PMID- 37422192
OWN - NLM
STAT- MEDLINE
DCOM- 20231114
LR  - 20231114
IS  - 2468-6530 (Electronic)
IS  - 2468-6530 (Linking)
VI  - 7
IP  - 11
DP  - 2023 Nov
TI  - Hyperreflective Material Boundary Remodeling in Neovascular Age-Related Macular 
      Degeneration: A Post Hoc Analysis of the AVENUE Trial.
PG  - 990-998
LID - S2468-6530(23)00295-6 [pii]
LID - 10.1016/j.oret.2023.06.024 [doi]
AB  - OBJECTIVE: To describe the spatial and temporal characteristics of 
      hyperreflective material (HRM) on spectral-domain OCT (SD-OCT) in neovascular 
      age-related macular degeneration (nAMD) during antiangiogenic treatment and 
      explore associations with best-corrected visual acuity (BCVA) and macular atrophy 
      (MA). DESIGN: Retrospective regrading of SD-OCT-images from the multicenter, 
      randomized controlled AVENUE trial (NCT02484690, conducted from August 2015 to 
      September 2017). PARTICIPANTS: Treatment-naive nAMD patients enrolled from 50 
      sites in the US. METHODS: Retrospective regrading and secondary analysis. MAIN 
      OUTCOME MEASURES: Spectral-domain OCT images from 207 study eyes that fit 
      criteria for the present analysis were graded for HRM features, its evolution, 
      and associated hypertransmission into choroid (HTC), a proxy for MA. The 
      appearance of a well-defined hyperreflective inner boundary that separated 
      persistent HRM from the neurosensory retina continuous with the adjacent retinal 
      pigment epithelium layer was defined as hyperreflective material boundary 
      remodeling (HRM-BR). Patterns of HRM composition/evolution were defined as 
      follows: (1) no subretinal HRM at baseline, (2) fully resolved, (3) persistent 
      with complete HRM-BR, or (4) partial/absent HRM-BR. Associations of HRM patterns 
      with BCVA and HTC were analyzed. Predictive factors for complete HRM-BR were 
      explored. RESULTS: Of 207 included eyes, subretinal HRM was present in 159 
      (76.8%) at baseline and persisted until month 9 in 118 (57.0%) eyes. Of these 118 
      eyes, 44.9% developed complete HRM-BR and had similar BCVA outcomes by month 9 
      compared with no/fully resolved subretinal HRM. Partial/absent HRM-BR had a 
      strong negative association with BCVA outcome (-6.1 ETDRS letters; P = 0.016) and 
      a higher frequency of intralesional HTC (69.2%) compared with eyes with complete 
      HRM-BR (20.8%) at month 9. Older age (odds ratio [OR], 0.96; P = 0.054) and 
      presence of intralesional HTC (OR, 0.06; P = 0.010) at baseline were associated 
      with lower odds of complete HRM-BR at month 9. CONCLUSIONS: In nAMD eyes under 
      antiangiogenic treatment, complete HRM-BR occurred frequently and was associated 
      with better BCVA than when HRM-BR was only partial/absent. FINANCIAL 
      DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes 
      and Disclosures at the end of this article.
CI  - Copyright (c) 2023 American Academy of Ophthalmology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Yu, Siqing
AU  - Yu S
AD  - F. Hoffmann-La Roche Ltd, Basel, Switzerland.
FAU - Bachmeier, Isabel
AU  - Bachmeier I
AD  - F. Hoffmann-La Roche Ltd, Basel, Switzerland.
FAU - Hernandez-Sanchez, Jules
AU  - Hernandez-Sanchez J
AD  - Roche Products Ltd, Welwyn Garden City, United Kingdom.
FAU - Garcia Armendariz, Beatriz
AU  - Garcia Armendariz B
AD  - F. Hoffmann-La Roche Ltd, Basel, Switzerland.
FAU - Ebneter, Andreas
AU  - Ebneter A
AD  - Cantonal Hospital, St. Gallen, Switzerland; University of Bern, Bern, 
      Switzerland.
FAU - Pauleikhoff, Daniel
AU  - Pauleikhoff D
AD  - St. Franziskus Hospital, Munster, Germany.
FAU - Chakravarthy, Usha
AU  - Chakravarthy U
AD  - Queens University of Belfast, Belfast, Northern Ireland.
FAU - Fauser, Sascha
AU  - Fauser S
AD  - F. Hoffmann-La Roche Ltd, Basel, Switzerland. Electronic address: 
      sascha.fauser@roche.com.
LA  - eng
SI  - ClinicalTrials.gov/NCT02484690
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20230706
PL  - United States
TA  - Ophthalmol Retina
JT  - Ophthalmology. Retina
JID - 101695048
RN  - 0 (Angiogenesis Inhibitors)
RN  - ZL1R02VT79 (Ranibizumab)
RN  - 0 (Vascular Endothelial Growth Factor A)
SB  - IM
MH  - Humans
MH  - Angiogenesis Inhibitors/therapeutic use
MH  - *Choroidal Neovascularization/diagnosis/drug therapy
MH  - *Macular Degeneration/diagnosis/drug therapy
MH  - Ranibizumab/therapeutic use
MH  - Retrospective Studies
MH  - Vascular Endothelial Growth Factor A
MH  - Visual Acuity
OTO - NOTNLM
OT  - Antiangiogenic treatment
OT  - Fibrosis
OT  - Hyperreflective material
OT  - Neovascular age-related macular degeneration
OT  - Spectral-domain OCT
EDAT- 2023/07/09 01:07
MHDA- 2023/11/06 06:42
CRDT- 2023/07/08 19:28
PHST- 2023/03/13 00:00 [received]
PHST- 2023/06/21 00:00 [revised]
PHST- 2023/06/30 00:00 [accepted]
PHST- 2023/11/06 06:42 [medline]
PHST- 2023/07/09 01:07 [pubmed]
PHST- 2023/07/08 19:28 [entrez]
AID - S2468-6530(23)00295-6 [pii]
AID - 10.1016/j.oret.2023.06.024 [doi]
PST - ppublish
SO  - Ophthalmol Retina. 2023 Nov;7(11):990-998. doi: 10.1016/j.oret.2023.06.024. Epub 
      2023 Jul 6.