title: Small retinal haemorrhages accompanied by macular soft drusen: prevalence, and funduscopic and angiographic characteristics.
abstract: OBJECTIVE
  To investigate the prevalence and clinical significance of small retinal haemorrhages accompanied by macular soft drusen in exudative age-related macular degeneration (AMD).
  
  
  METHODS
  This observational case series included patients who had first been diagnosed with exudative AMD. Small retinal haemorrhages were defined as preretinal or intraretinal haemorrhages, no larger than half the disc diameter in size and located within 3000 μm of the fovea centre. If there was more than one haemorrhage, the entire affected area was less than two-thirds of the disc diameter. Macular soft drusen was defined as the presence of soft drusen (≥125 μm in diameter) within the macular area. The presence of retinal angiomatous proliferation (RAP) was estimated based on the results of indocyanine green angiography (ICGA). The prevalence of reticular pseudodrusen was also estimated.
  
  
  RESULTS
  Among the 1921 eyes from 1604 patients who were newly diagnosed with exudative AMD during the 40 months prior to the study, 101 eyes (5.3%) from 79 patients presented with the fundus characteristics described above. ICGA images were available for 69 eyes. Among these eyes, 28 eyes (43.1%) and 25 eyes (38.5%) were found to have type 1 and 2 RAP, respectively. A chorioretinal anastomosis (type 3 RAP) was identified in 12 (18.5%) eyes. Reticular pseudodrusen were noted in 78 eyes (77.2%).
  
  
  CONCLUSIONS
  The presence of small retinal haemorrhages accompanied by macular soft drusen was highly predictive of RAP. The high prevalence of both soft drusen and reticular pseudodrusen in these eyes may suggest a profound decrease in choroidal perfusion in these eyes.
authors.affiliation: Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, South Korea.
authors.forename: Jae Hui
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, South Korea.
authors.forename: Tae Gon
authors.initials: TG
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, South Korea.
authors.forename: Jong Woo
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, South Korea.
authors.forename: Chul Gu
authors.initials: CG
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, South Korea.
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Cho
authors.affiliation: Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, South Korea.
authors.forename: Jung Il
authors.identifier: http://orcid.org/0000-0002-2211-5293
authors.initials: JI
authors.lastname: Han
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D015593:Retinal Drusen / Q000453:epidemiology*; D012166:Retinal Hemorrhage / Q000453:epidemiology*; D015861:Retinal Neovascularization / Q000175:diagnosis / Q000473:pathology*; D017678:Sex Distribution; D057135:Wet Macular Degeneration / Q000150:complications* / Q000473:pathology
chemical_list: D007208:Indocyanine Green
keywords: Retina