title: Clinical characteristics of reticular pseudodrusen in the fellow eye of patients with unilateral neovascular age-related macular degeneration.
abstract: OBJECTIVE
  To describe associations between reticular pseudodrusen, individual characteristics, and retinal function.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  We recruited 105 patients (age range, 52-93 years) who had advanced neovascular age-related macular degeneration (AMD) in only 1 eye from 3 clinical centers in Europe.
  
  
  METHODS
  Minimum follow-up was 12 months. The eye selected for study was the fellow eye without advanced disease. Clinical measures of vision were distance visual acuity, near visual acuity, and results of the Smith-Kettlewell low-luminance acuity test (SKILL). Fundus imaging included color photography, red-free imaging, blue autofluorescence imaging, fluorescein angiography, indocyanine green angiography, and optical coherence tomography using standardized protocols. These were used to detect progression to neovascular AMD in the study eye during follow-up. All imaging outputs were graded for the presence or absence of reticular pseudodrusen (RPD) using a multimodal approach. Choroidal thickness was measured at the foveal center and at 2 other equidistant locations from the fovea (1500 μm) nasally and temporally. Metrics on retinal thickness and volume were obtained from the manufacturer-supplied automated segmentation readouts.
  
  
  METHODS
  Presence of RPD, distance visual acuity, near visual acuity, SKILL score, choroidal thickness, retinal thickness, and retinal volume.
  
  
  RESULTS
  Reticular pseudodrusen was found in 43 participants (41%) on 1 or more imaging method. The SKILL score was significantly worse in those with reticular drusen (mean score ± standard deviation [SD, 38±12) versus those without (mean score ± SD, 33±9) (P = 0.034). Parafoveal retinal thickness, parafoveal retinal volume, and all of the choroidal thickness parameters measured were significantly lower in those with reticular drusen than in those without. The presence of RPD was associated with development of neovascular AMD when corrected for age and sex (odds ratio, 5.5; 95% confidence interval, 1.1-28.8; P = 0.042). All participants in whom geographic atrophy developed during follow-up had visible RPD at baseline.
  
  
  CONCLUSIONS
  Significant differences in retinal and choroidal anatomic features, visual function, and risk factor profile exist in unilateral neovascular AMD patients with RPD compared with those without; therefore, such patients should be monitored carefully because of the risk of developing bilateral disease.
authors.affiliation: Center for Experimental Medicine, Queen's University Belfast, Belfast, United Kingdom.
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Hogg
authors.affiliation: Ophthalmology Unit, Centro Hospitalar e Universitário Coimbra, and Faculty Medicine, University of Coimbra, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.
authors.forename: Rufino
authors.initials: R
authors.lastname: Silva
authors.affiliation: Eye Clinic, Department of Clinical Science "Luigi Sacco," Sacco Hospital, University of Milan, Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Staurenghi
authors.affiliation: Center for Experimental Medicine, Queen's University Belfast, Belfast, United Kingdom.
authors.forename: George
authors.initials: G
authors.lastname: Murphy
authors.affiliation: Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.
authors.forename: Ana R
authors.initials: AR
authors.lastname: Santos
authors.affiliation: Eye Clinic, Department of Clinical Science "Luigi Sacco," Sacco Hospital, University of Milan, Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Rosina
authors.affiliation: Center for Experimental Medicine, Queen's University Belfast, Belfast, United Kingdom. Electronic address: u.chakravarthy@qub.ac.uk.
authors.forename: Usha
authors.initials: U
authors.lastname: Chakravarthy
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015593:Retinal Drusen / Q000175:diagnosis*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity