Abstract
Purpose :
Reticular pseudodrusen (RPD) are associated with accelerated advancement to end-stage age-related macular degeneration (AMD). The pathogenesis of RPD is not fully understood. The purpose of this study was to analyze the RPD phenotype in human eyebank eyes that are graded according to AREDS criteria applied to human eyebank eyes Minnesota Grading System (MGS).
4-step (MGS-4) and 9-step (MGS-9) analysis (IOVS; 45:448-4490, 2004 and IOVS 58:5497-5506, 2017).
Methods :
Donor eyebank globes were graded according to the age-related eye disease study (AREDS) criteria for MGS-4 and MGS-9 respectively (IOVS; 45:448-4490, 2004 and IOVS 58:5497-5506, 2017) using stereoscopic, color fundus photographs of the macula with a direct view of the macular retinal pigment epithelium (RPE). Donor demographics include age, race, gender, time and cause of death, time of death and death to preservation time, and a limited medical and ocular history. The MGS-4 corresponds to standard AREDS stages while the MGS-9 quantifies three key phenotypic features: total drusen area, hyper- and de-pigmentation, and geographic atrophy. Fundus images detect the RPD. Statistical software; JMP 13 (SAS Institute Inc., Cary, NC, USA) determines the distribution of RPD in MGS stages. Nonparametric Wilcoxon rank sum test was used to compare the groups.
Results :
From 2005 through September 2018, 1888 human eyes were obtained with readable images in 1167 cases. There were 148 eyes with RPD (13%). In the MGS-9 severity scale, the distribution of eyes with RPD based on quartiles, there were 38 (26%) globes in the lowest quartile, 80 (54%) globes in the second quartile, 106 (71%) globes in the third quartile. RPD was significantly associated with severe grades of MGS score. (p<0.001).
Conclusions :
This study supports the current association of RPD as a high-risk phenotype for advanced AMD, confirmed by using eyebank eyes at risk for AMD, stratified according to the AREDS using the MGS-9 grading system.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.