Subretinal Hyperreflective Material, Atrophy, and Intraretinal Fluid in Pachychoroid Neovasculopathy.

Abstract

To assess the association between subretinal hyperreflective material (SHRM), atrophy, and intraretinal fluid (IRF) in pachychoroid neovasculopathy (PNV). Retrospective observational study. A total of 120 eyes diagnosed with PNV and treated with antivascular endothelial growth factor for more than 1 year. Central macular thickness (CMT), best-corrected visual acuity (BCVA), and the presence of SHRM, atrophy, fibrosis, subretinal fluid (SRF), and IRF were assessed at baseline, 3 months, and 1 year. SHRM and atrophy areas were also quantitatively measured. Comparisons were made between eyes with SHRM (SHRM [+]) and without SHRM (SHRM [-]) at baseline. Incidence and area of SHRM, development of atrophy and fibrosis, presence and resolution of IRF and SRF, changes in CMT and BCVA. At baseline, 57 eyes (47.5%) exhibited SHRM, which regressed in 85% after 1 year. Atrophy developed in 40% of eyes at 1 year, with 83.3% occurring in SHRM (+) eyes. Fibrosis was observed in 21.7% of eyes, with 92.3% in SHRM (+). IRF was more prevalent in SHRM (+) (all P ≤ .010) and showed limited resolution compared with SRF (McNemar P = .099 vs P < .001). SHRM (+) eyes had thinner CMT and worse BCVA. SHRM at baseline was associated with the development of atrophy, fibrosis, and IRF in PNV. Although most SHRM regressed after treatment, it frequently resulted in residual atrophy.