Br J Ophthalmol 95:979-985 doi:10.1136/bjo.2010.194977
  • Clinical science
  • Original article

Evolution of reticular pseudodrusen

Open Access
  1. Murray Killingsworth4
  1. 1Department of Ophthalmology, Prince of Wales Hospital, Randwick, Sydney, Australia
  2. 2Marsden Eye Centre, Sydney, Australia
  3. 3Retina Associates, Sydney, Australia
  4. 4South Western Area Pathology Services, Sydney, Australia
  1. Correspondence to John Sarks, 15 Parnell Street, Strathfield, NSW 2135 Australia; jssarks{at}
  • Accepted 31 October 2010
  • Published Online First 25 November 2010


Aims To report observations relating to the clinical recognition and possible basis of reticular pseudodrusen (RPD).

Methods This retrospective study reports the evolution of RPD in 166 patients who had follow-up of over 1 year using multiple imaging techniques. Mean age when first seen was 73.3 years and the mean period of observation was 4.9 years (range 1–18 years). Associated macular changes were recorded.

Results RPD were first identified in the upper fundus as a reticular network, which then became less obvious, developing a diffuse yellowish appearance. RPD also faded around choroidal neovascularisation (CNV). RPD therefore could be transient but the pattern often remained visible outside the macula or nasal to the discs. Manifestations of age-related macular degeneration (AMD) were present in nearly all eyes and there was a particularly high association with CNV (52.1%). In one clinicopathological case abnormal material was found in the subretinal space.

Conclusions The prevalence of RPD may be underestimated because their recognition depends upon the imaging method used, the area of fundus examined and the confusion with typical drusen. The pathology of one eye suggests that RPD may correspond to material in the subretinal space.


  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the University of New South Wales Human Research Ethics Committee number 05115.

  • Provenance and peer review Not commissioned; externally peer reviewed.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

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