AGE-RELATED RETINAL PIGMENT EPITHELIUM DISEASE: Clinical and Differential Features

We described the clinical characteristics of age-related retinal pigment epithelium disease (ARPED). This looks like an age-related, retinal disease showing a primary RPE involvement, no typical age-related macular degeneration features, and no pachychoroid-related characteristics.

The study was designed as observational, both cross-sectional and retrospective investigation. We collected data from patients affected by ARPED, defined by precise diagnostic criteria. We performed both qualitative and quantitative multimodal retinal imaging investigations. The main outcome measure is the characterization of ARPED, defined by precise diagnostic criteria, about age-related macular degeneration. Secondary outcome is the identification of differential diagnostic features about other retinal diseases.

We included 31 ARPED eyes (62 patients). Intergraders agreement for detecting ARPED was 0.98 ( P < 0.05). Age-related retinal pigment epithelium disease is characterized by the absence of age-related macular degeneration-related findings, such as drusen and pseudodrusen. Moreover, it is characterized by the absence of pachychoroid-related features, as also confirmed by fluorescein angiography and indocyanine green angiography.

Although further studies are warranted to better define ARPED features and if it may be considered a distinct macular disease, the characteristics of this clinical phenotype introduce new intriguing pathophysiologic features and should be carefully considered both in clinical practice and research contexts.