2017
DOI: 10.1167/iovs.17-22725
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Association Between Hyperreflective Dots on Spectral-Domain Optical Coherence Tomography in Macular Edema and Response to Treatment

Abstract: In patients with DME or macular edema due to RVO, the number of HRDs on SD-OCT may be a predictive indicator of the response to IVB injection or dexamethasone implant. In bevacizumab responders, the number of HRDs on SD-OCT was small. In contrast, more HRDs, which might reflect increased inflammation in the retina, were observed in dexamethasone responders. Therefore, dexamethasone implants might be more effective in DME or RVO eyes with multiple HRDs and OPL disruption on SD-OCT.

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Cited by 76 publications
(83 citation statements)
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References 41 publications
(52 reference statements)
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“…Hwang et al. () also found, in DME eyes resistant to three bevacizumab injections, that the presence of these kind of spots (from 20 to 40 μ m) at baseline is positively predictive for DEX response.…”
Section: Discussionmentioning
confidence: 93%
See 1 more Smart Citation
“…Hwang et al. () also found, in DME eyes resistant to three bevacizumab injections, that the presence of these kind of spots (from 20 to 40 μ m) at baseline is positively predictive for DEX response.…”
Section: Discussionmentioning
confidence: 93%
“…In our study, we considered as HRS only spots of size ranging between 20 and 40 lm which, according to Vujosevic represent activated microglial cells (Vujosevic et al 2016). Hwang et al (2017 also found, in DME eyes resistant to three bevacizumab injections, that the presence of these kind of spots (from 20 to 40 lm) at baseline is positively predictive for DEX response.…”
Section: Discussionmentioning
confidence: 99%
“…Larger number of HRS at week 48 were present in eyes with persistent macular oedema despite switching to aflibercept. Hwang et al reported HRS were associated with bevacizumab non‐responders significantly more than responders to treatment ( P < .001). A previous study by Turksever et al, reported on the reduction of HRS after switching from ranibizumab to aflibercept in eyes with neovascular AMD .…”
Section: Discussionmentioning
confidence: 99%
“…Hyperreflective spots are very small, round, well‐circumscribed, lesions, visible on OCT scans in the inner and outer retina that are equal to or with higher reflectivity than the RPE band . It has been hypothesized that HRS are activated macrophages or microglial cells . Presence and severity of HRS were evaluated within 1500 μm of the fovea on the horizontal scan passing through the foveal centre .…”
Section: Methodsmentioning
confidence: 99%
“…Eyes that responded poorly to bevacizumab were treated with dexamethasone implants. About 75% of such eyes showed a good response and corresponded to the eyes with a higher number of HRS [32]. Vujosevic and cols have also suggested that DME with a high number of HRS and a large area of increased foveal autofluorescence showed better morphologic and functional results (better retinal sensitivity) if, at least initially, was treated with intravitreal steroids versus anti-VEGF [28].…”
Section: Hyperreflective Retinal Spots (Hrs)mentioning
confidence: 96%