Reticular Pseudodrusen in Late-Onset Retinal Degeneration.

Area of Science:

• Ophthalmology
• Retinal Imaging
• Genetics

Background:

• Late-onset retinal degeneration (L-ORD) is a significant cause of vision loss.
• Reticular pseudodrusen (RPD) are drusenoid deposits associated with macular degeneration.
• The specific association and characteristics of RPD in L-ORD require further elucidation.

Purpose of the Study:

• To characterize the association of reticular pseudodrusen (RPD) with late-onset retinal degeneration (L-ORD).
• To investigate the prevalence, topographic distribution, and temporal changes of RPD in L-ORD using multimodal imaging.

Main Methods:

• Prospective, 2-center, longitudinal case series of 29 patients with molecularly confirmed L-ORD.
• Multimodal imaging including near-infrared reflectance, fundus autofluorescence, and spectral-domain OCT.
• Additional imaging modalities used in a subset of patients: indocyanine green angiography, fundus fluorescein angiography, mesopic microperimetry, and multifocal electroretinography.

Main Results:

• Reticular pseudodrusen (RPD) were detected in 62% of L-ORD patients at baseline.
• RPD prevalence varied with age, being most common in the fifth decade and absent in the eighth.
• RPD were predominantly located in the macula (sparing the fovea) and peripheral retina, with observed morphologic changes and regression over time.

Conclusions:

• Reticular pseudodrusen (RPD) are frequently observed in L-ORD, often at a younger age compared to age-related macular degeneration.
• RPD in L-ORD exhibit dynamic changes, including formation, collapse, and alterations in morphology.
• The characteristic macular and peripheral distribution, with relative foveal sparing, is notable in L-ORD associated RPD.