gms | German Medical Science

Aims: The aim of the study is the longitudinal analysis of reticular drusen (RDR) in patients with age-related macular degeneration (AMD) using simultaneous combined confocal scanning laser ophthalmoscopy and spectral-domain optical coherence tomography (SD-OCT).

Methods: The topographic distribution of RDR and their change over 18 months was quantified in 84 eyes of 42 patients (Median age: 75.9 years) with geographic atrophy by two independent readers using three-field-fundus autofluorescence images (FAF, exc. 488, em: 500–700 nm). A second analysis included SD-OCT scans of 55 eyes of 37 patients (age: 79.7 years) with AMD and with at least two visits. Hereby, follow-up images were used in order to ensure alignment of SD-OCT scans between different time points.

Results: Using FAF-imaging, an increase in both RDR retinal area involvement and RDR density was observed. Quantitative analysis revealed a mean RDR-area of 53.74 mm² (95%-confidence interval (95% CI) [40.71 to 66.75]) at baseline and a mean progression rate of 4.44 mm²/year (95% CI [1.94 to 6.93]). SD-OCT imaging disclosed in 13 eyes an increase, in 15 eyes a decrease and 16 eyes no changes of the previously described typical wavy RDR pattern in the outer retina, respectively. In 11 eyes, both an enlargement and a reduction of the RDR pattern in the same SD-OCT B-scan was seen.

Conclusion: FAF imaging allows for both qualitative and quantitative longitudinal analyses of the growth of retinal RDR area involvement. Findings by SD-OCT imaging are also indicative for dynamic changes over time. For the further analysis, an exact alignment of different imaging modalities and different time points appears to be mandatory in order to better investigate distinct alterations of RDR over time.