Localized Reticular Pseudodrusen and Their Topographic Relation to Choroidal Watershed Zones and Changes in Choroidal Volumes

PURPOSE. We identified a topographic relation of localized reticular pseudodrusen (RPD) to choroidal watershed zones (CWZ) and to changes in choroidal volumes (CV). METHODS. We included 30 eyes of 30 patients with RPD in an area <10 mm(2) and no other retinal alteration (76.7 +/- 6.9 years). Patients underwent spectral-domain optical coherence tomography (SD-OCT), enhanced depth imaging (EDI) OCT, fluorescein video-angiography (vFA), indocyanine green video-angiography (vICG), and confocal scanning laser ophthalmoscopy (cSLO). vICG was evaluated for the presence, localization, and configuration of CWZ. Retinal areas affected by RPD were measured, and their localization was determined in relation to CWZ. CV was measured using a choroidal thickness map of the posterior pole and the Early Treatment of Diabetic Retinoscopy Study (ETDRS) grid. RESULTS. In all study eyes, RPD could be demonstrated clearly in SD-OCT, EDI-OCT, FA, ICG, and cSLO. CWZ were identified in 25 eyes (83.3%). The area affected by RPD was 7.45 +/- 2.25 mm(2). RPD area was located fully or partly within the CWZ in 22 eyes (88.0%). Mean CV in the full ETDRS grid area was reduced significantly (4.49 +/- 1.44 mm(3)). Foveal CV and CV in the grid sector affected mostly by RPD were significantly diminished to 0.14 +/- 0.05 mm(3) and 0.85 +/- 0.38 mm(3), respectively. CONCLUSIONS. The site of localized RPD seems to be related to presence and site of CWZ, suggesting that choroidal hypoxia may have a role in RPD pathogenesis. Reduced CV in eyes with localized RPD could be demonstrated and may be cause or consequence of RPD development.