Hyperreflective Material Boundary Remodeling in Neovascular Age-Related Macular Degeneration: A Post Hoc Analysis of the AVENUE Trial.

Yu, Siqing; Bachmeier, Isabel; Hernandez-Sanchez, Jules; Armendariz, Beatriz Garcia; Ebneter, Andreas; Pauleikhoff, Daniel; Chakravarthy, Usha; Fauser, Sascha (2023). Hyperreflective Material Boundary Remodeling in Neovascular Age-Related Macular Degeneration: A Post Hoc Analysis of the AVENUE Trial. Ophthalmology retina, 7(11), pp. 990-998. Elsevier 10.1016/j.oret.2023.06.024

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OBJECTIVE

To describe the spatial and temporal characteristics of hyperreflective material (HRM) on spectral-domain optical coherence tomography (SD-OCT) in neovascular age-related macular degeneration (nAMD) during antiangiogenic treatment and explore associations with best-corrected visual acuity (BCVA) and macular atrophy (MA).

DESIGN

Retrospective regrading of SD-OCT-images from the multicenter randomized controlled AVENUE trial (NCT02484690, conducted August 2015-September 2017).

PARTICIPANTS

Treatment-naïve nAMD patients enrolled from 50 sites in the US.

METHODS

Retrospective regrading and secondary analysis.

MAIN OUTCOME MEASURE

SD-OCT images from 207 study eyes that fitted criteria for the present analysis were graded for HRM features, its evolution, and associated hypertransmission into choroid (HTC), a proxy for MA. The appearance of a well-defined hyperreflective inner boundary that separated persistent HRM from the neurosensory retina continuous with the adjacent retinal pigment epithelium layer was defined as HRM boundary remodeling (HRM-BR). Patterns of HRM composition/evolution were defined: 1) no subretinal HRM at baseline, 2) fully resolved, 3) persistent with complete HRM-BR, or 4) partial/absent HRM-BR. Associations of HRM patterns with BCVA and HTC were analyzed. Predictive factors for complete HRM-BR were explored.

RESULTS

Of 207 included eyes, subretinal HRM was present in 159 (76.8%) at baseline and persisted until month 9 in 118 (57.0%) eyes. Of these 118 eyes, 44.9% developed complete HRM-BR and had similar BCVA outcomes by month 9 compared with no/fully resolved subretinal HRM. Partial/absent HRM-BR had a strong negative association with BCVA outcome (-6.1 Early Treatment Diabetic Retinopathy Study letters; P = 0.016) and a higher frequency of intralesional HTC (69.2%) compared with eyes with complete HRM-BR (20.8%) at month 9. Older age (odds ratio [OR] 0.96; P = 0.054) and presence of intralesional HTC (OR 0.06; P = 0.010) at baseline were associated with lower odds of complete HRM-BR at month 9.

CONCLUSIONS

In nAMD eyes under antiangiogenic treatment, complete HRM-BR occurred frequently and was associated with better BCVA than when HRM-BR was only partial/absent.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology

UniBE Contributor:

Ebneter, Andreas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2468-6530

Publisher:

Elsevier

Language:

English

Submitter:

Pubmed Import

Date Deposited:

10 Jul 2023 14:40

Last Modified:

08 Jul 2024 00:25

Publisher DOI:

10.1016/j.oret.2023.06.024

PubMed ID:

37422192

Uncontrolled Keywords:

Hyperreflective material antiangiogenic treatment fibrosis neovascular age-related macular degeneration spectral-domain optical coherence-tomography

BORIS DOI:

10.48350/184611

URI:

https://boris.unibe.ch/id/eprint/184611

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