Abstract
Purpose: :
To investigate the prevalence of reticular pseudodrusen (RPD) in patients with Polypoidal Choroidal Vasculopathy (PCV).
Methods: :
Consecutive patients with PCV enrolled in a clinical trial and evaluated by the Digital Angiography Reading Center were retrospectively analyzed to determine the occurrence of RPD. All patients included in the study were submitted to color fundus picture, red-free fundus imaging or blue-light reflectance, fluorescein angiography, indocyanine green angiography (ICGA), and near infrared reflectance; baseline images were evaluated. The inclusion criterion was the diagnosis of active PCV in at least one eye confirmed by ICGA. The exclusion criteria were any prior treatment for PCV including photocoagulation or photodynamic therapy; retinal or choroidal vascular disease due to causes other than PCV, such as uveitis, trauma or pathological myopia; macular edema due to other causes; current or prior history of ischemic or occlusive retinal vascular disease; ocular media opacities that might interfere with photography; or inability to obtain fundus photographs of sufficient quality to be analyzed by the reading center. The diagnosis of RPD was determined by their typical appearance and distribution on multimodal imaging.
Results: :
Sixteen out of 32 patients showed bilateral PCV (48/64 eyes - 75%). The characteristic feature compatible with the diagnosis of RPD was determined by ICGA results; it was found in 18 out of 32 patients (56%) and it was bilateral in all cases (36/64 eyes - 56%). In 27 eyes (42%) PCV and RPD were found; 21 eyes (33%) showed PCV but no RPD; 9 eyes (14%) showed RPD but no sign of PCV and 7 eyes (11%) did not show PCV or RPD.
Conclusions: :
Our findings on ICGA suggest that RPD has a high prevalence in patients with PCV and reveal the bilateral characteristic of the reticular pattern, even when RPD are not documented, feature not yet reported in other advanced forms of AMD. This might indicate an association between RPD and PCV, which can contribute to a better understanding of the underlying physiopathological mechanisms in these conditions.
Keywords: imaging/image analysis: clinical • retina • age-related macular degeneration