title: PROGNOSTIC VALUE OF HYPERREFLECTIVE FOCI IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION TREATED WITH BEVACIZUMAB.
abstract: OBJECTIVE
  To study the prognostic value of optical coherence tomography hyperreflective foci (HF) in neovascular age-related macular degeneration.
  
  
  METHODS
  Charts of naive neovascular age-related macular degeneration eyes treated with intravitreal bevacizumab between January 2011 and January 2014 were reviewed, and optical coherence tomography was collected at baseline, 3 months, and 12 months. The presence, location (inner vs. outer retinal layers), and number (few = [0-10], moderate [11-20], many [>20]) of HF were graded.
  
  
  RESULTS
  Overall, charts of 111 eyes were reviewed and 76 eyes of 73 patients fulfilled inclusion criteria. Baseline best-corrected visual acuity was lower in eyes with HF > 20 (P = 0.001), inner layer HF (P = 0.009), increased central retinal thickness (P < 0.001), and intraretinal fluid (P < 0.001). Baseline HF > 20 (P = 0.002), inner layer HF (P = 0.01), increased central retinal thickness (P < 0.001), and intraretinal fluid (P = 0.001) had worst best-corrected visual acuity at 12 months. Eyes with intraretinal fluid, HF > 20, and HF adjacent to intraretinal fluid demonstrated a greater reduction in central retinal thickness; only baseline HF > 20 remained significant in multivariate analysis (P < 0.001). Eyes with a reduction in HF (P = 0.02) and resolution of inner layer HF (P = 0.01) had a greater central retinal thickness reduction.
  
  
  CONCLUSIONS
  Quantity and location of HF are of prognostic value in intravitreal bevacizumab-treated naive neovascular age-related macular degeneration. Increased awareness of specialists interpreting optical coherence tomography scans toward the number and location of HF is prudent.
authors.affiliation: *Department of Ophthalmology, Meir Medical Center, Kfar Sava, Israel; †Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; and ‡Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel.
authors.forename: Ori
authors.initials: O
authors.lastname: Segal
authors.forename: Edward
authors.initials: E
authors.lastname: Barayev
authors.forename: Arie Y
authors.initials: AY
authors.lastname: Nemet
authors.forename: Noa
authors.initials: N
authors.lastname: Geffen
authors.forename: Igor
authors.initials: I
authors.lastname: Vainer
authors.forename: Michael
authors.initials: M
authors.lastname: Mimouni
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D011379:Prognosis; D012160:Retina / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab