Subretinal Lipid Globules an Early Biomarker of Macular Neovascularization in Eyes with Intermediate Age-Related Macular Degeneration.

To explore the association between subretinal lipid globules (SLG) detected in eyes with intermediate age-related macular degeneration (iAMD) with the presence of non-exudative macular neovascularization (NE-MNV). This was a retrospective analysis of 113 consecutive patients with bilateral iAMD (226 eyes) followed for a least 6 months. All eyes underwent multimodal imaging with fundus autofluorescence, spectral-domain optical coherence tomography (SD-OCT), and OCT angiography (OCTA). SLG were identified on SD-OCT as round hyporeflective lesions measuring 31-157 mm located between the ellipsoid zone and the retinal pigment epithelium /Bruch's membrane complex. NE-MNV was detected with OCTA. The features of NE-MNV lesions detected in eyes with SLG were compared to those in eyes without SLG. SLG were identified in 15 eyes of which 14/15 eyes (93.3%) demonstrated NE-MNV on OCTA. In the remaining 98 eyes without SLG, 18 (18.4%) displayed NE-AMD on OCTA. MNV area was larger in the SLG subgroup (+0.38 vs. +0.21 mm2, p=0.008) and showed faster horizontal growth (+727 μm, CI95% 250.4, 1205.4) than MNV in eyes without SLG (+ 64.9 μm, CI95%, 24.3, 154) on OCT B-scan. After a mean of 11.6 months, the conversion rate to exudative MNV was similar between eyes with SLG and those without SLG [8/26 (38.5%) vs. 3/13 (27.3%), p=0.56)]. The detection of SLG in eyes with iAMD was strongly correlated with the presence of NE-MNV. While these MNV lesions were larger and grew faster than NE-MNV detected in eyes lacking SLG, rates of conversion to exudative MNV appeared similar.

Déclaration de conflit d'intérêts

Conflict of Interest: Commercial Relationships/Disclosures: Dr. Parravano reports personal fees from Allergan, Novartis, Bayer, Zeiss, Omikron, Alfaintes, Sifi outside the submitted work. Dr. Monica Varano reports personal fees from Allergan, Novartis, Bayer, Sifi outside the submitted work. Dr. K. B. Freund is a consultant for Heidelberg Engineering, Zeiss, Allergan, Bayer, Genentech, and Novartis and receives research support from Genentech/Roche.