Wada Iori, Nakao Shintaro, Shiose Satomi, Kaizu Yoshihiro, Yamaguchi Muneo, Ishikawa Keijiro, Kiyohara Kohei, Ishibashi Tatsuro, Sonoda Koh-Hei
Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Jpn J Ophthalmol. 2025 Jun 12. doi: 10.1007/s10384-025-01219-x.
This study quantifies hyperreflective foci (HRFs) in neovascular age-related macular degeneration (nAMD) before and after anti-VEGF therapy in the initial loading phase using en-face ultra-high-resolution spectral domain OCT (UHR-SD-OCT), investigating their correlation with clinical findings.
Retrospective observational study METHODS: This retrospective study included 30 eyes from 30 patients with treatment-naïve nAMD. The patients received monthly intravitreal injections of anti-VEGF therapy for three months as the initial loading phase. At each visit, comprehensive ophthalmic examinations were conducted. HRFs were quantified using our custom-developed software from an en-face UHR-SD-OCT. The number of HRFs was compared before and after the loading phase and investigated the relationship with best-corrected visual acuity (BCVA), greatest linear dimension (GLD), macular neovascularization (MNV) size and incidence of macular atrophy (MA).
This evaluation system showed a significant reduction in the number of HRFs after anti-VEGF therapy compared to before the loading phase (p < 0.0001). The number of pre-treatment HRFs significantly correlated with pre-treatment BCVA, GLD, and MNV size. The number of post-treatment HRFs significantly correlated with pre-treatment GLD and pre-treatment MNV size. Additionally, patients who developed MA two years after treatment initiation exhibited significantly higher counts of pre-treatment HRFs compared to those without the MA development (465.7 ± 187.0 vs. 212.9 ± 93.8, p < 0.05).
Quantification of HRF using en-face UHR-SD-OCT may be a useful clinical biomarker during anti-VEGF therapy in nAMD.
本研究使用表面增强超高分辨率光谱域光学相干断层扫描（UHR-SD-OCT）对新生血管性年龄相关性黄斑变性（nAMD）患者在初始负荷期抗VEGF治疗前后的高反射灶（HRF）进行量化，并研究其与临床结果的相关性。
回顾性观察研究
本回顾性研究纳入了30例初治nAMD患者的30只眼。患者在初始负荷期接受每月一次的玻璃体内抗VEGF治疗，持续三个月。每次就诊时均进行全面的眼科检查。使用我们自行开发的软件从表面增强UHR-SD-OCT中对HRF进行量化。比较负荷期前后HRF的数量，并研究其与最佳矫正视力（BCVA）、最大线性尺寸（GLD）、黄斑新生血管（MNV）大小和黄斑萎缩（MA）发生率的关系。
该评估系统显示，与负荷期前相比，抗VEGF治疗后HRF数量显著减少（p < 0.0001）。治疗前HRF的数量与治疗前BCVA、GLD和MNV大小显著相关。治疗后HRF的数量与治疗前GLD和治疗前MNV大小显著相关。此外，治疗开始两年后发生MA的患者与未发生MA的患者相比，治疗前HRF计数显著更高（465.7 ± 187.0 vs. 212.9 ± 93.8，p < 0.05）。
使用表面增强UHR-SD-OCT对HRF进行量化可能是nAMD抗VEGF治疗期间一种有用的临床生物标志物。
