{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T16:27:38Z","timestamp":1794414458542,"version":"4.9.1"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"16","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eye"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate whether baseline well-delineated hyperreflective material (wdHRM) is associated with short-term visual outcome in treatment-na\u00efve neovascular age-related macular degeneration (nAMD), whether this association differs by macular neovascularisation (MNV) subtype, and how wdHRM relates to atrophy-related OCT biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Multicentre observational analysis of 2036 treatment-na\u00efve eyes (PRECISE cohort) completing three monthly aflibercept 2\u2009mg injections. Best-corrected visual acuity (BCVA) at Visit 4 (V4) was modelled against baseline wdHRM using adjusted multivariable linear regression. Secondary analyses assessed subtype interaction and eye-level association with atrophy-related OCT biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean BCVA improved from 58.0 to 62.6 letters by V4. Baseline wdHRM was present in 14.6% of eyes, and foveal-involving wdHRM independently predicted lower V4 BCVA (\u03b2 =-6.60 letters, 95%confidence interval [CI]-8.18 to -5.02;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Foveal-involving baseline choroidal hypertransmission (HTM) showed a stronger adverse association (\u03b2 =-8.98, 95%CI-10.97 to -6.98;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The wdHRM association differed by subtype (interaction\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016), with adjusted BCVA reductions of -10.6 letters in Type 3 MNV, -4.8 in Type 2\/mixed MNV, -4.1 in Type 1 MNV, and -1.0 in polypoidal choroidal vasculopathy. By V4, wdHRM increased to 21.0% and was associated with HTM and greater outer retinal disruption.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In treatment-na\u00efve nAMD, baseline wdHRM is independently associated with poorer short-term visual outcome, particularly in Type 3 MNV. Short-term visual outcome should be interpreted in relation to both fibrosis-related and atrophy-related OCT biomarkers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41433-026-04858-7","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T11:42:11Z","timestamp":1789645331000},"page":"2556-2564","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Macular neovascularisation subtype determines visual consequences of early fibro-atrophic remodelling in neovascular AMD: PRECISE study report 11"],"prefix":"10.1038","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4159-3960","authenticated-orcid":false,"given":"Livia","family":"Faes","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Syed","family":"Kubravi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5096-3786","authenticated-orcid":false,"given":"Kimberly","family":"Spooner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sridevi","family":"Thottarath","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sobha","family":"Sivaprasad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2852-6912","authenticated-orcid":false,"given":"Dun Jack","family":"Fu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"},{"role":"corresponding-author","vocabulary":"crossref"}]},{"name":"for the PRECISE Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faruque","family":"Ghanchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Grabowska","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen James","family":"Talks","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Pearce","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"McKibbin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajay","family":"Kotagiri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geeta","family":"Menon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin J. 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Members of the Eye editorial board. SK: Nothing to declare. KS: Nothing to declare. ST: Nothing to declare. SS: Funding\/fees from AbbVie, Amgen, Apellis, Bayer, Biogen, Boehringer Ingelheim, Novartis, Eyebiotech, Eyepoint Pharmaceuticals, Janssen Pharmaceuticals, Novo Nordisk, Optos, Ocular Therapeutix, Outlook therapeutics, Kriya Therapeutics, OcuTerra, Roche, Stealth Biotherapeutics. Sandoz, Sanofi. DJF: is supported by a NIHR academic clinical lectureship. Consulting and\/or research support: AbbVie, Allergan, Apellis, Boehringer Ingelheim, Galimedix, Roche. Members of the Eye editorial board.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}}]}}