Abstract
Purpose :
To investigate spatial distribution of reticular pseudodrusen (RPD) in eyes with age-related macular degeneration (AMD) and their correlation with - functional measures, retina thickness and changes over time.
Methods :
Participants with a wide spectrum of AMD (including no AMD) were prospectively recruited and evaluated regularly by multimodal imaging. Color fundus imaging was used to assess AMD severity scores. RPD were evaluated by presence on optical coherence tomography (OCT) volumes and confirmed on 2D enface OCT. RPD contours were outlined manually on infrared reflectance images. One study eye per participant underwent dark adaptation (DA) testing measuring rod intercept time (RIT) at 5° and/or 12° eccentricity (superior retina).
Results :
A total of 53 eyes (36 participants) had ≥1 visit with RPD detected, (followed for a duration of 2.19±2.04 (μ±σ), range 0-5 years), totaling 171 study eye visits with RPD. RPD were detected more frequently in AMD severity groups 6-7 with the largest areas occurring in AMD severity 6. RPD distribution showed a predilection for the superior retina, especially the outer superior subfield of the Early Treatment Diabetic Retinopathy Study (ETDRS) grid with central subfield having least involvement. The area of RPD lesions inversely correlated with central subfield thickness. Functional DA at 5° was at the test ceiling in > 85% of eyes, irrespective of RPD involving the test location. The RIT of eyes with RPD lesions at the 12° test spot was higher than those without (median 31.0 vs 16.5 minutes, p<0.05) and correlated with RPD area, p<0.005). Over 5 subsequent years, 6 eyes developed GA, and 17 progressed to CNV. In the 15 eyes without CNV, over 5 years, RPD area was seen to regress from the inner superior subfield (Δ=-35.7%) and grow in the outer nasal (Δ=+26%) subfield, while the retina thickness of central and inner subfields demonstrated the greatest change over time (mean change of -5.47%).
Conclusions :
In AMD, RPD have the predominant involvement in the superior retina and can involve all ETDRS subfields. The area affected by RPD correlates negatively with central subfield thickness. At 5°, rod dysfunction exists regardless of RPD presence at the test spot. Testing at 12° showed DA function negatively correlated with RPD area and test spot involvement. Eyes with RPD undergo a fast rate of outer retina thinning especially in the inner and central subfields.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.