title: Pseudodrusen in the Fellow Eye of Patients with Unilateral Neovascular Age-Related Macular Degeneration: A Meta-Analysis.
abstract: OBJECTIVE
  The fellow eye of patients with unilateral neovascular age-related degeneration (nAMD) is at increased risk of developing late AMD. Several cohort studies have evaluated the prevalence of pseudodrusen and the association between pseudodrusen and late AMD in the fellow eye of patients with unilateral nAMD. However, these studies have limited sample sizes and their results are inconsistent.
  
  
  OBJECTIVE
  To evaluate the prevalence rate of pseudodrusen, and the association between pseudodrusen and incidence of late AMD (nAMD and geographic atrophy (GA)) in the fellow eye of patients with unilateral nAMD.
  
  
  METHODS
  The PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched up to July 2015, as well as other systematic reviews.
  
  
  METHODS
  All cohort studies for pseudodrusen with late AMD in the fellow eye of patients with unilateral nAMD.
  
  
  METHODS
  The numbers of patients with and without pseudodrusen at baseline and the numbers of incident nAMD and GA during follow up among patients with and without pseudodrusen were independently extracted by 2 authors. The results were pooled using random-effects meta-analysis. Heterogeneity was assessed using the I2 test.
  
  
  METHODS
  Prevalence rate of pseudodrusen, risk ratios (RRs) and their 95% confidence intervals (95% CIs) for associations between pseudodrusen and the incidence of nAMD and GA in the fellow eye.
  
  
  RESULTS
  Five cohort studies (N = 677 patients) from 8 countries across 4 continents were included. The pooled prevalence rate of pseudodrusen in the fellow eye was 48.1% (95% Cl: 36.7-59.5%, I2 = 87%). Pseudodrusen were associated with an increased risk of nAMD (RR = 1.54, 95% Cl: 1.10-2.16, I2 = 42%), GA (RR = 4.70, 95% Cl: 1.22-18.1, I2 = 64%), and late AMD (RR = 2.03, 95% Cl: 1.35-3.06, I2 = 60%).
  
  
  CONCLUSIONS
  For patients with unilateral nAMD, pseudodrusen were present in about half of the fellow eyes. The presence of pseudodrusen was associated with a 1.5 times higher risk of developing nAMD, a 4.7 times higher risk of developing GA, and a 2 times higher risk of developing late AMD. Pseudodrusen should be considered in evaluating the risk of late AMD development; however, due to considerable heterogeneity across these studies, a larger study is needed to validate these findings.
authors.affiliation: Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, P. R. China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Department of Ophthalmology, Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
authors.forename: James
authors.initials: J
authors.lastname: Shaffer
authors.affiliation: Department of Ophthalmology, Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
authors.forename: Gui-shuang
authors.initials: GS
authors.lastname: Ying
mesh_terms: D057092:Geographic Atrophy / Q000150:complications / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016017:Odds Ratio; D015593:Retinal Drusen / Q000150:complications* / Q000453:epidemiology*; D057135:Wet Macular Degeneration / Q000150:complications* / Q000453:epidemiology*