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Retina

Case 56

Contributor: Marko Tien (University of British Columbia Medical Student) 

Patient Presentation: A 67-year-old woman was referred to ophthalmology for AMD screening. She has no ocular complaints. No other neurological symptoms. She has a history of hypertension and hypercholesterolemia, for which she is taking medications for. On presentation, visual acuity was 20/25 OU. 

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Question: OCT 5 line raster was done and shown above. Between which layers is an abnormality seen?

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Question: Fundus photography and autofluorescence were taken and shown above. What is the primary abnormality seen in the set of photos?

Question: Based on the findings, what is the most likely diagnosis?

Question: How does a reticular pseudodrusen differ from a typical drusen?

Question: How does the prognosis of reticular pseudodrusen differ from typical drusen? Reticular pseudodrusens are ______

References:

  1. Chan, H., Cougnard-Grégoire, A., Delyfer, M. N., Combillet, F., Rougier, M. B., Schweitzer, C., Dartigues, J. F., Korobelnik, J. F., & Delcourt, C. (2016). Multimodal Imaging of Reticular Pseudodrusen in a Population-Based Setting: The Alienor Study. Investigative ophthalmology & visual science, 57(7), 3058–3065. https://doi.org/10.1167/iovs.16-19487

  2. De Bats, F., Wolff, B., Mauget-Faÿsse, M., Meunier, I., Denis, P., & Kodjikian, L. (2013). Association of reticular pseudodrusen and early onset drusen. ISRN ophthalmology, 2013, 273085. https://doi.org/10.1155/2013/273085

  3. Rabiolo, A., Sacconi, R., Cicinelli, M. V., Querques, L., Bandello, F., & Querques, G. (2017). Spotlight on reticular pseudodrusen. Clinical ophthalmology (Auckland, N.Z.), 11, 1707–1718. https://doi.org/10.2147/OPTH.S130165

  4. Wightman, A. J., & Guymer, R. H. (2019). Reticular pseudodrusen: current understanding. Clinical & experimental optometry, 102(5), 455–462. https://doi.org/10.1111/cxo.12842

Learning Objectives:

  1. To identify reticular pseudodrusen on OCT and fundus photos

  2. To understand how reticular pseudodrusens differ from typical drusens

  3. To understand the prognostic value and association of reticular pseudodrusens with late AMD

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