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Macular lesions associated with age-related macular degeneration in pachydrusen eyes



To investigate the prevalence of macular lesions associated with age-related macular degeneration (AMD) in eyes with pachydrusen.


Clinical records and multimodal imaging data of patients over 50 years old with drusen or drusenoid deposits were retrospectively assessed, and eyes with pachydrusen were included in this study. The presence of AMD features, including drusen or drusenoid deposits, macular pigmentary abnormalities, geographic atrophy (GA), and macular neovascularization (MNV), were evaluated.


Out of 967 eyes of 494 patients with drusen or drusenoid deposits, 330 eyes of 183 patients had pachydrusen (34.1%). The mean age was 66.1 ± 9.3 years, and the subfoveal choroidal thickness (SFCT) was 292.7 ± 100.1 μm. The mean number of pachydrusen per eye was 2.22 ± 1.73. The majority of eyes with pachydrusen had no other drusen or drusenoid deposits (95.2%). Only 16 eyes (4.8%) had other deposits, including soft drusen (10 eyes, 3.0%), cuticular drusen (3 eyes, 0.9%), and reticular pseudodrusen (RPD; 3 eyes, 0.9%). Macular pigmentary abnormalities accompanied pachydrusen in 68 eyes (27.4%). None of the eyes had GA, and 82 eyes (24.8%) had MNV. The majority of MNV was polypoidal choroidal vasculopathy (PCV; 65 eyes, 19.7%), followed by type 1 (10 eyes, 3.0%), type 2 (5 eyes, 1.5%), and type 3 MNV (2 eyes, 0.6%).


Eyes with pachydrusen in Korean population have several characteristic AMD lesions in low frequencies. These findings indicate that pachydrusen might have diagnostic and prognostic values that are different from those of other drusen or drusenoid deposits.

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Fig. 1: A representative case with macular pachydrusen.
Fig. 2: A representative case with pachydrusen and soft drusen.
Fig. 3: A representative case of neovascular age-related macular degeneration with pachydrusen.

Data availability

The datasets generated and/or analysed during the current study are not publicly available due to privacy or ethical restrictions but are available from the corresponding author on reasonable request.


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The authors would like to thank all the patients who participated in this study and Editage ( for English language editing.

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Authors and Affiliations



SWN wrote the initial draft of the manuscript. SWN, HN, JMY, MK, and D-IH conceived the concept for this study. SWN manually extracted the original data from selected studies. HN, JMY, MK, and D-IH checked all extracted data. SWN performed the statistical analysis. SWN and D-IH had full access to all data in the study, taking responsibility for data integrity and the accuracy of the data analysis. MK and D-IH were involved in the critical revision of the manuscript. D-IH supervised the study as corresponding authors.

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Correspondence to Don-Il Ham.

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Nam, S.W., Noh, H., Yoon, J.M. et al. Macular lesions associated with age-related macular degeneration in pachydrusen eyes. Eye (2023).

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