{
  "abstract": "Background To assess prevalence and associations of intraretinal hyperreflective foci (HRFs) in a general population.Methods Participants of the population-based Beijing Eye Study underwent optical coherence tomography and macula photography.Results The study cohort included 1641 eyes (mean age: 62.8±9.1 years; range: 50–93 years). Prevalence of any HRF or HRFs located only above the ellipsoid zone (EZ) increased from 33/590 (5.6%; 95% CI 4.0 to 7.0) and 22/590 (3.7%; 95% CI 2.2 to 5.2), respectively, in normal eyes to 371/725 (51.2%; 95% CI 47.7 to 54.7) and 246/725 (33.9%; 95% CI 30.4 to 37.4), respectively, in eyes with early age-related macular degeneration (AMD), to 283/314 (90.1%; 95% CI 87.1 to 93.1) and 260/314 (82.8%; 95% CI 78.8 to 86.8), respectively, in eyes with intermediate AMD, and to 12/12 (100%) and 12/12 (100%), respectively, in late AMD. HRFs above the EZ were spatially associated with EZ defects in 298/540 (55.2%) eyes and external limiting membrane (ELM) defects in 203/540 (37.6%) eyes. 52 (96%) of 54 eyes with macular hyperpigmentations showed HRFs above the EZ, and 52 (9.6%) of 540 eyes with HRFs above the EZ had corresponding macular hyperpigmentations. Higher HRF prevalence was associated (multivariable analysis) with higher AMD stage (OR: 1.75; 95% CI 1.36 to 2.26; p<0.001), and higher prevalences of EZ defects (OR: 36.6; 95% CI 8.56 to 157; p<0.001), reticular pseudodrusen (OR: 1.91; 95% CI 1.29 to 2.82; p<0.001), retinal pigment epithelium (RPE) elevations (OR: 34.5; 95% CI 10.4 to 111; p<0.001) and interdigitation zone thinnings (OR: 4.22; 95% CI 1.90 to 9.35; p<0.001).Conclusions The HRF prevalence was relatively high in early AMD and increased to late AMD. HRF location and shape suggested intraretinally migrated RPE cells as their equivalent. The majority of HRFs were not associated with an ophthalmoscopically detected macular hyperpigmentation. HRFs can also be found in locations with a localised interdigitation zone thinning with spatially corresponding EZ defects and ELM defects.",
  "authors": [
    {
      "affiliations": [
        "Institute Francais de Myopie, Rothschild Foundation Hospital, Paris, France",
        "Singapore Eye Research Institute, Singapore",
        "Beijing Visual Science and Translational Eye Research Institute (BERI), Beijing Tsinghua Changgung Hospital, Tsinghua Medicine, Tsinghua University, Beijing, People's Republic of China",
        "L V Prasad Eye Institute, Hyderabad, India",
        "Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong",
        "New York Eye and Ear Infirmary of Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA",
        "Privatpraxis Prof Jonas und Dr. Panda-Jonas, Heidelberg, Germany"
      ],
      "name": "Jost B Jonas"
    },
    {
      "affiliations": [
        "Ophthalmology, Heidelberg University Medical Faculty Heidelberg, Heidelberg, Germany",
        "Rothschild Foundation Hospital, Paris, France",
        "L V Prasad Eye Institute, Hyderabad, Telangana, India"
      ],
      "name": "Songhomitra Panda-Jonas"
    },
    {
      "affiliations": [
        "Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China",
        "Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China"
      ],
      "name": "Zhe Pan"
    },
    {
      "affiliations": [
        "Beijing Institute of Ophthalmology, Beijing, China"
      ],
      "name": "Jie Xu"
    },
    {
      "affiliations": [
        "Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany",
        "NIHR Biomedical Research Centre at Moorfields, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK"
      ],
      "name": "Rahul A Jonas"
    },
    {
      "affiliations": [
        "Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital University of Medical Science, Beijing, China"
      ],
      "name": "Ya Xing Wang"
    }
  ],
  "title": "Prevalence and associations of intraretinal hyperreflective foci in age-related macular degeneration: the Beijing Eye Study",
  "uid": "53c9a745-6ab9-5070-945a-442517f7c2d3"
}