Hyperreflective Foci Number Correlates with Choroidal Neovascularization Activity in Angioid Streaks

Parodi, Maurizio Battaglia; Arrigo, Alessandro; Romanò, Francesco; Aragona, Emanuela; Marchese, Alessandro; Cicinelli, Maria Vittoria; Mercuri, Stefano; Bandello, Francesco

doi:10.1167/iovs.18-24291

Cited by 21 publications

(14 citation statements)

References 27 publications

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“…This might be the reason why we were able to distinguish four clinically and anatomically different patients’ subgroups as well as to identify different signs of progression at the one-year follow-up. Similar observations can be applied when looking at the behavior of HF in our subgroups; indeed, Pattern 3 and 4 showed higher numbers of HF and these correlated with worse anatomical and visual outcomes, as already reported [8,9].…”

Section: Discussionsupporting

confidence: 85%

Choroidal Patterns in Stargardt Disease: Correlations with Visual Acuity and Disease Progression

Arrigo

Grazioli

Romanò

et al. 2019

JCM

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Background: To identify different choroidal patterns in Stargardt disease (STGD) and to assess their clinical correlates. Methods: 100 STGD eyes (29 males; mean age 42.6 ± 16.5 years) and 100 control eyes (29 males; mean age 43.2 ± 8.5 years) were included. Optical coherence tomography (OCT) and OCT angiography (OCTA) images were obtained. Four different choroidal patterns, quantitative OCT and OCTA parameters were assessed and statistically analyzed. The main outcome was the correlation between each choroidal pattern and anatomical and functional retinal status. Furthermore, we assessed structural and best corrected visual acuity (BCVA) changes of each STGD subgroup after one-year. Results: Mean BCVA was 0.63 ± 0.44 LogMAR for STGD patients and 0.0 ± 0.0 LogMAR for controls (p < 0.01). All quantitative parameters appeared deteriorated in STGD compared to controls (p < 0.01). Choroidal patterns were distributed as follows: Pattern 1 (normal appearing choroid) (15%), Pattern 2 (reduced Sattler or Haller layer) (29%), Pattern 3 (reduced Sattler and Haller layers) (26%), Pattern 4 (Pattern 3 + choroidal caverns) (30%). More advanced patterns significantly correlated with a more severe loss of retinal structural integrity. Furthermore, only Pattern 3 and Pattern 4 showed remarkable signs of progression after one year. Conclusions: Choroidal patterns were related with retinal structural status and BCVA loss, and with different disease progression.

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Section: Discussionsupporting

confidence: 85%

Choroidal Patterns in Stargardt Disease: Correlations with Visual Acuity and Disease Progression

Arrigo

Grazioli

Romanò

et al. 2019

JCM

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“…The higher number of retinal and choroidal HF in STGD patients has already been described12 and represents an imaging biomarker of the disease's activity, as reported in other conditions 13…”

Section: Discussionmentioning

confidence: 60%

OCTA-Based Identification of Different Vascular Patterns in Stargardt Disease

Arrigo

Romanò

Aragona

et al. 2019

Trans. Vis. Sci. Tech.

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PurposeThe aim of the present study was to analyze quantitative optical coherence tomography (OCT) and OCT angiography (OCTA) parameters to identify clinically relevant cutoff values able to detect clinically different Stargardt's disease (STGD) subgroups.MethodsConsecutive STGD patients were recruited and underwent complete ophthalmologic examination, including multimodal imaging. Several quantitative parameters were extracted both from structural OCT and OCTA images and were statistically analyzed. A post hoc analysis was performed to identify a quantitative cutoff able to distinguish two clinically different STGD subgroups. Main outcome measures were total retinal thickness, central macular thickness (CMT), retinal layers thickness, retinal and choroidal hyperreflective foci (HF) number, vessel density (VD), vessel tortuosity (VT), vessel dispersion (Vdisp), and vessel rarefaction (VR) of macular and optic nerve head plexa.ResultsOverall, 54 eyes of 54 STGD patients (18 males) and 54 eyes of 54 healthy age- and sex-matched controls were included in the analysis. All quantitative parameters resulted significantly worse in STGD than controls (P < 0.01). Moreover, a VT cutoff of 5 allowed to distinguish the following two categories: a functionally and anatomically better STGD group and a worse group. BCVA resulted 0.42 ± 0.28 logMAR in the best group versus 1.09 ± 0.36 logMAR in the worst (P < 0.01). Structural OCT and OCTA parameters significantly differed between the two STGD groups.ConclusionsQuantitative OCTA was able to detect different morphofunctional STGD phenotypes.Translational RelevanceOCTA-based classification of STGD patients detected different patients' subgroups, differing in terms of morphologic and functional features, with a potential impact on clinical and research settings.

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“…[ 2 ] They have been described in wet ARMD,[ 1 ] diabetic macular edema (DME),[ 2 ] retinal vein occlusions,[ 3 ] central serous retinopathy,[ 4 ] MacTel type 2,[ 5 ] retinitis pigmentosa,[ 6 ] Stargardts disease,[ 7 ] Best disease,[ 8 ] and choroidal neovascularization due to other etiologies. [ 9 ]…”

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confidence: 99%

Hyperreflective foci as biomarkers for inflammation in diabetic macular edema: Retrospective analysis of treatment naïve eyes from south India

Mohankumar

Sindal

Rashmita

2021

Indian Journal of Ophthalmology

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Purpose: The aim of this study was to analyze the factors associated with hyperreflective foci (HRF) in diabetic macular edema (DME) in treatment naïve eyes. Methods: This retrospective observational study included 131 eyes of 91 treatment naïve patients with DME. Details of ophthalmological examination with duration of vision loss and systemic parameters were noted. The spectral-domain optical coherence tomography (SD-OCT) images were analyzed for number and location of HRF and the associated imaging biomarkers. Results: Inner retinal (IR) HRF were seen in 88 eyes (67%), outer retinal (OR) in 28 (21%), and subretinal (SR) in 12 (9%). The IR had (7.1 ± 7) HRF, the OR (6.5 ± 4.8), and SR (3.9 ± 2.9). A greater proportion of eyes with HRF also had subretinal fluid (SRF), significantly higher blood pressure and lower serum triglycerides. Univariate linear regression analysis showed women (3 HRF greater vs. men, P = 0.04), eyes with cystoid spaces (2.95 more HRF vs. no cystoid spaces, P = 0.02), and SRF (2.96 more HRF vs. no SRF, P = 0.007) had more HRF, whereas higher triglycerides (1 HRF lesser per 50 mg lower TGL, P = 0.03) had lesser. Conclusion: Our study highlights the importance of HRF as an imaging biomarker in DME suggesting an inflammatory origin. Long-term observations of large cohorts with automated analysis can give more insights.

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Hyperreflective Foci Number Correlates with Choroidal Neovascularization Activity in Angioid Streaks

Abstract: Our findings suggest that HF represent useful markers to monitor CNV activity. Choroidal HF appear already increased in the fovea 1 month before CNV reactivation. Validation of our results might lead to earlier anti-VEGF reinjection and possibly better visual outcomes.

Cited by 21 publications

References 27 publications

Choroidal Patterns in Stargardt Disease: Correlations with Visual Acuity and Disease Progression

Choroidal Patterns in Stargardt Disease: Correlations with Visual Acuity and Disease Progression

OCTA-Based Identification of Different Vascular Patterns in Stargardt Disease

Hyperreflective foci as biomarkers for inflammation in diabetic macular edema: Retrospective analysis of treatment naïve eyes from south India

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