Prevalence and Associated Features of Reticular Pseudodrusen in Neovascular Age-Related Macular Degeneration in an Asian Population.

Abstract

To investigate the prevalence and associated features of reticular pseudodrusen (RPD) in an Asian cohort with neovascular age-related macular degeneration (nAMD). Retrospective, observational, cross-sectional study. A total of 353 patients presenting with treatment-naïve unilateral nAMD. Patients presenting with treatment-naïve unilateral nAMD who enrolled in the Asian AMD Phenotyping study between 2015 and 2025 were reviewed. All patients underwent protocolized imaging, which included color fundus photography, spectral-domain optical coherence tomography (SD-OCT), and fluorescein and indocyanine green angiography. Images were evaluated for drusen, and RPD were considered present based on SD-OCT. Patients with ungradable eyes due to extensive neovascular changes or poor image qualities were excluded. Baseline characteristics of patients with RPD were compared with those with soft/cuticular or no drusen. The prevalence and associated features of RPD. The systemic and ocular parameters were compared among the patients with RPD, soft/cuticular drusen, and no drusen. Among 353 eligible patients (706 eyes), RPD were found in 68 eyes in 51 patients (9.6% per eye, 14.4% per patient). Patients with RPD were older compared with those with soft/cuticular or no drusen (P = .0005 and P < .0001, respectively). Eyes with RPD showed thinner choroidal thickness and higher prevalence of type 3 macular neovascularization (MNV) (odds ratio, 6.94, P = .01) compared with those with soft/cuticular or no drusen. This is one of the largest series evaluating the prevalence of RPD in nAMD in the Asian population. Our findings suggest that ethnicity mainly impacts the prevalence of RPD. However, among patients with RPD, regardless of their ethnicity, there is a strong association with thin choroid and type 3 MNV.