Prognostic Value of Hyperreflective Foci in Neovascular Age-Related Macular Degeneration Treated With Bevacizumab

Segal, Ori; Barayev, Edward; Nemet, Arie Y.; Geffen, Noa; Vainer, Igor

doi:10.1097/iae.0000000000001033

Cited by 29 publications

(33 citation statements)

References 22 publications

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“…The authors assumed that due to more severe blood-retina barrier damage, eyes with HRF at baseline spectral domain OCT have more active CNV. Similar conclusions were also made by another study group [25] , which showed that resolution of HRF was associated with better final VA, while others found high amounts of HRF at baseline to indicate low VA [26] . So far, HRF have been hypothesised as a clinical marker of inflammatory response, aggregates of microglia-activated cells, protein and/or lipid deposits, and lipid-laden macrophages [15,20,21,25] .…”

Section: Discussionsupporting

confidence: 82%

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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Section: Discussionsupporting

confidence: 82%

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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“…85 HRS have been recently evaluated in different retinal and choroidal conditions, such as early stages of DR, DME, AMD, and macular edema due to retinal vein occlusion. 63,65,[88][89][90][91][92][93][94][95][96][97] HRS with specific characteristics, such as dimension <30 lm, reflectivity similar to nerve fiber layer, absence of back-shadowing, and location in both inner and outer retina, were suggested to represent activated aggregates of microglial cells, thus can be considered an imaging biomarker of retinal inflammatory response (Fig. 2).…”

Section: Noninvasive Imaging Retinal Biomarkers Of Inflammation In Drmentioning

confidence: 99%

Local and Systemic Inflammatory Biomarkers of Diabetic Retinopathy: An Integrative Approach

Vujosevic¹,

Simó

2017

Invest. Ophthalmol. Vis. Sci.

125

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Proinflammatory cytokines/chemokines play an essential role in the pathogenesis of DR. Therefore, circulating biomarkers and retinal imaging aimed at assessing inflammation have emerged as useful tools for monitoring the onset and progression of DR. In addition, "liquid biopsy" of AH seems a good option in patients with advanced stages of DR requiring intravitreous injections. This strategy may permit us to implement a more personalized treatment with better visual function outcome. Further evaluation and validation of circulating and local biomarkers, as well as multimodal imaging is needed to gain new insights into this issue.

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“…This feature of exudative disease also shows statistically significant reduction during anti-VEGF therapy. [51][52][53][54]…”

Section: Eyementioning

confidence: 99%

“…To date, only one study has reported resolution of hyperreflective foci to be associated with better visual outcomes. 70 Several investigators have found their resolution solely to be associated with reduction in central retinal thickness, 51,54 which per se has shown to lack correlation with visual function during the maintenance phase. Analyses of the impact of the mere presence and location of hyperreflective foci on visual function at baseline and during therapy have revealed that a high amount (420) of hyperreflective foci and a location in the inner and subretinal layers are associated with worse VA outcomes.…”

Section: Risk Of Progressionmentioning

confidence: 99%

“…Analyses of the impact of the mere presence and location of hyperreflective foci on visual function at baseline and during therapy have revealed that a high amount (420) of hyperreflective foci and a location in the inner and subretinal layers are associated with worse VA outcomes. [52][53][54] Formation of a disciform scar via degradation and remodeling of extracellular space is the ultimate consequence of an untreated or treatment-resistant neovascular invasion, accompanied by loss of RPE and photoreceptors. 33 Photoreceptor integrity, naturally, is vital for visual improvement during anti-VEGF therapy.…”

Section: Risk Of Progressionmentioning

confidence: 99%

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A view of the current and future role of optical coherence tomography in the management of age-related macular degeneration

Schmidt‐Erfurth

Klimscha

Waldstein

et al. 2016

Eye

128

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Optical coherence tomography (OCT) has become an established diagnostic technology in the clinical management of age-related macular degeneration (AMD). OCT is being used for primary diagnosis, evaluation of therapeutic efficacy, and long-term monitoring. Computer-based advances in image analysis provide complementary imaging tools such as OCT angiography, further novel automated analysis methods as well as feature detection and prediction of prognosis in disease and therapy by machine learning. In early AMD, pathognomonic features such as drusen, pseudodrusen, and abnormalities of the retinal pigment epithelium (RPE) can be imaged in a qualitative and quantitative way to identify early signs of disease activity and define the risk of progression. In advanced AMD, disease activity can be monitored clearly by qualitative and quantified analyses of fluid pooling, such as intraretinal cystoid fluid, subretinal fluid, and pigment epithelial detachment (PED). Moreover, machine learning methods detect a large spectrum of new biomarkers. Evaluation of treatment efficacy and definition of optimal therapeutic regimens are an important aim in managing neovascular AMD. In atrophic AMD hallmarked by geographic atrophy (GA), advanced spectral domain (SD)-OCT imaging largely replaces conventional fundus autofluorescence (FAF) as it adds insight into the condition of the neurosensory layers and associated alterations at the level of the RPE and choroid. Exploration of imaging features by computerized methods has just begun but has already opened relevant and reliable horizons for the optimal use of OCT imaging for individualized and population-based management of AMD-the leading retinal epidemic of modern times.

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Prognostic Value of Hyperreflective Foci in Neovascular Age-Related Macular Degeneration Treated With Bevacizumab

Abstract: Quantity and location of HF are of prognostic value in intravitreal bevacizumab-treated naive neovascular age-related macular degeneration. Increased awareness of specialists interpreting optical coherence tomography scans toward the number and location of HF is prudent.

Cited by 29 publications

References 22 publications

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

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

Local and Systemic Inflammatory Biomarkers of Diabetic Retinopathy: An Integrative Approach

A view of the current and future role of optical coherence tomography in the management of age-related macular degeneration

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