Spectral-domain OCT characteristics of intraretinal hyper-reflective foci associated with age-related macular degeneration and diabetic retinopathy

Maryam Ashrafkhorasani; Abbas Habibi; Muneeswar Gupta Nittala; Mehdi Yaseri; Mehdi Emamverdi; Swetha Bindu Velaga; Charles C Wykoff; Thomas A Ciulla; Michael Ip; SriniVas R Sadda

doi:10.1016/j.jcjo.2024.07.017

Spectral-domain OCT characteristics of intraretinal hyper-reflective foci associated with age-related macular degeneration and diabetic retinopathy

Can J Ophthalmol. 2024 Aug 8:S0008-4182(24)00239-4. doi: 10.1016/j.jcjo.2024.07.017. Online ahead of print.

Affiliations

¹ Doheny Eye Institute, Los Angeles, CA, USA; Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
² Doheny Eye Institute, Los Angeles, CA, USA.
³ Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran.
⁴ Retina Consultants of Texas, Houston, TX, USA; Blanton Eye Institute, Houston, TX, USA.
⁵ Doheny Eye Institute, Los Angeles, CA, USA; Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. Electronic address: ssadda@doheny.org.

PMID: 39128832
DOI: 10.1016/j.jcjo.2024.07.017

Abstract

Objective: The purpose of this study was to quantitatively analyze and compare OCT characteristics of intraretinal hyper-reflective foci (IHRF) in eyes with diabetic retinopathy (DR) versus age-related macular degeneration (AMD).

Design: a retrospective observational study.

Participants: 54 treatment-naïve eyes (27 DR and 27 AMD).

Methods: The IHRF lesions in OCT B-scan were semi-automatically segmented. Mean reflectivity (MR), maximum diameter, circularity index (Cir), area, and the angle between the greatest linear dimension (GLD) and the horizontal were computed for each IHRF lesion. The presence and absence of a posterior shadow and the axial location were assessed. The MR was normalized using the vitreous and nerve fiber layer reflectance as dark and bright reference standards, respectively.

Results: A total of 1149 IHRF (1051 in DR and 98 in the AMD group) were identified, with a mean of 39 ± 36 lesions in DR eyes compared to only 4 ± 4 in AMD eyes (p < 0.001). The mean area of individual IHRF lesions was greater in DR eyes (1305 ± 1647 μm² vs 1031 ± 750 μm²; p = 0.016), but IHRF in AMD eyes had higher reflectivity (1.17 ± 0.14 vs 1.03 ± 0.17; p < 0.001). The angle of the GLD relative to the horizontal was greater in AMD eyes, indicating that IHRF in AMD eyes were more horizontally oriented. In AMD eyes, 88.8% of IHRF were located beneath the inner border of the outer nuclear layer (ONL), while in DR eyes, 56.9% were located there (p < 0.001).

Conclusions: IHRF lesions in eyes with DR and AMD demonstrate significant differences, with IHRF in DR eyes tending to be larger and less hyper-reflective compared to AMD eyes.