Viggiano Pasquale, Boscia Giacomo, Giannaccare Giuseppe, Santoro Michele, Petrara Giovanni, Borriello Ciro, Borrelli Enrico, Reibaldi Michele, Grassi Maria Oliva, Alessio Giovanni, Boscia Francesco
Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro," Bari, Italy.
Eye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy.
Invest Ophthalmol Vis Sci. 2024 Dec 2;65(14):45. doi: 10.1167/iovs.65.14.45.
The purpose of this study was o examine the optical coherence tomographic (OCT) characteristics of hyper-reflective foci (HRF) in patients with neovascular age-related macular degeneration (nAMD) and to assess the potential of HRF as a predictive factor for the development of macular atrophy following anti-vascular endothelial growth factor (anti-VEGF) therapy.
This was a retrospective analysis of 61 treatment-naïve eyes diagnosed with exudative AMD and type 1 macular neovascularization (MNV). The HRF was identified in the inner retina and outer retina layers, and the treatment response of HRF was documented. An analysis was conducted to explore the association between HRF and the development of macular atrophy.
The number of HRF in the inner retina and outer retina layers showed significant reduction after 12 months of anti-VEGF treatment (P = 0.002 and P < 0.0001, respectively). Similarly, compared with baseline, the number of HRFs in the inner retina and outer retina layers was significantly reduced after 24 months of anti-VEGF treatment (P = 0.002 and P < 0.0001, respectively). Moreover, the multivariate linear regression analysis revealed that the most substantial associations observed with the development of macular atrophy after 12 months were specifically tied to the number of HRFs in the outer retina (P = 0.039) at the baseline visit. This finding was confirmed after 24 months of anti-VEGF treatment (P = 0.007).
After only 1 year of antiangiogenic therapy, there was a significant decrease in HRFs observed across all retinal layers. This reduction persisted even after 2 years of anti-VEGF treatment. Notably, the quantity of HRFs in the outer retina at baseline exhibited a correlation with the development of macular atrophy that endured at both the 1-year and 2-year follow-ups after anti-VEGF treatment.
本研究旨在检查新生血管性年龄相关性黄斑变性（nAMD）患者中高反射灶（HRF）的光学相干断层扫描（OCT）特征，并评估HRF作为抗血管内皮生长因子（抗VEGF）治疗后黄斑萎缩发生的预测因素的潜力。
这是一项对61只初治眼的回顾性分析，这些眼被诊断为渗出性AMD和1型黄斑新生血管（MNV）。在视网膜内层和外层识别出HRF，并记录HRF的治疗反应。进行分析以探讨HRF与黄斑萎缩发生之间的关联。
抗VEGF治疗12个月后，视网膜内层和外层的HRF数量显著减少（分别为P = 0.002和P < 0.0001）。同样，与基线相比，抗VEGF治疗24个月后，视网膜内层和外层的HRF数量显著减少（分别为P = 0.002和P < 0.0001）。此外，多变量线性回归分析显示，在基线访视时，12个月后观察到的与黄斑萎缩发生最显著的关联特别与外层视网膜中的HRF数量相关（P = 0.039）。抗VEGF治疗24个月后这一发现得到证实（P = 0.007）。
仅经过1年的抗血管生成治疗，所有视网膜层的HRF均显著减少。即使在抗VEGF治疗2年后这种减少仍持续存在。值得注意的是，基线时外层视网膜中HRF的数量与抗VEGF治疗后1年和2年随访时黄斑萎缩的发生均存在相关性。
