June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Prevalence and Characteristics of Reticular Pseudodrusen in the Carotenoids in Age-Related Eye Disease Study 2 (CAREDS2)
Author Affiliations & Notes
  • Jeong W Pak
    Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Spencer Cleland
    Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Amitha Domalpally
    Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Zhe Liu
    Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Barbara Blodi
    Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Steven T Bailey
    Ophthalmology, Oregon Health & Science University, Portland, Oregon, United States
  • Karen M Gehrs
    Ophthalmology and Visual Sciences, University of Iowa Hospital & Clinics, Iowa City, Iowa, United States
  • Robert B Wallace
    Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, United States
  • Lesley Tinker
    Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States
  • Julie A Mares
    Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Footnotes
    Commercial Relationships   Jeong Pak, None; Spencer Cleland, None; Amitha Domalpally, None; Zhe Liu, None; Barbara Blodi, None; Steven Bailey, None; Karen Gehrs, None; Robert Wallace, None; Lesley Tinker, None; Julie Mares, None
  • Footnotes
    Support  NEI grants EY013018, EY016886, EY025292, EY025292-01S1 and P30 EY016665; Research to Prevent Blindness, Inc.; NHLBI grants N01WH22110, 24152, 32100-2, 32105-6, 32108-9, 32111-13, 32115, 32118-32119, 32122, 2107-26, 42129-32, and 44221: NIH grant UL1TR002373
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 108. doi:
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      Jeong W Pak, Spencer Cleland, Amitha Domalpally, Zhe Liu, Barbara Blodi, Steven T Bailey, Karen M Gehrs, Robert B Wallace, Lesley Tinker, Julie A Mares; Prevalence and Characteristics of Reticular Pseudodrusen in the Carotenoids in Age-Related Eye Disease Study 2 (CAREDS2). Invest. Ophthalmol. Vis. Sci. 2021;62(8):108.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Reticular pseudodrusen (RPD) have been identified as an independent risk factor in the progression of age-related macular degeneration (AMD), particularly predictive of geographic atrophy. However, RPD characteristics are poorly defined in natural history studies. We determined the prevalence and morphological features of RPD using multimodal imaging and assessed associations with demographics, AMD status, and visual acuity in participants of CAREDS2, an ancillary study of the Women’s Health Initiative.

Methods : Multimodal imaging included spectral domain optical coherence tomography (SD OCT) and infrared reflectance (IR) to identify RPD characteristics, such as presence, location (within or outside the ETDRS grid), peripapillary involvement, pattern, and RPD area. AMD features from SD OCT, IR, and color photographs were also assessed and AMD severity was categorized.

Results : In 927 eyes from 466 female participants (age 69 to 101), RPD were present in 130 eyes (14% of eyes, 16% of participants) and 76% participants with RPD had bilateral involvement. There was increasing prevalence with age; 7% in < 78 years, 14% in 78-83 years, and 30% in > 83 years. The AMD severity classification from the color photographs showed RPD in 2.4% of eyes with no AMD, 11.5% in early AMD, 25.1% in intermediate AMD and 51.1% in late AMD. Ribbon morphology (53%) was more common than dot morphology RPD (36%). RPD were mostly located both within and outside the ETDRS grid with primarily superior retinal distribution. Among eyes with RPD, 35% had peripapillary involvement which showed an increase with age. Mean RPD area was 17.4 (14.7) mm2 and was not significantly associated with age (P = 0.10) or with AMD status (P=0.60). RPD were visualized with corresponding color fundus photography in only 38 eyes (4% of total eyes). Participants with and without RPD had a visual acuity ± standard error of 77.9 (1.4) and 81.3 (0.4) letters, respectively (P = 0.02).

Conclusions : The prevalence of RPD in the aging female population of CAREDS2 was associated with advancing age and AMD severity. RPD were also detected in eyes without other features of AMD which could represent an earlier disease state. Sensitivity for visualizing RPD was greatly enhanced using multimodal imaging with SD OCT and IR over color fundus photography.

This is a 2021 ARVO Annual Meeting abstract.

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