ArticleOphthalmology. Retina2020
Hyperreflective Foci and Specks Are Associated with Delayed Rod-Mediated Dark Adaptation in Nonneovascular Age-Related Macular Degeneration.
Article in Ophthalmology. Retina, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
49 citing papers in PubMed, 1 synthesis or guideline pooled it, 63 citations in OpenAlex.
- Retinal sensitivity changes in early/intermediate AMD: a systematic review and meta-analysis of visual field testing under mesopic and scotopic lighting.Eye (London, England) · 2024Pooled it
- Impact of Baseline Quantitative OCT Features on Response to Risuteganib for the Treatment of Dry Age-Related Macular Degeneration: The Importance of Outer Retinal Integrity.Ophthalmology. Retina · 2022Trial
- Insights into the modulation of age-related macular degeneration: Molecular and systems-level perspectives.Acta ophthalmologica · 2026Article
- Interpreting Hyperreflective Foci in Age-Related Macular Degeneration: A Critical Review of Cell Origins, Evolving Terminology and Clinical Utility.Clinical & experimental ophthalmology · 2026Review
- Optical Coherence Tomography Biomarkers Predicting Progression to Atrophy in Non-Exudative Age-Related Macular Degeneration.Diagnostics (Basel, Switzerland) · 2026Review
- Automated Segmentation and Characterization of Retinal Hyperreflective Foci in Age-Related Macular Degeneration.Translational vision science & technology · 2026Article
- Choriocapillaris Flow Signal Deficits Are Associated With AMD Onset and Early Progression Over Three Years: ALSTAR2 Follow-Up.Investigative ophthalmology & visual science · 2026Article
- Cellular-Scale Photoreceptor Remodeling After Macular Hole Surgery Examined by Adaptive Optics Optical Coherence Tomography.Investigative ophthalmology & visual science · 2026Article
- Natural History of Visual Function Changes Over Three Years in Normal Aging and in Early and Intermediate Age-Related Macular Degeneration: ALSTAR2.Translational vision science & technology · 2026Article
- Preserved Contrast Sensitivity in Early and Intermediate Age-Related Macular Degeneration and Marked Loss in Late Stage: ALSTAR2.Investigative ophthalmology & visual science · 2026Article
- Determinants of Intergrader Agreement for Key Retinal Photography and OCT Biomarkers in AMD.Translational vision science & technology · 2025Article
- Hypertransmission and Vision in Aging and Age-Related Macular Degeneration: Longitudinal Data From ALSTAR2.American journal of ophthalmology · 2025Article
- Article
- Using adaptive optics to assess hyporeflective clump speed and size in age-related macular degeneration in the PINNACLE Study. (PINNACLE Study Report 6).Eye (London, England) · 2025Article
- Total Retinal Pigment Epithelium Thickness and Reflectivity, in Relation to Histology and Vision, at the Aging-AMD Transition: ALSTAR2 Baseline.Investigative ophthalmology & visual science · 2025Article
- High risk does not guarantee high accuracy-Evaluating the prognostic accuracy of OCT biomarkers for predicting late AMD.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2025Article
- Glycolipids implicated as mediators of clinically visible retinal pigment epithelial migration in age-related macular degeneration.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
- Genetic Associations of Rod- and Cone-Mediated Vision in Aging and Age-Related Macular Degeneration.Investigative ophthalmology & visual science · 2025Article
- Quantifications of Outer Retinal Bands in Geographic Atrophy by Comparing Superior Axial Resolution and Conventional OCT.Investigative ophthalmology & visual science · 2025Article
- Topographic Analysis of Two-Wavelength Autofluorescence Supports Higher Macular Xanthophyll Pigment in AMD Than Aging: ALSTAR2 Baseline.Investigative ophthalmology & visual science · 2025Article
Corrections and comments
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Authors and funding
14 authors at 3 institutions in 1 country.
Funding
Abstract
purposeHyperreflective foci (HRF) are OCT biomarkers for the progression of nonneovascular age-related macular degeneration (AMD) attributed to anteriorly migrated retinal pigment epithelial cells. We examined associations between rod- and cone-mediated vision and HRF plus smaller hyperreflective specks (HRS); we identified a histologic candidate for HRS.
designCross-sectional study and histologic survey.
participantsPatients with healthy maculae (n = 34), early AMD (n = 26), and intermediate AMD (n = 41).
methodsAMD severity was determined by color fundus photography. In OCT scans, HRF and HRS were counted manually. Vision tests probed cones (best-corrected visual acuity [VA], contrast sensitivity), mixed cones and rods (low-luminance VA, low-luminance deficit, mesopic light sensitivity), or rods (scotopic light sensitivity, rod-mediated dark adaptation [RMDA]). An online AMD histopathologic resource was reviewed.
main outcome measuresVision in eyes assessed for HRF and HRS; histologic candidate for HRS.
resultsIn 101 eyes of 101 patients, HRF and HRS were identified in 25 and 95 eyes, respectively, with good reliability. Hyperreflective foci were present but sparse in healthy eyes, infrequent in early AMD eyes, and frequent but highly variable among intermediate AMD eyes (mean±standard deviation [SD] number per eye, 0.1 ± 0.2, 0.2 ± 0.5, and 1.9 ± 3.4 for healthy, early AMD, and intermediate AMD eyes, respectively). Hyperreflective specks outnumbered HRF in all groups (mean±SD, 4.5 ± 3.2, 6.3 ± 5.8, and 19.4 ± 22.4, respectively). Delayed RMDA was associated strongly with more HRF and HRS (P < 0.0001). Hyperreflective foci also were associated with worse low-luminance VA (P = 0.0117). Hyperreflective specks were associated with worse contrast sensitivity (P = 0.0278), low-luminance VA (P = 0.0010), low-luminance deficit (P = 0.0031), and mesopic (P = 0.0018) and scotopic (P < 0.0001) sensitivity. By histologic analysis, cone lipofuscin was found in outer retinal layers of 25% of healthy aged eyes.
conclusionsHyperreflective foci and HRS are markers of cellular activity associated with visual dysfunction, especially delayed RMDA, an AMD risk indicator assessing efficiency of retinoid resupply. Hyperreflective specks may represent lipofuscin translocating inwardly within cones. HRF and HRS may serve as structural end points in clinical trials targeting AMD stages earlier than atrophy expansion. These results should be confirmed in a larger sample.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.