Influence of subretinal drusenoid deposit on retinal sensitivity in age-related macular degeneration

This retrospective study aimed to assess the impact of subretinal drusenoid deposit (SDD), also known as reticular pseudodrusen, on retinal sensitivity (RS) in patients with intermediate age-related macular degeneration (iAMD) using microperimetry. Eyes meeting the modified criteria of iAMD, including SDD, and total drusen area greater than 0.50 mm² were included. The presence of SDD, as well as soft drusen (SD), and specific type of SDD (dot or ribbon) were determined through multimodal imaging modalities including fundus photography, fundus autofluorescence, infrared reflectance image and optical coherence tomography. RS was measured using MAIA microperimetry. A total of 302 eyes from 302 patients were analyzed. Patients with SDD were older and predominantly female. Average RS was significantly lower in eyes with SDD than without SDD. (19.75 (5.06) vs. 21.21 (4.53) (average (SD)), P = 0.003). The presence of SD alone did not significantly affect RS. Among eyes with SDD, those with ribbon-type SDD exhibited significantly lower RS (18.02 ± 6.49) than those with dot-type SDD (20.67 ± 4.13; P < 0.001). In multivariable linear regression analysis, older age and the presence of ribbon-type SDD were significantly associated with reduced RS. In conclusion, eyes with iAMD and SDD demonstrate reduced RS, with ribbon-type SDD exerting a greater negative impact on retinal function than dot-type SDD.