Reticular macular disease is associated with multilobular geographic atrophy in age-related macular degeneration

• Published in: Retina (Philadelphia, Pa.) Vol. 33; no. 9; pp. 1850 - 1862
• Main Authors: Xu, Luna, Blonska, Anna M, Pumariega, Nicole M, Bearelly, Srilaxmi, Sohrab, Mahsa A, Hageman, Gregory S, Smith, R Theodore
• Format: Journal Article
• Language: English
• Published: United States 01-10-2013
• Subjects: Aged, 80 and over; Disease Progression; Female; Fluorescein Angiography; Follow-Up Studies; Geographic Atrophy - classification; Geographic Atrophy - complications; Geographic Atrophy - diagnosis; Humans; Macular Degeneration - complications; Macular Degeneration - diagnosis; Male; Multimodal Imaging; Ophthalmoscopy; Retinal Drusen - diagnosis; Retinal Dystrophies - diagnosis; Retinal Dystrophies - etiology; Retinal Pigment Epithelium - pathology
• ISSN: 0275-004X; 1539-2864
• DOI: 10.1097/IAE.0b013e31828991b2

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.
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.
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).
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.