Subretinal Drusenoid Deposits Reduce Retinal Sensitivity

Microperimetry provides a functional assessment of retinal areas beyond the fovea and is thus more comprehensive than visual acuity testing, particularly in diseases like AMD where pathology may not initially affect central vision. The risk of AMD progression is known to differ according to the pattern of subretinal drusenoid deposits (SDD). In light of this, a recent study published in Scientific Reports examined retinal function impairment in relation to the type of SDD as well as the type of drusen, using microperimetry in conjunction with multimodal imaging approaches. Eyes with SDD exhibited reduced retinal sensitivity, although central vision did not show significant differences. Moreover, the ribbon-type SDD had an independent effect on retinal sensitivity, while the presence of dot SDD did not. In this study, multivariable regression analysis revealed that increasing age is associated with decreased retinal sensitivity. These images from the study show a representative case of soft drusen (SD) alone (A–D) and both SD and subretinal drusenoid deposit (SDD) (E–H). SDD includes both dot and ribbon type SDD. (A) and (E) are fundus photos. (B) and (F) are blue peak fundus autofluorescence (FAF) images. (C) and (G) are infrared reflectance images. (D) and (H) show pointwise retinal sensitivity and OCT. Photo: Lim SH, et al. Sci Rep. 2025;15(1):34952. Click image to enlarge. A total of 302 eyes from 302 patients were analyzed. Patients with SDD were older and predominantly female. Eyes meeting the modified criteria of intermediate AMD, including SDD and total drusen area greater than 0.50 mm2 were included. The presence of SDD, as well as soft drusen, and specific type of SDD (dot or ribbon) were determined through multimodal imaging modalities including fundus photography, fundus autofluorescence, infrared reflectance image and optical coherence tomography. Retinal sensitivity was measured using MAIA microperimetry.SDD was found more frequently in female patients. (87.3% in SDD vs. 65.9% in non-SDD). The mean age of SDD patients was higher compared to that of patients without SDD (75.31 in SDD vs. 72.17 in non-SDD). Patients with eyes having both SDD and SD are older than patients with SD alone. Dot and ribbon types of SDD were found in 113 eyes and 69 eyes, respectively, while 38 eyes had SDD but did not fit into either dot or ribbon type.Average retinal sensitivity was significantly lower in eyes with SDD than without SDD (19.75 vs. 21.21). The presence of soft drusen alone did not significantly affect sensitivity. Among eyes with SDD, those with ribbon-type SDD exhibited significantly lower retinal sensitivity (18.02) than those with dot-type SDD (20.67). In multivariable linear regression analysis, older age and the presence of ribbon-type SDD were significantly associated with reduced RS.The current study revealed that retinal sensitivity was more reduced in the outer macula compared to the inner and central macula. SDD typically originated from the upper mid-periphery and spread along the outer macula, often sparing the fovea. The researchers noted that this distribution corresponded with areas of high rod photoreceptor density.“These findings underlie the importance of SDD as significant pathologic markers in intermediate AMD,” the study authors concluded in their paper. Click here for the journal source. Lim SH, Yamaguchi TCN, Herrmann R, et al. Influence of subretinal drusenoid deposit on retinal sensitivity in age-related macular degeneration. Sci Rep. 2025;15(1):34952.  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.