Longitudinal Assessment of Area of Reticular Pseudodrusen in Eyes with Age-Related Macular Degeneration

To evaluate the change in the area of reticular pseudodrusen (RPD) and choroidal thickness over 2 years in eyes with age-related macular degeneration (AMD).

Longitudinal cohort study.

The study reviewed 1332 eyes from 666 subjects with baseline and 2-year follow-up data, of which 108 eyes were graded to have RPD. Among these, 35 eyes from 22 participants (mean age: 72.8 ± 8.9 years; range: 50-84; 37% female) were eligible for this analysis because they had early or intermediate AMD with RPD at baseline, absence of geographic atrophy at 2 years, and images that were gradable for the presence of RPD.

Infrared reflectance (IR), blue-light fundus autofluorescence, and spectral-domain OCT were obtained for all subjects at baseline and at 2 years. Using the instrument software, a certified grader delineated the RPD area (mm²) on the IR image using the free hand tool. Choroidal thickness was measured for both baseline and month 24 using a previously described deep learning algorithm to compute a choroidal volume.

Changes in RPD area (mm²) and mean volumetric choroidal thickness (μm) between baseline and 2 years.

The RPD area increased significantly (P < 0.001) by month 24 compared with baseline with a mean increase of 6.23 ± 4.64 mm². The mean volumetric choroidal thickness was not significantly different from baseline 182.2 ± 94.36 (134.20-227.90) to month 24 178.2 ± 41.10 (109-258).

In this longitudinal natural history analysis, we observed an increase in RPD area of >6 mm² over 2 years in the absence of a significant change in choroidal thickness. Although AMD eyes with presence of RPD typically have a thinner choroid, the increase in extent of these lesions does not appear to be associated with further thinning of the choroid.

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