Accepted Manuscript Grey hyper-reflective subretinal exudative lesions in exudative age-related macular degeneration Raphaelle Ores, MD Nathalie Puche, MD Giuseppe Querques, MD, PhD Rocio Blanco-Garavito, MD Benedicte Merle, PhD Gabriel Coscas, MD Hassiba Oubraham, MD Oudy Semoun, MD Eric H. Souied, MD, PhD PII:

S0002-9394(14)00228-1

DOI:

10.1016/j.ajo.2014.04.025

Reference:

AJOPHT 8902

To appear in:

American Journal of Ophthalmology

Received Date: 12 October 2013 Revised Date:

24 April 2014

Accepted Date: 25 April 2014

Please cite this article as: Ores R, Puche N, Querques G, Blanco-Garavito R, Merle B, Coscas G, Oubraham H, Semoun O, Souied EH, Grey hyper-reflective subretinal exudative lesions in exudative age-related macular degeneration, American Journal of Ophthalmology (2014), doi: 10.1016/ j.ajo.2014.04.025. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Grey hyper-reflectivity in age-related macular degeneration ACCEPTED MANUSCRIPT 1 -Original ArticleGrey hyper-reflective subretinal exudative lesions in exudative age-related macular degeneration

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Raphaelle Ores, MD, Nathalie Puche, MD, Giuseppe Querques, MD, PhD, Rocio Blanco-Garavito, MD, Benedicte Merle, PhD, Gabriel Coscas, MD, Hassiba Oubraham, MD, Oudy Semoun, MD, Eric H Souied, MD, PhD. From the Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil, Université Paris Est, 40 Avenue de Verdun, 94000 Creteil, France

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Corresponding author: Eric H SOUIED, Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil, Universite Paris Est Creteil, 40 Avenue de Verdun, 94000 Creteil, France. Tel: 33-1-45175222 Fax: 33-1-45175227 Email: [email protected] The authors have no proprietary interest in the materials used in this study. Short tittle: Grey hyper-reflectivity in age-related macular degeneration

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Keywords: Age-related macular degeneration; choroidal neovascularization; exudative; grey; hyper-reflective; ranibizumab; spectral-domain optical coherence tomography; subretinal lesions

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ACCEPTED MANUSCRIPT

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ABSTRACT Purpose: To investigate the effects of ranibizumab 0.5 mg on grey hyper-reflective subretinal lesions diagnosed by spectral-domain optical coherence tomography (SDOCT) in patients with exudative age-related macular degeneration (AMD). Design: Retrospective interventional study. Methods: Data from 28 consecutive patients affected with neovascular AMD that presented subretinal hyper-reflective lesions as visualized by SD-OCT were collected. Grey hyper-reflective subretinal lesion characteristics were analyzed, before and after intravitreal ranibizumab 0.5 mg injection. Results: Thirty eyes of 28 patients (5 male, 23 female, aged 57-91 years) were included. At study entry, grey lesion was associated with exudative features in 24/30 eyes (80%), including subretinal fluid (SRF) in 20/30 of eyes (67%), and retinal cystoid spaces in 11/30 of eyes (37%). Twenty-four eyes with exudative features at study entry received prompt treatment; 6 eyes without exudative features at study entry received deferred treatment (after one-month observation), when exudative signs emerged (SRF in 3/6 eyes and retinal cystoid spaces in 5/6 eyes). Ninety-three percent of the grey lesions responded to ranibizumab treatment at two months and 77% at six months. Grey hyper-reflective subretinal lesion thickness was significantly reduced after treatment at both two months (from 482±116µm to 367±102µm, P