Ocular Perfusion Pressure and Choroidal Thickness in Early Age-Related Macular Degeneration Patients With Reticular Pseudodrusen

The purpose of this study was to investigate the relationship between the ocular perfusion pressure (OPP) and subfoveal choroidal thickness (CT) in eyes with early age-related macular degeneration (AMD) with or without reticular pseudodrusen (RPD). We evaluated the clinical history, blood pressure parameters, fundus photography, and optical coherence tomography images of consecutive patients with early AMD. We calculated the mean OPP from blood pressure and intraocular pressure. We included 103 eyes from 103 patients, classifying 45 as the RPD group and 58 as the non-RPD group. The mean OPP of the RPD group (46.1 ± 6.5 mm Hg) did not differ from that of the non-RPD group (45.1 ± 5.1 mm Hg, P = 0.325), but the RPD group showed a thinner mean subfoveal CT (158.3 ± 73.0 μm) than the non-RPD group (220.9 ± 67.0 μm, P < 0.001). Among 64 patients who underwent follow-up examination, the rate of change in subfoveal CT in the RPD group (-4.74 ± 0.86 μm/y) was greater than that in the non-RPD group (-2.46 ± 0.75 μm/y, P = 0.028). In the RPD group, a history of systemic hypertension and lower baseline OPP were associated with a higher rate of change in subfoveal CT (P = 0.019 and P = 0.010, respectively). Subfoveal CT was thinner in early AMD patients with RPD than in those without RPD. Lower baseline mean OPP and a history of systemic hypertension could be risk factors associated with the progression of choroidal thinning in early AMD patients with RPD.