Subretinal drusenoid deposits associated with pigment epithelium detachment in age-related macular degeneration

To characterize retrospectively subretinal drusenoid deposits (SDD) in patients with pigment epithelium detachment (PED) secondary to age-related macular degeneration.

Confocal scanning laser ophthalmoscopy near-infrared reflectance images (820 nm) were recorded in 208 eyes of 104 patients with serous, drusenoid, or vascularized PED because of age-related macular degeneration in at least 1 eye. The digital images were evaluated by two independent readers with subsequent senior reader arbitration for prevalence of SDD.

Serous PED was present in only two patients and was therefore not included in the statistical analysis. Subretinal drusenoid deposits were detected in 55 of 102 (53.9%) patients in at least 1 eye. Forty-six of those 55 patients showed SDD bilaterally (83.6%). Subretinal drusenoid deposits were present in 51 (50%) right eyes and 50 (49.0%) left eyes. One hundred and forty-six of 204 eyes showed a PED secondary to age-related macular degeneration of which 111 (76%) were vascularized and 35 (24%) drusenoid. Prevalence of SDD was correlated with age (P < 0.0001) and female gender (P = 0.014), but not with the type of PED (P = 0.174). Cohen kappa statistics showed good interobserver agreement for infrared imaging (0.78 for right eyes, 0.74 for left eyes).

Subretinal drusenoid deposits represent a common phenotypic characteristic in eyes with PED because of age-related macular degeneration . As described in previous studies, SDD are readily identified using confocal scanning laser ophthalmoscopy imaging technology. Future studies should pursue the pathophysiologic role and the predictive value of the presence of SDD in the development of PED and a subsequent rip of the retinal pigment epithelium.