June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
RETICULAR PSEUDODRUSEN AND THE FIVE-YEAR RISK OF PROGRESSION FOR LATE AMD
Author Affiliations & Notes
  • João Pedro Marques
    Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
    Coimbra Ophthalmology Reading Centre (CORC), Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
  • João Quadrado Gil
    Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
    Coimbra Ophthalmology Reading Centre (CORC), Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
  • Inês Laíns
    Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
    Faculty of Medicine University of Coimbra (FMUC), Coimbra, Portugal
  • Miguel Ângelo Costa
    Coimbra Coordinating Centre for Clinical Research (4C), Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
  • Sandrina Nunes
    Coimbra Coordinating Centre for Clinical Research (4C), Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
  • Maria Luz Cachulo
    Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
    Coimbra Ophthalmology Reading Centre (CORC), Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
  • Rufino Silva
    Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
    Faculty of Medicine University of Coimbra (FMUC), Coimbra, Portugal
  • Footnotes
    Commercial Relationships João Pedro Marques, None; João Gil, None; Inês Laíns, None; Miguel Ângelo Costa, None; Sandrina Nunes, None; Maria Luz Cachulo, None; Rufino Silva, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 3779. doi:
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      João Pedro Marques, João Quadrado Gil, Inês Laíns, Miguel Ângelo Costa, Sandrina Nunes, Maria Luz Cachulo, Rufino Silva; RETICULAR PSEUDODRUSEN AND THE FIVE-YEAR RISK OF PROGRESSION FOR LATE AMD. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3779.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

Despite recent advances in retinal imaging, reticular pseudodrusen (RPD) remain an under-reported and under-researched retinal phenotype. The presence of RPD has been recognized as a significant risk factor for exudative age-related macular degeneration (eAMD) but a long-term follow-up is lacking. We conducted a retrospective observational clinical study to assess the influence of RPD on the 5-year risk of progression to late-stage disease, in a population of unaffected fellow eyes of eAMD.

 
Methods
 

Only fellow eyes of patients with unilateral eAMD were included. Minimum follow-up was 5 years, unless progression to late-AMD occurred first. Using an innovative grading software (RetmarkerAMD®, Critical Health SA), the areas of drusen and RPD were measured in baseline color fundus photographs (CFP), fundus auto-fluorescence (FAF), infra-red (IR) and red-free (RF) images. Presence of RPD was assumed whenever noticeable in at least one imaging modality. Main outcome measures were the incidence of choroidal neovascularization (CNV) and geographic atrophy (GA).

 
Results
 

Sixty-three patients, mean-aged 76.19±6.63 years and with a mean follow-up of 66.03±20.95 months, were included. Prevalence of RPD was 55.56% (n=35). RPD were more frequently recognized in IR and FAF (52.4% for both) than in CFP (15.8%). Forty-one (65.1%) of the study eyes progressed to late-stage AMD: 82.9% (n=34) developed CNV and 17.1% (n=7) developed GA. Time to progression was not significantly different between patients with and without RPD (30.64 and 31.77 months respectively, p=0.79). After correcting for age and sex, presence of RPD was significantly associated (OR=3.96, p=0.01) with the development of late-stage AMD. Significance was maintained for CNV (OR=3.96, p=0.011) but not for GA (OR=0.943, p=0.94). Mean total area of RPD did not correlate with the risk of progression, regardless of the imaging modality used for measurement. Mean drusen area also did not significantly impact the 5-year risk of progression for late AMD (p=0.99). Multivariate analysis using a model that included intermediate and large drusen, revealed that the independent association between RPD and progression was maintained (OR=5.14, p=0.009).

 
Conclusions
 

RPD are associated with increased long-term risk of progression to late AMD in the second eye of patients with wet AMD, even in the presence of other known risk factors.

 
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