Abstract: Objective This study aimed to investigate the effect of subretinal hyperreflective material(SHRM)on the visual prognosis of neovascular macular degeneration(nAMD)patients with anti-vascular endothelial growth factor. Methods A total of 50 patients(50 eyes)diagnosed with nAMD were retrospectively analyzed. To determine whether SHRM affects the visual prognosis of these patients, they were divided into two groups. A total of 27 and 23 patients were grouped into the improved vision and non-improved vision groups, respectively. The effects of SHRM on the visual acuity of patients before and after treatment were evaluated by comparing the baseline and end points with or without SHRM. Results Before the treatment, no significant differences in sex, age, baseline best-corrected visual acuity(BCVA), baseline central macular thickness(CMT), baseline width and height of the SHRM, or injection times were observed between the two groups. After 12 months of treatment, CMT(P=0.027), width(P=0.036), and height(P=0.027)of SHRM were significantly lower in the improved vision group than those in the non-improved vision group. Furthermore, patients with nAMD who had baseline SHRM had a lower baseline BCVA than those without baseline SHRM(P=0.022). Patients without baseline or endpoint SHRM had significantly better endpoint BCVA than those with baseline or endpoint SHRM(P=0.015, P=0.008). Conclusion Patients that endpoint visual acuity better than baseline had lower SHRM width and height. On the other hand, patients with baseline or endpoint SHRM had poorer visual prognoses. SHRM may be used as an optical coherence tomography biomarker to assist ophthalmologists in predicting the visual prognosis of patients with nAMD.

Key words: Neovascular age-related macular degeneration, Wet age-related macular degeneration, Subretinal hyperreflective material, Anti-vascular endothelial growth factor, Subretinal fibrosis