Dataset Information

Reticular Pseudodrusen in Late-Onset Retinal Degeneration.

ABSTRACT:

Purpose

To characterize the association of reticular pseudodrusen (RPD) with late-onset retinal degeneration (L-ORD) using multimodal imaging.

Design

Prospective, 2-center, longitudinal case series.

Participants

Twenty-nine patients with L-ORD.

Methods

All patients were evaluated within a 3-year interval with near-infrared reflectance, fundus autofluorescence, and spectral-domain OCT. In addition, a subset of patients also underwent indocyanine green angiography, fundus fluorescein angiography, mesopic microperimetry, and multifocal electroretinography.

Main outcome measures

Prevalence, topographic distribution, and temporal phenotypic changes of RPD in L-ORD.

Results

A total of 29 patients with molecularly confirmed L-ORD were included in this prospective study. Reticular pseudodrusen was detected in 18 patients (62%) at baseline, 10 of whom were men. The prevalence of RPD varied with age. The mean age of RPD patients was 57.3 ± 7.2 years. Reticular pseudodrusen was not seen in patients younger than the fifth decade of life (n = 3 patients) or in the eighth decade of life (n = 5 patients). Reticular pseudodrusen were found commonly in the macula with relative sparing of the fovea and also were identified in the peripheral retina. The morphologic features of RPD changed with follow-up. Two patients (3 eyes) demonstrated RPD regression.

Conclusions

Reticular pseudodrusen is found frequently in patients with L-ORD and at a younger age than in individuals with age-related macular degeneration (AMD). Reticular pseudodrusen exhibits quick formation and collapse, change in type and morphologic features with time, and relative foveal sparing and also has a peripheral retinal location in L-ORD.

SUBMITTER: Borooah S

PROVIDER: S-EPMC8217414 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature

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Publications

Reticular Pseudodrusen in Late-Onset Retinal Degeneration.

Borooah Shyamanga S Papastavrou Vasileios V Lando Leonardo L Han Jonathan J Lin Jonathan H JH Ayyagari Radha R Dhillon Baljean B Browning Andrew C AC

Ophthalmology. Retina 20201222 10

<h4>Purpose</h4>To characterize the association of reticular pseudodrusen (RPD) with late-onset retinal degeneration (L-ORD) using multimodal imaging.<h4>Design</h4>Prospective, 2-center, longitudinal case series.<h4>Participants</h4>Twenty-nine patients with L-ORD.<h4>Methods</h4>All patients were evaluated within a 3-year interval with near-infrared reflectance, fundus autofluorescence, and spectral-domain OCT. In addition, a subset of patients also underwent indocyanine green angiography, fun ...[more]

PMID: 33352318

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Project description:BackgroundTo investigate the characteristics of retinal vessels and retinal thickness in eyes with early age-related macular degeneration (AMD) with or without reticular pseudodrusen.MethodsWe retrospectively evaluated the clinical history and optical coherence tomography (OCT) and OCT angiography images of consecutive patients with early AMD. We calculated the retinal vessel densities of the superficial and deep capillary plexus with the ImageJ software (National Institutes of Health, Bethesda, MD, USA) and investigated the relationship with mean retinal thickness and subfoveal choroidal thickness.ResultsWe included 135 early AMD eyes and classified 60 of them into a reticular pseudodrusen group and 75 into a non-reticular pseudodrusen group. The vascular densities of the superficial and deep capillary plexus in the reticular pseudodrusen group (32.35% ± 3.67 and 26.71% ± 2.88%) were not different from those of the non-reticular pseudodrusen group (33.18% ± 2.2% and % 27.43 ± 1.79%; P = 0.546 and P = 0.318, respectively). The retinal thickness of the reticular pseudodrusen group (287.31 μm ± 24.36 μm) did not differ from that of the non-reticular pseudodrusen group (294.27 μm ± 20.71 μm; P = 0.493), while subfoveal choroidal thickness in the reticular pseudodrusen group (158.13 μm ± 42.53 μm) was lower than that in the non-reticular pseudodrusen group (237.89 μm ± 60.94 μm; P < 0.001). Multivariate analysis revealed that lower vascular density of the superficial capillary plexus and subfoveal choroidal thickness were associated with retinal thinning in reticular pseudodrusen group (P = 0.003 and P = 0.036) and older age was associated with retinal thickness in the non-reticular pseudodrusen group (P = 0.005).ConclusionsRetinal thinning in early AMD patients with reticular pseudodrusen was accompanied by choroidal and retinal vascular loss, which suggests a possible linkage of retinal thinning with vascular alterations.

Project description:PurposeTo determine the interreader agreement for reticular pseudodrusen (RPD) assessment on combined infrared reflectance (IR) and OCT imaging in the early stages of age-related macular degeneration across a range of different criteria to define their presence.DesignInterreader agreement study.ParticipantsTwelve readers from 6 reading centers.MethodsAll readers evaluated 100 eyes from individuals with bilateral large drusen for the following: (1) the presence of RPD across a range of different criteria and (2) the number of Stage 2 or 3 RPD lesions (from 0 to ≥ 5 lesions) on an entire OCT volume scan and on a selected OCT B-scan. Supportive information was available from the corresponding IR image.Main outcome measuresInterreader agreement, as assessed by Gwet's first-order agreement coefficient (AC1).ResultsWhen evaluating an entire OCT volume scan, there was substantial interreader agreement for the presence of any RPD, any or ≥ 5 Stage 2 or 3 lesions, and ≥ 5 definite lesions on en face IR images corresponding to Stage 2 or 3 lesions (AC1 = 0.60-0.72). On selected OCT B-scans, there was also moderate-to-substantial agreement for the presence of any RPD, any or ≥ 5 Stage 2 or 3 lesions (AC1 = 0.58-0.65) and increasing levels of agreement with increasing RPD stage (AC1 = 0.08, 0.56, 0.78, and 0.99 for the presence of any Stage 1, 2, 3, and 4 lesions, respectively). There was substantial agreement regarding the number of Stage 2 or 3 lesions on an entire OCT volume scan (AC1 = 0.68), but only fair agreement for this evaluation on selected B-scans (AC1 = 0.30).ConclusionsThere was generally substantial or near-substantial-but not near-perfect-agreement for assessing the presence of RPD on entire OCT volume scans or selected B-scans across a range of differing RPD criteria. These findings underscore how interreader variability would likely contribute to the variability of findings related to the clinical associations of RPD. The low levels of agreement for assessing RPD number on OCT B-scans underscore the likely challenges of quantifying RPD extent with manual grading.Financial disclosuresProprietary or commercial disclosure may be found after the references.

Project description:ObjectiveTo propose Deep-RPD-Net, a 3-dimensional deep learning network with semisupervised learning (SSL) for the detection of reticular pseudodrusen (RPD) on spectral-domain OCT scans, explain its decision-making, and compare it with baseline methods.DesignDeep learning model development.ParticipantsThree hundred fifteen participants from the Age-Related Eye Disease Study 2 Ancillary OCT Study (AREDS2) and 161 participants from the Dark Adaptation in Age-related Macular Degeneration Study (DAAMD).MethodsTwo datasets comprising of 1304 (826 labeled) and 1479 (1366 labeled) OCT scans were used to develop and evaluate Deep-RPD-Net and baseline models. The AREDS2 RPD labels were transferred from fundus autofluorescence images, which were captured at the same visit for OCT scans, and DAAMD RPD labels were obtained from the Wisconsin reading center. The datasets were divided into 70%, 10%, and 20% at the participant level for training, validation, and test sets, respectively, for the baseline model. Then, SSL was used with the unlabeled OCT scans to improve the trained model. The performance of Deep-RPD-Net was compared to that of 3 retina specialists on a subset of 50 OCT scans for each dataset. En face and B-scan heatmaps of all networks were visualized and graded on 25 OCT scans with positive labels, using a scale of 1 to 4, to explore the models' decision-making.Main outcome measuresAccuracy and area under the receiver-operating characteristic curve (AUROC).ResultsDeep-RPD-Net achieved the highest performance metrics, with accuracy and AUROC of 0.81 (95% confidence interval [CI]: 0.76-0.87) and 0.91 (95% CI: 0.86-0.95) on the AREDS2 dataset and 0.80 (95% CI: 0.75-0.84) and 0.86 (95% CI: 0.79-0.91) on the DAAMD dataset. On the subjective test, it achieved accuracy of 0.84 compared with 0.76 for the most accurate retina specialist on the AREDS2 dataset and 0.82 compared with 0.84 on the DAAMD dataset. It also achieved the highest visualization grades, of 3.26 and 3.32 for en face and B-scan heatmaps, respectively.ConclusionsDeep-RPD-Net was able to detect RPD accurately from OCT scans. The visualizations of Deep-RPD-Net were the most explainable to the retina specialist with the highest accuracy. The code and pretrained models are publicly available at https://github.com/ncbi-nlp/Deep-RPD-Net.Financial disclosuresProprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Project description:PurposeTo analyze reticular pseudodrusen (RPD) as an independent risk factor for progression to late age-related macular degeneration (AMD), alongside traditional macular risk factors (soft drusen and pigmentary abnormalities) considered simultaneously.DesignPost hoc analysis of 2 clinical trial cohorts: Age-Related Eye Disease Study (AREDS) and AREDS2.ParticipantsEyes with no late AMD at baseline in AREDS (6959 eyes, 3780 participants) and AREDS2 (3355 eyes, 2056 participants).MethodsColor fundus photographs (CFPs) from annual visits were graded for soft drusen, pigmentary abnormalities, and late AMD. Presence of RPD was from grading of fundus autofluorescence images (AREDS2) and deep learning grading of CFPs (AREDS). Proportional hazards regression analyses were performed, considering AREDS AMD severity scales (modified simplified severity scale [person] and 9-step scale [eye]) and RPD presence simultaneously.Main outcome measuresProgression to late AMD, geographic atrophy (GA), and neovascular AMD.ResultsIn AREDS, for late AMD analyses by person, in a model considering the simplified severity scale simultaneously, RPD presence was associated with a higher risk of progression: hazard ratio (HR), 2.15 (95% confidence interval [CI], 1.75-2.64). However, the risk associated with RPD presence differed at different severity scale levels: HR, 3.23 (95% CI, 1.60-6.51), HR, 3.81 (95% CI, 2.38-6.10), HR, 2.28 (95% CI, 1.59-3.27), and HR, 1.64 (95% CI, 1.20-2.24), at levels 0-1, 2, 3, and 4, respectively. Considering the 9-step scale (by eye), RPD presence was associated with higher risk: HR, 2.54 (95% CI, 2.07-3.13). The HRs were 5.11 (95% CI, 3.93-6.66) at levels 1-6 and 1.78 (95% CI, 1.43-2.22) at levels 7 and 8. In AREDS2, by person, RPD presence was not associated with higher risk: HR, 1.18 (95% CI, 0.90-1.56); by eye, it was HR, 1.57 (95% CI, 1.31-1.89). In both cohorts, RPD presence carried a higher risk for GA than neovascular AMD.ConclusionsReticular pseudodrusen represent an important risk factor for progression to late AMD, particularly GA. However, the added risk varies markedly by severity level, with highly increased risk at lower/moderate levels and less increased risk at higher levels. Reticular pseudodrusen status should be included in updated AMD classification systems, risk calculators, and clinical trials.

Dataset Information

Reticular Pseudodrusen in Late-Onset Retinal Degeneration.

Purpose

Design

Participants

Methods

Main outcome measures

Results

Conclusions

Publications

Reticular Pseudodrusen in Late-Onset Retinal Degeneration.

Similar Datasets

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