PMID- 35654365
OWN - NLM
STAT- MEDLINE
DCOM- 20221108
LR  - 20231102
IS  - 2468-6530 (Electronic)
IS  - 2468-7219 (Print)
IS  - 2468-6530 (Linking)
VI  - 6
IP  - 11
DP  - 2022 Nov
TI  - Bacillary Detachment in Neovascular Age-Related Macular Degeneration: Incidence, 
      Clinical Features, and Response to Anti-VEGF Therapy.
PG  - 1061-1069
LID - S2468-6530(22)00267-6 [pii]
LID - 10.1016/j.oret.2022.05.022 [doi]
AB  - OBJECTIVE: To evaluate the incidence of bacillary layer detachment among patients 
      with neovascular age-related macular degeneration (nAMD) and their response to 
      anti-VEGF therapy. DESIGN: Post hoc analysis of the OSPREY clinical trial, a 
      prospective, double-masked, phase II study comparing 6-mg brolucizumab with 2-mg 
      aflibercept over 56 weeks. PARTICIPANTS: Participants with treatment-naive nAMD 
      at the initiation of the trial were included in the analysis (n = 81). METHODS: 
      Spectral-domain OCT (SD-OCT) scans were obtained at 4-week intervals throughout 
      the OSPREY study and were segmented automatically using a proprietary, machine 
      learning-enabled higher-order feature-extraction platform. MAIN OUTCOME MEASURES: 
      The presence of bacillary detachment, and in these eyes the effect of anti-VEGF 
      therapy on change from baseline in visual acuity (VA), central subfield thickness 
      (CST), retinal fluid volumes, subretinal hyper-reflective material (SHRM) volume, 
      subretinal pigment epithelium (sub-RPE) fluid volume, and ellipsoid zone (EZ) 
      integrity at week 56. RESULTS: Bacillary detachment was identified in 7.4% (6 of 
      81) eyes, which had higher fluid volumes, increased CST, EZ attenuation, and 
      increased sub-RPE volume at baseline compared with eyes without bacillary 
      detachment. Anti-VEGF treatment resulted in the resolution of bacillary 
      detachment in 100% of the eyes. In eyes with bacillary detachment at baseline, 
      the anti-VEGF treatment decreased CST, fluid burden, and SHRM volumes throughout 
      the treatment course; however, there was no significant change from baseline in 
      VA, sub-RPE volume, or EZ integrity throughout the 56-week course of anti-VEGF 
      treatment. CONCLUSIONS: Bacillary detachment is an OCT signature that is 
      identifiable in a notable proportion of nAMD eyes. Anti-VEGF therapy resulted in 
      100% resolution of bacillary detachment and significant decreases in CST and SHRM 
      volume; however, improvements in VA may have been limited by persistent EZ 
      attenuation.
CI  - Copyright (c) 2022 American Academy of Ophthalmology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Yordi, Sari
AU  - Yordi S
AD  - The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and 
      Advanced Imaging Research, Cleveland Clinic, Cleveland, Ohio; Cole Eye Institute, 
      Cleveland Clinic, Cleveland, Ohio.
FAU - Sarici, Kubra
AU  - Sarici K
AD  - The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and 
      Advanced Imaging Research, Cleveland Clinic, Cleveland, Ohio; Cole Eye Institute, 
      Cleveland Clinic, Cleveland, Ohio.
FAU - Cetin, Hasan
AU  - Cetin H
AD  - The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and 
      Advanced Imaging Research, Cleveland Clinic, Cleveland, Ohio; Cole Eye Institute, 
      Cleveland Clinic, Cleveland, Ohio.
FAU - Lunasco, Leina M
AU  - Lunasco LM
AD  - The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and 
      Advanced Imaging Research, Cleveland Clinic, Cleveland, Ohio; Cole Eye Institute, 
      Cleveland Clinic, Cleveland, Ohio.
FAU - Le, Thuy K
AU  - Le TK
AD  - The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and 
      Advanced Imaging Research, Cleveland Clinic, Cleveland, Ohio; Cole Eye Institute, 
      Cleveland Clinic, Cleveland, Ohio.
FAU - Sevgi, Duriye Damla
AU  - Sevgi DD
AD  - The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and 
      Advanced Imaging Research, Cleveland Clinic, Cleveland, Ohio; Cole Eye Institute, 
      Cleveland Clinic, Cleveland, Ohio.
FAU - Zahid, Robert
AU  - Zahid R
AD  - Novartis Pharmaceuticals Corporation, East Hanover, New Jersey.
FAU - Meng, Xiangyi
AU  - Meng X
AD  - Novartis Pharmaceuticals Corporation, East Hanover, New Jersey.
FAU - Reese, Jamie L
AU  - Reese JL
AD  - The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and 
      Advanced Imaging Research, Cleveland Clinic, Cleveland, Ohio; Cole Eye Institute, 
      Cleveland Clinic, Cleveland, Ohio.
FAU - Srivastava, Sunil K
AU  - Srivastava SK
AD  - The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and 
      Advanced Imaging Research, Cleveland Clinic, Cleveland, Ohio; Cole Eye Institute, 
      Cleveland Clinic, Cleveland, Ohio.
FAU - Ehlers, Justis P
AU  - Ehlers JP
AD  - The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and 
      Advanced Imaging Research, Cleveland Clinic, Cleveland, Ohio; Cole Eye Institute, 
      Cleveland Clinic, Cleveland, Ohio. Electronic address: ehlersj1@yahoo.com.
LA  - eng
GR  - K23 EY022947/EY/NEI NIH HHS/United States
PT  - Clinical Trial, Phase II
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20220530
PL  - United States
TA  - Ophthalmol Retina
JT  - Ophthalmology. Retina
JID - 101695048
RN  - 0 (Angiogenesis Inhibitors)
RN  - 0 (Vascular Endothelial Growth Factors)
SB  - IM
MH  - Humans
MH  - Intravitreal Injections
MH  - Prospective Studies
MH  - Incidence
MH  - *Tomography, Optical Coherence/methods
MH  - Angiogenesis Inhibitors/therapeutic use
MH  - Vascular Endothelial Growth Factors
MH  - *Macular Degeneration/drug therapy
PMC - PMC10576655
MID - NIHMS1811944
OTO - NOTNLM
OT  - Bacillary detachment
OT  - Neovascular age-related macular degeneration
OT  - Subretinal hyperreflective material
COIS- Sari Yordi is a Betty J. Powers Retina Research Fellow. Sunil K. Srivastava is a 
      consultant for Novartis. Justis P. Ehlers is a consultant for Novartis, Roche, 
      Regeneron, Adverum, Stealth, Allegro, Allergan, Alcon, Zeiss, and Oxurion and 
      receives grant support from Novartis, Regeneron, Roche, Stealth, Allegro, Zeiss, 
      and Allergan. Robert Zahid and Xiangyi Meng are employees of Novartis. Kubra 
      Sarici, Hasan Cetin, Thuy Le, Duriye Damla Sevgi, and Jamie L. Reese have no 
      disclosures to report.
EDAT- 2022/06/03 06:00
MHDA- 2022/11/09 06:00
PMCR- 2023/11/01
CRDT- 2022/06/02 19:28
PHST- 2022/02/01 00:00 [received]
PHST- 2022/05/23 00:00 [revised]
PHST- 2022/05/24 00:00 [accepted]
PHST- 2022/06/03 06:00 [pubmed]
PHST- 2022/11/09 06:00 [medline]
PHST- 2022/06/02 19:28 [entrez]
PHST- 2023/11/01 00:00 [pmc-release]
AID - S2468-6530(22)00267-6 [pii]
AID - 10.1016/j.oret.2022.05.022 [doi]
PST - ppublish
SO  - Ophthalmol Retina. 2022 Nov;6(11):1061-1069. doi: 10.1016/j.oret.2022.05.022. 
      Epub 2022 May 30.