Original articleHyporeflective Wedge-Shaped Band in Geographic Atrophy Secondary to Age-related Macular Degeneration: An Underreported Finding
Section snippets
Patients and Methods
The SD-OCT images of patients with GA secondary to AMD who were participants of a prospective, longitudinal, follow-up study were reviewed. The study was based at the Institut de la Màcula i de la Retina, Centro Médico Teknon, Barcelona, Spain. Consecutive patients 50 years of age and older were examined from January 2010 through June 2011. The study followed the tenets of the Declaration of Helsinki, local ethics committee approval was obtained, and all participants signed an informed consent
Results
In total, 96 eyes of 71 patients were included. The study group included 52 women (73.2%), the mean age was 79.0 years (range, 50–95 years), and there were 44 right eyes (45.8%). All patients were white. In 70 (72.9%; 95% confidence interval, 63.9–82.0) of the 96 eyes, a marked hyporeflective wedge-shaped structure was found, with its base on Bruch's membrane and its apex pointing toward the inner limit of the OPL adjacent to the margin between the atrophied area and the preserved retina (Fig 1
Discussion
A hyporeflective wedge-shaped structure is a frequent finding in patients with GA secondary to AMD (Figure 1, Figure 3). Using an eccentrically located SD-OCT examination, differentiation of the limits between the ONL and HFL appears to be very clear. Therefore, this technique will be useful in enabling a better understanding of the composition and potential clinical implications of the wedge-shaped band.
Previously, this finding has been interpreted as the so-called falling of the ONL as a
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2022, American Journal of OphthalmologyImaging Features Associated with Progression to Geographic Atrophy in Age-Related Macular Degeneration: Classification of Atrophy Meeting Report 5
2021, Ophthalmology RetinaCitation Excerpt :These features include INL and OPL subsidence, hyporeflective wedges, ELM descent, outer nuclear layer thinning, ELM and EZ integrity loss, and hypertransmission of the OCT signal into the choroid (Fig 1). Hyporeflective wedges, described initially by Monés et al9 at the margin of GA, which can be seen in iRORA and cRORA, refer to triangular, hyporeflective regions with the base adjacent to Bruch’s membrane and the apex extending internally to the inner aspect of the OPL (Fig S2, available at www.ophthalmologyretina.org). These features have also been characterized histologically.
Quantification of Geographic Atrophy Using Spectral Domain OCT in Age-Related Macular Degeneration
2021, Ophthalmology RetinaCitation Excerpt :Reticular pseudodrusen were identified on SD-OCT as a hyper-reflective signal forming granular material, mounds, and cones between the RPE and the ellipsoid layer, as described by Querques et al.28 Outer retinal tubules were defined as round to ovoid hyporeflective spaces with a hyper-reflective border located in the outer retina on OCT B-scans.29–31 Hyporeflective wedge-shaped bands were located within the outer plexiform layer at the boundaries of the atrophic areas on OCT B-scans.32 The FAF, IR, and color fundus photographs images were graded for GA by certified evaluators at the Fundus Photograph Reading Center using the Age-Related Eye Disease Study grading methods (Fig 2).33
Structural Features Associated With the Development and Progression of RORA Secondary to Maternally Inherited Diabetes and Deafness
2020, American Journal of OphthalmologyCitation Excerpt :It was located within the area of retinal pigment epithelial loss and hypertransmission. Similar to the original description in GA secondary to AMD,16 a distinct hyperreflective separation between this OCT feature and the end of ONL was generally present. With progression of the RORA, the hyporeflective wedges moved correspondingly (Figure 2).
Manuscript no. 2011-1537.
Financial Disclosure(s): The author(s) have made the following disclosure(s): Jordi Monés, Consultant, Novartis, Allegan, Bayer, Ophthotech, Alimera, and Notalvision.
Supported by Barcelona Macula Foundation, Barcelona, Spain.