{
  "abstract": "Background/aims Reticular pseudodrusen (RPD) are increasingly recognised as a distinct phenotype in the age-related macular degeneration (AMD) disease spectrum. This study investigates the association between RPD and cardiovascular outcomes, specifically myocardial infarction (MI) and stroke in the UK Biobank (UKBB).Methods Retrospective analysis of UKBB participants (n=2010). A validated deep learning framework identified and quantified subjects with RPD, drusen and controls on optical coherence tomography. Five retina specialists validated the artificial intelligence findings. Multivariable logistic regression models assessed the association between RPD/drusen and stroke, MI and combined MI/stroke, adjusting for age, sex, high-density lipoprotein cholesterol/low-density lipoprotein cholesterol ratio and smoking history.Results The study cohort included 71 subjects with pure RPD, 401 with pure drusen, 368 with both and 1170 controls. Univariable analysis showed that for every 20 RPD lesions, the OR for stroke increased by 1.02 (95% CI 1.00 to 1.04, p=0.028). The mean number of RPD per patient in this cohort was 199, indicating an increased stroke risk of 20%. Multivariable analysis showed a significant association between RPD load and stroke risk (OR 1.02, 95% CI 1.00 to 1.04, p=0.042) after adjustment for confounders. No significant association was found between drusen and stroke or between RPD/drusen and MI.Conclusion Increased RPD load is associated with a higher risk of stroke, independent of traditional cardiovascular risk factors. Drusen did not have similar associations, suggesting that RPD may represent a distinct disease entity. Evaluating cardiovascular risk in patients with numerous RPD might be advisable. Further prospective studies are needed to validate these findings and explore the underlying mechanisms.",
  "authors": [
    {
      "affiliations": [
        "NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, UK",
        "Moorfields Eye Hospital NHS Foundation Trust, London, UK",
        "Apellis, a subsidiary of Biogen, London, UK"
      ],
      "name": "Roy Schwartz"
    },
    {
      "affiliations": [
        "NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, UK"
      ],
      "name": "Abraham Olvera-Barrios"
    },
    {
      "affiliations": [
        "Moorfields Eye Hospital NHS Foundation Trust, London, UK",
        "University College London, Institute of Cardiovascular Science, London, UK"
      ],
      "name": "Alasdair N. Warwick"
    },
    {
      "affiliations": [
        "Moorfields Eye Hospital NHS Foundation Trust, London, UK"
      ],
      "name": "Hagar Khalid"
    },
    {
      "affiliations": [
        "Moorfields Eye Hospital NHS Foundation Trust, London, UK"
      ],
      "name": "Sumita Phatak"
    },
    {
      "affiliations": [
        "Moorfields Eye Hospital NHS Foundation Trust, London, UK"
      ],
      "name": "Mahima Jhingan"
    },
    {
      "affiliations": [
        "Quantitative Healthcare Analysis (qurAI) Group, Informatics Institute, University of Amsterdam, Amsterdam, Netherlands",
        "Amsterdam UMC location University of Amsterdam, Biomedical Engineering and Physics, Amsterdam, Netherlands"
      ],
      "name": "Coen de Vente"
    },
    {
      "affiliations": [
        "NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, UK",
        "Moorfields Eye Hospital NHS Foundation Trust, London, UK",
        "Department of Biomedical Engineering, University of Basel, Basel, Switzerland",
        "Department of Ophthalmology, University Hospital Basel, Basel, Switzerland"
      ],
      "name": "Philippe Valmaggia"
    },
    {
      "affiliations": [
        "Cologne Image Reading Center, Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany",
        "Department of Ophthalmology, Goethe University, Frankfurt, Germany"
      ],
      "name": "Sandra Liakopoulos"
    },
    {
      "affiliations": [
        "Southampton Eye Unit, University Hospital Southampton, Southampton, UK"
      ],
      "name": "Yanling Ouyang"
    },
    {
      "affiliations": [
        "Quantitative Healthcare Analysis (qurAI) Group, Informatics Institute, University of Amsterdam, Amsterdam, Netherlands",
        "Amsterdam UMC location University of Amsterdam, Biomedical Engineering and Physics, Amsterdam, Netherlands"
      ],
      "name": "Clara I. Sanchez-Guiterrez"
    },
    {
      "affiliations": [
        "NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, UK",
        "Moorfields Eye Hospital NHS Foundation Trust, London, UK"
      ],
      "name": "Catherine Egan"
    },
    {
      "affiliations": [
        "NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, UK",
        "Moorfields Eye Hospital NHS Foundation Trust, London, UK"
      ],
      "name": "Adnan Tufail"
    }
  ],
  "title": "Reticular pseudodrusen load is associated with an increased risk of stroke",
  "uid": "4721c057-fdf0-5e75-9495-f3e552a482ca"
}