Reticular Pseudodrusen, Enlarging Geographic Atrophy, and Decreased Choroidal Thickness in Age-Related Macular Degeneration

Abstract

 

Purpose

 

To compare subfoveal choroidal thickness (CT) measurements in eyes with non-exudative age-related macular degeneration (AMD) with and without reticular pseudodrusen (RPD) and eyes with no known ocular disease.

 

Methods

 

Retrospective study of AMD patients enrolled in the COMPLETE study (30 drusen-only eyes and 30 eyes with geographic atrophy [GA]) compared to an age-distributed normal control group (155 eyes of normal subjects). CT was measured in the subfoveal region using enhanced-depth SD-OCT imaging. Multimodal images were evaluated to detect the presence of RPD in eyes with non-exudative AMD.

 

Results

 

Three drusen eyes (10%) were diagnosed with RPD. In the GA group, 20 eyes (66.7%) were diagnosed with RPD. After controlling CT for age and axial length, the mean subfoveal CT of the GA group was significantly thinner than the drusen group (p=0.007), but the drusen group was not significantly different than the normal controls (p=0.090). After separating the GA group into eyes with and without RPD, the GA group without RPD had a mean CT (335.3±123.2μm) that was not significantly different from normal eyes (286.1±84.5;p=0.076) or eyes with drusen (315.6±86.2; p=0.45), while the GA group with RPD (213.7±53.1μm) was significantly thinner than the GA group without RPD (p=0.001). In eyes without RPD, increasing area of GA was strongly correlated with decreasing CT (p=0.001).

 

Conclusions

 

Subfoveal CT measurements in eyes with non-exudative AMD and without RPD were similar to normal age-adjusted control eyes. Choroidal thinning in eyes with non-exudative AMD was associated with the presence of RPD or an increasing area of GA.