Original article
Macular Choroidal Thickness and Volume of Eyes With Reticular Pseudodrusen Using Swept-Source Optical Coherence Tomography

https://doi.org/10.1016/j.ajo.2014.01.018Get rights and content

Purpose

To investigate the choroidal thickness/volume of eyes with reticular pseudodrusen using high-penetration swept-source optical coherence tomography (SS-OCT) and to evaluate the choroidal vasculature changes using en face images.

Design

Prospective cross-sectional study.

Methods

Thirty-eight eyes with reticular pseudodrusen and 14 normal eyes were studied with prototype SS-OCT. Eyes with reticular pseudodrusen were classified into 3 subgroups: eyes without late age-related macular degeneration (AMD) (Group1), eyes with neovascular AMD (Group2), and eyes with geographic atrophy (Group3). Mean regional choroidal thickness/volume measurements were obtained by 3-dimensional (3D) raster scanning. The choroidal vascular area was measured using en face images reconstructed from a 3D SS-OCT data set.

Results

Mean age and axial length did not differ between eyes with reticular pseudodrusen and normal eyes. The mean choroidal thickness and volume of each sector was significantly reduced in eyes with reticular pseudodrusen compared with normal eyes (P < .020 for all). Mean choroidal thickness and volume of each area showed no significant difference between the 3 groups; however, most of them showed decreased thickness compared with normal eyes. En face images through the choroid revealed narrow and sparse choroidal vessels in eyes with reticular pseudodrusen. The area of choroidal vasculature was significantly reduced in eyes with reticular pseudodrusen compared with normal eyes (P = .037).

Conclusions

In eyes with reticular pseudodrusen, macular choroidal thickness/volume was reduced regardless of choroidal neovascularization/geographic atrophy. Thinned vessels in the choroid suggest choroidal involvement in the pathogenesis of reticular pseudodrusen.

Section snippets

Methods

All 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. After the nature and possible consequences of the study were explained, written informed consent was obtained from all the participating subjects.

Results

In this study, 75 eyes of 44 patients with reticular pseudodrusen were examined. Among them, 12 eyes were excluded because of poor image quality (owing to unstable fixation or media opacity). Thus, the images obtained for 63 eyes from 38 patients were suitable for analysis. If both eyes were eligible for inclusion, 1 eye was selected randomly. Finally, 38 eyes from 38 patients (19 men and 19 women) with reticular pseudodrusen were included in this study. Fourteen normal eyes in 14 subjects (6

Discussion

With the development of imaging techniques, it has been possible to examine the details of choroidal structures; such examination has revealed that the choroid plays an important role in the pathogenesis of various diseases.22, 23, 24, 25, 30, 31 Although the pathophysiology of reticular pseudodrusen remains unknown, there is sufficient evidence to show that the underlying mechanism may involve choroidal vascular abnormalities, such as impaired choroidal filling as detected by IA.14 Recently,

Naoko Ueda-Arakawa, MD, graduated from Kyoto University, Faculty of Medicine. She completed her residency program at Kyoto University Hospital and a fellowship at Osaka Red Cross Hospital, Osaka, Japan. She is now in a PhD program in the Department of Ophthalmology and Visual Sciences at Kyoto University under the supervisor of Professor Nagahisa Yoshimura. Her main interest is imaging analysis of macular diseases.

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    Naoko Ueda-Arakawa, MD, graduated from Kyoto University, Faculty of Medicine. She completed her residency program at Kyoto University Hospital and a fellowship at Osaka Red Cross Hospital, Osaka, Japan. She is now in a PhD program in the Department of Ophthalmology and Visual Sciences at Kyoto University under the supervisor of Professor Nagahisa Yoshimura. Her main interest is imaging analysis of macular diseases.

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