dcae033ece6aa0265f1e45cb2fa8ace5 335918.pdf 64987797066241992ea528bf44556b086d9aea21 335918.pdf bc8c21b1e997744fc83f3afaaf8aff4209671f8ee04cfa4cf67a027701bf5b2b 335918.pdf Title: Ultrasound-Enhanced Assessment of Vitreous Status in Exudative AMD: Associations with Neovascular Phenotypes, Treatment Burden, and Functional Outcomes Subject: Background/Objectives: The influence of the vitreoretinal interface on neovascular age-related macular degeneration (nAMD) remains poorly characterized. Most previous studies relied solely on macular optical coherence tomography (OCT), which provides limited information about global posterior vitreous detachment (PVD). This study evaluated (1) whether ultrasonography-defined PVD status differs between nAMD eyes and healthy controls, and (2) whether baseline PVD influences macular neovascularization (MNV) phenotype and functional outcomes following anti-vascular endothelial growth factor (anti-VEGF) therapy. Methods: In this prospective longitudinal study, treatment-naïve nAMD eyes and population-based healthy controls underwent dynamic B-scan ultrasonography and spectral-domain OCT. PVD was categorized as absent, partial, or complete. nAMD eyes received intravitreal aflibercept according to a treat-and-extend protocol and were followed for 12 months. Structural parameters—including subretinal fluid (SRF), intraretinal fluid (IRF), and central foveal thickness—along with best-corrected visual acuity (BCVA) were recorded. A multivariable linear regression model was performed to assess whether PVD independently predicted BCVA gain after adjusting for age, baseline BCVA, MNV subtype, SRF, atrophy, and number of injections. Results: Absence of PVD was significantly more frequent in nAMD eyes than in controls (p < 0.001), whereas complete PVD prevalence was comparable. In nAMD, absence of PVD was associated with a higher prevalence of MNV type 2 (p = 0.032), while partial/complete PVD correlated with type 1 lesions. After 12 months, eyes without PVD achieved the greatest visual improvement (mean BCVA gain +0.34 0.26), outperforming eyes with complete PVD (p = 0.026). A multivariable model confirmed that absence of PVD was an independent predictor of greater BCVA gain ( = -0.27; 95% CI -0.42 to -0.12; p = 0.0008). Eyes with complete PVD required more injections (p = 0.046). SRF and foveal-thickness reductions occurred across groups, whereas IRF changes were similar. Conclusions: Ultrasonography-defined PVD status differs markedly between nAMD and healthy eyes and independently influences neovascular phenotype and functional response to anti-VEGF therapy. These findings underscore the physiological importance of the vitreoretinal interface and support the use of ocular ultrasonography as an adjunct tool for assessing global vitreous status in selected nAMD settings. Keywords: posterior vitreous detachment; age-related macular degeneration; B-scan ultrasound; vitreoretinal interface; anti-VEGF therapy Author: Cristina Rodriguez-Vidal, Lucía Galletero Pandelo, Nerea Martínez-Alday, Manuel Bande and María José Blanco Teijeiro Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25; modified using OpenPDF 1.4.2 CreationDate: Fri Dec 26 07:11:28 2025 CET ModDate: Fri Dec 26 07:58:13 2025 CET Custom Metadata: yes Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 17 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 550148 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- VGQLQA+URWPalladioL-Bold Type 1 Custom yes yes yes 163 0 GGJWAI+EURM10 Type 1 Builtin yes yes yes 164 0 JFDOCJ+URWPalladioL-Roma Type 1 Custom yes yes yes 165 0 IIWSGQ+URWPalladioL-Ital Type 1 Custom yes yes yes 166 0 AQQIAU+CMSY10 Type 1 Builtin yes yes yes 167 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 231 0 XIRVNA+EURB10 Type 1 Builtin yes yes yes 244 0 JMFOAF+PalatinoLinotype TrueType WinAnsi yes yes no 261 0 JMFOAD+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 262 0 JMFOAF+PalatinoLinotype TrueType WinAnsi yes yes no 279 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-09-18 04:26:38 CEST RepresentationInformation: 335918.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-09-17 13:40:57 CEST Size: 550148 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 561 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Item: Title: Materials and Methods Children: Item: Title: Study Design Item: Title: Setting and Ethics Approval Item: Title: Participants Item: Title: Control Group Selection Item: Title: Variables and Assessments Item: Title: Ultrasound-Based Assessment of PVD Item: Title: Clinical Management and Follow-Up Item: Title: Ultrasound Image Evaluation Item: Title: Unit of Analysis Item: Title: Statistical Analysis Item: Title: Results Children: Item: Title: Comparison with a Control Sample Item: Title: Descriptive Analysis of the nAMD Group Item: Title: Vitreous Detachment Status and Clinical Profile in nAMD Item: Title: Vitreous Dynamics and Clinical Changes During Follow-Up Item: Title: Association Between Baseline Vitreous Status and the Evolution of Clinical Parameters Item: Title: Treatment Item: Title: Discussion Children: Item: Title: Comparison with the Control Group Item: Title: nAMD: Descriptive Clinical Profile Item: Title: Vitreous Detachment and Clinical Profile in Patients with nAMD Item: Title: Vitreous Dynamics and Changes in Clinical Parameters During Treatment Item: Title: Evolution of Visual Acuity Item: Title: Treatment Burden According to Vitreous Status Item: Title: Limitations Item: Title: Conclusions Item: Title: References Info: Title: Ultrasound-Enhanced Assessment of Vitreous Status in Exudative AMD: Associations with Neovascular Phenotypes, Treatment Burden, and Functional Outcomes Author: Cristina Rodriguez-Vidal, Lucía Galletero Pandelo, Nerea Martínez-Alday, Manuel Bande and María José Blanco Teijeiro Subject: Background/Objectives: The influence of the vitreoretinal interface on neovascular age-related macular degeneration (nAMD) remains poorly characterized. Most previous studies relied solely on macular optical coherence tomography (OCT), which provides limited information about global posterior vitreous detachment (PVD). This study evaluated (1) whether ultrasonography-defined PVD status differs between nAMD eyes and healthy controls, and (2) whether baseline PVD influences macular neovascularization (MNV) phenotype and functional outcomes following anti-vascular endothelial growth factor (anti-VEGF) therapy. Methods: In this prospective longitudinal study, treatment-naïve nAMD eyes and population-based healthy controls underwent dynamic B-scan ultrasonography and spectral-domain OCT. PVD was categorized as absent, partial, or complete. nAMD eyes received intravitreal aflibercept according to a treat-and-extend protocol and were followed for 12 months. Structural parameters—including subretinal fluid (SRF), intraretinal fluid (IRF), and central foveal thickness—along with best-corrected visual acuity (BCVA) were recorded. A multivariable linear regression model was performed to assess whether PVD independently predicted BCVA gain after adjusting for age, baseline BCVA, MNV subtype, SRF, atrophy, and number of injections. Results: Absence of PVD was significantly more frequent in nAMD eyes than in controls (p < 0.001), whereas complete PVD prevalence was comparable. In nAMD, absence of PVD was associated with a higher prevalence of MNV type 2 (p = 0.032), while partial/complete PVD correlated with type 1 lesions. After 12 months, eyes without PVD achieved the greatest visual improvement (mean BCVA gain +0.34 0.26), outperforming eyes with complete PVD (p = 0.026). A multivariable model confirmed that absence of PVD was an independent predictor of greater BCVA gain ( = -0.27; 95% CI -0.42 to -0.12; p = 0.0008). Eyes with complete PVD required more injections (p = 0.046). SRF and foveal-thickness reductions occurred across groups, whereas IRF changes were similar. Conclusions: Ultrasonography-defined PVD status differs markedly between nAMD and healthy eyes and independently influences neovascular phenotype and functional response to anti-VEGF therapy. These findings underscore the physiological importance of the vitreoretinal interface and support the use of ocular ultrasonography as an adjunct tool for assessing global vitreous status in selected nAMD settings. Keywords: posterior vitreous detachment; age-related macular degeneration; B-scan ultrasound; vitreoretinal interface; anti-VEGF therapy Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25; modified using OpenPDF 1.4.2 CreationDate: Fri Dec 26 07:11:28 CET 2025 ModDate: Fri Dec 26 07:58:13 CET 2025 ID: 0x8c72ab41a32785b73b457d056d1825b6, 0x25a9224c9cd5309d6046e2ee6e783625 Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: VGQLQA+URWPalladioL-Bold FontSubset: true FirstChar: 3 LastChar: 237 FontDescriptor: FontName: VGQLQA+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: GGJWAI+EURM10 FontSubset: true FirstChar: 12 LastChar: 31 FontDescriptor: FontName: GGJWAI+EURM10 Flags: Symbolic FontBBox: -32, -243, 1060, 720 FontFile: true ToUnicode: true Font: BaseFont: XIRVNA+EURB10 FontSubset: true FirstChar: 22 LastChar: 22 FontDescriptor: FontName: XIRVNA+EURB10 Flags: 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