Purpose To determine if increasing drusen height correlates with predictive optical coherence tomography (OCT) biomarkers of atrophy. Methods Retrospective cross-sectional study that enrolled patients with drusen associated with intermediate AMD. Macular drusen were classified as small, intermediate, large, or very large based on OCT quartile measurement of height. Drusen diameter was also tabulated. The presence and localization of the OCT biomarkers of atrophy were assessed: disruption of the external limiting membrane and ellipsoid zone, intraretinal hyper-reflective foci, RPE disruption, choroidal hypertransmission, and presence of hyporeflective cores. Predictive OCT biomarkers of atrophy were correlated with drusen height. Results A total of 155 eyes from 104 patients met the inclusion and exclusion criteria. The mean age was 75.7 ± 8.7 years, and patients were predominantly female (74.0%). The mean visual acuity was logMAR 0.2 ± 0.2 (Snellen equivalent 20/32). The average drusen height was 134.6 ± 107.5 µm and the greatest horizontal diameter was 970.7 ± 867.4 µm. Disruption of the external limiting membrane and ellipsoid zone, RPE thickening or thinning, intraretinal hyper-reflective foci, choroidal hypertransmission, and presence of hyporeflective cores ( P < 0.05) were more common in eyes with large drusen and very large drusen versus small or intermediate drusen. All biomarkers were positively correlated with drusen height. OCT biomarkers of atrophy were predominantly located at the apex of the drusen. Conclusions Predictive OCT biomarkers of atrophy, specifically signs of RPE breakdown and disruption, occur more commonly in large or very large drusen, especially in drusen with greater height and separation of the RPE from the underlying choroid.

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Background Tyrosine kinase inhibitors (TKIs) are the standard treatment for chronic myeloid leukemia (CML). Despite their clinical success, TKIs are faced with challenges such as treatment resistance, which may be driven by kinase domain mutations, and frequent disease relapse upon the cessation of treatment. The combination of arsenic trioxide (ATO) and interferon‐α (IFN) was previously demonstrated to inhibit proliferation and induce apoptosis in CML cell lines, prolong the survival of primary wild‐type CML mice, and dramatically decrease the activity of leukemia‐initiating cells (LICs). Methods The ATO/IFN combination was tested in vitro on imatinib (IMN)‐resistant K562‐R and Ar230‐R cells. 3‐(4,5‐Dimethylthiazol‐2‐yl)‐2,5‐diphenyl tetrazolium bromide and terminal deoxynucleotidyl transferase–mediated deoxyuridine triphosphate nick‐end labeling assays were used to evaluate proliferation and apoptosis, respectively. The acridine orange assay was used to assess autophagy, and quantitative reverse transcription–polymerase chain reaction was used to assess the involvement of the hedgehog (Hh) pathway. In vivo, a retroviral transduction/transplantation T315I BCR‐ABL CML mouse model was used to assay the effect of the treatment on survival, tumor burden (histopathology and blood counts), and LIC activity (secondary transplantation). Results In vitro, ATO/IFN synergized to inhibit proliferation and induce apoptosis of IMN‐resistant cells with variant modes of resistance. Furthermore, the preclinical effects of ATO/IFN were associated with induction of autophagy along with inhibition of the Hh pathway. Most remarkably, ATO/IFN significantly prolonged the survival of primary T315I‐CML mice and displayed a dramatic impairment of disease engraftment in secondary mice, which reflected decreased LIC activity. Conclusions Collectively, the ATO/IFN strategy has been demonstrated to have the potential to lead to durable remissions in TKI‐resistant CML preclinical models and to overcome various TKI‐specific mechanisms of resistance.

Age-related macular degeneration (AMD) represents a massive burden of vision impairment and blindness in the United States and worldwide, 1 but the management of this devastating disease has remarkably progressed because of the development of advanced retinal imaging tools, especially highresolution, depth-resolved optical coherence tomography (OCT) and OCT angiography (OCTA). Currently recognized OCT biomarkers for neovascular activity include intraretinal fluid (IRF), subretinal fluid (SRF), subretinal pigment epithelium fluid, and subretinal hyperreflective material (SHRM), which are critical factors guiding therapy. [2][3][4] Fluid is a major hallmark of exudation and angiogenic activity in eyes with neovascular AMD, indicating the need for treatment with anti-vascular endothelial growth factor (VEGF) injection. 2,3,5 A long list of pivotal clinical trials essential for the ratification and approval of various anti-VEGF therapies, including aflibercept, 6 brolucizumab, 7 and faricimab, 8 relied on the OCT response of anatomical biomarkers of neovascular activity to corroborate the observed functional efficacy of the investigated agent. In all cases, the study drug was no less effective or was better in resolving fluid markers such as IRF and SRF, and these OCT outcomes were critical factors that were evaluated to determine the treatment effect of the anti-VEGF agent. Fluid as a marker of neovascular activity is a universal concept that is essential for clin-

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