{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T19:39:49Z","timestamp":1785267589885,"version":"3.55.0"},"reference-count":32,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T00:00:00Z","timestamp":1726099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: To assess the clinical characteristics of patients with macular neovascularization (MNV) with no drusen in the fellow eye, we investigated the incidence of MNV in fellow eyes and the outcomes of intravitreal aflibercept (IVA) monotherapy in MNV eyes of patients with unilateral MNV with a punctate hyperfluorescence spot (PHS) in the fellow eye. Methods: We retrospectively studied 58 treatment-na\u00efve patients with unilateral MNV with no drusen in the fellow eye. Patients were classified into a PHS group (n = 29) or no-PHS group (n = 29) based on the presence of PHS. We evaluated the incidence of MNV in the fellow eye, and the retreatment rate after initiation of three monthly aflibercept injections over one year. Results: Fellow eyes in the PHS group had a thicker choroid (p &lt; 0.05) and higher prevalence of pachychoroid pigment epitheliopathy (PPE) (p &lt; 0.001). MNV eyes in the PHS group had a thicker choroid (p = 0.09). The PHS group had a lower retreatment rate (p &lt; 0.05) and required fewer injections (p &lt; 0.05) than the no-PHS group. MNV developed in one eye in both the PHS and no-PHS groups, and both cases occurred in areas of hypofluorescence on indocyanine green angiography within the PPE area before the onset of MNV. Conclusions: The PHS group frequently exhibited pachychoroid disease characteristics and responded better to IVA monotherapy than the no-PHS group. These groups may represent distinct populations of patients with unilateral MNV with no drusen in the fellow eye.<\/jats:p>","DOI":"10.3390\/jcm13185394","type":"journal-article","created":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T05:03:04Z","timestamp":1726117384000},"page":"5394","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Clinical Characteristics of Punctate Hyperfluorescence Spots in the Fellow Eye of Patients with Unilateral Macular Neovascularization with No Drusen"],"prefix":"10.3390","volume":"13","author":[{"given":"Hiroyuki","family":"Kamao","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0114, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsutoshi","family":"Goto","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0114, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuto","family":"Date","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0114, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryutaro","family":"Hiraki","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0114, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichi","family":"Mizukawa","sequence":"additional","affiliation":[{"name":"Shirai Eye Hospital, 1339 Takasecho Kamitakase, Mitoyo 767-0001, Kagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Miki","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0114, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1097\/IAE.0b013e3182953df4","article-title":"Pachychoroid pigment epitheliopathy","volume":"33","author":"Warrow","year":"2013","journal-title":"Retina"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/IAE.0000000000000331","article-title":"Pachychoroid neovasculopathy","volume":"35","author":"Pang","year":"2015","journal-title":"Retina"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1097\/IAE.0b013e3182680a66","article-title":"Type 1 (sub-retinal pigment epithelial) neovascularization in central serous chorioretinopathy masquerading as neovascular age-related macular degeneration","volume":"32","author":"Fung","year":"2012","journal-title":"Retina"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1097\/00006982-199515020-00003","article-title":"Indocyanine green videoangiography of idiopathic polypoidal choroidal vasculopathy","volume":"15","author":"Spaide","year":"1995","journal-title":"Retina"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1652","DOI":"10.1097\/IAE.0000000000001907","article-title":"Peripapillary pachychoroid syndrome","volume":"38","author":"Phasukkijwatana","year":"2018","journal-title":"Retina"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1001\/archophthalmol.2011.148","article-title":"The expanded spectrum of focal choroidal excavation","volume":"129","author":"Margolis","year":"2011","journal-title":"Arch. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/s10384-020-00740-5","article-title":"Pachychoroid disease: A new perspective on exudative maculopathy","volume":"64","author":"Yanagi","year":"2020","journal-title":"Jpn. J. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1007\/BF00225936","article-title":"Indocyanine green angiography of central serous chorioretinopathy","volume":"9","author":"Hayashi","year":"1986","journal-title":"Int. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1097\/IAE.0000000000001689","article-title":"Disease expression in nonexudative age-related macular degeneration varies with choroidal thickness","volume":"38","author":"Spaide","year":"2018","journal-title":"Retina"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1097\/00006982-199911000-00005","article-title":"Persistent and bilateral choroidal vascular abnormalities in central serous chorioretinopathy","volume":"19","author":"Iida","year":"1999","journal-title":"Retina"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Fukuda, Y., Sakurada, Y., Sugiyama, A., Yoneyama, S., Matsubara, M., Kikushima, W., Tanabe, N., Parikh, R., and Kashiwagi, K. (2020). Pachydrusen in fellow eyes predict response to aflibercept monotherapy in patients with polypoidal choroidal vasculopathy. J. Clin. Med., 9.","DOI":"10.3390\/jcm9082459"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Kamao, H., Mitsui, E., Date, Y., Goto, K., Mizulawa, K., and Miki, A. (2024). Clinical characteristics of unilateral macular neovascularization patients with pachydrusen in the fellow eye. J. Clin. Med., 13.","DOI":"10.3390\/jcm13133757"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1097\/IAE.0b013e3181c72068","article-title":"Punctate hyperfluorescent spots associated with central serous chorioretinopathy as seen on indocyanine green angiography","volume":"30","author":"Tsujikawa","year":"2010","journal-title":"Retina"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1016\/j.ajo.2014.08.010","article-title":"Punctate hyperfluorescence spot as a common choroidopathy of central serous chorioretinopathy and polypoidal choroidal vasculopathy","volume":"158","author":"Park","year":"2014","journal-title":"Am. J. Ophthalmol."},{"key":"ref_15","first-page":"2353428","article-title":"Effects of smoking on outcomes of antivascular endothelial growth factor therapy in patients with neovascular age-related macular degeneration smoking and anti-VEGF Therapy in nAMD","volume":"2018","author":"Kamao","year":"2018","journal-title":"J. Ophthalmol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1097\/IAE.0000000000001580","article-title":"Optical coherence tomography angiography of flat irregular pigment epithelium detachment in chronic central serous chorioretinopathy","volume":"38","author":"Bousquet","year":"2018","journal-title":"Retina"},{"key":"ref_17","first-page":"6683532","article-title":"Clinical characteristics of neovascular age-related macular degeneration without typical drusen","volume":"2021","author":"Kamao","year":"2021","journal-title":"J. Ophthalmol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.ajo.2016.06.031","article-title":"Subretinal hyperreflective material imaged with optical coherence tomography angiography","volume":"169","author":"Dansingani","year":"2016","journal-title":"Am. J. Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"423","DOI":"10.3928\/23258160-20150422-04","article-title":"Punctate hyperfluorescent spots associated with polypoidal choroidal vasculopathy on indocyanine green angiography","volume":"46","author":"Kim","year":"2015","journal-title":"Ophthalmic. Surg. Lasers Imaging Retina."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.1007\/s00417-021-05180-6","article-title":"Pachydrusen, choroidal vascular hyperpermeability, and punctate hyperfluorescent spots","volume":"259","author":"Kang","year":"2021","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Miyake, M., Ooto, S., Yamashiro, K., Takahashi, A., Yoshikawa, M., Akagi-Kurashige, Y., Ueda-Arakawa, N., Oishi, A., Nakanishi, H., and Tamura, H. (2015). Pachychoroid neovasculopathy and age-related macular degeneration. Sci. Rep., 5.","DOI":"10.1038\/srep16204"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1007\/s10384-018-0562-0","article-title":"Efficacy of treat-and-extend regimen with aflibercept for pachychoroid neovasculopathy and Type 1 neovascular age-related macular degeneration","volume":"62","author":"Matsumoto","year":"2018","journal-title":"Jpn. J. Ophthalmol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2303","DOI":"10.1016\/j.ophtha.2015.06.053","article-title":"Factors associated with recurrence of age-related macular degeneration after anti-vascular endothelial growth factor treatment: A retrospective cohort study","volume":"122","author":"Kuroda","year":"2015","journal-title":"Ophthalmology"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Kuranami, A., Maruko, R., Maruko, I., Hasegawa, T., and Iida, T. (2023). Pachychoroid neovasculopathy has clinical properties that differ from conventional neovascular age-related macular degeneration. Sci. Rep., 13.","DOI":"10.1038\/s41598-023-33936-z"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Matsumoto, H., Hoshino, J., Mukai, R., Nakamura, K., Kishi, S., and Akiyama, H. (2021). Chronic choriocapillaris ischemia in dilated vortex vein region in pachychoroid neovasculopathy. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-95904-9"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1097\/IAE.0000000000002635","article-title":"Relationship between choroidal vascular hyperpermeability, choriocapillaris flow density, and choroidal thickness in eyes with pachychoroid pigment epitheliopathy","volume":"40","author":"Sakurada","year":"2020","journal-title":"Retina"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1016\/j.oret.2019.08.002","article-title":"The pachychoroid disease spectrum-and the need for a uniform classification system","volume":"3","author":"Siedlecki","year":"2019","journal-title":"Ophthalmol Retina"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"100201","DOI":"10.1016\/j.xops.2022.100201","article-title":"Natural course of pachychoroid pigment epitheliopathy","volume":"2","author":"Yagi","year":"2022","journal-title":"Ophthalmol. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Tang, J., Han, X., Tang, R., Li, M., Wang, Z., Zhao, M., and Qu, J. (2022). Case series: Pachychoroid pigment epitheliopathy transformed to polypoidal choroidal vasculopathy after long-term follow-up. BMC Ophthalmol., 22.","DOI":"10.1186\/s12886-022-02487-8"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1016\/j.ajo.2008.12.008","article-title":"A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes","volume":"147","author":"Margolis","year":"2009","journal-title":"Am. J. Ophthalmol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"8438","DOI":"10.1167\/iovs.11-8108","article-title":"Subfoveal choroidal thickness in relation to sex and axial length in 93 danish university students","volume":"52","author":"Li","year":"2011","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Lee, G.W., Roh, H.C., Kang, S.W., Kim, A.Y., Noh, H., and Choi, K.J. (2021). The implications of subretinal fluid in pachychoroid neovasculopathy. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-83650-x"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/18\/5394\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:54:26Z","timestamp":1760111666000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/18\/5394"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,12]]},"references-count":32,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["jcm13185394"],"URL":"https:\/\/doi.org\/10.3390\/jcm13185394","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,12]]}}}