Quantification of Hyperreflective Foci in Age-related Macular Degeneration by Polarization-Sensitive OCT

IF 4.6 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-04-10 DOI:10.1016/j.xops.2025.100792

Ryo Terao MD, PhD , Shuichiro Aoki MD, PhD , Kohdai Kitamoto MD, PhD , Kota Totani AE , Masahiro Yamanari PhD , Satoshi Sugiyama MSc , Tatsuya Inoue MD, PhD , Ryo Obata MD, PhD , Keiko Azuma MD, PhD

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Abstract

Purpose

To quantify hyperreflective foci (HRF) using polarization-sensitive OCT (PS-OCT) and evaluate the effect of anti-VEGF therapy on HRF reduction.

Design

Retrospective study.

Subjects

Twelve eyes from 12 patients with neovascular age-related macular degeneration (nAMD) who underwent PS-OCT imaging before and after 4 intravitreal injections of faricimab, administered every 4 weeks.

Methods

Retinal layers between the inner border of the inner nuclear layer and the outer border of the outer segment of photoreceptors were analyzed. Regions with entropy values exceeding the mean + 2 standard deviations from healthy controls (entropy: 0.0896 ± 0.0270) were isolated to quantify hyperentropic foci (HEF), representing HRF.

Main Outcome Measures

The sum and area of HEF were calculated as total HEF and area aggregate to compare before and after the treatment.

Results

The mean patient age was 77.4 ± 8.6 years, with an equal distribution of males and females (6 each). Total HEF was significantly associated with worse baseline visual acuity (coefficient: 0.0015297, P = 0.0004). Faricimab treatment significantly reduced both total HEF (P = 0.0049) and area aggregate (P = 0.0068). However, conventional OCT did not detect significant improvements in total reflectivity nor area aggregate.

Conclusions

Polarization-sensitive OCT is a valuable imaging modality for extracting and quantifying HRF in the neurosensory retina. Faricimab significantly reduces HEF in nAMD eyes, highlighting its potential therapeutic effect beyond conventional OCT-detected changes.

Financial Disclosure(s)

Proprietary or commercial disclosures may be found in the Footnotes and Disclosures at the end of this article.

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偏振敏感OCT对老年性黄斑变性高反射灶的定量研究

目的应用偏振敏感OCT （PS-OCT）定量研究高反射灶（hyperreflective focal， HRF），评价抗vegf治疗对HRF降低的影响。DesignRetrospective研究。研究对象12例新生血管性年龄相关性黄斑变性（nAMD）患者，每4周进行4次法利西单抗玻璃体内注射前后，对12只眼进行PS-OCT成像。方法分析内核层内缘与感光器外段外缘之间的视网膜层。分离熵值超过健康对照平均值+ 2个标准差（熵：0.0896±0.0270）的区域，量化高熵病灶（hyperentropic foci， HEF），代表HRF。主要观察指标以HEF总量和面积总和计算治疗前后HEF的总和和面积，进行比较。结果患者平均年龄为77.4±8.6岁，男女平均分布（各6岁）。总HEF与基线视力差显著相关（系数：0.0015297,P = 0.0004）。Faricimab治疗显著降低HEF总量（P = 0.0049）和面积聚集（P = 0.0068）。然而，常规OCT并没有检测到总反射率和面积聚集的显著改善。结论偏振敏感OCT是提取和定量神经感觉视网膜HRF的一种有价值的成像方式。Faricimab可显著降低nAMD眼睛的HEF，突出其潜在的治疗效果，超出常规oct检测的变化。财务披露专有或商业披露可在本文末尾的脚注和披露中找到。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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