Prevalence of Subtypes of Reticular Pseudodrusen in Newly Diagnosed Exudative Age-Related Macular Degeneration and Polypoidal Choroidal Vasculopathy in Korean Patients

In Brief Purpose: To evaluate the prevalence and characteristics of subtypes of pseudodrusen in newly diagnosed exudative age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV). Methods: This retrospective cross-sectional study included 321 eyes of 321 patients who were newly diagnosed with exudative AMD or PCV. Reticular pseudodrusen was classified into dot pseudodrusen and ribbon pseudodrusen; the prevalence of each subtype was estimated and compared between exudative AMD excluding retinal angiomatous proliferation (RAP), PCV, and RAP. Patient age and choroidal thickness were compared between patients with dot pseudodrusen only and those with ribbon pseudodrusen. Results: The prevalence of reticular pseudodrusen was 13.9% (15 of 108 eyes) in exudative AMD excluding RAP, 3.4% (6 of 175 eyes) in PCV, and 68.4% (27 of 38 eyes) in RAP. Among the eyes with pseudodrusen, dot pseudodrusen and ribbon pseudodrusen were noted in 100% and 40.0%, respectively, in exudative AMD excluding RAP, 100% and 16.7%, respectively, in PCV, and 96.2% and 69.2%, respectively, in RAP. Ribbon pseudodrusen was more frequently observed in RAP (P = 0.032). Patients with ribbon pseudodrusen were significantly older (77.3 ± 6.6 years vs. 72.9 ± 8.1 years, P = 0.042) than those with dot pseudodrusen only. Conclusion: The markedly higher incidence of ribbon pseudodrusen in RAP may suggest possible influence of ribbon pseudodrusen on the development of RAP. Patients with ribbon pseudodrusen were significantly older than those with dot pseudodrusen. In addition, the prevalence of ribbon pseudodrusen was markedly higher in retinal angiomatous proliferation than in other subtypes of choroidal neovascularization, suggesting a possible association of ribbon pseudodrusen with retinal angiomatous proliferation.