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K. Laud, S. A. Zweifel, R. F. Spaide; Multi-Modal Imaging of Reticular Pseudodrusen and Adult Vitelliform Detachment. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4382.
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To report a novel association of reticular pseudodrusen and adult vitelliform detachment and evaluate the clinical findings of these patients using multi-modal imaging.
A retrospective review was done of five cases of adult vitelliform detachment secondary to reticular pseudodrusen. Clinical examination, color and red-free fundus photography, fundus autofluorescence (FAF) and spectral domain optical coherence tomography (SD-OCT) data were retrospectively reviewed for the five patients. Reticular pseudodrusen were observed to be subretinal drusenoid deposits above the level of the retinal pigment epithelium (RPE) with a predeliction for the superior paramacula. Adult vitelliform detachments were hyperautofluorescent accumulations of vitelliform material in the subretinal space between the IS/OS junction and RPE. The time interval for follow-up examination varied from three to twenty one months.
Five patients with this distinct subretinal drusenoid pattern were found to have an accumulation of vitelliform material in the subretinal space. All five patients maintained stable visual acuity over the follow-up interval. These patients all had preservation of the junction of the inner and outer photoreceptor segments (IS/OS) and external limiting membrane (ELM). There was no associated outer nuclear layer (ONL) thinning observed in these patients.
We utilized multi-modal imaging to document the novel finding of adult vitelliform detachment associated with subretinal drusenoid deposits commonly referred to as reticular pseudodrusen in five patients. These subretinal deposits may be mistaken for basal laminar cuticular drusen but can be easily distinguished with multi-modal imaging. Multi-modal imaging served as an essential adjunct to clinical examination in the diagnosis and follow-up of patients with adult vitelliform detachment and reticular pseudodrusen. All patients with this new finding maintained stable visual outcomes over the follow up period without any therapeutic intervention.
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