title: Intraretinal Hyperreflective Foci in Acquired Vitelliform Lesions of the Macula: Clinical and Histologic Study.
abstract: OBJECTIVE
  To describe the natural course, visual outcomes, and anatomic changes and provide histologic correlates in eyes with intraretinal hyperreflective foci associated with acquired vitelliform lesions.
  
  
  METHODS
  Retrospective cohort study and imaging-histology correlation in a single donor eye.
  
  
  METHODS
  participants: Patients with intraretinal hyperreflective foci and acquired vitelliform lesions from 2 tertiary referral centers were evaluated from January 2002 to January 2014.
  
  
  METHODS
  The chronology of clinical and imaging features of retinal anatomic changes and the pattern of intraretinal hyperreflective foci migration were documented using spectral-domain optical coherence tomography (OCT). One donor eye with intraretinal hyperreflective foci was identified in a pathology archive by ex vivo OCT and was studied with high-resolution light and electron microscopic examination.
  
  
  RESULTS
  Intraretinal hyperreflective foci were associated with acquired vitelliform lesions in 25 of 254 eyes (9.8%) with a strong female preponderance (86% of patients). Focal disruptions to the ellipsoid zone and external limiting membrane overlying the acquired vitelliform lesions were observed prior to the occurrence of intraretinal hyperreflective foci in 75% of cases. Histologic evaluation showed that intraretinal hyperreflective foci represent cells of retinal pigment epithelium origin that are similar to those found in the vitelliform lesions themselves and contain lipofuscin granules, melanolipofuscin granules, and melanosomes. The occurrence of intraretinal hyperreflective foci was not a significant determinant of final visual acuity (P = .34), but development of outer retinal atrophy was (P = .003).
  
  
  CONCLUSIONS
  Intraretinal hyperreflective foci associated with acquired vitelliform lesions are of retinal pigment epithelium origin, and the natural course and functional changes are described.
authors: Department of Ophthalmology, New York University School of Medicine, New York, New York.
authors: Kevin C
authors: KC
authors: Chen
authors: Department of Ophthalmology, New York University School of Medicine, New York, New York; Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York; Vitreous Retina Macula Consultants of New York, New York, New York; LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York.
authors: Jesse J
authors: JJ
authors: Jung
authors: Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, Alabama.
authors: Christine A
authors: CA
authors: Curcio
authors: Vitreous Retina Macula Consultants of New York, New York, New York; LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York; Department of Physiology and Pharmacology, Lions Eye Institute, University of Western Australia, Perth, Australia.
authors: Chandrakumar
authors: C
authors: Balaratnasingam
authors: Department of Ophthalmology, University and Polytechnic Hospital La Fe, Valencia, Spain.
authors: Roberto
authors: R
authors: Gallego-Pinazo
authors: Department of Ophthalmology, University and Polytechnic Hospital La Fe, Valencia, Spain.
authors: Rosa
authors: R
authors: Dolz-Marco
authors: Department of Ophthalmology, New York University School of Medicine, New York, New York; Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York; Vitreous Retina Macula Consultants of New York, New York, New York; LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York.
authors: K Bailey
authors: KB
authors: Freund
authors: Department of Ophthalmology, New York University School of Medicine, New York, New York; Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York; Vitreous Retina Macula Consultants of New York, New York, New York; LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York. Electronic address: layanuzzi@gmail.com.
authors: Lawrence A
authors: LA
authors: Yannuzzi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D061848:Optical Imaging; D012160:Retina / Q000473:pathology*; D012189:Retrospective Studies; D014019:Tissue Donors; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D057826:Vitelliform Macular Dystrophy / Q000175:diagnosis* / Q000503:physiopathology