Imaging Hyperreflective Foci as an Inflammatory Biomarker after Anti-VEGF Treatment in Neovascular Age-Related Macular Degeneration Patients with Optical Coherence Tomography Angiography.

Jing Wu,Jingfa Zhang,Chaoyang Zhang,Jingting Zhang,Hai Xie,Fang Liu,Qian Yang,Dawei Luo,Kun Liu,Qinghua Qiu,Qian Wang

doi:10.1155/2021/6648191

Abstract

Purpose To investigate the hyperreflective foci (HRF) as an inflammatory biomarker using optical coherence tomography angiography (OCTA) in neovascular age-related macular degeneration (AMD) patients after antivascular endothelial growth factor (anti-VEGF) treatment and its association with the retinal microcapillary density. Methods Twenty-five eyes from 25 patients with neovascular AMD were included in the study. All eyes were imaged with OCTA at baseline (M0) and after 3 consecutive injections (M3; injection performed each month) of anti-VEGF. The number of HRF in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and outer retina was counted. The vascular density of the fovea, parafovea, and the whole macula, as well as the area of the foveal avascular zone (FAZ), was measured. Results The mean interval between baseline and follow-up with OCTA was 93.08 ± 5.00 (range, 85-101) days. Compared with the baseline, the number of HRF significantly decreased in DCP (7.52 ± 3.06 vs. 3.76 ± 1.48, P < 0.01) and outer retina (12.04 ± 4.91 vs. 5.88 ± 3.32, P < 0.01) after treatment. There was no significant difference for HRF number in the SCP, the vascular density (containing foveal, parafoveal, and whole macular), and FAZ area before and after treatments. Conclusion The number of HRF in DCP and outer retina might serve as an inflammatory biomarker in patients with neovascular AMD. The reduced HRF possibly represents the alleviation of inflammation after anti-VEGF treatment in patients with AMD.

Highlights

Age-related macular degeneration (AMD) is the main cause of irreversible severe vision loss in elderly individuals, with a prevalence that exponentially increases with aging
Analysis of the optical coherence tomography angiography (OCTA) parameters revealed that the hyperreflective foci (HRF) was distributed across all retinal layers, including superficial capillary plexus (SCP), deep capillary plexus (DCP), and outer retina, in neovascular AMD patients
There was no significant difference for HRF number in the SCP before and after treatment (P = 0:12)

Summary

Introduction

Age-related macular degeneration (AMD) is the main cause of irreversible severe vision loss in elderly individuals, with a prevalence that exponentially increases with aging. It has been estimated that about 288 million people worldwide will suffer from AMD by 2040 [1]. AMD is subdivided into two types, dry and wet form. The wet form is called neovascular AMD, which largely benefits from anti-VEGF reagent intravitreal injection. The exact pathophysiological mechanism of AMD remains unclear, the prolonged inflammatory response has a crucial role in the onset and development of AMD [2]. During AMD progression, retinal inflammation can lead to the disturbance of the retinal

Methods

Results

Conclusion