Reticular pseudodrusen in early age-related macular degeneration are associated with choroidal thinning.
OBJECTIVE
To compare choroidal thickness (CT) measurements in early AMD between patients with and without reticular pseudodrusen (RPD) using spectral-domain optical coherence tomography (SD-OCT).


METHODS
This cross-sectional study examined 84 age- and sex-matched AMD patients (40 RPD [63 eyes], 44 non-RPD [75 eyes]). Fundus photographs and scanning laser ophthalmoscopy images were graded to identify RPD and non-RPD groups by three retinal specialists (MO, SY, SB) who were masked to corresponding SD-OCTs. CT at the fovea and 2400 to 3000 μm superior and inferior to the fovea was measured on SD-OCT by a grader (AG) and reviewed by a retinal specialist (SB). Only images with a clear posterior choroidal margin were analyzed (six eyes excluded due to poor image quality), and enhanced depth imaging SD-OCT was used when available (20 of 138 eyes). Greatest retinal thickness (RT) on horizontal foveal SD-OCT was also recorded.


RESULTS
Mean CTs in the superior, foveal, and inferior macula in RPD (191.3 μm ± 57.9 SD, 176.3 μm ± 60.5 SD, 179.7 μm ± 56.24 SD) were significantly less than that of non-RPD (228.0 μm ± 66.1 SD, 216.5 μm ± 70.3 SD, 224.4 μm ± 71.9 SD; P = 0.0010, P = 0.0005, P = 0.0001, respectively), as was greatest RT (P = 0.0301).


CONCLUSIONS
CT was thinner throughout the macula in the RPD group as compared with the non-RPD group. The current analysis supports an association between RPD and a thinned choroidal layer and is consistent with a choroidal etiology of RPD. CT may be integral to understanding RPD, and may be helpful in stratifying AMD progression risk.
Department of Ophthalmology, Columbia University College of Physicians and Surgeons, New York, New York.
Aakriti
A
Garg
Maris
M
Oll
Suzanne
S
Yzer
Stanley
S
Chang
Gaetano R
GR
Barile
John C
JC
Merriam
Stephen H
SH
Tsang
Srilaxmi
S
Bearelly
D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000473:pathology*; D015862:Choroid Diseases / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D005584:Fovea Centralis; D006801:Humans; D008268:Macular Degeneration / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015593:Retinal Drusen / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000379:methods
choroidal layer; early age-related macular degeneration; reticular pseudodrusen; retinal ischemia; spectral-domain optical coherence tomography