Abstract
Purpose
To report the association and prevalence of reticular pseudodrusen (RPD) in eyes with newly presenting adult onset foveomacular vitelliform dystrophy (AFVD). To compare the strength of association with other pathologies resulting from dysfunction of the choroid-Bruch’s membrane–retinal pigment epithelium (RPE) complex, including eyes with geographic atrophy (GA) and angioid streaks.
Methods
Retrospective single-centre review of all consecutive newly presenting AFVD. Multimodal imaging with spectral domain optical coherence tomography, fundus photographs, red-free/blue light images, and fundus fluorescein angiograms were graded for the presence of RPD. For comparison, all consecutive newly presenting cases of GA and eyes with angioid streaks were studied.
Results
Fifteen (15) patients were identified with AFVD (mean age of 77.3 years; 73.3% female). Mean age of patients with AFVD and RPD was 80.5 years (SD 3.7), whereas that of patients with AFVD without RPD was 75.1 years (SD 7.0). This age difference did not reach statistical significance, P=0.1. Six (40%) had identifiable RPD; being a bilateral finding in 100% of patients. No males with AFVD and RPD were identified. A total of 92 eyes presented with GA. Twenty-three (23) of these (25.0%) had RPD. Twelve (12) patients presented with identifiable angioid streaks, with 4 (36.4%) having RPD.
Conclusion
RPD are a frequent finding in eyes with newly presenting AFVD; not being restricted to AMD, but a finding common among diseases where pathophysiological mechanisms involve damage to Bruch’s membrane and the RPE, whether genetic or degenerative. Our study supports the concept that they occur with high but variable frequencies in eyes with various pathologies.
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This research was funded in part by a Research Grant from the Macular Society, UK.
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Professor Winfried Amoaku, MBChB, has disclosed the following relevant financial relationships: Served as an advisor or consultant for: Alcon Laboratories, Inc.; Alimera Sciences; Allergan, Inc.; Bayer HealthCare Pharmaceuticals; Novartis Pharmaceuticals Corporation; Pfizer Inc; Roche; ThromboGenics, Inc. Served as a speaker or a member of the speaker's bureau for: Alimera Sciences; Allergan, Inc.; Novartis Pharmaceuticals Corporation; Pfizer. Received grants for clinical research from: Allergan, Inc.; CenterVue; Novartis Pharmaceuticals Corporation; Pfizer. Other (Educational Travel Grants): Allergan, Inc.; Bayer HealthCare Pharmaceuticals; Novartis Pharmaceuticals Corporation. The remaining authors declare no conflict of interest.
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Wilde, C., Lakshmanan, A., Patel, M. et al. Prevalence of reticular pseudodrusen in newly presenting adult onset foveomacular vitelliform dystrophy. Eye 30, 817–824 (2016). https://doi.org/10.1038/eye.2016.46
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DOI: https://doi.org/10.1038/eye.2016.46
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