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Spectral-Domain Optical Coherence Tomography of Subretinal Hyperreflective Exudation in Myopic Choroidal Neovascularization.

AbstractPURPOSE:
To study the effect of anti-vascular endothelial growth factor (VEGF) therapy on subretinal hyperreflective exudation detected by spectral-domain optical coherence tomography (SD OCT) in myopic choroidal neovascularization (CNV).
DESIGN:
Retrospective consecutive observational cohort study.
METHODS:
Thirty-one eyes of 31 consecutive highly myopic patients with CNV and showing a subretinal hyperreflective exudation on SD OCT were included. Morphologic changes were assessed before and after anti-VEGF therapy, based on the subretinal hyperreflective exudation thickness, retinal thickness at the level of the CNV, and central macular thickness.
RESULTS:
After anti-VEGF treatment (mean follow-up of 1.9 ± 0.8 months, mean number of injections 1.8 ± 0.6), the subretinal hyperreflective exudation regressed completely in 29 of 31 eyes (93.5%) and partially in 2 of 31 eyes (6.5%). Mean subretinal hyperreflective exudation thickness, mean retinal thickness at the level of the CNV, and mean central macular thickness significantly decreased from 102 ± 50 μm to 2.6 ± 10.2 μm (P < .0001), from 419 ± 99 μm to 312 ± 64 μm (P < .0001), and from 361 ± 69 μm to 326 ± 72 μm (P = .0008), respectively.
CONCLUSION:
The subretinal hyperreflective exudation was an SD OCT finding that correlated with signs of active myopic CNV (either subretinal fluid/intraretinal cysts on SD OCT or dye leakage on fluorescein angiography) and responded to treatment with anti-VEGF agents. The presence of a subretinal hyperreflective exudation on SD OCT could help in making decisions on the need to perform or not perform fluorescein angiography, and regarding treatment or retreatment.
AuthorsElsa Bruyère, Violaine Caillaux, Salomon Yves Cohen, David Martiano, Raphaelle Ores, Nathalie Puche, Eric H Souied
JournalAmerican journal of ophthalmology (Am J Ophthalmol) Vol. 160 Issue 4 Pg. 749-58.e1 (Oct 2015) ISSN: 1879-1891 [Electronic] United States
PMID26164828 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2015 Elsevier Inc. All rights reserved.
Chemical References
  • Angiogenesis Inhibitors
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
Topics
  • Aged
  • Angiogenesis Inhibitors (therapeutic use)
  • Blood-Retinal Barrier
  • Capillary Permeability
  • Choroidal Neovascularization (diagnosis, drug therapy, physiopathology)
  • Female
  • Fluorescein Angiography
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Myopia, Degenerative (diagnosis, drug therapy, physiopathology)
  • Retrospective Studies
  • Subretinal Fluid (physiology)
  • Tomography, Optical Coherence
  • Vascular Endothelial Growth Factor A (antagonists & inhibitors)

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