分岐型網膜静脈閉塞症に伴う黄斑浮腫治療後の高輝度脈絡膜病変とその経時的変化

To evaluate the clinical relevance of hyperreflective choroidal foci (HCF) and characterize their longitudinal alterations following treatment in patients with macular edema (ME) secondary to branched retinal vein occlusion (BRVO).

In this retrospective cohort study, we evaluated the data of 68 patients diagnosed with treatment-naïve BRVO-ME involving the fovea. HCF were quantified separately in the inner and outer choroidal layers within the central 4500 μm region of the fovea. Additionally, central macular and subfoveal choroidal thickness and integrity of the external limiting membrane (ELM) were analyzed.

The HCF count decreased notably in the inner and whole choroidal layers after treatment, while outer choroidal HCF remained unchanged. Univariate and multivariate regression analyses revealed that a higher residual HCF count was associated with a greater required annual number of intravitreal injections and a briefer recurrence to ME. Spearman's analysis correlated higher baseline HCF counts with disrupted baseline ELM status. However, no significant correlation was observed between HCF counts and final best-corrected visual acuity.

HCF may dynamically indicate ongoing choroidal activity in BRVO. Their incomplete resolution following treatment correlates with earlier ME recurrence and greater treatment demand, indicating their potential role in guiding retreatment decisions and assessing disease activity.