RPD More Common in Intermediate AMD Stages, ARMS2 Variants

RPD is a warning sign for AMD-related vision loss. Photo: Jessica Haynes, OD. Click image to enlarge. Reticular pseudodrusen (RPD) may be a more common comorbidity with neovascular AMD (nAMD) in intermediate and advanced cases and in Asian populations, says a recent study.Among a cohort of 353 Asian individuals (706 eyes in total) with unilateral nAMD, 14.4% were also found to have RPD findings on OCT. Explaining their reasoning for surveying exclusively Asian patients in a paper for American Journal of Ophthalmology, the Chinese researchers mentioned that “[a]mong Asian populations, there have been limited reports” of the prevalence of RPD or AMD in general or of the two conditions together, so their aim was to improve understanding of the relationship in this specific patient type. All patients were 50 years of age or older.The researchers defined specific criteria that confirmed the presence of RPD: patients presenting with “10 or more lesions of hyperreflective material at any stage in 25 horizontal B-scans of the macula” as well as “regression of material and outer retinal atrophy with intact RPE,” a common sign of stage 4 RPD. Macular neovascularization (MNV) was also common enough among the studied participants to be included as a factor. The researchers explained in their paper that “[n]on-MNV eyes were evaluated separately from MNV eyes” and that those with MNV were classified into three groups (Type 1, Type 2, Type 3) based on the type and severity of MNV presentation.After performing the necessary imaging protocol, the researchers reported that eyes with intermediate AMD “showed a significantly higher prevalence of RPD, soft drusen and cuticular drusen compared to those with early AMD, even after adjustment for age and gender.” They also noted that only 4.8% of eyes with early AMD also had RPD; in contrast, among those with intermediate-stage AMD, 47.4% presented with RPD. Previous research discussed in the study has “reported a clear association between the ARMS2/HTRA1 [Age-Related Maculopathy Susceptibility 2]” gene “and higher RPD load,” particularly in individuals 55 and older.RPD is a common finding in AMD and one of the most severe identifiers of late-stage AMD, indicating possible future vision loss and other signs of degeneration. The findings of this study imply an additional genetic link between RPD and the ARMS2 gene, which may be more prevalent in Asian populations than in others.Click here for the journal source. Kikushima W, Gilead N, Sherif M, et al. Prevalence and associated features of reticular pseudodrusen in neovascular age-related macular degeneration in an Asian population. Am. J. Ophthalmol. February 6, 2026. [Epub ahead of print.] This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.