Hyperreflective choroidal vessels in geographic atrophy secondary to age-related macular degeneration

Background And Objective: To describe choroidal vessels in areas of geographic atrophy (GA) secondary to age-related macular degeneration that appear as hyperreflective choroidal vessels (HRCVs) on multicolor (MC) imaging. patients and methods: Retrospective case series of patients with GA. Multimodal imaging evaluation was performed. results: HRCVs, which seem to be sclerotic on MC imaging, appeared as hyperautofluorescent on fun-dus autofluorescence, clearly distinguishable over the background of hypo-autofluorescence, and correlated with late-phase hypocyanescence areas on indocyanine green angiography. Average size of GA areas was significantly larger in eyes with (4.19 mm ± 0.83 mm) compared to eyes without (3.22 mm ± 1.05 mm) HRVCs (P = .0002). Similarly, mean choroidal thickness (CT) was significantly thinner in eyes with (78.5 μm ± 33.8 μm) compared to eyes without (155.4 μm ± 69.8 μm) HRVCs (P < .0001). conclusions: HRCVs are more clearly distinguishable than other choroidal vessels on MC imaging in GA. HRCV identification is more frequent in eyes with larger areas of atrophy and reduced CT, and thus possibly represent a maker of more advanced GA.