On spectral-domain OCT, a patient with dry AMD shows a hyperreflective band immediately above the RPE that is thinner than the RPE itself and does not shadow underlying structures. Which layer does this represent?

• A Bruch's membrane
• B Ellipsoid zone (IS/OS junction)
• C Subretinal drusenoid deposits ✓
• D Outer nuclear layer

Explanation

Subretinal drusenoid deposits (also called reticular pseudodrusen) appear on SD-OCT as hypereflective material between the ellipsoid zone and the RPE, distinct from conventional drusen which lie below the RPE. They are strongly associated with progression to late AMD and geographic atrophy. The ellipsoid zone lies more superficial (inner) to the RPE band, and Bruch's membrane appears as a thin hyperreflective line immediately basal to the RPE.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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