Subretinal Hyperreflective Material, Atrophy, and Intraretinal Fluid in Pachychoroid Neovasculopathy.

PURPOSE: To assess the association between subretinal hyperreflective material (SHRM), atrophy, and intraretinal fluid (IRF) in pachychoroid neovasculopathy (PNV).

DESIGN

Retrospective observational study.

SUBJECTS: A total of 120 eyes diagnosed with PNV and treated with antivascular endothelial growth factor for more than 1 year.

METHODS

Central macular thickness (CMT), best-corrected visual acuity (BCVA), and the presence of SHRM, atrophy, fibrosis, subretinal fluid (SRF), and IRF were assessed at baseline, 3 months, and 1 year. SHRM and atrophy areas were also quantitatively measured. Comparisons were made between eyes with SHRM (SHRM [+]) and without SHRM (SHRM [-]) at baseline.

MAIN OUTCOME MEASURES: Incidence and area of SHRM, development of atrophy and fibrosis, presence and resolution of IRF and SRF, changes in CMT and BCVA.

RESULTS

At baseline, 57 eyes (47.5%) exhibited SHRM, which regressed in 85% after 1 year. Atrophy developed in 40% of eyes at 1 year, with 83.3% occurring in SHRM (+) eyes. Fibrosis was observed in 21.7% of eyes, with 92.3% in SHRM (+). IRF was more prevalent in SHRM (+) (all P ≤ .010) and showed limited resolution compared with SRF (McNemar P = .099 vs P < .001). SHRM (+) eyes had thinner CMT and worse BCVA.

CONCLUSIONS

SHRM at baseline was associated with the development of atrophy, fibrosis, and IRF in PNV. Although most SHRM regressed after treatment, it frequently resulted in residual atrophy.