Hyperreflective foci and subretinal drusenoid deposits as predictors of exudation in intermediate AMD eyes with contralateral neovascular AMD
摘要
To examine the prognostic significance of intraretinal hyperreflective foci (HRF) and subretinal drusenoid deposits (SDD) as predictors of atrophy presence and progression to exudative macular neovascularisation (eMNV) in the unaffected second eye of participants with eMNV in the first eye.
MethodsPost hoc prognostic analysis on iAMD eyes from the prospective EDNA cohort. SD-OCT scans of 459 study eyes were graded for presence of HRF, SDD, and their characteristics, including location within retina (inner, outer, or both), proximity to irregular elevation of RPE (adjacent, remote or both), and SDD load (mild or moderate to severe). The cohort was subdivided in four follow up groups, iAMD without focal regions of atrophy (FoA), persistent or new onset FoA, eMNV alone and eMNV with FoA.
ResultsOf the 459 included eyes, 234 (51.0%) had HRF and 273 (60.0%) had SDD at baseline. Persistent or new onset FoA was seen in 83, 66 progressed to eMNV alone and 38 to eMNV with FoA, and 272 had no worsening of iAMD status. Presence of HRF and especially a higher SDD load were associated with a significantly faster progression to exudation. A higher SDD load doubled the hazard of progression to any eMNV compared to eyes with a mild load or without SDD. This hazard was highest in eyes with the presence of both HRF and SDD. HRF were associated with a lower BCVA.