Upon investigating genetic and non-genetic risk factors for fellow eye progression in patients with unilateral exudative age-related macular degeneration (AMD), researchers confirmed the role of hyper-reflective foci (HF) as a biomarker for progression in patients’ fellow eye. They presented their findings last week at the annual ARVO conference in Vancouver.

This retrospective analysis included 127 European patients with unilateral exudative AMD in one eye and non-exudative AMD without central geographic atrophy (GA) in the fellow eye. All patients had a minimum of two years of follow-up with fundus photography, fluorescein angiography and spectral-domain optical coherence tomography at baseline. 

During a mean follow-up time of 5.26 ± 2.46 years, 69 patients (54.33%) developed late AMD in the fellow eye (49 with exudative AMD, 20 with central GA). They found that patients with intermediate AMD and paracentral atrophy, reticular drusen or hyper-reflective foci showed a significantly increased likelihood of developing late AMD in the fellow eye. After adjusting for age and gender, they discovered that HF still showed a significant influence on progression in the fellow eye, whereas reticular drusen and intermediate AMD plus paracentral atrophy in the fellow eye were not significantly correlated.

The team advises intensified monitoring potentially with new high resolution imaging modalities for early detection of progression to prevent vision loss.