Subretinal drusenoid deposits (reticular pseudodrusen) in the general population: a European multicohort study

To investigate the prevalence and determinants of subretinal drusenoid deposits (SDDs; also known as reticular pseudodrusen, RPDs) in the European general population.

Altogether 18 931 adults from eight population-based studies were included. SDDs/RPDs were determined on optical coherence tomography and/or infrared photography. The prevalence of SDDs/RPDs and associated ocular and systemic determinants using multivariable logistic regression modelling per study and pooled results using random effects meta-analysis were analysed.

Mean age ranged from 58.7±10.6 to 88.4±0.0 years in the different studies and prevalence of SDDs/RPDs ranged from 0.6% to 56.0%. Meta-analyses showed that increasing age (OR 1.09 per year, 95% CI 1.04 to 1.13; p<0.001), prevalent early/intermediate and late age-related macular degeneration (AMD) (OR 10.93, 95% CI 5.55 to 21.51; p<0.001 and OR 11.65, 95% CI 4.78 to 28.40; p<0.001, respectively) and AMD genetic risk score (OR 1.21 per unit, 95% CI 1.05 to 1.39; p=0.008) are associated with prevalent SDDs/RPDs. Sex, smoking, education and cardiovascular disease showed borderline association at some cohort levels but not in the meta-analysis. In sensitivity analyses, only age and AMD genetic risk score remained associated with SDDs/RPDs prevalence among participants without any AMD.

This multi-cohort analysis emphasises the wide range of SDDs/RPDs prevalence and determinants. Besides age, presence of AMD and AMD genetic risk variants increase the risk of SDDs/RPDs. These cross-sectional findings are compatible with the hypothesis that SDDs/RPDs may not represent a separate disease entity but be an additional sign of retinal pigment epithelium and photoreceptor stress.