Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2022, Vol. 36 ›› Issue (6): 101-105.doi: 10.6040/j.issn.1673-3770.0.2022.345

• 论著 • Previous Articles    

Effects of subretinal hyperreflective material on the visual prognosis of anti-VEGF therapy in patients with neovascular macular degeneration

WANG Luping1, KOU Fangning2, WANG Hao3, ZHANG Canwei4, WANG Yanling1, YOU Ran1, WU Weizhen1   

  1. 1. Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;
    2. Department of Ophthalmology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China;
    3. Department of Clinical Epidemiology and Evidence-Based Medicine, Beijing Clinical Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;
    4. Department of Ophthalmology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong, China
  • Published:2022-12-07

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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

CLC Number: 

  • R774.5
[1] Song PG, Du YH, Chan KY, et al. The national and subnational prevalence and burden of age-related macular degeneration in China[J]. J Glob Health, 2017, 7(2): 020703. doi:10.7189/jogh.07.020703.
[2] 赵露, 谢国丽, 王艳玲. 玻璃体腔注射雷珠单抗对湿性年龄相关性黄斑变性患者眼血流动力学的影响[J]. 山东大学耳鼻喉眼学报, 2016, 30(4): 101-104. doi:10.6040/j.issn.1673-3770.0.2015.481. ZHAO Lu, XIE Guoli, WANG Yanling. Changes of ocular hemodynamics after intravitreal ranibizumab injection in patients with wet age-related macular degeneration[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2016, 30(4): 101-104. doi:10.6040/j.issn.1673-3770.0.2015.481.
[3] Lanzetta P, Cruess AF, Cohen SY, et al. Predictors of visual outcomes in patients with neovascular age-related macular degeneration treated with anti-vascular endothelial growth factor therapy: post hoc analysis of the VIEW studies[J]. Acta Ophthalmol, 2018, 96(8): e911-e918. doi:10.1111/aos.13751.
[4] Willoughby AS, Ying GS, Toth CA, et al. Subretinal hyperreflective material in the comparison of age-related macular degeneration treatments trials[J]. Ophthalmology, 2015, 122(9): 1846-1853.e5. doi:10.1016/j.ophtha.2015.05.042.
[5] Shah VP, Shah SA, Mrejen S, et al. Subretinal hyperreflective exudation associated with neovascular age-related macular degeneration[J]. Retina, 2014, 34(7): 1281-1288. doi:10.1097/IAE.0000000000000166.
[6] Alex D, Giridhar A, Gopalakrishnan M, et al. Subretinal hyperreflective material morphology in neovascular age-related macular degeneration: a case control study[J]. Indian J Ophthalmol, 2021, 69(7): 1862-1866. doi:10.4103/ijo.IJO_3156_20.
[7] 石佳, 孙大卫. 雷珠单抗治疗新生血管性年龄相关性黄斑变性方案的临床推荐[J]. 国际眼科纵览, 2019, 43(2): 111-117. doi:10.3760/cma.j.issn.1673-5803.2019.02.008.
[8] Gale RP, Mahmood S, Devonport H, et al. Action on neovascular age-related macular degeneration(nAMD): recommendations for management and service provision in the UK hospital eye service[J]. Eye(Lond), 2019, 33(1): 1-21. doi:10.1038/s41433-018-0300-3.
[9] Sarkar A, Junnuthula V, Dyawanapelly S. Ocular therapeutics and molecular delivery strategies for neovascular age-related macular degeneration(nAMD)[J]. Int J Mol Sci, 2021, 22(19): 10594. doi:10.3390/ijms221910594.
[10] Patel P, Sheth V. New and innovative treatments for neovascular age-related macular degeneration(nAMD)[J]. J Clin Med, 2021, 10(11): 2436. doi:10.3390/jcm10112436.
[11] 余岚, 陈长征, 易佐慧子, 等. 玻璃体腔注射康柏西普治疗渗出型老年性黄斑变性的疗效观察[J]. 中华眼底病杂志, 2015, 31(3): 256-259. doi:10.3760/cma.j.issn.1005-1015.2015.03.011.
[12] 中华医学会眼科学分会眼底病学组. 中国老年性黄斑变性临床诊断治疗路径[J]. 中华眼底病杂志, 2013, 29(4): 343-355. doi:10.3760/cma.j.issn.1005-1015.2013.04.002.
[13] 张陶然, 王薇, 李明铭, 等. IVR治疗mCNV患者黄斑中心凹下脉络膜厚度分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 68-71. doi:10.6040/j.issn.1673-3770.0.2021.059. ZHANG Taoran, WANG Wei, LI Mingming, et al. Subfoveal choroidal thickness changes following intravitreal ranibizumab treatment in choroidal neovascularization due to pathological myopia[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 68-71.doi:10.6040/j.issn.1673-3770.0.2021.059.
[14] Finger RP, Daien V, Eldem BM, et al. Anti-vascular endothelial growth factor in neovascular age-related macular degeneration-a systematic review of the impact of anti-VEGF on patient outcomes and healthcare systems[J]. BMC Ophthalmol, 2020, 20(1): 294. doi:10.1186/s12886-020-01554-2.
[15] Yerramothu P. New therapies of neovascular AMD-beyond anti-VEGFs[J]. Vision(Basel), 2018, 2(3): E31. doi:10.3390/vision2030031.
[16] Wang L, Zhang C, Hua R. Clinical effectiveness of ranibizumab and conbercept for neovascular age-related macular degeneration: a meta-analysis[J]. Drug Des Devel Ther, 2018,29(12):3625-3633.doi: 10.2147/DDDT.S176021.
[17] Waldstein SM, Simader C, Staurenghi G, et al. Morphology and visual acuity in aflibercept and ranibizumab therapy for neovascular age-related macular degeneration in the VIEW trials[J]. Ophthalmology, 2016, 123(7): 1521-1529. doi:10.1016/j.ophtha.2016.03.037.
[18] Alex D, Giridhar A, Gopalakrishnan M, et al. Subretinal hyperreflective material morphology in neovascular age-related macular degeneration: a case control study[J]. Indian J Ophthalmol, 2021, 69(7): 1862-1866. doi:10.4103/ijo.ijo_3156_20.
[19] Alex D, Giridhar A, Gopalakrishnan M, et al. Subretinal hyperreflective material morphology in neovascular age-related macular degeneration: a case control study[J]. Indian J Ophthalmol, 2021, 69(7):1862-1866. doi: 10.4103/ijo.IJO_3156_20.
[20] Roberts PK, Schranz M, Motschi A, et al. Baseline predictors for subretinal fibrosis in neovascular age-related macular degeneration[J]. Sci Rep, 2022, 12(1): 88. doi:10.1038/s41598-021-03716-8.
[21] Keane PA, Liakopoulos S, Chang KT, et al. Relationship between optical coherence tomography retinal parameters and visual acuity in neovascular age-related macular degeneration[J]. Ophthalmology, 2008, 115(12): 2206-2214. doi:10.1016/j.ophtha.2008.08.016.
[22] Cheung CMG, Grewal DS, Teo KYC, et al. The evolution of fibrosis and atrophy and their relationship with visual outcomes in Asian persons with neovascular age-related macular degeneration[J]. Ophthalmol Retina, 2019, 3(12): 1045-1055. doi:10.1016/j.oret.2019.06.002.
[23] Fayed AE, Baddar D, Estawro RG, et al. Masking of macular neovascular membranes by subretinal hyperreflective material on optical coherence tomography angiography[J]. Eur J Ophthalmol, 2022, 32(6): 3547-3555. doi:10.1177/11206721221085396.
[24] Ehlers JP, Zahid R, Kaiser PK, et al. Longitudinal assessment of ellipsoid zone integrity, subretinal hyperreflective material, and subretinal pigment epithelium disease in neovascular age-related macular degeneration[J]. Ophthalmol Retina, 2021, 5(12): 1204-1213. doi:10.1016/j.oret.2021.02.012.
[25] Ehlers JP, Patel N, Kaiser PK, et al. The association of fluid volatility with subretinal hyperreflective material and ellipsoid zone integrity in neovascular AMD[J]. Invest Ophthalmol Vis Sci, 2022, 63(6): 17. doi:10.1167/iovs.63.6.17.
[26] Fang M, Chanwimol K, Maram J, et al. Morphological characteristics of eyes with neovascular age-related macular degeneration and good long-term visual outcomes after anti-VEGF therapy[J]. Br J Ophthalmol, 2021. doi:10.1136/bjophthalmol-2021-319602.
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