Ulla Lorena, Foti Claudio, Arrigo Alessandro, Battaglia Parodi Maurizio, Cicinelli Maria Vittoria, Marolo Paola, Miserocchi Elisabetta, Peronetti Mario, Bandello Francesco, Borrelli Enrico, Reibaldi Michele
Department of Surgical Sciences, University of Turin, Turin, Italy.
Department of Ophthalmology, "City of Health and Science" Hospital, Turin, Italy.
Invest Ophthalmol Vis Sci. 2025 Jun 2;66(6):42. doi: 10.1167/iovs.66.6.42.
To evaluate the presence, distribution, and potential implications of choroidal hyperreflective foci (HRFs) across different types of macular atrophy and their relationship with the size of atrophic regions.
This retrospective case series analyzed 95 eyes from 87 patients with macular atrophy caused by various conditions, including geographic atrophy due to age-related macular degeneration, pachychoroid disease, punctate inner choroidopathy, angioid streaks, and Stargardt disease. Structural optical coherence tomography (OCT) images were evaluated to identify HRFs in different choroidal layers. HRF counts were correlated with the size of macular atrophy and underlying conditions using multiple regression analysis.
HRFs were observed in all cases, with their number significantly associated with the size of macular atrophy (P < 0.001). The highest HRF counts were found in Stargardt disease, while the lowest were in pachychoroid disease. However, no association was identified between HRF quantity and specific disease type (P = 0.2). HRFs were primarily located in the choriocapillaris, Sattler's layer, and near Bruch's membrane but were absent within choroidal vessels.
HRFs represent a common OCT finding in various disorders associated with macular atrophy. Their quantity correlates with atrophy size rather than disease type, suggesting they are likely normal choroidal components rendered visible by RPE loss. Future studies are warranted to elucidate their origin and potential implications for disease progression.
评估不同类型黄斑萎缩中脉络膜高反射灶（HRF）的存在、分布及其潜在影响，以及它们与萎缩区域大小的关系。
本回顾性病例系列分析了87例因各种情况导致黄斑萎缩的患者的95只眼，这些情况包括年龄相关性黄斑变性引起的地图样萎缩、厚脉络膜疾病、点状内层脉络膜病变、血管样条纹和Stargardt病。对结构光学相干断层扫描（OCT）图像进行评估，以识别不同脉络膜层中的HRF。使用多元回归分析将HRF计数与黄斑萎缩的大小和潜在情况相关联。
所有病例均观察到HRF，其数量与黄斑萎缩的大小显著相关（P < 0.001）。在Stargardt病中发现的HRF计数最高，而在厚脉络膜疾病中最低。然而，未发现HRF数量与特定疾病类型之间存在关联（P = 0.2）。HRF主要位于脉络膜毛细血管层、萨特勒层和靠近布鲁赫膜的位置，但在脉络膜血管内不存在。
HRF是与黄斑萎缩相关的各种疾病中常见的OCT表现。它们的数量与萎缩大小相关，而非疾病类型，这表明它们可能是因视网膜色素上皮（RPE）缺失而显现的正常脉络膜成分。有必要进行进一步研究以阐明其起源及其对疾病进展的潜在影响。
