Retina | 2021
Response Letter to the Editor Correspondence: Correlation of Subretinal Hyperreflective Material Morphology and Visual Acuity in Neovascular Age-related Macular Degeneration.
Abstract
1. In the results section under “Subretinal Hyperreflective Material Size,” the last sentence of the second paragraph should read “By contrast, the significant relationship between increased SHRM height and decreased visual acuity that was observed at 12 and 24 weeks (Tables 2–3) was not statistically significant at baseline (Table 1). 2. In Table 3: association of Week 24 SHRM with the visual acuity at Week 24, the median value for foveal center height, width, and area are noted as zero because the measurements of the SHRM lesion were all extrafoveal. 3. When the SHRM height was greater than the median height at 12 and 24 weeks, the corresponding visual acuity was significantly worse at both of these time points. There was a similar trend although not statistically significant, when the SHRM height at baseline was compared with the visual acuity at baseline, 12 weeks, and 24 weeks. Thus, the findings in this study are consistent with those in our previous work on SHRM in the comparison of age-related macular degeneration treatment trials in which we found that greater SHRM height and width correlated with worse visual acuity.3 4. The caption under the image of Figure 4C should read “hyperreflective as RNFL” not retinal pigment epithelium. 5. In the results section under “SHRM Size,” measurements were acquired at foveal center, within center 1-mm area (not 1 cm) and within the entire macula. 6. In the results section under “Correlation of SHRM with Retinal Layer Integrity,” 66.4% of SHRM lesions (not 6.4%) became more consolidated from baseline to 12 weeks than had disappeared (25.8%). 7. In Figure 2, the caption should read “OCT tomography scans highlighting separation of SHRM from the outer retina (red arrow) (B), and separation of SHRM from the retinal pigment epithelium (yellow arrow) (A). 8. The total number of patients included was 170, which is the total number of subjects for all of the tables. The total number of images that was graded: 170 subjects · 3 study images per patient (baseline, 12 weeks, and 24 weeks) = 510. 9. Although hyperreflective spots within SHRM lesion at 12 and 24 weeks follow-up visits were associated with worse visual acuity, the presence of hyperreflective spots at baseline was not significantly correlated with worse visual acuity at weeks 12 and 24. In the second sentence of the discussion, “subretinal hyperreflective spots” should be omitted. 10. A layered SHRM appearance and hyperreflectivity within the SHRM represent two separate morphological features. If a layered appearance was present at baseline, then at the follow-up visits, most of the corresponding SHRM lesions became more hyperreflective, and lost their layered appearance.