Reticular Macular Disease

Abstract

Purpose To present a unified description of reticular macular disease (RMD), a common clinical entity that includes reticular pseudodrusen and confers high risk of progression to advanced age-related macular degeneration (AMD). Design Population-based, retrospective, cross-sectional study. Participants Forty-two patients with reticular findings in at least one imaging modality, of whom 21 had follow-up. Methods RMD was defined as reticular pseudodrusen (RPD) in color or red-free (RF) photography and/or a reticular pattern on scanning laser ophthalmoscope (SLO) imaging (autofluorescence (AF) scans, infrared (IR) photographs or indocyanine green (ICG) angiography). Color and RF images were contrast-enhanced, and color photos were examined in green and blue channels. Image registration in different modalities allowed comparison of areas involved and assessment of lesion co-localization. Results RMD was generally present in both photography and SLO imaging. When present in two image modalities, areas of RMD either largely overlapped, or one fell within the other. Individual lesions had high spatial correspondence. Serial imaging showed faded to absent findings in eyes that developed choroidal neovascularization (CNV). Conclusions RMD is a single disease entity with stereotypical presentations in multiple imaging modalities, of which reticular pseudodrusen is one. AF, IR, and ICG suggest that it involves the retinal pigment epithelium and choriocapillaris, while photographic patterns implicate the inner choroid. IR imaging, unlike other modalities, can demonstrate RMD in the central macula. RMD is associated with progression to advanced AMD, perhaps on an inflammatory basis. RMD deserves wider recognition among clinicians caring for our elderly patients.

Longitudinal Analysis of Reticular Drusen Associated With Geographic Atrophy in Age-Related Macular Degeneration

“…10,11 More recently, reticular drusen (RDR), also called ''reticular pseudodrusen,'' have been implicated as associated with AMD. [12][13][14] The term ''reticular pseudodrusen visible en lumière bleue (the pseudo-drusen visible in blue light)'' was introduced by Mimoun and colleagues in 1990. 10 They initially described ''retinal lesions with a variable diameter of approximately 100 microns that did not appear hyperfluorescent on fluorescein angiography.''…”

Choroidal Flow Signal in Late-Onset Stargardt Disease and Age-Related Macular Degeneration: An OCT-Angiography Study

“…For example, choroidal insufficiency has been previously implicated in the pathogenesis of subphenotypes within the spectrum of AMD including ''reticular macular disease'' and ''diffuse-trickling geographic atrophy'' based on indocyanine green and fluorescein angiography findings, pronounced choroidal thinning, and cardiovascular comorbidity. [33][34][35][36][37] Limitations of this study need to be considered. While STGD1 and AMD patients exhibited phenotypic differences inside of RPE atrophy, these differences appeared to be not adequately quantified by the AFS area fraction.…”

“…To avoid potential confounding, patients exhibiting ''diffusetrickling geographic atrophy'' were not included, as choroidal insufficiency has been previously implicated in the pathogenesis. [33][34][35][36][37] Genetic testing was conducted at the Institute of Human Genetics, University of Regensburg (n ¼ 7), and at the Center for Human Genetics Bioscientia, Ingelheim (n ¼ 6). Analysis of all coding exons of the ABCA4 and PRPH2 genes was done by either direct chain-terminating dideoxynucleotide Sanger sequencing, a custom-designed GeneChip CustomSeq Resequencing Array (RetChip; Affymetrix, Santa Clara, CA, USA), or next-generation sequencing (Regensburg, n ¼ 5; Bioscientia, n ¼ 6).…”

Reticular pseudodrusen: a tale of two species?

“…6 However, the imaging properties of RPD in each of these cases are so different that we need to consider the possibility that these are in fact two separate entities. What is currently known as RPD may actually represent an umbrella term for at least two separate entities with two separate anatomic origins.…”