Choroidal Changes Associated With Reticular Pseudodrusen

Purpose:To analyze choroidal changes associated with reticular pseudodrusen by indocyanine green angiography (ICGA) and enhanced-depth-imaging spectral-domain optical coherence tomography (EDI SD-OCT).Methods:Twenty-two consecutive patients (22 eyes) with reticular pseudodrusen, and without medium/large drusen, underwent ICGA and EDI OCT. Twenty-one age and sex matched subjects (21 eyes) with early age-related macular degeneration (AMD), and without pseudodrusen, also underwent EDI OCT.Results:Mean age of patients with reticular pseudodrusen and with early AMD was 82.5±0.9 and 79.3±4.4 year-old, respectively (p=0.9), and 59.0% and 76.2% were women, respectively (p=0.7). On ICGA, reticular patterns appeared as hypofluorescent, not overlying the large choroidal vessels. Areas of iso/hyperfluorescence on ICGA, occurring adjacently to reticular patterns, appeared on OCT as subretinal deposits. The mean subfoveal choroidal thickness was significantly reduced in the group with reticular pseudodrusen compared with the control group (174.6±10.1 and +241.4±16.5, respectively; p<0.001). At all measurement points but the 3000-μm superior to the fovea, the choroidal thickness of eyes with reticular pseudodrusen appeared thinner than that of the control group. Interestingly, the choroid of eyes with reticular pseudodrusen appeared thicker at 3000-μm superior to the fovea compared with all other measurement points.Conclusions:We showed that the reticular patterns appeared as hypofluorescent lesions on ICGA, closely abutting, but not overlying the large choroidal vessels. EDI OCT revealed an overall thinned choroid, supporting the hypothesis that the derangement of the RPE because of underlying atrophy and fibrosis of the choroid could lead to the accumulation of subretinal debris.