Subretinal Hyperreflective Material (SHRM) as biomarker of activity in Exudative and Non- exudative inflammatory choroidal neovascularization. (2nd January 2023)

• Record Type: Journal Article
• Authors: Arora, Atul; Agarwal, Aniruddha; Bansal, Reema; Katoch, Deeksha; Marchese, Alessandro; Aggarwal, Kanika; Agrawal, Rupesh; Gupta, Vishali
• Is Part Of: Ocular immunology and inflammation. Volume 31:Number 1(2023)
• Page Start: 48
• Page End: 55
• Publication Date: 2023-01-02
• Subjects: Optical coherence tomography angiography -- choroidal neovascularization -- CNV -- subclinical CNV -- subretinal hyper-reflective material -- posterior uveitis -- anti-VEGF; Eye -- Diseases -- Immunological aspects -- Periodicals; Eye -- Inflammation -- Periodicals; 617.7
• DOI: 10.1080/09273948.2021.1980813
• Languages: English
• ISSNs: 0927-3948

Abstract

ABSTRACT: Aim: To analyze the structural features and therapeutic response in clinical and subclinical inflammatory choroidal neovascularization (i-CNV) detected inside subretinal hyperreflective material (SHRM) using swept-source optical coherence tomography (SS-OCT) and SS-OCT angiography (SS-OCTA). Methods: In this prospective interventional study, subjects with quiescent posterior uveitis presenting with SHRM on SS-OCT and CNV network on SS-OCTA were included. Subjects with intraretinal fluid/subretinal fluid (IRF/SRF) received intravitreal antivascular endothelial growth factor (anti-VEGF) injections, while those with no IRF/SRF either received treatment or observation for 6 months until they developed IRF/SRF or decrease in best-corrected visual acuity (BCVA)/metamorphopsia. Serial comparisons included SHRM width and height and intrinsic flow signal on OCTA. Results: 28 eyes of 22 subjects (12 males; mean age: 29.52 ± 12.56 years) were evaluated. Subjects with IRF/SRF at baseline (n = 6 eyes; termed as exudative iCNVs) receiving treatment showed significant improvement in BCVA ( p = .017), SHRM width/height and flow signal ( p < .05). Among eyes with no IRF/SRF (n = 22; termed as non-exudative iCNVs), 7 received treatment and showed significant improvement in SHRM parameters and BCVA ( p < .05). 4/15(26.67%) eyes that received no treatment developed IRF/SRF upon 6-month follow-up. Conclusion: SHRM may act as a useful biomarker to monitor activity and response to therapy in eyes with iCNV.