (AMD), and to analyse the association between RPD, age-related maculopathy (ARM) and AMD. Method: Two observational consecutive prospective series. In series 1, patients with AMD with newly diagnosed CNV were sampled to determine the incidence of RPD. Eyes with and without RPD were compared by the Mann-Whitney non-parametric test and Fisher's exact test for age, sex of patients, the eye involved and type of CNV. Series 2 comprised 100 patients referred for fundus photography, fluorescein and/or indocyanine green angiography, for whom pictures showed RPD. This second cohort was then selected from a larger group of patients. Results: Patients with newly diagnosed CNV in series 1 comprised 67 women and 33 men, aged 57-96 years (mean 79.5). CNV was ''classic'' (32 eyes), ''occult'' (41) or exhibited vascularised pigment epithelial detachment (PED, 11), retinal angiomatous proliferation (RAP) with or without PED (13), or haemorrhagic or fibrovascular scarring (3). In all, 24 (24%) eyes had RPD. The prevalence of RAP was significantly higher in eyes with RPD than in those without (p = 0.0128), despite the small number of patients with RAP. In series 2, 100 patients with RPD were enrolled in 3 months, and corresponded to 8% of the overall cases referred to our centre (Centre Ophtalmologique d'Imagerie et de Laser, Paris, France). There were 77 women and 23 men, aged 54-93 years (mean 79.2). Eyes with RPD (n = 155) usually exhibited signs of ARM or AMD, including soft drusen (101 eyes) and/or retinal pigment epithelium abnormalities (70), geographical atrophy (27) and/or CNV (61). In both studies, examination of blue-light fundus pictures was extremely helpful in diagnosing RPD. Conclusion: RPD have a high prevalence among patients with AMD with newly diagnosed CNV (24% of cases). RPD were commonly associated with ARM or AMD. This study suggests that eyes with RPD could be classified as a phenotype of ARM.

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

“…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.…”

“…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.…”

Clinical Characteristics and Current Treatment of Age-Related Macular Degeneration

“…The origin of these lesions remains unclear, but may represent direct photoreceptor damage. Reticular pseudodrusen were initially associated with neovascular AMD (Arnold et al 1995;Cohen et al 2007), but recent studies show that they also represent a risk factor for progression to geographic atrophy (Klein et al 2008b;Pumariega et al 2011). …”

Scanning Laser Ophthalmoscope in the Management of Age-related Macular Degeneration

“…59 Prior studies reported lower percentages. 56,[60][61][62] The recent discovery of the strong association between reticular disease and AMD progression is attributed to increased utilization of autofluorescence and IR imaging in the management of AMD, as these patterns were difficult to visualize with color fundus photography. process, has also been measured using fine matrix mapping and MP in patients with abnormal patterns of FAF in this zone.…”

“…These pseudo-drusen are a new, distinctive morphologic feature observed in AMD that is best seen with red-free, IR, FAF, and indocyanine green angiography ICGA images. [55][56][57] Klein and colleagues defined them as ill-defined networks of broad, interlacing ribbons. 58 The combination of reticular drusen and a reticular FAF pattern has been associated with an increased risk of progression to advanced AMD.…”