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Raphaelle Ores, Nathalie Puche, Giuseppe Querques, Rocio Blanco-Garavito, Benedicte Merle, Gabriel J Coscas, Hassiba Oubraham, Oudy Semoun, Eric H Souied; Grey hyper-reflective subretinal exudative lesions in wet age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3406.
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To investigate the effects of ranibizumab 0.5 mg on grey hyper-reflective subretinal lesions (GHSL) diagnosed by spectral domain optical coherence tomography (SD-OCT) in patients with exudative age-related macular degeneration (AMD).
Retrospective study. Data from 28 consecutive patients affected with neovascular AMD that presented subretinal hyper-reflective lesions as visualized by SD-OCT were collected. GHSL characteristics were analyzed, before and after intravitreal ranibizumab 0.5 mg injection.
Thirty eyes of 28 patients (5 male, 23 female, aged 57-91 years) were included. At study entry, GHSL was associated with exudative features in 24/30 eyes (80%), including subretinal fluid (SRF) in 20/30 of eyes (67%), and retinal cysts in 11/30 of 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 one-month observation), when exudative signs emerged (SRF in 3/6 eyes and retinal cysts in 5/6 eyes). Ninety-three percent of the GHSL responded to ranibizumab treatment. GHSL thickness was significantly reduced (from 482±116μm to 367±102μm, p<0.0001) after treatment.
Our findings suggest that GHSL might be considered as qualitative criteria for retreatment of exudative AMD. It may represent an early sign of active CNV, and should prompt to early treatment.
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