Elsevier

American Journal of Ophthalmology

Volume 156, Issue 6, December 2013, Pages 1184-1191.e2
American Journal of Ophthalmology

Original article
Reduction of Retinal Sensitivity in Eyes With Reticular Pseudodrusen

https://doi.org/10.1016/j.ajo.2013.06.036Get rights and content

Purpose

To evaluate the effect of macular reticular pseudodrusen on retinal function using multiple imaging methods.

Design

Prospective cross-sectional study.

Methods

Thirteen eyes with reticular pseudodrusen, but without any other macular abnormality or glaucoma, and 20 normal eyes were evaluated. All subjects underwent color fundus photography, infrared reflectance (IR), fundus autofluorescence (FAF), and microperimetry.

Results

The similarity in the number of reticular pseudodrusen was evaluated through inter-observer intraclass correlation coefficients, which ranged from 0.852-0.944. IR could detect reticular pseudodrusen within the center circle area in 12 eyes, whereas blue-channel fundus photography and FAF could only detect these lesions in 1 and 3 eyes, respectively. The number of reticular pseudodrusen correlated among the different imaging modalities (P < .001 for all) for all areas of the macula, except the center. The mean retinal sensitivity in eyes with reticular pseudodrusen was lower in all areas of the macula, compared with normal eyes (P < .001 for all). The number of reticular pseudodrusen correlated with retinal sensitivity in all areas by IR imaging (P = .003, P < .001, P = .003 for center, inner ring, outer ring, respectively), in the inner and outer rings by blue-channel fundus photography (P < .001 for both), and in the inner and outer rings by FAF (P < .001 and P = .001, respectively).

Conclusions

Although multiple imaging modalities are capable of quantifying reticular pseudodrusen, IR appears to have the best ability to do so as compared to blue-channel photography and FAF. The distribution and number of reticular pseudodrusen lesions are closely associated with retinal sensitivity.

Section snippets

Methods

All of the study investigations adhered to the tenets of the Declaration of Helsinki, and this study was approved by the Institutional Review Board and the Ethics Committee of Kyoto University Graduate School of Medicine. The nature of the study, the implications of participating in this research study, and its possible consequences were explained to the study candidates, after which a written informed consent was obtained from all participants.

Results

Fifteen consecutive eyes with reticular pseudodrusen but without any other macular abnormality or glaucoma were examined. Among them, 2 eyes were excluded because of the poor image quality. Thus 13 eyes from 10 patients were included in this study. Twenty normal eyes in 20 subjects were included as control. The ages of the subjects ranged from 55-86 years (mean ± SD, 71.6 ± 9.4 years) for patients with reticular pseudodrusen and from 65-79 years (mean ± SD, 70.2 ± 4.8 years) for normal

Discussion

Reticular pseudodrusen have traditionally been identified with blue-light fundus photography. However, recent studies have suggested that additional imaging modalities, such as IR, FAF, indocyanine green angiography imaging, and SDOCT, would facilitate the identification of these interlacing networks.4, 5, 8, 9, 10, 13, 14, 15, 16, 17 Using SDOCT, Zweifel and associates suggested the hyperreflective material could be graded by the thickness of the accumulation above the RPE and their

Sotaro Ooto MD, PhD, joined the Faculty of Medicine of Kyoto University and completed a medical course. He completed his residency in ophthalmology in 2001, after which he joined Kyoto University Graduate School of Medicine, where he worked on stem cell research. He became an assistant professor of Kyoto University Graduate School of Medicine in 2008, and he has been working as a member of the Macular Service and conducting studies on retinal imaging.

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    • Cited by (0)

    Sotaro Ooto MD, PhD, joined the Faculty of Medicine of Kyoto University and completed a medical course. He completed his residency in ophthalmology in 2001, after which he joined Kyoto University Graduate School of Medicine, where he worked on stem cell research. He became an assistant professor of Kyoto University Graduate School of Medicine in 2008, and he has been working as a member of the Macular Service and conducting studies on retinal imaging.

    Supplemental Material available at AJO.com.

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