Reticular Pseudodrusen Disappearance after Development of Macular Neovascularization

Abstract

To explore changes in reticular pseudodrusen (RPD) number and location after the development of macular neovascularization (MNV) in eyes with prior intermediate age-related macular degeneration (iAMD), focusing on different retinal regions differently affected by MNV. This retrospective longitudinal study included iAMD eyes with RPD that developed MNV. RPD were assessed at baseline, when MNV was diagnosed (MNV stage), and after anti-VEGF treatment. Three regions of interest (ROI) were considered: MNV area, subretinal fluid (SRF) area, and a marginal area 1000 μm around SRF (marginal zone). RPD counts were compared with age- and gender-matched control eyes with RPD who did not develop MNV. RPD number exhibited a significant decrease after MNV development in the MNV area (p=0.048) and in the area with SRF (p=0.078). A statistically significant decrease was also disclosed in the marginal area around SRF (p=0.002), associated with larger SRF areas. Control eyes did not show any significant change in the RPD count. RPD reduction after MNV development suggests a complex interplay involving the MNV itself, the presence of SRF and trophic changes. Our results highlight the role of MNV in retinal nutritional balance and provide intriguing results in the RPD life-cycle.