Abstract
<p>Purpose: To evaluate the change in the area of reticular pseudodrusen (RPD) and choroidal thickness over 2 years in eyes with age-related macular degeneration (AMD). Design: Longitudinal cohort study. Subjects: The study reviewed 1332 eyes from 666 subjects with baseline and 2-year follow-up data, of which 108 eyes were graded to have RPD. Among these, 35 eyes from 22 participants (mean age: 72.8 +/- 8.9 years; range: 50-84; 37% female) were eligible for this analysis because they had early or intermediate AMD with RPD at baseline, absence of geographic atrophy at 2 years, and images that were gradable for the presence of RPD. Methods: Infrared reflectance (IR), blue-light fundus autofluorescence, and spectral-domain OCT were obtained for all subjects at baseline and at 2 years. Using the instrument software, a certified grader delineated the RPD area (mm2) on the IR image using the free hand tool. Choroidal thickness was measured for both baseline and month 24 using a previously described deep learning algorithm to compute a choroidal volume. Main Outcome Measures: Changes in RPD area (mm2) and mean volumetric choroidal thickness (mu m) between baseline and 2 years. Results: The RPD area increased significantly (P < 0.001) by month 24 compared with baseline with a mean increase of 6.23 +/- 4.64 mm2. The mean volumetric choroidal thickness was not significantly different from baseline 182.2 +/- 94.36 (134.20-227.90) to month 24 178.2 +/- 41.10 (109-258). Conclusions: In this longitudinal natural history analysis, we observed an increase in RPD area of >6 mm2 over 2 years in the absence of a significant change in choroidal thickness. Although AMD eyes with presence of RPD typically have a thinner choroid, the increase in extent of these lesions does not appear to be associated with further thinning of the choroid. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article. Ophthalmology Science 2025;5:100881 (c) 2025 by the American Academy of Ophthalmology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).</p>