Background
Subretinal drusenoid deposits (SDD), also denominated reticular pseudodrusen, are closely associated with age-related macular degeneration (AMD) and have been identified as an independent risk factor for a worse prognosis due to progression to atrophic or neovascular AMD. Recently, it has been shown that the condition is associated with choroidal thinning and thinning of the ganglion cell layer-inner plexiform layer of the retina.However, the etiopathogenesis and implications of SDD are still not completely clarified.
Objectives
The primary purpose of this study is to evaluate blood flow and vascular density of the macular superficial and deep vascular plexus, peripapillary plexus, choriocapillaris, and evaluation of the foveal avascular zone in patients with SDD. Furthermore, ganglion cell complex (GCC) thickness will be evaluated. Analysis of data will be carried out to seek possible correlations of the GCC thickness with macular vascular alterations, and to evaluate the predominance of neuronal and/or vascular component changes using these parameters.
Subjects/Methods
Patients with AMD will be enrolled composed as follows: patients with SDD alone or predominant SDD, patients with conventional (soft) drusen alone or predominant drusen, and a group of healthy, age-matched controls. Visual acuity assessment and comprehensive ophthalmological examination with photographic documentation will be performed. Near infrared reflectance, optical coherence tomography angiography (OCT-A) and standard OCT images will be acquired. Drusen and SDD will be diagnosed based on OCT scans and near infrared reflectance images. GCC thickness maps will be generated with automated segmentation of OCT. OCT-A will include evaluation of the foveal avascular zone, density and flow of the superficial and deep macular vascular plexus, peripapillary plexus, and choriocapillaris.
