June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Bacillary Detachment in Neovascular AMD: Incidence, SD-OCT Compartmental Features, and Response to Anti-VEGF Therapy in the HAWK Study
Author Affiliations & Notes
  • Sari Yordi
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
    The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Katherine Wise
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
    The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Leina Lunasco
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
    The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Hasan Cetin
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
    The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Katherine Talcott
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
    The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Sunil K Srivastava
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
    The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Joanne Hu
    Novartis AG, East Hanover, New Jersey, United States
  • Robert Zahid
    Novartis AG, East Hanover, New Jersey, United States
  • Justis P Ehlers
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
    The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Sari Yordi Betty J. Powers Retina Research Fellowship, Code S (non-remunerative); Katherine Wise None; Leina Lunasco None; Hasan Cetin None; Katherine Talcott Zeiss, Novartis, RegenxBio, Code F (Financial Support); Sunil Srivastava Bausch and Lomb, Adverum, Novartis, Regeneron, Code C (Consultant/Contractor), Regeneron, Allergan, Gilead, Code F (Financial Support), Leica, Code P (Patent); Joanne Hu Novartis, Code E (Employment); Robert Zahid Novartis, Code E (Employment); Justis Ehlers Aerpio, Alcon, Allegro, Allergan, Genentech/Roche, Novartis, Thrombogenics/Oxurion, Leica, Zeiss, Regeneron, Santen, Stealth, Adverum, IvericBIO, Apellis, Boehringer-Ingelheim, RegenxBIO, Code C (Consultant/Contractor), Aerpio, Alcon, Thrombogenics/Oxurion, Regeneron, Genentech, Novartis, Allergan, Boehringer-Ingelheim, IvericBio, Adverum, Code F (Financial Support), Leica, Code P (Patent)
  • Footnotes
    Support  NIH-NEI P30 Core Grant (IP30EY025585) (Cole Eye), Unrestricted Grants from The Research to Prevent Blindness, Inc (Cole Eye), Cleveland Eye Bank Foundation awarded to the Cole Eye Institute (Cole Eye), K23-EY022947-01A1 (JPE), Grant from Novartis
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 1063 – F0310. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Sari Yordi, Katherine Wise, Leina Lunasco, Hasan Cetin, Katherine Talcott, Sunil K Srivastava, Joanne Hu, Robert Zahid, Justis P Ehlers; Bacillary Detachment in Neovascular AMD: Incidence, SD-OCT Compartmental Features, and Response to Anti-VEGF Therapy in the HAWK Study. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1063 – F0310.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : Bacillary detachment (BD) is a unique optical coherence tomography (OCT) signature that has been traditionally described primarily in inflammatory disorders. A previous analysis identified BD in neovascular age-related macular degeneration (nAMD) in the Phase 2 OSPREY study. The goal of this analysis was to evaluate BD incidence, clinical features, and response to anti-vascular endothelial growth factor (VEGF) therapy in a large Phase 3 nAMD study.

Methods : This was a post hoc analysis of the spectral domain (SD)-OCT images collected during the 48-week anti-VEGF treatment period from the randomized clinical trial HAWK in participants with nAMD. BD was defined on SD-OCT as a hyporeflective space above a hyperreflective linear structure continuous with the ellipsoid zone (EZ) band (Figure 1). Characterization of compartmental parameters, including retinal metrics and retinal fluid volumes, was performed using a machine-learning-augmented feature extraction platform. Fluid contained within the BD was identified as subretinal fluid for this analysis. This hypothesis-generating analysis did not adjust for multiple comparisons and was treatment agnostic.

Results : A total of 72/656 eyes (11%) had BD at baseline on SD-OCT. Compared to eyes without BD at baseline, BD eyes demonstrated significantly higher mean central subfield thickness (CST, 498 µm vs 366 µm; p<0.001), total retinal fluid volume (1.14 mm3 vs 0.53 mm3; p<0.001), subretinal fluid volume (1.01 mm3 vs 0.37 mm3; p<0.001), macular total retinal fluid index (TRFI, 0.09% vs 0.05%; p<0.001), and lower EZ-retinal pigment epithelium (RPE) CST (2.42 mm3 vs 4.64 mm3; p<0.001), respectively. After a single anti-VEGF injection, resolution of BD was noted in 94.4% of eyes at Week 4.

Conclusions : BD was identified in a significant proportion of nAMD eyes and was associated with higher baseline fluid volumes and CST. Anti-VEGF therapy resulted in a rapid and dramatic resolution of BD lesions in nearly 95% of eyes with a single injection.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

Example of Bacillary Detachment With Adjacent Subretinal Fluid on SD-OCT

Example of Bacillary Detachment With Adjacent Subretinal Fluid on SD-OCT

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×