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: |
06 Nov 2023 00:13 |
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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