Author(s): Cleland SC, Domalpally A, Liu Z, Pak JW, Blodi BA, Bailey S, Gehrs K, Wallace R, Tinker L, Mares JA; Second Carotenoids in Age-Related Eye Disease Study Investigators. Reticular Pseudodrusen Characteristics and Associations in the Carotenoids in Age-Related Eye Disease Study 2 (CAREDS2). Ophthalmol Retina. 2020 Dec 30. pii: S2468-6530(20)30506-6. doi: 10.1016/j.oret.2020.12.019. [Epub ahead of print] PMID 33387684
Journal: Ophthalmology. Retina, Dec 2020
PURPOSE To determine the prevalence and morphological features of reticular pseudodrusen (RPD) and their association with participant demographics and AMD status in the Carotenoids in Age-Related Eye Disease Study 2 (CAREDS2) sample, an ancillary study of the Women’s Health Initiative Observational Study.
DESIGN Cross-sectional, multicenter, natural history study.
PARTICIPANTS 946 eyes from 473 female postmenopausal participants aged 69 to 101 years old METHODS: Multimodal imaging including spectral domain optical coherence tomography (SD OCT) and infrared reflectance (IR) were used to identify RPD characteristics, such as location (within or outside the 6 mm diameter circle centered at the macula), presence of peripapillary RPD, pattern of RPD, and RPD area. AMD features from SD OCT, IR, and color photographs were also assessed and AMD severity was categorized.
MAIN OUTCOME MEASURES RPD prevalence using SD OCT and IR imaging, and AMD status.
RESULTS RPD were present in 130 eyes (14% of eyes, 16% of participants), with increasing prevalence with age; 7% in 83 years. Using clinical classification of AMD with color photography, RPD were seen in 2.4% of eyes with no AMD/ aging changes, 11.5% in early AMD, 25.1% in intermediate AMD and 51.1% in late AMD. Mean RPD area was 17.4 (14.7) mm2. Ribbon morphology (53%) was more common than dot morphology RPD (36%). RPD were mostly located both within and outside the 6 mm circle with primarily superior retinal distribution. 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).
CONCLUSION The prevalence of RPD in CAREDS2 increased with age and was associated with AMD severity. RPD was detected in eyes without other features of AMD and could represent an earlier disease state. Multimodal imaging with SD OCT and IR has significantly greater sensitivity for visualizing RPD than color fundus photography.