title: Hyperreflective dots: a new spectral-domain optical coherence tomography entity for follow-up and prognosis in exudative age-related macular degeneration.
abstract: OBJECTIVE
  Spectral-domain optical coherence tomography (SD-OCT) enables high-resolution analysis of retinal layers and previously unseen hyperreflective dots (HRD). HRD morphological characteristics, evolution, possible origin and prognostic value are discussed.
  
  
  METHODS
  We conducted a prospective study of 100 patients with exudative age-related macular degeneration (AMD), who were treated and followed up with monthly imaging examinations. Statistical correlations between visual acuity (VA) and pre-/post- treatment HRD characteristics were evaluated.
  
  
  RESULTS
  HRD were present in all cases, mainly in the outer retinal layers but also elsewhere. After treatment, HRD regressed in a few days, 1 month (p < 0.04) and 3 months (p < 0.01). Regression was evident in all VA and morphological subsets. Resolution was associated with better final VA (p < 0.001).
  
  
  CONCLUSIONS
  Presence of initial/recurrent HRD, rapid treatment response and the growing role that early biological inflammatory reaction plays in AMD suggests HRD are activated microglia cells. The correlation between VA and HRD could make HRD a clinical marker for early decisions about treatment and retreatment.
authors.affiliation: Centre d'Ophtalmologie, University Paris-Est Créteil, Paris XII, France. gabriel.coscas@gmail.com
authors.forename: Gabriel
authors.initials: G
authors.lastname: Coscas
authors.forename: Umberto
authors.initials: U
authors.lastname: De Benedetto
authors.forename: Florence
authors.initials: F
authors.lastname: Coscas
authors.forename: Concetta I
authors.initials: CI
authors.lastname: Li Calzi
authors.forename: Sabrina
authors.initials: S
authors.lastname: Vismara
authors.forename: Françoise
authors.initials: F
authors.lastname: Roudot-Thoraval
authors.forename: Francesco
authors.initials: F
authors.lastname: Bandello
authors.forename: Eric
authors.initials: E
authors.lastname: Souied
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity; D057135:Wet Macular Degeneration / Q000175:diagnosis*