Local and Global Associations of Reticular Pseudodrusen in Age-Related Macular Degeneration.
Ophthalmol Retina
; 8(7): 646-656, 2024 Jul.
Article
de En
| MEDLINE
| ID: mdl-38278174
ABSTRACT
PURPOSE:
To investigate the spatial distribution of reticular pseudodrusen (RPD) in eyes with age-related macular degeneration (AMD) and their correlation with functional measures, retinal thickness, and changes over time.DESIGN:
Longitudinal, cohort study.PARTICIPANTS:
Thirty-five participants with RPD and spectrum of AMD severity (including no AMD).METHODS:
Multimodal imaging was graded by a reading center, including evaluation of color fundus imaging to assess AMD severity scores. Reticular pseudodrusen presence on OCT volumes was confirmed on en face imaging and the RPD extent was contoured on infrared images. One study eye per participant underwent rod-mediated dark adaptation, measuring rod intercept time (RIT) at 5° and, if needed, 12° superior to the fovea. MAIN OUTCOMEMEASURES:
The primary outcome was RIT and OCT thickness measures which were correlated with RPD area.RESULTS:
A total of 51 eyes had ≥ 1 visit with RPD detected (mean follow-up, 2.19 ± 2.04 years; range, 0-5 years), totaling 169 eye-based visits with RPD. Of the 51 eyes with RPD, 5 (9.8%) developed geographic atrophy and 17 (33.3%) progressed to neovascular AMD. Larger RPD areas were detected more frequently in AMD severity scores 6-7. Reticular pseudodrusen area within an eye generally increased over time. The lesion distribution showed a predilection for the superior retina, especially the outer superior subfield of the ETDRS grid, with the central subfield having least involvement. Reticular pseudodrusen area was inversely correlated with central subfield thickness and positively correlated with RIT at 5° (P = 0.001; r2 = 0.01) and 12° (P = 0.004; r2 = 0.01). Rod-mediated dark adaptation at 5° reached the test ceiling in > 85% of visits, irrespective of RPD lesion presence/absence at the test location. Retinal thickness decreased monotonically, with the central subfield demonstrating the greatest percentage change over 5 years (Δ = -5.47%).CONCLUSIONS:
In AMD, RPD involve predominantly the superior retina but can involve all ETDRS subfields and evolve over time. Eyes with RPD exhibit structural and functional impairments that can be measured beyond the boundaries of the RPD lesions, suggesting changes associated with RPD are associated with both local changes and a more widespread process. FINANCIAL DISCLOSURES Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Angiographie fluorescéinique
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Druses de la rétine
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Tomographie par cohérence optique
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Fond de l'oeil
Type d'étude:
Observational_studies
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Risk_factors_studies
Limites:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Langue:
En
Journal:
Ophthalmol Retina
Année:
2024
Type de document:
Article
Pays de publication:
EEUU
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ESTADOS UNIDOS
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ESTADOS UNIDOS DA AMERICA
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EUA
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UNITED STATES
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UNITED STATES OF AMERICA
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US
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USA