Reticular pseudodrusen (RPD), or subretinal drusenoid deposits (SDD), refer to distinct lesions that occur in the subretinal space. Over the past three decades, their presence in association with age-related macular degeneration (AMD) has become increasingly recognized, especially as RPD have become more easily distinguished with newer clinical imaging modalities. There is also an increasing appreciation that RPD appear to be a critical AMD phenotype, where understanding their pathogenesis will provide further insights into the processes driving vision loss in AMD. However, key barriers to understanding the current evidence related to the independent impact of RPD include the heterogeneity in defining their presence, and failure to account for the confounding impact of the concurrent presence and severity of AMD pathology. This review thus critically discusses the current evidence on the prevalence and clinical significance of RPD and proposes a clinical imaging definition of RPD that will help move the field forward in gathering further key knowledge about this critical phenotype. It also proposes a putative mechanism for RPD formation and how they may drive progression to vision loss in AMD, through examining current evidence and presenting novel findings from preclinical and clinical studies.

网状假玻璃疣 (RPD) 或视网膜下玻璃疣沉积物 (SDD) 是指发生在视网膜下空间的不同病变。在过去的三十年里，它们与年龄相关性黄斑变性 (AMD) 相关的存在已得到越来越多的认可，特别是随着 RPD 变得更容易与新的临床成像方式区分开来。越来越多的人认识到 RPD 似乎是一种关键的 AMD 表型，了解其发病机制将进一步了解导致 AMD 视力丧失的过程。然而，理解与 RPD 的独立影响相关的当前证据的主要障碍包括定义其存在的异质性，以及未能解释并发存在和 AMD 病理学严重程度的混杂影响。因此，本综述批判性地讨论了关于 RPD 患病率和临床意义的当前证据，并提出了 RPD 的临床影像学定义，这将有助于推动该领域进一步收集有关这一关键表型的关键知识。它还通过检查当前证据并展示临床前和临床研究的新发现，提出了 RPD 形成的推定机制以及它们如何推动 AMD 视力丧失的进展。