A recent study has determined a significant association between reticular pseudodrusen (RPD) and the development of geographic atrophy (GA) in AMD. While researchers did not find an increased risk for wet AMD in patients with RPD, they found a significant association with ARMS2 risk alleles and genetic risk score.

The study evaluated fundus autofluorescence images of 5,021 eyes with intermediate AMD in one or both eyes enrolled in the AREDS2 study. They noted RPD in 1,186 eyes (29% participants). Its prevalence varied with each eye’s baseline AREDS AMD severity level, with 6% in early AMD (n=458), 26% in intermediate AMD (n=2,606), 36% in GA (n=682) and 19% in wet AMD (n=1,246). The odds ratio adjusted for age, gender, race, educational status, smoking and AMD severity level for 1,710 eyes at risk of developing late AMD at the next annual visit was 2.42 for GA and 1.21 for wet AMD. Researchers found a significant association between RPD presence and higher GRS and ARMS2 risk alleles.

The researchers conclude that RPD is an important risk marker and clinicians should include them in the classification systems they use for AMD prognosis. 

Domalpally A, Agron E, Pak JW, et al. Prevalence, risk and genetic association of reticular pseudodrusen in age-related macular degeneration. AREDS2 Report 20. Ophthalmology. July 29, 2019. [Epub ahead of print].