title: Gray hyper-reflective subretinal exudative lesions in exudative age-related macular degeneration.
abstract: OBJECTIVE
  To investigate the effects of ranibizumab 0.5 mg on gray hyper-reflective subretinal lesions diagnosed by spectral-domain optical coherence tomography (SD OCT) in patients with exudative age-related macular degeneration (AMD).
  
  
  METHODS
  Retrospective interventional study.
  
  
  METHODS
  Data from 28 consecutive patients affected with neovascular AMD that presented subretinal hyper-reflective lesions as visualized by SD OCT were collected. Gray hyper-reflective subretinal lesion characteristics were analyzed before and after intravitreal ranibizumab 0.5 mg injection.
  
  
  RESULTS
  Thirty eyes of 28 patients (5 male, 23 female, aged 57-91 years) were included. At study entry, gray lesion was associated with exudative features in 24 of 30 eyes (80%), including subretinal fluid (SRF) in 20 of 30 eyes (67%) and retinal cystoid spaces in 11 of 30 eyes (37%). Twenty-four eyes with exudative features at study entry received prompt treatment; 6 eyes without exudative features at study entry received deferred treatment (after 1 month observation), when exudative signs emerged (SRF in 3/6 eyes and retinal cystoid spaces in 5/6 eyes). Ninety-three percent of the gray lesions responded to ranibizumab treatment at 2 months and 77% at 6 months. Gray hyper-reflective subretinal lesion thickness was significantly reduced after treatment at both 2 months (from 482±116 μm to 367±102 μm, P<.0001) and 6 months (from 482±116 μm to 369±71 μm, P<.0001).
  
  
  CONCLUSIONS
  Our findings suggest that gray hyper-reflective subretinal lesions might be considered as a qualitative criterion for retreatment of exudative AMD. They may represent an early sign of active choroidal neovascularization, and should prompt to early treatment.
authors.affiliation: Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil, Université Paris Est, Creteil, France.
authors.forename: Raphaelle
authors.initials: R
authors.lastname: Ores
authors.affiliation: Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil, Université Paris Est, Creteil, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Puche
authors.affiliation: Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil, Université Paris Est, Creteil, France.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Querques
authors.affiliation: Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil, Université Paris Est, Creteil, France.
authors.forename: Rocio
authors.initials: R
authors.lastname: Blanco-Garavito
authors.affiliation: Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil, Université Paris Est, Creteil, France.
authors.forename: Benedicte
authors.initials: B
authors.lastname: Merle
authors.affiliation: Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil, Université Paris Est, Creteil, France.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Coscas
authors.affiliation: Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil, Université Paris Est, Creteil, France.
authors.forename: Hassiba
authors.initials: H
authors.lastname: Oubraham
authors.affiliation: Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil, Université Paris Est, Creteil, France.
authors.forename: Oudy
authors.initials: O
authors.lastname: Semoun
authors.affiliation: Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil, Université Paris Est, Creteil, France. Electronic address: eric.souied@chicreteil.fr.
authors.forename: Eric H
authors.initials: EH
authors.lastname: Souied
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D012160:Retina / Q000187:drug effects / Q000473:pathology*; D012189:Retrospective Studies; D058471:Subretinal Fluid / Q000187:drug effects*; D041623:Tomography, Optical Coherence / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity; D057135:Wet Macular Degeneration / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab