Correlation Between Hyperreflective Foci and Clinical Outcomes in Neovascular Age-Related Macular Degeneration After Switching to Aflibercept

Aghdam, Kaveh Abri; Pielen, Amelie; Framme, Carsten; Junker, Bernd

doi:10.1167/iovs.15-17338

Cited by 37 publications

(34 citation statements)

References 28 publications

(32 reference statements)

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“…35,36 Moreover, decrease in HF quantity also was observed after anti-VEGF treatment in AMD and diabetic maculopathy patients. 4,6,9,30 Interestingly, in this study, HF also might be associated with rs943080 variant at the VEGFA gene in intermediate AMD patients, which has been reported previously to have influence on treatment response. 37 Besides, VEGFA variant rs943080 is known to be inversely associated with the presence of AMD.…”

Section: Discussionsupporting

confidence: 66%

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Association of Hyperreflective Foci Present in Early Forms of Age-Related Macular Degeneration With Known Age-Related Macular Degeneration Risk Polymorphisms

Altay

Scholz

Schick

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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Citation: Altay L, Scholz P, Schick T, et al. Association of hyperreflective foci present in early forms of age-related macular degeneration with known age-related macular degeneration risk polymorphisms. Invest Ophthalmol Vis Sci. 2016;57:4315-4320. DOI:10.1167/iovs.15-18855 PURPOSE. We evaluated the association of hyperreflective foci (HF) observed in early and intermediate age-related macular degeneration (AMD) with known AMD risk alleles. METHODS.In this pilot case-control study, HF were defined as lesions with reflectivity equal or higher than the retinal pigment epithelium band in spectral domain optical coherence tomography (SDOCT). Hyperreflective foci in the outer nuclear layer and photoreceptor complex were evaluated in 518 individuals with early and intermediate AMD. Definite presence of HF was defined as at least 10 HF in all SDOCT scans. Genotyping was performed for 22 single nucleotide polymorphisms (SNPs). Associations between AMD severity stages, HF, and SNPs were determined by logistic regression analyses. RESULTS.Hyperreflective foci (n ‡ 10) were significantly associated with AMD severity and the association was strongest with intermediate AMD (odds ratio [OR], 8.45; P ¼ 1.092*10 À8 ). Independently, HF showed associations with ARMS2 rs104909/HtRA1 rs11200638 (OR, 1.64; P ¼ 0.017), CFH rs1061170 (OR, 1.70; P ¼ 0.011), and APOE4/TOMM40 rs2075650 (OR, 2.26; P ¼ 0.005) variants. Within the group of intermediate AMD, associations were similar (ARMS2 rs104909/HtRA1 rs11200638 OR, 1.79, P ¼ 0.010; CFH rs1061170 OR, 1.77, P ¼ 0.013; APOE4/TOMM40 rs2075650 OR, 1.98; P ¼ 0.034) and showed additional trending associations with VEGFA rs943080 variant (OR, 0.59; P ¼ 0.024). After Bonferroni-correction for 22 SNPs, none of the associations was statistically significant (P 0.0023).CONCLUSIONS. The presence of HF is related to AMD severity. Despite limited power of this pilot study, our results suggest an association of HF with polymorphisms in ARMS2/HTRA1, CFH, APOE4/TOMM40, and VEGFA genes which could be triggered by modification of the extracellular matrix, altered complement system or lipid metabolism.

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Section: Discussionsupporting

confidence: 66%

“…They may present in vivo inflammatory components of the disease and, therefore, may be used as a new clinical biomarker. 4,6,9 In histologic analyses, intraretinal HF represented cholesterol crystal precipitations of phagocytic origin, which also may originate from microglia. 10 In AMD, heritability accounts for approximately 71% of the condition.…”

mentioning

confidence: 99%

Association of Hyperreflective Foci Present in Early Forms of Age-Related Macular Degeneration With Known Age-Related Macular Degeneration Risk Polymorphisms

Altay

Scholz

Schick

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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“…Presence of HRF at spectral domain OCT scan at baseline indicated significantly better structural improvement at months 12 and 18 compared with eyes without HRF. Abri Aghdam et al [21] also found a decrease in HRF after the loading dose of aflibercept in ranibizumab pro re nata-pretreated patients and a positive significant correlation between the baseline number of HRF and CRT. The authors assumed that due to more severe blood-retina barrier damage, eyes with HRF at baseline spectral domain OCT have more active CNV.…”

Section: Discussionmentioning

confidence: 86%

“…Recently, HRF have attracted the attention of some authors as a spectral domain OCT finding in different retinal diseases such as diabetic retinopathy [20] , AMD [21] , acquired vitelliform lesions of the macula [22] , central serous chorioretinopathy [23] , and uveitis [24] . Our results suggest that the presence of HRF decreases during aflibercept treatment with TER in ranibizumab-pretreated nAMD eyes.…”

Section: Discussionmentioning

confidence: 99%

Baseline Optical Coherence Tomography Findings as Outcome Predictors after Switching from Ranibizumab to Aflibercept in Neovascular Age-Related Macular Degeneration following a Treat-and-Extend Regimen

Türksever

Prünte²,

Hatz³

2017

Ophthalmologica

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Purpose: To evaluate outcome predictors of aflibercept in neovascular age-related macular degeneration pretreated with ranibizumab based on a treat-and-extend regimen (TER). Methods: We performed a retrospective evaluation of 18-month follow-up of 45 consecutive patients with limited response to ranibizumab. Results: At month 18, mean central retinal thickness and intraretinal fluid (IRF) height were significantly reduced. The recurrence-free treatment interval (RFTI) increased from 7.0 ± 1.8 to 8.5 ± 2.4 weeks (p = 0.01); visual acuity remained stable. At month 18, 58.1% of patients showed a longer RFTI. At month 12, eyes with baseline subretinal fluid (SRF) had a shorter RFTI than those without SRF (p = 0.032). Eyes with baseline IRF showed a longer RFTI than those without IRF (p = 0.037). Baseline hyperreflective foci (HRF) presence indicated improvement in SRF (p = 0.024) and IRF at month 12 (p = 0.049). Conclusion: Baseline HRF presence predicted better morphological outcome, while SRF predicted a shorter RFTI and IRF a longer RFTI after switching from ranibizumab to aflibercept within a TER.

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“…To best our knowledge, there were two studies in the literature that focused on IRF and HRF in the switching patients with refractory nAMD [28,29]. Both studies showed that the switch from ranibizumab to aflibercept led to a significant decrease in the number of HRF.…”

Section: Discussionmentioning

confidence: 99%

Real-life outcomes in patients with neovascular age-related macular degeneration switched from ranibizumab to aflibercept

Çakir¹,

Erden²,

Bölükbaşı³

et al. 2017

Eye Care Vis

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Correlation Between Hyperreflective Foci and Clinical Outcomes in Neovascular Age-Related Macular Degeneration After Switching to Aflibercept

Abstract: Citation: Abri Aghdam K, Pielen A, Framme C, Junker B. Correlation between hyperreflective foci and clinical outcomes in neovascular agerelated macular degeneration after switching to aflibercept. Invest Ophthalmol Vis Sci. 2015;56:6448-6455.

Cited by 37 publications

References 28 publications

Association of Hyperreflective Foci Present in Early Forms of Age-Related Macular Degeneration With Known Age-Related Macular Degeneration Risk Polymorphisms

Association of Hyperreflective Foci Present in Early Forms of Age-Related Macular Degeneration With Known Age-Related Macular Degeneration Risk Polymorphisms

Baseline Optical Coherence Tomography Findings as Outcome Predictors after Switching from Ranibizumab to Aflibercept in Neovascular Age-Related Macular Degeneration following a Treat-and-Extend Regimen

Real-life outcomes in patients with neovascular age-related macular degeneration switched from ranibizumab to aflibercept

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