Ophthalmology science · 2025
Quantification of Hyperreflective Foci in Age-related Macular Degeneration by Polarization-Sensitive OCT.
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Terao Ryo, Aoki Shuichiro, Kitamoto Kohdai, Totani Kota, Yamanari Masahiro, Sugiyama Satoshi, Inoue Tatsuya, Obata Ryo, Azuma Keiko
Аннотация
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 DISCLOSURES: Proprietary or commercial disclosures may be found in the Footnotes and Disclosures at the end of this article.
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 DISCLOSURES: Proprietary or commercial disclosures may be found in the Footnotes and Disclosures at the end of this article.