Associations between β-peripapillary atrophy and reticular pseudodrusen in early age-related macular degeneration

Aakriti Garg, Dana M. Blumberg, Lama A. Al-Aswad, Maris Oll, Suzanne Yzer, Max Forbes, Rando L. Allikmets, Srilaxmi Bearelly

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


PURPOSE. Choroidal thinning has been associated with reticular pseudodrusen (RPD) and bperipapillary atrophy (β-PPA), which have been linked to normal-tension glaucoma (NTG). This analysis sought to determine whether RPD are independently associated with β-PPA in early AMD patients. Secondary outcomes included the association of RPD and preexisting diagnosis of glaucoma, cup-to-disc ratio (CDR), subfoveal choroidal thickness (SFCT), and IOP. METHODS. This prospective cross-sectional study examined 78 age-and sex-matched early AMD patients: 43 RPD patients (63 eyes) and 35 non-RPD patients (64 eyes). Exclusion criteria included advanced AMD, high myopia, and vitreoretinal conditions/surgery. RPD and non-RPD groups were identified by confocal scanning laser ophthalmoscopy. β-PPA as well as CDR were graded on digital, nonstereoscopic fundus photos. SFCT was measured on spectraldomain optical coherence tomography for 69 patients (35 RPD and 34 non-RPD). IOP and glaucoma diagnosis were extracted from charts. RESULTS. β-PPA had a greater prevalence in RPD than non-RPD (44% vs. 19%, P = 0.002); however, this relationship was not significant when SFCT was added to the model (P = 0.150). A preexisting diagnosis of glaucoma (P = 0.156), CDR (P = 0.176), and IOP (P = 0.98) was not different between groups. CONCLUSIONS. RPD in early AMD are associated with presence of β-PPA, but choroidal thickness is a confounder in this relationship. Because β-PPA is a common finding in NTG, focusing on a potential shared pathway between RPD and NTG could improve the understanding of pathophysiology and expand therapies for each condition.

Original languageEnglish (US)
Pages (from-to)2810-2815
Number of pages6
JournalInvestigative Ophthalmology and Visual Science
Issue number5
StatePublished - May 2017
Externally publishedYes


  • Age-related macular degeneration
  • Beta-peripapillary atrophy
  • Choroidal thinning
  • Normal-tension glaucoma
  • Reticular pseudodrusen

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience


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