Decreased macular choriocapillaris perfusion in eyes with macular reticular pseudodrusen imaged with swept-source OCT angiography

Abstract

Purpose : To determine if macular reticular pseudodrusen (RPD) were associated with markers of impaired macular choroidal perfusion, we investigated measurements of macular choriocapillaris (CC) flow deficits (FDs), CC thickness, and mean choroidal thickness (MCT) in eyes with macular RPD compared with normal eyes and eyes with soft drusen.

Methods : In this retrospective cohort from a prospective swept-source OCT angiography (SS-OCTA) natural history study, we investigated eyes with intermediate age-related macular degeneration (iAMD) and normal eyes. Eyes underwent 6X6mm SS-OCTA imaging to diagnose macular drusen and RPD. Eyes with RPD had to have RPD occupying at least 25% of a fovea-centered 5mm diameter circle. Other measurements included outer retinal layer (ORL) thickness, CC FDs, CC thickness, MCT, and choroidal vascularity index (CVI) within a fovea-centered 5mm diameter circle using previously published strategies.

Results : Ninety eyes were included: 30 normal eyes, 30 eyes with soft drusen, and 30 eyes with macular RPD. RPD eyes showed higher macular CC FDs than normal eyes (P < 0.001) and soft drusen eyes (P = 0.019). Macular CC thickness was decreased in RPD eyes compared with normal eyes (P < 0.001) and soft drusen eyes (P = 0.016). Macular MCT in RPD eyes was thinner than normal eyes (P = 0.005) and soft drusen eyes (P < 0.001). No statistically and clinically significant differences were found in the ORL thickness and CVI measurements between RPD eyes and the other two groups (all P > 0.05).

Conclusions : Eyes with macular RPD had decreased macular CC perfusion, decreased CC thickness, and decreased MCT measurements compared with normal and soft drusen eyes, suggesting that RPD may result from impaired choroidal perfusion.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.