PMID- 31047325
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220409
IS  - 2468-6530 (Electronic)
IS  - 2468-6530 (Linking)
VI  - 2
IP  - 5
DP  - 2018 May
TI  - Tomographic Biomarkers Predicting Progression to Fibrosis in Treated Neovascular 
      Age-Related Macular Degeneration: A Multimodal Imaging Study.
PG  - 451-461
LID - S2468-6530(17)30176-8 [pii]
LID - 10.1016/j.oret.2017.08.019 [doi]
AB  - PURPOSE: To describe the photoreceptor-retinal pigment epithelium (RPE) interface 
      changes and to analyze the relationships between these features and 
      hyperreflective material (HRM) with scarring and atrophy at the macula of 
      patients with neovascular age-related macular degeneration (nAMD). DESIGN: 
      Retrospective single-center observational study. PARTICIPANTS: A total of 150 
      eyes from 144 patients with naive nAMD were included. METHODS: All patients had 
      OCT (HRA-OCT Spectralis, Heidelberg Engineering, Heidelberg, Germany) at baseline 
      and at 1, 3, 6, and 12 months. Macular scar and macular atrophy (MA) were 
      determined on multimodal imaging, including color fundus (CF) and near-infrared 
      imaging at baseline and month 12 (M12). MAIN OUTCOME MEASURES: Change in HRM type 
      (undefined and well-defined) and location, development of fibrotic or nonfibrotic 
      macular scar, MA, and best-corrected visual acuity (BCVA) at M12. RESULTS: At 
      baseline, eyes with fibrin on CF had thicker and wider HRM on OCT that correlated 
      strongly with presence of undefined HRM. The proportion of eyes with undefined 
      HRM fell dramatically by month 1 but well-defined HRM increased. At M12 defined 
      HRM was strongly associated with macular scar (chi-square, 82.1; P < 0.001). 
      Ordinal regression showed that both the thickness and the width of HRM were 
      significant risk factors for development of fibrotic scar (P < 0.001 and P = 
      0.02) but not nonfibrotic scars (P = 0.67 and P = 0.65). Fibrotic macular scar 
      (P = 0.001) but not nonfibrotic scar (P = 0.129) negatively affected visual 
      acuity at M12. Ordinal regression showed that the risk factors for progression to 
      MA were reticular pseudodrusen and thinner HRM (P = 0.017 and P = 0.028, 
      respectively). MA negatively affected BCVA at M12 (P < 0.001). CONCLUSION: Our 
      study supports the role of HRM as an important biomarker for the evolution of 
      macular scar and atrophy in patients with nAMD undergoing treatment with 
      anti-VEGF therapies. Undefined HRM can resolve with treatment, whereas 
      well-defined HRM likely contains vascular complexes and fibrotic elements.
CI  - Copyright (c) 2017 American Academy of Ophthalmology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Casalino, Giuseppe
AU  - Casalino G
AD  - Ophthalmology Macular Service, Belfast Health and Social Care Trust and Centre 
      for Population Health, Queen's University Belfast, Belfast, United Kingdom; 
      Department of Ophthalmology, San Raffaele Scientific Institute, Vita-Salute 
      University, Milan, Italy.
FAU - Stevenson, Michael R
AU  - Stevenson MR
AD  - Ophthalmology Macular Service, Belfast Health and Social Care Trust and Centre 
      for Population Health, Queen's University Belfast, Belfast, United Kingdom.
FAU - Bandello, Francesco
AU  - Bandello F
AD  - Department of Ophthalmology, San Raffaele Scientific Institute, Vita-Salute 
      University, Milan, Italy.
FAU - Chakravarthy, Usha
AU  - Chakravarthy U
AD  - Ophthalmology Macular Service, Belfast Health and Social Care Trust and Centre 
      for Population Health, Queen's University Belfast, Belfast, United Kingdom. 
      Electronic address: U.Chakravarthy@qub.ac.uk.
LA  - eng
GR  - 07/36/01/DH_/Department of Health/United Kingdom
GR  - 12/142/07/DH_/Department of Health/United Kingdom
PT  - Journal Article
DEP - 20171026
PL  - United States
TA  - Ophthalmol Retina
JT  - Ophthalmology. Retina
JID - 101695048
SB  - IM
EDAT- 2019/05/03 06:00
MHDA- 2019/05/03 06:01
CRDT- 2019/05/04 06:00
PHST- 2017/01/30 00:00 [received]
PHST- 2017/08/08 00:00 [revised]
PHST- 2017/08/18 00:00 [accepted]
PHST- 2019/05/04 06:00 [entrez]
PHST- 2019/05/03 06:00 [pubmed]
PHST- 2019/05/03 06:01 [medline]
AID - S2468-6530(17)30176-8 [pii]
AID - 10.1016/j.oret.2017.08.019 [doi]
PST - ppublish
SO  - Ophthalmol Retina. 2018 May;2(5):451-461. doi: 10.1016/j.oret.2017.08.019. Epub 
      2017 Oct 26.