Reticular macular disease is associated with multilobular geographic atrophy in age-related macular degeneration

Retina. 2013 Oct;33(9):1850-62. doi: 10.1097/IAE.0b013e31828991b2.


Purpose: To investigate the incidence of reticular macular disease (RMD), a subphenotype of age-related macular degeneration, in multilobular geographic atrophy (GA) and its relation to GA progression.

Methods: One hundred and fifty-seven eyes of 99 subjects with age-related macular degeneration, primary GA, and good quality autofluorescence, and/or infrared images were classified into unilobular GA (1 lesion) or multilobular GA (≥ 2 distinct and/or coalescent lesions). Thirty-four subjects (50 eyes) had serial imaging. The authors determined the spatiotemporal relationships of RMD to GA and GA progression rates in five macular fields.

Results: 91.7% eyes (144 of 157) had multilobular GA, 95.8% of which exhibited RMD. In subjects with serial imaging, the mean GA growth rate significantly differed between the unilobular and multilobular groups (0.40 vs. 1.30 mm2/year, P < 0.001). Of the macular fields in these eyes, 77.1% of fields with RMD at baseline showed subsequent GA progression, while 53.4% of fields without RMD showed progression (P < 0.001). Percentage of fields with RMD significantly correlated with GA progression rate (P = 0.01).

Conclusion: Autofluorescence and infrared imaging demonstrates that RMD is nearly always present with multilobular GA in age-related macular degeneration. Furthermore, GA lobules frequently develop in areas of RMD, suggesting progression of a single underlying disease process.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Disease Progression
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Geographic Atrophy / classification
  • Geographic Atrophy / complications*
  • Geographic Atrophy / diagnosis
  • Humans
  • Macular Degeneration / complications
  • Macular Degeneration / diagnosis
  • Male
  • Multimodal Imaging
  • Ophthalmoscopy
  • Retinal Drusen / diagnosis
  • Retinal Dystrophies / diagnosis
  • Retinal Dystrophies / etiology*
  • Retinal Pigment Epithelium / pathology*

Supplementary concepts

  • Retinal Dystrophy, Reticular Pigmentary, of Posterior Pole