Multimodal Imaging of Reticular Pseudodrusen in a Population-Based Setting: The Alienor Study

Area of Science:

• Ophthalmology
• Gerontology
• Medical Imaging

Background:

• Reticular pseudodrusen (RPD) are a subtype of drusen associated with age-related macular degeneration (AMD).
• Previous prevalence estimates may be limited by imaging techniques used.

Purpose of the Study:

• To determine the prevalence of RPD in French elderly subjects using multimodal imaging.
• To evaluate the diagnostic performance of different imaging modalities for RPD.

Main Methods:

• A cohort of 494 elderly subjects (≥77 years) from the Alienor study was examined.
• RPD were defined using at least two imaging methods: color retinal photography, spectral-domain optical coherence tomography (SD-OCT), fundus autofluorescence (FAF), and infrared reflectance (IR).
• Youden index was calculated to assess diagnostic performance.

Main Results:

• The prevalence of definite RPD was 13.4%, higher in women and increasing with age.
• Infrared reflectance (IR) showed 100% sensitivity, while color fundus photography was less sensitive.
• IR and SD-OCT demonstrated the highest Youden indices, indicating superior diagnostic utility.
• RPD were associated with various stages of AMD and specific types of soft drusen.

Conclusions:

• Multimodal imaging reveals a higher prevalence of RPD than previously reported.
• RPD frequently coexist with other signs of AMD.
• Infrared reflectance and SD-OCT are highly effective for diagnosing RPD.