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Author Spotlight: Ex Vivo OCT-Based Multimodal Imaging of Human Donor Eyes for Research into Age-Related Macular Degeneration
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Hyperreflective Foci Contiguous With the Retinal Pigment Epithelium Associated With Visual Function in Aging, Early,
Lukas Goerdt1, Vanessa Basten2, Jan H Terheyden3
1From the Department of Ophthalmology, University of Bonn (L.G., J.H.T., F.G.H., M.S.), Bonn, Germany; GRADE Reading Center Bonn, University Bonn (L.G., S.S.V., F.G.H., M.S.), Bonn, Germany.
American Journal of Ophthalmology
|March 25, 2026
Summary
Hyperreflective foci contiguous with the retinal pigment epithelium (rpeHRF) are linked to vision impairment in age-related macular degeneration (AMD). These findings suggest rpeHRF may predict disease progression and aid in selecting participants for clinical trials.
Area of Science:
- Ophthalmology
- Retinal Imaging
- Macular Degeneration Research
Background:
- Age-related macular degeneration (AMD) is a leading cause of vision loss.
- Early detection and understanding of AMD progression are crucial for effective management.
- Hyperreflective foci contiguous with the retinal pigment epithelium (rpeHRF) are a potential indicator of retinal health.
Purpose of the Study:
- To investigate the association between rpeHRF and visual function impairment.
- To compare rpeHRF presence and visual function across normal aging, early AMD, and intermediate AMD.
- To assess the potential of rpeHRF as a biomarker for AMD progression.
Main Methods:
- Prospective cohort study of participants from the MACUSTAR study.
- Utilized color fundus photography and optical coherence tomography (OCT) for imaging.
- Assessed visual functions including best-corrected visual acuity (BCVA), low luminance VA (LLVA), contrast sensitivity (CS), and pointwise sensitivity deviation (PSD).
- Quantified rpeHRF using custom FiJi software and analyzed associations with functional parameters via statistical methods.
Main Results:
- rpeHRF counts were significantly higher in intermediate AMD compared to early AMD and normal aging eyes (p < 0.001).
- Visual functions like BCVA, LLVA, and CS were significantly worse in intermediate AMD eyes with rpeHRF (all p < 0.001).
- rpeHRF burden showed a modest association with CS, scPSD, LLVA, and BCVA in intermediate AMD.
Conclusions:
- The presence and burden of rpeHRF are independently associated with impaired visual function in AMD.
- rpeHRF may serve as a prognostic biomarker for AMD progression.
- rpeHRF could be a valuable criterion for enriching participant selection in future interventional trials for AMD.
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