Central posterior hyaloidal fibrosis - A novel optical coherence tomography feature associated with choroidal neovascular membrane

Abstract

Purpose: To describe a novel optical coherence tomography (OCT) finding at the vitreomacular interface (VMI), and report its association with advanced choroidal neovascularisation (CNV).

Observations: Optical coherence tomography (OCT) scans performed at three retinal imaging centres at Amanat Eye Hospital, Pakistan from May 2016 till May 2021 were reviewed. A specific change at the vitreomacular interface was noted consisting of abnormal hyper reflectivity at the point of attachment of the posterior hyaloid membrane to the foveal center which appears to 'fill in' the foveolar depression.Eight eyes of eight patients were identified. All affected eyes had advanced CNV and persistent vitreofoveolar adhesion. In all eyes, the foveal contour (concavity) was maintained and there was no inner retinal surface wrinkling which differentiates this OCT feature from vitreomacular traction or epiretinal membranes. The authors propose the term Central Posterior Hyaloidal Fibrosis (CPHF) for this specific OCT finding.

Conclusions and importance: Central Posterior Hyaloidal Fibrosis (CPHF) is a newly reported OCT finding associated with advanced CNV, which may represent a possible profibrotic influence of a choroidal neovascular membrane to the overlying posterior hyaloid adhesion.

Keywords: AMD, Age related macular degeneration; CNV, Choroidal neovascularisation; CPHF, Central Posterior Hyaloidal Fibrosis; Choroidal neovascular membrane; Optical coherence tomography; SD- OCT, Spectral domain Optical Choroidal Tomography; VMA, Vitreomacular adhesion; VMI, Vitreomacular interface; VMT, Vitreomacular traction; Vitreomacular interface.