gms | German Medical Science

23rd Annual Meeting of the German Retina Society

German Retina Society

24.09. - 25.09.2010, Freiburg

Reticular Drusen Associated with Geographic Atrophy in Age-Related Macular Degeneration

Meeting Abstract

  • Florian Alten - University Eye Clinic Bonn
  • S. Schmitz-Valckenberg - University Eye Clinic Bonn
  • J. Steinberg - University Eye Clinic Bonn
  • G. J. Jaffe - Duke University Eye Center Durham, NC
  • M. Fleckenstein - University Eye Clinic Bonn
  • T. C. Hohman - Alcon Laboratories Inc. Fort Worth, TX
  • F. G. Holz - University Eye Clinic Bonn

German Retina Society. 23rd Annual Conference of the German Retina Society. Freiburg i. Br., 24.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc10rg05

doi: 10.3205/10rg05, urn:nbn:de:0183-10rg050

This is the English version of the article.
The German version can be found at:

Published: September 21, 2010

© 2010 Alten et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Purpose: To characterize reticular drusen (RD) in patients with geographic atrophy (GA) secondary to age-related macular degeneration (AMD) in the multicenter, prospective natural history GAP-study.

Methods: Confocal scanning laser ophthalmoscopy (cSLO, Heidelberg Engineering) and conventional fundus camera (FC) images in 1104 eyes of 552 patients with GA (age 77.1±7.7 years) were evaluated by two independent readers with subsequent senior reader arbitration for prevalence and topographic distribution of RD.

Results: RD in at least one eye of each patient were detected more common by cSLO (59.1%) compared to FC imaging (17.8%). Kappa-statistics for interobserver reliability were as follows 0.82 for cSLO infrared, 0.81 for cSLO fundus autofluorescence, 0.48 for cSLO red-free, 0.48 for FC redfree and 0.40 for FC colours. Analysis of the topographic distribution using three-field FAF imaging (202 right eyes) demonstrated the presence of RD most frequently superior to the fovea (99.0%). In 93 (49.7%) right eyes, RD were found nasal to the optic nerve head. Spectral-domain OCT imaging revealed alterations anterior to the RPE cell monolayer.

Conclusions: RD are a common phenotypic hallmark in eyes with GA secondary to AMD. In contrast to fundus photographs, RD are readily identified in various cSLO imaging modes. This may explain the high prevalence determined herein in contrast to previous reports based on fundus photographs. SD-OCT suggests a disease process at the level of the photoreceptors rather than the sub-retinal pigment epithelium space.