The Relationship Between Reticular Macular Disease and Choroidal Thickness

Abstract

Purpose/Aim Subretinal drusenoid deposits (SDD) are the main structural lesion of reticular macular disease (RMD), a phenotype of age-related macular degeneration (AMD). We aim to demonstrate spatiotemporal relationships between SDD and choroidal thickness alterations in RMD+ and RMD− eyes. Materials and Methods 33 eyes (26 subjects) with early AMD/no SDD (RMD−) and 18 eyes (16 subjects) with early AMD/SDD (RMD+) underwent enhanced depth imaging spectral domain optical coherence tomography for choroidal thickness (CTh) measurements at 11 points per scan, in 5 horizontal B scans, creating a grid of 55 points/eye. The 55 points were treated as a cluster, controlling within-subject correlation. Marginal generalized estimating equation modeling was used to estimate the association between CTh and RMD status. All eyes were divided by their median age (≤82 and >82 years) for stratified analyses. Results CTh was not significantly reduced in RMD+ eyes compared to RMD-eyes (mean difference [MD] −16.84 μm, P=0.24). Among younger subjects, mean CTh was significantly reduced in RMD+ vs. RMD− eyes (MD −53.72 μm, P=0.01). Conversely, among older subjects, there was no significant difference in CTh between RMD+ and RMD−. Conclusions In RMD, the association of SDD and choroidal thickness alterations varies with age but not by macular region. Among younger subjects (<82 years old), CTh was significantly thinner in RMD+ vs. RMD− eyes.

Relationship between reticular pseudodrusen and choroidal thickness in intermediate age‐related macular degeneration

“…Similar to and supporting our findings, Cheng et al . found that mean ChT was significantly thinner in RPD eyes prior to adjustment but this result was no longer significant when adjusting for variables such as age and axial length . Similarly, Thorell et al .…”

“…This was similar to Cheng et al . whom studied ChT in eyes with early AMD with and without RPD . They found that those with RPD were older and composed of more females when compared to the non‐RPD group.…”

“…Cheng et al . further dichotomized their group by median age of all subjects . They found that among subjects ≤82 years old, eyes with RPD had significantly thinner choroids than AMD eyes without RPD, suggesting that the effects of RPD on ChT occur earlier in the AMD process as there was no difference in ChT in the ≥ 82 year old group.…”

“…These studies however are often limited either by a small sample size, a cohort with various stages of AMD or had elements of selection bias, or did not adequately adjust for variables known to influence ChT such as age and refractive error . There has also been one study that did not find a clear association between ChT and RPD …”

Relationship between reticular pseudodrusen and choroidal thickness in intermediate age‐related macular degeneration: response

“…Similarly, Cheng et al . reported that, after adjustment for age, mean ChT was not significantly thinner among eyes with RPD . However, they did find an association between RPD and ChT among participants who were less than 82 years old.…”