Spectral-Domain Optical Coherence Tomography Analysis of Fibrotic Lesions in Neovascular Age-Related Macular Degeneration

Souied, Eric H.; Addou-Regnard, Manar; Ohayon, Avi; Semoun, Oudy; Blanco-Garavito, Rocío; Bunod, Roxane; Jung, Camille; Sikorav, Anne; Mière, Alexandra

doi:10.1016/j.ajo.2020.02.016

Cited by 20 publications

(13 citation statements)

References 64 publications

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“…Since fibrotic lesions was shown in neovascular AMD [32], and fibrosis was associated with an upregulation of B1R [33], we evaluated the occurrence of fibrosis in both forms of AMD using the expression of α-SMA and collagen 1α as markers [34,35]. Neither the control (Figure 7C,D) nor the dry AMD (Figure 7G,H) retinae showed any specific staining to evidence fibrosis formation.…”

Section: Fibrosis Formationmentioning

confidence: 99%

Differential Expression of Kinin Receptors in Human Wet and Dry Age-Related Macular Degeneration Retinae

et al. 2020

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Kinins are vasoactive peptides and mediators of inflammation, which signal through two G protein-coupled receptors, B1 and B2 receptors (B1R, B2R). Recent pre-clinical findings suggest a primary role for B1R in a rat model of wet age-related macular degeneration (AMD). The aim of the present study was to investigate whether kinin receptors are differentially expressed in human wet and dry AMD retinae. The cellular distribution of B1R and B2R was examined by immunofluorescence and in situ hybridization in post-mortem human AMD retinae. The association of B1R with inflammatory proteins (inducible nitric oxide synthase (iNOS) and vascular endothelial growth factor A (VEGFA)), fibrosis markers and glial cells was also studied. While B2R mRNA and protein expression was not affected by AMD, a significant increase of B1R mRNA and immunoreactivity was measured in wet AMD retinae when compared to control and dry AMD retinae. B1R was expressed by Müller cells, astrocytes, microglia and endothelial/vascular smooth muscle cells, and colocalized with iNOS and fibrosis markers, but not with VEGFA. In conclusion, the induction and upregulation of the pro-inflammatory and pro-fibrotic kinin B1R in human wet AMD retinae support previous pre-clinical studies and provide a clinical proof-of-concept that B1R represents an attractive therapeutic target worth exploring in this retinal disease.

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Section: Fibrosis Formationmentioning

confidence: 99%

Differential Expression of Kinin Receptors in Human Wet and Dry Age-Related Macular Degeneration Retinae

et al. 2020

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“…These relationships suggest that sub-macular hemorrhage particularly favors the development of a fibrotic component in the repair tissue, while a progressive remodeling process ensues over time 32,33 . The higher reflectivity of the RPE-SHT complex at the last follow-up visit may in fact reflect the natural progression of the fibrotic changes as well as the gradual pigmentation of the newly-growing RPE layer 25,34 . On the other hand, a lower reflectivity of the repair tissue was significantly associated with the recovery of autofluorescence signal over time, seeming to suggest the presence of a hypopigmented RPE layer filling the previous tear defect 12,16 .…”

Section: Discussionmentioning

confidence: 99%

Optical coherence tomography features of the repair tissue following RPE tear and their correlation with visual outcomes

Romanò

Parrulli

Parodi

et al. 2021

Sci Rep

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To assess the optical coherence tomography (OCT) features of the repair tissue after retinal pigment epithelial (RPE) tear in neovascular age-related macular degeneration. Retrospective, observational study. Medical and imaging records of patients that developed tears after starting anti-VEGF treatment and with at least 12 months of follow-up were reviewed. OCT reflectivity of the RPE-subretinal hyperreflective tissue (SHT) complex was measured at 6, 12 and 18 months (when available). Reflectivity of the adjacent unaffected RPE-Bruch’s membrane was taken as internal reference. Other variables: grade and rip occurrence (early/late); number of intravitreal injections; type of macular neovascularization; sub-macular hemorrhage (SMH) at onset. Forty-nine eyes (age: 76.1 ± 7.0 years; VA: 0.54 ± 0.27 LogMAR) were included. Thirty-eight eyes had OCT signs of healing during the follow-up, with 21 showing SMH at baseline. Final VA positively correlated with the number of injections and negatively correlated with the RPE-SHT reflectivity and the presence of SMH (p < 0.001). Reflectivity of the RPE-SHT complex was positively associated with time and SMH at baseline (p < 0.05). In our study, most eyes showed signs of tissue repair after RPE tear. The reflectivity of repair tissue, the SMH presence and the number of anti-VEGF injections appeared to be major predictors of visual outcomes.

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“…Other data were also collected based on the images performed on the baseline visit. In particular, we evaluated the following: neovascularization subtype, presence of either drusen or subretinal drusenoid deposits, presence of complete RPE and outer retinal atrophy (cRORA) [ 14 ], fibrosis [ 15 ], and prechoroidal cleft.…”

Section: Methodsmentioning

confidence: 99%

Prechoroidal cleft thickness correlates with disease activity in neovascular age-related macular degeneration

Cozzi

Monteduro

Parrulli

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Purpose The purpose of this study was to investigate the structural variations of the hyporeflective pocket of fluid (prechoroidal cleft) located between Bruch’s membrane and the hyperreflective material within the pigment epithelial detachment (PED) in patients with neovascular age-related macular degeneration (nAMD). Methods In this retrospective, observational case series study, patients diagnosed with nAMD and prechoroidal cleft associated with other activity signs of the macular neovascularization (MNV) were included. Structural optical coherence tomography (OCT) scans were evaluated to obtain anatomical measurements of prechoroidal cleft and PED at three different visits (T0, inactive MNV; T1, active MNV; T2, treated inactive MNV). The variations in size of the cleft and the PED were correlated with nAMD activity. Results Twenty-nine eyes from 27 patients were included. The subfoveal measurements showed a significant increase of prechoroidal cleft height and width from T0 to T1 (P < 0.05) and a subsequent decrease of the cleft height after treatment with anti-VEGF agents (P = 0.004). A similar significant trend was observed for the greatest prechoroidal cleft height and width, obtained assessing the whole OCT raster. In the multivariate analysis, the cleft height was significantly affected by both time (P = 0.001) and PED height (P < 0.0001). By contrast, the effect of fibrovascular tissue size within the PED was not significant. Visual acuity did not correlate with prechoroidal cleft size. Conclusion Prechoroidal cleft increased in association with MNV reactivation and decreased after treatment. Our results suggest that prechoroidal cleft could represent an accumulation of fluid actively exudating from the MNV and should be considered a sign of nAMD activity.

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Spectral-Domain Optical Coherence Tomography Analysis of Fibrotic Lesions in Neovascular Age-Related Macular Degeneration

Cited by 20 publications

References 64 publications

Differential Expression of Kinin Receptors in Human Wet and Dry Age-Related Macular Degeneration Retinae

Differential Expression of Kinin Receptors in Human Wet and Dry Age-Related Macular Degeneration Retinae

Optical coherence tomography features of the repair tissue following RPE tear and their correlation with visual outcomes

Prechoroidal cleft thickness correlates with disease activity in neovascular age-related macular degeneration

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