HYPERREFLECTIVE CHOROIDAL FOCI AND THEIR LONGITUDINAL CHANGES AFTER TREATMENT FOR BRANCHED RETINAL VEIN OCCLUSION-ASSOCIATED MACULAR EDEMA.

PURPOSE: To evaluate the clinical relevance of hyperreflective choroidal foci (HCF) and characterize their longitudinal alterations after treatment in patients with macular edema (ME) secondary to branched retinal vein occlusion (BRVO).

METHODS: In this retrospective cohort study , the authors evaluated the data of 68 patients diagnosed with treatment-naïve BRVO-ME involving the fovea. HCF were quantified separately in the inner and outer choroidal layers within the central 4,500 µ m region of the fovea. In addition, central macular and subfoveal choroidal thickness and integrity of the external limiting membrane were analyzed.

RESULTS: The HCF count decreased notably in the inner and whole choroidal layers after treatment, while outer choroidal HCF remained unchanged. Univariate and multivariate regression analyses revealed that a higher residual HCF count was associated with a greater required annual number of intravitreal injections and a briefer recurrence to ME. Spearman analysis correlated higher baseline HCF counts with disrupted baseline external limiting membrane status. However, no significant correlation was observed between HCF counts and final best-corrected visual acuity.

CONCLUSION: HCF may dynamically indicate ongoing choroidal activity in BRVO. Their incomplete resolution after treatment correlates with earlier ME recurrence and greater treatment demand, indicating their potential role in guiding retreatment decisions and assessing disease activity.