Purpose: To investigate the correlation between hyperreflective foci (HF) on spectral domain optical coherence tomography at baseline and visual outcomes after intravitreal anti-vascular endothelial growth factor injection in neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV).
Methods: The authors retrospectively reviewed the medical records of 44 patients with nAMD and 44 patients with PCV. The number of HF was counted according to the location of HF on spectral domain optical coherence tomography: neurosensory retinal layer, outer retinal layer, and subretinal layer. Statistical correlation between final visual acuity and pretreatment and posttreatment optical coherence tomographic parameters including the number of HF, the status of external limiting membrane and inner segment ellipsoid zone was evaluated.
Results: The number of HF in all retinal layers was reduced in nAMD and PCV after treatment. In multivariate regression analysis, final visual acuity was associated with baseline visual acuity (P = 0.028), number of subretinal HF (P = 0.046), and ellipsoid zone disruption length (P = 0.009) in nAMD. In PCV, final visual acuity was associated with baseline visual acuity (P = 0.001), number of subretinal HF (P = 0.001), and pigment epithelial detachment thickness (P = 0.034). The baseline number of subretinal HF was correlated with final foveal thickness and thickness of subretinal fluid and choroidal neovascularization in nAMD (P = 0.002, P < 0.001, P = 0.009, respectively). In PCV, the baseline number of subretinal HF was correlated with final foveal thickness and ellipsoid zone and external limiting membrane disruption lengths (P = 0.027, P = 0.010, P = 0.020, respectively).
Conclusion: The number of HF at subretinal layer on spectral domain optical coherence tomography at baseline might predict the final visual acuity after treatment in nAMD and PCV.