Evaluation of Coronary Artery Disease as a Risk Factor for Reticular Pseudodrusen

Purpose: Reticular pseudodrusen (RPD) is a risk factor for late age-related macular degeneration (AMD). Associations between RPD and coronary artery disease (CAD) have been reported from small case-control studies. This study investigated the association of RPD within a predominantly CAD cohort. Methods: A subgroup of subjects from a multicenter randomized controlled trial of computed tomography coronary angiography (CTCA) underwent ultra-widefield (UWF) retinal imaging CAD determined by CTCA was categorized as normal, non-obstructive or obstructive. Specific AMD features in UWF images were graded. Standardized grids were used to record the spatial location of AMD features, including RPD. Multivariate confounder adjusted regression models assessed the association between RPD and CAD. Results: The 534 participants were aged from 27-75 years (mean 58 ±9 years; 425 (80%) ≥50 years) with a male preponderance (56%). Within the study sample, 178 (33%) had no CAD, 351 (66%) had CAD. RPD was detected in 30 participants (5.6%) and bilaterally in 23. Most participants with bilateral RPD had intermediate AMD 17 (74%). After adjustment for potential confounders (age, sex, drusen >125 µm, smoking status), multivariate analysis found no significant association between CAD and RPD (odds ratio [OR] 1.31; 95% Confidence Interval [CI] (0.57-3.01); p=0.52). A significant association was identified between RPD and intermediate AMD (OR 3.18; 95% CI (1.61-6.27); p= 0.001). Conclusion: We found no evidence to support an association between CAD and RPD. RPD was strongly associated with intermediate AMD features.