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Subretinal Hyperreflective Material, Atrophy, and Intraretinal Fluid in Pachychoroid Neovasculopathy.
Jiwon Baek1, Ho Ra1, Seung Hoon Lee1
1From the Department of Ophthalmology (J.B., H.R., and S.H.L.), Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Gyeonggi-do, Republic of Korea; Department of Ophthalmology (J.B., H.R., and S.H.L.), College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Subretinal hyperreflective material (SHRM) in pachychoroid neovasculopathy (PNV) is linked to atrophy and intraretinal fluid (IRF). While SHRM often regresses with treatment, it can lead to persistent atrophy.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Choroidal Neovascularization
Background:
- Pachychoroid neovasculopathy (PNV) is a significant cause of vision impairment.
- Understanding the predictors of disease progression in PNV is crucial for effective management.
Purpose of the Study:
- To investigate the association between subretinal hyperreflective material (SHRM) and the development of atrophy and intraretinal fluid (IRF) in patients with PNV.
- To evaluate the impact of SHRM on visual acuity and macular thickness in PNV.
Main Methods:
- Retrospective observational study of 120 eyes with PNV treated with anti-VEGF therapy for over one year.
- Assessment of central macular thickness (CMT), best-corrected visual acuity (BCVA), and presence of SHRM, atrophy, fibrosis, subretinal fluid (SRF), and IRF at baseline, 3 months, and 1 year.
- Quantitative measurement of SHRM and atrophy areas, comparing eyes with and without SHRM at baseline.
Main Results:
- At baseline, 47.5% of eyes had SHRM, which regressed in 85% after one year.
- Atrophy developed in 40% of eyes by one year, predominantly in eyes with baseline SHRM (83.3%).
- Intraretinal fluid (IRF) was more prevalent in SHRM-positive eyes and showed limited resolution compared to subretinal fluid (SRF).
Conclusions:
- Subretinal hyperreflective material (SHRM) at baseline is a significant risk factor for atrophy, fibrosis, and IRF development in PNV.
- Despite regression of SHRM with anti-VEGF treatment, residual atrophy is a common sequela.
- SHRM presence is associated with poorer visual outcomes and increased macular thickness in PNV.
