The Epidemiology of Retinal Reticular Drusen

Abstract

Purpose-To describe the prevalence and 15-year cumulative incidence of and risk factors for reticular drusen.Design-Population-based prospective study. Setting: Beaver Dam, WisconsinStudy population: 4,926 persons, 43-86 years of age in 1988-1990, of whom 3,684, 2,764, and 2,119 participated in 5-, 10-, and 15-year follow-up examinations, respectively. Main outcome measures:Prevalence and 15-year incidence of reticular drusen determined by grading stereoscopic color fundus photographs.Results-The prevalence at baseline and the15-year cumulative incidence in either eye of reticular drusen was 0.7% and 3.0%, respectively. The 15-year incidence of reticular drusen varied with age from 0.4% in those 43-54 years of age to 6.6% in those 75 years or older at baseline (P<0.001). In a multivariable model, while controlling for age, risk factors statistically significantly associated with increased risk of incident reticular drusen included (Odds ratio): being female (2.8), current smoking (vs never 1.9), less education (per category 1.7), B-vitamin complex use (vs none 2.5, single vitamin B (vs none 2.9), history of steroid eye drops use (5.9), glaucoma (2.8), and more severe drusen type (e.g., soft indistinct drusen) (1.4) while diabetes (0.1) at baseline was associated with decreased risk. Right eyes with reticular drusen at baseline had higher cumulative incidence of geographic atrophy (21% vs 9%) and exudative AMD (20% vs 10%) compared to eyes with soft indistinct drusen.Conclusions-This population-based study documents the long-term cumulative incidence of reticular drusen, its risk factors, and shows its association with a high risk of incident late AMD. KeywordsReticular drusen; epidemiology; incidence; age-related macular degenerationIn the Wisconsin Age-Related Maculopathy (AMD) Grading System, "reticular drusen" was used to describe retinal drusen that "formed ill-defined networks of broad interlacing ribbons" (Figure 1). 1 Reticular drusen have also been described by others and have been shown to be associated with a high risk of progression to neovascular AMD. 2-8 Most of the Correspondence to: Ronald Klein, MD, MPH, Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, 610 North Walnut Street, 417 WARF, Madison, WI 53726-2336, (608) FAX (608) 263-0279, kleinr@epi.ophth.wisc.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript observations have been either from case reports, case series, or from clinical trials. 2-8 These lesions have be...

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