Quantity of Intraretinal Hyperreflective Foci in Patients With Intermediate Age-Related Macular Degeneration Correlates With 1-Year Progression

Purpose: The purpose of this study was to evaluate the correlation between quantity of intraretinal hyperreflective foci (HRF) in the eye with intermediate AMD and progression to late AMD. Methods: Volume optical coherence tomography (OCT) scans from 114 eyes of 114 patients were retrospectively reviewed. HRF were assessed both qualitatively and quantitatively. Five sequential en face slabs from midretina were thresholded to isolate the HRF. These five slabs were recombined, and HRF area was measured in the whole 6 × 6-mm image (HRFTOT) and within the central 3-mm (HRF3mm) and 5-mm (HRF5mm) regions. These measurements were correlated with the development of late AMD (defined as choroidal neovascularization [CNV] and/or complete RPE and photoreceptor atrophy [cRORA]) after 1 year of follow-up. Results: HRF area in all three regions showed significant correlations with progression to late AMD: R = 0.610 for HRF3mm, R = 0.622 for HRF5mm, and R = 0.614 for HRFTOT (all P < 0.001). Correlations remained significant with progression to cRORA alone, though not for progression to CNV alone. While qualitative assessment of HRF (i.e., presence of HRF: yes or no) also showed a significant correlation with progression to late AMD (R = 0.454, P < 0.001) and atrophy alone (R = 0.445, P < 0.001), they were weaker than by HRF quantification. Conclusions: The area of HRF from en face OCT in eyes with intermediate AMD correlates with the 1-year risk of progression to late AMD, and in particular with the development of atrophy.