Subretinal drusenoid deposits in an elderly population with age-related macular degeneration (MONTRACHET study: Maculopathy, Optic Nerve, nuTRition, neurovasCular and HEarT diseases)

Purpose To determine the frequency of subretinal drusenoid deposits (SDD) in a French population of elderly patients presenting an age-related macular degeneration (AMD) in the MONTRACHET study. Methods The three-city study (3C) was a population-based study including 9294 patients older than 65 years from three French cities (Dijon, Bordeaux and Montpellier) at baseline in 1999. After 10 years, the cohort of Dijon benefited from a complete ophthalmologic examination as part of the MONTRACHET study. Each patient underwent a non-mydriatic retinophotography associated with a spectral-domain OCT examination (SD-OCT) of the macula. AMD classification was established according to the classification of the Multi-Ethnic study of Atherosclerosis (MESA) for the retinophotography analysis and with the E3 CONSORTIUM classification for the SD-OCT analysis. Patients with uninterpretable images of both eyes were excluded from statistical analysis. Results One thousand one hundred fifty three subjects were included. 62.7% were female and the mean age was 82.2 ± 3.8 years. With retinophotography analysis, the frequency of SDD was 1.9% (n = 38 eyes). With the SD-OCT macular analysis, the frequency of SDD was 14.8% (n = 342). In patients presenting with SDD, 68.8% (n = 137) had a bilateral involvement. The relative risk (RR) of presenting SDD lesions in patients older than 80 years old was 2.6 (p < 0.001) and in women at 1.3 (p < 0.045). An interruption of the ellipsoide line and an alteration of the retinal pigment epithelium were statistically associated with the presence of SDD: RR = 5.9 (p < 0.001) and RR = 2.8 (p < 0.001), respectively. The average thickness of the subfoveal choroid was thinner in subjects presenting SDD (174.9 μm with SDD vs 209.8 μm without SDD, p < 0.001). Conclusions Few population-based studies have established the frequency of SDD in an elderly population.