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Aakriti Garg, Maris Oll, Suzanne Yzer, Rando Allikmets, Stanley Chang, Gaetano Barile, Roland Smith, John Merriam, Stephen Tsang, Srilaxmi Bearelly; Reticular Pseudodrusen in Early Age-Related Macular Degeneration is Associated with Choroidal Thinning. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4169.
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To compare subfoveal choroidal thickness (SFCT) measurements in early age-related macular degeneration (AMD) between patients with and without reticular pseudodrusen (RPD) using spectral-domain optical coherence tomography (SDOCT).
This cross-sectional study examined 84 AMD patients (40 RPD, 44 non-RPD) who were age- and gender-matched (RPD: 32 of 40 (80%) were female, mean age 76.9 years ± 7.5 SD; non-RPD: 32 of 44 (73%) were female, mean age 73.9 years ± 7.8 SD). 63 RPD eyes and 75 non-RPD eyes were included in the analysis. Exclusion criteria included late AMD (geographic atrophy greater than 500 microns2 or history of choroidal neovascularization), myopia greater than -6 diopters, central serous chorioretinopathy, or past vitreoretinal surgery. Color fundus photographs and scanning laser ophthalmoscopy (including autofluorescence and infrared imaging) were graded in a masked fashion by three retinal specialists (SY, SB, MO) to identify RPD and non-RPD groups. SDOCT was used to measure choroidal thickness for all eyes. For each eye, the best SDOCT image with a clear posterior margin of choroid was chosen for analysis. Enhanced depth imaging spectral-domain optical coherence tomography (EDI-SDOCT) was used when available (20 of 138 eyes). SFCT was measured using Heidelberg Eye Explorer interactive software.
Mean SFCT of RPD eyes (176.3 microns ± 60.5 SD) was significantly less than that of non-RPD eyes (216.5 microns ± 70.3 SD) by the Student’s t-test for independent samples (p = 0.0005).
These results support previous smaller studies that have shown RPD is associated with a thinner choroid. As RPD has been associated with increased risk of advanced AMD, SFCT may be integral to understanding the RPD process, as well as stratifying risk of AMD progression.
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