Performance characteristics of multicolor versus blue light and infrared imaging in the identification of reticular pseudodrusen.

Abstract

To describe the appearance of reticular pseudodrusen on multicolor imaging and to evaluate its diagnostic accuracy as compared with the two modalities that may be considered the current reference standard, blue light and infrared imaging. Retrospective study in which all multicolor images (constructed from images acquired at 486nm-blue, 518nm-green and 815nm-infrared) of 45 consecutive patients visited in a single center was reviewed. Inclusion criteria involved the presence of>1 reticular pseudodrusen on a 30°×30° image centered on the fovea as seen with the blue light channel derived from the multicolor imaging. Three experienced observers, masked to each other's results with other imaging modalities, independently classified the number of reticular pseudodrusen with each modality. The median interobserver agreement (kappa) was 0.58 using blue light; 0.65 using infrared; and 0.64 using multicolor images. Multicolor and infrared modalities identified a higher number of reticular pseudodrusen than blue light modality in all fields for all observers (p<0.0001). Results were not different when multicolor and infrared were compared (p≥0.27). These results suggest that multicolor and infrared are more sensitive and reproducible than blue light in the identification of RPD. Multicolor did not appear to add a significant value to infrared in the evaluation of RDP. Clinicians using infrared do not need to incorporate multicolor for the identification and quantification of RPD.