Association of Reticular Pseudodrusen and Early Onset Drusen

Purpose. To report an association between reticular pseudodrusen, located above the retinal pigment epithelium (RPE), and Early Onset Drusen (EOD) as described using Spectral-Domain Optical Coherence Tomography (SD-OCT). Methods. Eight patients (16 eyes) with EOD were examined. EOD were classified into three entities called Large Colloid Drusen (LCD), Malattia Leventinese (ML), and Cuticular Drusen (CD). Best-corrected visual acuity, fundus examination, color fundus photographs, fundus autofluorescence (FAF), fluorescein angiography (FA), indocyanine green angiography (ICGA), and SD-OCT were performed in all study patients. Results. Four patients had LCD, 2 had ML, and 2 had CD. Reticular pseudodrusen were observed with SD-OCT in all study patients; all these patients had hyperreflective lesions above and below the RPE. Conclusion. Early Onset Drusen appear to be associated with reticular pseudodrusen. SD-OCT is helpful in distinguishing the location of the deposits that are above and below the RPE in EOD. Further studies are needed to understand the role of reticular pseudodrusen in the pathophysiology of EOD. 1. Introduction “Soft drusen” are defined as deposits located between the retinal pigment epithelium (RPE) and the inner collagenous layer of Bruch’s membrane [1]. These lesions usually appear after the age of 50 and are usually associated with AMD [2]. Younger people can have similar deposits called “Early Onset Drusen” (EOD). These lesions have been recently classified into three entities called Large Colloid Drusen (LCD), Malattia Leventinese (ML), and Cuticular Drusen (CD) [3]. Recent papers have described the multimodal morphological features of EOD as deposits classically located under the RPE similar to the soft drusen observed in AMD [4–6]. Reticular pseudodrusen, frequently associated with AMD, have been described using SD-OCT. Our purpose was to report a frequent association of reticular pseudodrusen, located above the RPE, and EOD using Spectral-Domain Optical Coherence Tomography (SD-OCT). 2. Patients and Methods Patients with Early Onset Drusen underwent a comprehensive ophthalmologic examination which included best-corrected visual acuity (BCVA), fundus examination, color fundus photographs, multicolor images, fundus autofluorescence (FAF), fluorescein angiography (FA), indocyanine green angiography (ICGA), and Spectral-Domain (Cirrus, Carl Zeiss-Meditec, Dublin, CA, USA; and Spectralis Heidelberg Retinal Angiography OCT, Heidelberg Engineering, Heidelberg, Germany) Optical Coherence Tomography (SD-OCT). Informed consent was