Terao Ryo, Aoki Shuichiro, Kitamoto Kohdai, Totani Kota, Yamanari Masahiro, Sugiyama Satoshi, Inoue Tatsuya, Obata Ryo, Azuma Keiko
Department of Ophthalmology, University of Tokyo School of Medicine, Bunkyo-Ku, Japan.
Tomey Corporation, Nagoya, Japan.
Ophthalmol Sci. 2025 Apr 10;5(5):100792. doi: 10.1016/j.xops.2025.100792. eCollection 2025 Sep-Oct.
To quantify hyperreflective foci (HRF) using polarization-sensitive OCT (PS-OCT) and evaluate the effect of anti-VEGF therapy on HRF reduction.
Retrospective study.
Twelve eyes from 12 patients with neovascular age-related macular degeneration (nAMD) who underwent PS-OCT imaging before and after 4 intravitreal injections of faricimab, administered every 4 weeks.
Retinal layers between the inner border of the inner nuclear layer and the outer border of the outer segment of photoreceptors were analyzed. Regions with entropy values exceeding the mean + 2 standard deviations from healthy controls (entropy: 0.0896 ± 0.0270) were isolated to quantify hyperentropic foci (HEF), representing HRF.
The sum and area of HEF were calculated as total HEF and area aggregate to compare before and after the treatment.
The mean patient age was 77.4 ± 8.6 years, with an equal distribution of males and females (6 each). Total HEF was significantly associated with worse baseline visual acuity (coefficient: 0.0015297, = 0.0004). Faricimab treatment significantly reduced both total HEF ( = 0.0049) and area aggregate ( = 0.0068). However, conventional OCT did not detect significant improvements in total reflectivity nor area aggregate.
Polarization-sensitive OCT is a valuable imaging modality for extracting and quantifying HRF in the neurosensory retina. Faricimab significantly reduces HEF in nAMD eyes, highlighting its potential therapeutic effect beyond conventional OCT-detected changes.
Proprietary or commercial disclosures may be found in the Footnotes and Disclosures at the end of this article.
使用偏振敏感光学相干断层扫描（PS - OCT）对高反射灶（HRF）进行定量分析，并评估抗血管内皮生长因子（VEGF）治疗对HRF减少的影响。
回顾性研究。
12例患有新生血管性年龄相关性黄斑变性（nAMD）的患者的12只眼睛，这些患者在每4周进行一次玻璃体内注射法西单抗，共注射4次之前和之后接受了PS - OCT成像。
分析内核层内边界与光感受器外段外边界之间的视网膜层。分离出熵值超过健康对照平均值+2个标准差（熵：0.0896±0.0270）的区域，以量化代表HRF的高熵灶（HEF）。
计算HEF的总和及面积，分别作为总HEF和面积总和，用于比较治疗前后的情况。
患者的平均年龄为77.4±8.6岁，男女分布相等（各6例）。总HEF与较差的基线视力显著相关（系数：0.0015297，P = 0.0004）。法西单抗治疗显著降低了总HEF（P = 0.0049）和面积总和（P = 0.0068）。然而，传统光学相干断层扫描未检测到总反射率和面积总和有显著改善。
偏振敏感光学相干断层扫描是一种用于提取和量化神经感觉视网膜中HRF的有价值的成像方式。法西单抗显著降低了nAMD眼中的HEF，突出了其超越传统光学相干断层扫描检测到的变化的潜在治疗效果。
专有或商业披露信息可在本文末尾的脚注和披露中找到。
