UNILATERAL RETICULAR PSEUDODRUSEN: Clinical Features and Potential Protective Factors

Area of Science:

• Ophthalmology
• Retinal Diseases
• Age-Related Macular Degeneration (AMD)

Background:

• Reticular pseudodrusen (RPD) are drusenoid deposits associated with intermediate and advanced age-related macular degeneration (AMD).
• Unilateral presentation of RPD is rare, making it challenging to study protective factors.
• Understanding factors associated with unilateral RPD can offer insights into AMD pathogenesis.

Purpose of the Study:

• To characterize demographic and clinical data of patients with rare unilateral reticular pseudodrusen (RPD).
• To identify potential protective features against the formation of unilateral RPD.
• To investigate the role of choroidal and choriocapillaris-retinal pigment epithelium (RPE) complex in RPD development.

Main Methods:

• Retrospective, multicenter case series of patients with unilateral RPD.
• Collection and comparison of demographic, longitudinal clinical, and multimodal imaging (MMI) data between affected and fellow eyes.
• Measurement of central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and choroidal vascular index (CVI).

Main Results:

• Ten eyes of 10 patients with unilateral RPD were analyzed (mean age 87.3 years).
• Fellow eyes showed retinal vein occlusion (RVO) in 4 cases and macular microaneurysm (MA) in 1 case.
• Eyes with RPD had lower average SFCT (168.4 µm) and CVI (0.39) compared to fellow eyes (SFCT 194.4 µm, CVI 0.48).

Conclusions:

• The choroid and choriocapillaris-RPE complex appear to play a crucial role in the pathogenesis of RPD.
• Thinner choroidal thickness and lower choroidal vascularity may be protective factors against unilateral RPD development.
• Further research is warranted to elucidate the mechanisms underlying these protective effects in AMD.