Incidence et facteurs de risque des pseudodrusen réticulés : l’étude ALIENOR

Abstract : Purpose: to describe in a population-based study of French elderly subjects the incidence of reticular pseudodrusen (RPD) as detected using multimodal imaging, and to analyze their potential associated risk factors. Methods: population-based sample of 759 residents of Bordeaux, France, who participated in the Antioxydants, Lipides Essentiels, Nutrition et Maladies Oculaires (ALIENOR) Study. 257 were unable to come to hospital and did not perform all exams. Of the remaining 1004 eyes (502 participants), 532 eyes were excluded. Data were collected between February 22, 2011 and February 15, 2017 mean (SD) follow-up duration was 3.7 (1.0) years. RPD were defined as definite if they were classified as present with at least two imaging methods from among color fundus photography, fundus autofluorescence, near-infrared reflectance and optical coherence tomography. Results: f the 472 eyes participants, 263 (55.7%) were women, and the mean (SD) age was 81.9 (3.2) years. 42 eyes were incident for RPD with an overall annual incidence of 2.047% (95% CI, 1.373-3.051) and an estimated 5-year incidence of 9.73%. Annual incidence was higher in females, i.e. 1.948% (95% CI, 1.287-2.947) versus 1.512% (95% CI, 0.786-2.911) in males, and increased with age. In multivariate analysis, three risk factors were identified: subfoveal choroidal thinning (HR, 1.06; 95% CI 1.01-1.11; P=0.0085), presence of risk allele of ARMS2 rs10490924 (HR, 3.36; 95% CI 1.64-6.88; P=0.0009) and LIPC rs10468017 (HR, 2.65; 95% CI 1.39-5.03; P=0.0029). Taking liposoluble statin medication (HR, 0.18; 95% CI 0.03-0.96; P=0.0448) was shown to be a protective factor. Conclusions: in this cohort, RPD incidence rate was higher to those observed in other population-based study. We confirm high risk for incident RPD in patients with subfoveal choroidal thinning and carriers of ARMS2 and LIPC at-risk genotypes. Also, taking liposoluble statin medication could be a protective factor.
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Master Thesis
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Cyril Dutheil. Incidence et facteurs de risque des pseudodrusen réticulés : l’étude ALIENOR. Médecine humaine et pathologie. 2018. ⟨dumas-02077128⟩

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