title: A hyporeflective space between hyperreflective materials in pigment epithelial detachment and Bruch's membrane in neovascular age-related macular degeneration.
abstract: BACKGROUND
  The purpose of this study was to investigate the clinical characteristics of a hyporeflective space between hyperreflective materials in pigment epithelial detachment (PED) and Bruch's membrane in neovascular age-related macular degeneration (AMD) using spectral-domain optical coherence tomography (SD-OCT) or swept source optical coherence tomography (SS-OCT).
  
  
  METHODS
  Among 223 patients with neovascular AMD, 227 eyes were studied retrospectively. Using SD-OCT or SS-OCT, we reviewed clinical characteristics of the space.
  
  
  RESULTS
  Twenty-two (10%) of the 227 eyes showed a space between hyperreflective materials in PED and Bruch's membrane. In all spaces, fibrovascular changes of the choroidal neovascularization (CNV) membrane were seen on funduscopy, with OCT images showing the retinal pigment epithelium (RPE) above the space adhering tightly and continuously to the CNV membranes. Nineteen (86%) of the 22 eyes with this cleft also had serous retinal detachment or cystoid macular edema. Five eyes (23%) had an RPE tear during follow-up.
  
  
  CONCLUSIONS
  A hyporeflective space between hyperreflective materials in PED and Bruch's membrane sometimes appears in neovascular AMD. The appearance of such a space may indicate residual activities of the hyperreflective materials.
authors.affiliation: Department of Ophthalmology, Gunma University, School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma 371-8511, Japan. ryohmukai@gmail.com.
authors.forename: Ryo
authors.initials: R
authors.lastname: Mukai
authors.forename: Taku
authors.initials: T
authors.lastname: Sato
authors.forename: Shoji
authors.initials: S
authors.lastname: Kishi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016570:Bruch Membrane / Q000473:pathology*; D005109:Extracellular Matrix / Q000473:pathology*; D005110:Extracellular Space; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008269:Macular Edema / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000175:diagnosis*; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D057135:Wet Macular Degeneration / Q000175:diagnosis*