A new British study found that a 10-unit increase in RPD lesions increases stroke risk by 1%, independent of age and sex.

A new British study found that a 10-unit increase in RPD lesions increases stroke risk by 1%, independent of age and sex. Photo: Jessica Haynes, OD. Click image to enlarge.

Though the link between drusen and systemic disease is well-documented, associations between reticular pseudodrusen (RPD) and systemic health are not. A recent study aimed to investigate whether the presence of RPD increases the risk of stroke, as a few small studies have suggested a potential link between RPD and cardiovascular disease. The results, presented during a poster session this past Sunday at ARVO in Seattle, showed that a 10-unit increase in RPD lesions raises the chances of experiencing a stroke by 1%, independent of age and sex.

The retrospective cross-sectional analysis obtained participant data from a large British biomedical database. The cohort comprised 768 subjects with drusen, including 400 with 'pure drusen,' 439 with RPD (71 of which were pure RPD) and 1,170 controls. All subjects were 60 or older, 55% were female and 96% were of white ethnicity.

A machine learning framework was employed to quantify the number of RPD and drusen lesions for each subject, with verification by human experts. To be classified as RPD or drusen positive, at least five lesions were necessary. Subjects with bilateral drusen measuring less than 63µm were excluded from the study. Univariable and multivariable logistic regression models were used to test associations between RPD, drusen, and stroke, adjusting for age, sex, RPD count and drusen count.

The analysis revealed a statistically significant association between RPD and stroke risk, with an odds ratio (OR) of 1.01 for every 10 RPD lesions. This association remained significant even after adjusting for age and sex. However, no associations were observed between the number of drusen and stroke risk, nor between RPD or drusen and the risk of myocardial infarction.

“This study suggests that RPD and drusen are different, with RPD having a unique association with stroke risk,” the researchers wrote in their ARVO abstract. “This could be crucial for early detection and prevention strategies for strokes, as identifying people with high numbers of RPD could flag them as being at higher risk,” they suggested.

Original abstract content © Association for Research in Vision and Ophthalmology 2024.

Schwartz R, Olvera-Barrios A, Warwick AN, et al. Increasing stroke risk correlated with higher reticular pseudo-drusen counts: evidence from the UK Biobank. ARVO 2024 annual meeting.