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Retina:
doi: 10.1097/IAE.0b013e31828991b2
Original Study

RETICULAR MACULAR DISEASE IS ASSOCIATED WITH MULTILOBULAR GEOGRAPHIC ATROPHY IN AGE-RELATED MACULAR DEGENERATION

Xu, Luna MD*; Blonska, Anna M. MD*; Pumariega, Nicole M. MS*; Bearelly, Srilaxmi MD, MHS*; Sohrab, Mahsa A. MD*; Hageman, Gregory S. PhD; Smith, R. Theodore MD, PhD

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Abstract

Purpose:

To investigate the incidence of reticular macular disease (RMD), a subphenotype of age-related macular degeneration, in multilobular geographic atrophy (GA) and its relation to GA progression.

Methods:

One hundred and fifty-seven eyes of 99 subjects with age-related macular degeneration, primary GA, and good quality autofluorescence, and/or infrared images were classified into unilobular GA (1 lesion) or multilobular GA (≥2 distinct and/or coalescent lesions). Thirty-four subjects (50 eyes) had serial imaging. The authors determined the spatiotemporal relationships of RMD to GA and GA progression rates in five macular fields.

Results:

91.7% eyes (144 of 157) had multilobular GA, 95.8% of which exhibited RMD. In subjects with serial imaging, the mean GA growth rate significantly differed between the unilobular and multilobular groups (0.40 vs. 1.30 mm2/year, P < 0.001). Of the macular fields in these eyes, 77.1% of fields with RMD at baseline showed subsequent GA progression, while 53.4% of fields without RMD showed progression (P < 0.001). Percentage of fields with RMD significantly correlated with GA progression rate (P = 0.01).

Conclusion:

Autofluorescence and infrared imaging demonstrates that RMD is nearly always present with multilobular GA in age-related macular degeneration. Furthermore, GA lobules frequently develop in areas of RMD, suggesting progression of a single underlying disease process.

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