To investigate the risk factors predictive for the development of neovascular age-related macular degeneration (NVAMD) by means of spectral-domain optical coherence tomography.
Retrospective study of 73 eyes graded Stage 2 and Stage 3 according to the AMD International Grading System with minimum follow-up of 24 months. Drusenoid pigment epithelial detachment, hyperreflective foci, external limiting membrane, inner ellipsoid band, and retinal pigment epithelium integrity were analyzed at baseline and last follow-up. Binary logistic regression model analyzed significant predictors of neovascular conversion.
The discontinuity of external limiting membrane, inner ellipsoid band, and retinal pigment epithelium bands were significantly more prevalent in the NVAMD group at baseline and last follow-up (P < 0.001). Hyperreflective foci represented the single most important predictor of neovascular conversion (Exp [B], 15.15; P = 0.005) as confirmed by Kaplan–Meier curve (P = 0.002). Drusenoid pigment epithelial detachment width was significantly greater in NVAMD group than control subjects at baseline and last follow-up (P < 0.001), and its delta value also resulted a significant neovascular predictor (Exp [B], 0.99; P = 0.04).
Hyperreflective foci significantly increase the risk of NVAMD progression. The delta width of drusenoid pigment epithelial detachment also predicts disease progression, integrating the stratification of NVAMD progression risk.
The presence of hyperreflective foci diagnosed through spectral-domain optical coherence tomography represented a significant predictor of neovascular conversion in patients with age-related macular degeneration.
*Department of Medical–Surgical Sciences and Biotechnologies, UOC Ophthalmology, Sapienza University of Rome, Terracina, Italy; and
†Department of Ophthalmology, IRCCS Azienda Ospedaliera Universitaria San Martino—IST, Genoa, Italy.
Reprint requests: Serena Fragiotta, MD, Department of Medical–Surgical Sciences and Biotechnologies, UOC Ophthalmology, Sapienza University of Rome, Via Provenzale, 9, Latina (LT) 04100, Italy; e-mail: email@example.com
None of the authors has any financial/conflicting interests to disclose.