ABSTRACT
Purpose: To analyze the structural features of subretinal hyper-reflective material (SHRM) in posterior uveitis using swept-source optical coherence tomography (SS-OCT) and optical coherence tomography angiography (SS-OCTA). Methods: In this observational study, subjects with quiescent posterior uveitis and the presence of SHRM on SS-OCT were subjected to SS-OCTA to identify the presence of an intrinsic choroidal neovascular (CNV) network. OCT features were compared for SHRM harboring CNV (vascular SHRM) with those without CNV network (avascular SHRM) to identify clinical signs pointing toward the presence of CNVM inside SHRM. Results: Forty-two eyes of 33 subjects (18 males; mean age: 29.52 ± 12.56 years) were evaluated. Two-thirds (28/42) of eyes having SHRM on SS-OCT harbored intrinsic neovascular network (vascular SHRM). Increased reflectivity of SHRM (P < 0.001) and increased transmission of OCT signal underlying SHRM (P = 0.03) were suggestive of the absence of CNVM. The presence of intra/subretinal fluid (P = 0.08) and pitchfork sign (P = 0.017) were important markers of vascular SHRM. Conclusion: SHRM is an important OCT finding in eyes with posterior uveitis. Meticulous assessment of SHRM characteristics on SS-OCT can aid in identifying the underlying intrinsic neovascular network.
ABSTRACT
@#AIM: To explore the prevalence of outer retinal tubulation(ORT)in nAMD patients treated with anti-VEGF and the frequency of anti-VEGF therapy before and after ORT appearance.<p>METHODS:Sixty eyes of 54 patients were included in the study(treated with ranibizumab by pro re nata regimen(PRN)and followed up for 24mo. At baseline, patients underwent fluorescein fundus angiography(FFA), fundus color photography(CFP), best corrected visual acuity(BCVA)and macular optical coherence tomography(OCT), and followed up monthly thereafter. The subretinal hyper reflective material(SHRM)and ORT was recorded at baseline, and the time of new appearance of outer retinal tubulation structure during followup also was noted. The average number of intravitreal injections before and after ORT was compared. The BCVA and central retinal thickness(CRT)were compared between ORT eyes and non-ORT eyes. <p>RESULTS: ORT was found in 15.0%, 21.7%, 25.0% and 46.7% of patients at baseline. After ORT appearance, the average number of injections of anti-VEGF per month decreased(Whitman <i>U</i> test, <i>P</i>=0.006), and the difference was statistically significant. At baseline, 78.3% of the eyes had SHRM, 66.0% of which eventually had ORT, while at baseline, there was only 23.1% of the eyes had ORT in no SHRM eyes, with a relative risk of 2.86(<i>P</i><0.01). The BCVA and CRT were worse in ORT eyes than those in non-ORT eyes. <p>CONCLUSION: ORT increases gradually with the prolongation of the course of the disease, and the frequency of anti-VEGF retreatment decreases after the occurrence of ORT.