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Importance The morphologic changes and their pathognomonic distribution in progressing age-related macular degeneration (AMD) are not well understood. Objectives To characterize the pathognomonic distribution and time course of morphologic patterns in AMD and to quantify changes distinctive for progression to macular neovascularization (MNV) and macular atrophy (MA). Design, Setting, and Participants This cohort study included optical coherence tomography (OCT) volumes from study participants with early or intermediate AMD in the fellow eye in the HARBOR (A Study of Ranibizumab Administered Monthly or on an As-needed Basis in Patients With Subfoveal Neovascular Age-Related Macular Degeneration) trial. Patients underwent imaging monthly for 2 years (July 1, 2009, to August 31, 2012) following a standardized protocol. Data analysis was performed from June 1, 2018, to January 21, 2020. Main Outcomes and Measures To obtain topographic correspondence between patients and over time, all scans were mapped into a joint reference frame. The time of progression to MNV and MA was established, and drusen volumes and hyperreflective foci (HRF) volumes were automatically segmented in 3 dimensions using validated artificial intelligence algorithms. Topographically resolved population means of these markers were constructed by averaging quantified drusen and HRF maps in the patient subgroups. Results Of 1097 patients enrolled in HARBOR, 518 (mean [SD] age, 78.1 [8.2] years; 309 [59.7%] female) had early or intermediate AMD in the fellow eye at baseline. During the 24-month follow-up period, 135 (26%) eyes developed MNV, 50 eyes (10%) developed MA, and 333 (64%) eyes did not progress to advanced AMD. Drusen and HRF had distinct topographic patterns. Mean drusen thickness at the fovea was 29.6 μm (95% CI, 20.2-39.0 μm) for eyes progressing to MNV, 17.2 μm (95% CI, 9.8-24.6 μm) for eyes progressing to MA, and 17.1 μm (95% CI, 12.5-21.7 μm) for eyes without disease progression. At 0.5-mm eccentricity, mean drusen thickness was 25.8 μm (95% CI, 19.1-32.5 μm) for eyes progressing to MNV, 21.7 μm (95% CI, 14.6-28.8 μm) for eyes progressing to MA, and 14.4 μm (95% CI, 11.2-17.6 μm) for eyes without disease progression. The mean HRF thickness at the foveal center was 0.072 μm (95% CI, 0-0.152 μm) for eyes progressing to MNV, 0.059 μm (95% CI, 0-0.126 μm) for eyes progressing to MA, and 0.044 μm (95% CI, 0.007-0.081) for eyes without disease progression. At 0.5-mm eccentricity, the largest mean HRF thickness was seen in eyes progressing to MA (0.227 μm; 95% CI, 0.104-0.349 μm) followed by eyes progressing to MNV (0.161 μm; 95% CI, 0.101-0.221 μm) and eyes without disease progression (0.085 μm; 95% CI, 0.058-0.112 μm). Conclusions and Relevance In this study, drusen and HRF represented imaging biomarkers of disease progression in AMD, demonstrating distinct topographic patterns over time that differed between eyes progressing to MNV, eyes progressing to MA, or eyes without disease progression. Automated localization and precise quantification of these factors may help to develop reliable methods of predicting future disease progression.

PURPOSE To investigate the relationship between baseline number of hyperreflective foci (HF) on spectral domain optical coherence tomography (SD-OCT) in patients with diabetic macular edema (DME), as well as the dynamics of HF during treatment with anti-vascular endothelial growth factor (VEGF), and treatment response. METHODS We evaluated patients diagnosed with DME scheduled for treatment with intravitreal bevacizumab. Eyes were classified as adequate or insufficient treatment responders based on logMAR visual acuity improvement and central retinal thickness (CRT) decrease after three consecutive injections. Associations between number of HF at baseline and treatment response, the change in HF over the course of treatment, and the distribution of HF within the retinal layers were evaluated. RESULTS In 54 eyes of 41 patients, mean number of HF and CRT decreased after intravitreal treatment with bevacizumab (p = 0.002 and p

PURPOSE. To assess the changes in hyperreflective foci (HF) by means of spectral-domain optical coherence tomography (SD-OCT) in patients undergoing anti-VEGF treatment for subfoveal choroidal neovascularization (CNV) secondary to angioid streaks (AS). METHODS. Fifteen eyes with diagnosis of AS-related CNV (8 males) and 15 control eyes with uncomplicated AS were consecutively recruited. Patients and controls underwent complete ophthalmologic examination and SD-OCT. Patients were subjected to a pro re nata treatment regimen, including monthly examinations and intravitreal aflibercept injection in case of fluid detection on SD-OCT. HF were measured on horizontal scans of the six-line radial SD-OCT, in the fovea and parafovea and the subdivided as retinal or choroidal. Specifically, HF were analyzed at the following time points: baseline, dry on SD-OCT, 1 month before its reactivation, and the time of CNV reactivation. RESULTS. HF numbers resulted higher in all CNV phases with respect to controls, except during inactive phase. Moreover, foveal and parafoveal HF were found significantly increased in active, prereactive, and reactive phases when compared with inactive phase (P < 0.05). A similar trend was detected for choroidal HF. Interestingly, a subanalysis revealed that only foveal choroidal HF are significantly higher in a prereactive phase if compared with an inactive phase (P = 0.03). Our correlational analysis unveiled negative associations between intraretinal HF numbers and logMAR best-corrected visual acuity. CONCLUSIONS. Our findings suggest that HF represent useful markers to monitor CNV activity. Choroidal HF appear already increased in the fovea 1 month before CNV reactivation. Validation of our results might lead to earlier anti-VEGF reinjection and possibly better visual outcomes.

Diabetic hyperreflective foci in the outer retinal layers are a clinically relevant finding on optical coherence tomography (OCT) images, although their characteristics remain to be elucidated. Here we investigated the decorrelation signal around hyperreflective foci on OCT angiography (OCTA) images in diabetic retinopathy (DR). We retrospectively reviewed sufficient quality OCTA images from 102 eyes of 66 patients that were obtained using split-spectrum amplitude-decorrelation angiography algorithm. Most confluent hyperreflective foci were randomly deposited or appeared in a radiating array on the en-face structural OCT images in the inner nuclear layer (INL) or Henle’s fiber layer (HFL), respectively. Within the INL, hyperreflective foci were not accompanied by decorrelation signals and attached to capillaries on OCTA images. Decorrelation signals were sometimes delineated in hyperreflective foci in the HFL and other times appeared to be pseudopod-like or wrapping around hyperreflective foci, referred to as reflectance-decorrelated foci. The decorrelation signal intensity of hyperreflective foci in the HFL was associated with logMAR VA (R = 0.553, P R = 0.408, P reflectance-decorrelated foci on OCTA images are clinically relevant as well as shed lights on the properties in diabetic hyperreflective foci.

Optical Coherence Tomography (OCT) is one of the most advanced, non-invasive method of eye examination. Age-related macular degeneration (AMD) is one of the most frequent reasons of acquired blindness. Our aim is to develop automatic methods that can accurately identify and characterize biomarkers in OCT images, related to AMD. We present methods for quantizing hyperreflective foci (HRF) with deep learning. We also describe an algorithm for determining pigmentepithelial detachment (PED) and localizing outer retinal tubulation (ORT) that appears between the layers of the retina.

Purpose. Long-term follow-up of patients with diabetic macular edema (DME) treated with intravitreal antivascular endothelial growth factor (anti-VEGF) combined focal laser and identification of prognostic morphological characteristics. Methods. Prospective clinical trial (50 treatment-naive eyes) with DME randomized 1 : 1 receiving intravitreal ranibizumab (0.5 mg/0.05 ml) and prompt grid laser compared with ranibizumab and deferred laser. Morphological characteristics potentially relevant for prognosis were assessed at baseline, month 6, month 9, and years 1, 2, 3, 4, and 5 of follow-up. Results. Although functional results were slightly higher in the prompt group at week 12 (0.5; 20/40 Snellen (SD = 0.04, 0.3 logMAR) versus 0.4; 20/50 Snellen (SD = 0.04, logMAR: 0.4), p=0.4) and month 9 (prompt group: 0.5; 20/40 Snellen (SD = 0.03, 0.3 logMAR) versus deferred group: 0.4; 20/50 Snellen (SD = 0.04, 0.4 logMAR), p=0.4), these were statistically insignificant. There was no significant benefit regarding functionality during long-term follow-up in the prompt group compared to the deferred group. BCVA in the eyes with clusters of hyperreflective foci in the central macular region was inferior compared with the eyes without these alterations at year 5 (0.39; 20/50 Snellen, (SD = 0.25, 0.4 logMAR) versus 0.63; 20/80 Snellen (SD = 0.22, 0.2 logMAR), p<0.01). Conclusion. Grid laser and ranibizumab therapy are effective in DME management during the long-term follow-up. Intraretinal hyperreflective material in SD-OCT is negatively related to BCVA.

Background: Hyperreflective foci have been described in OCT imaging of patients with retinal vascular diseases. It has been suggested that they may play a role as a prognostic factor of visual outcomes in these diseases. The purpose of this study is to describe the presence of hyperreflective foci in patients with non-infectious uveitic macular edema and evaluate their behavior after treatment. Methods: We conducted a multicenter, prospective, observational, 12-month follow-up study. Inclusion criteria were age > 18 years and a diagnosis of non-infectious uveitic macular edema, defined as central macular thickness of > 300 mu m as measured by OCT and fluid in the macula. Collected data included best corrected visual acuity, central macular thickness and the presence, number and distribution (inner or outer retinal layers) of hyperreflective foci. Evaluations were performed at baseline, and at 1, 3, 6, and 12 months after starting treatment. Results: We included 24 eyes of 24 patients. The frequency of patients with >= 11 hyperreflective foci was 58.4% at baseline, falling to 20.8% at 12 months. Further, hyperreflective foci were observed in the outer retinal layers in 50% of patients at baseline and just 28.6% at 12 months. Mean LogMAR visual acuity improved from 0.55 (95% CI 0.4-0. 71) at baseline to 0.22 (95% CI 0.08-0.35) at 12 months (p < 0.001). Mean central macular thickness decreased from 453.83 mu m (95% CI 396.6-511) at baseline to 269.32 mu m (95% CI 227.7-310.9) at 12 months (P < 0.001). Central macular thickness was associated with number (p = 0.017) and distribution (p = 0.004) of hyperreflective foci. Conclusions: We have observed hyperreflective foci in most of our patients with non-infectious uveitic macular edema. During follow-up and after treatment, the number of foci diminished and they tended to be located in the inner layers of the retina. This work was supported by grants from: Spanish Ministry of Economy, Industry and Competitivity, Carlos III Health Institute: PI 13/02148, cofinanced by the European Regional Development Fund.

To report on the presence of hyperreflective foci (HF) on spectral domain optical coherence tomography in patients with Best vitelliform macular dystrophy (BVMD), and to describe the relationship between HF and stages of the disease.Consecutive patients diagnosed with BVMD were enrolled in a prospective cross-sectional study. All patients and control subjects underwent a complete ophthalmologic examination, including best-corrected visual acuity and spectral domain optical coherence tomography.identification of HF in BVMD. Secondary outcome: assessment of the HF in each stage and correlation with best-corrected visual acuity.Overall, 75 eyes of 39 patients were included in the study (Stage 1: 13%, Stage 2: 43%, Stage 3: 15%, Stage 4: 21%, and Stage 5: 8%). On spectral domain optical coherence tomography assessment, intraretinal HF were present in 83% of all eyes, in 91% of eyes affected by clinical BVMD (Stages 2-5) and in 100% of patients in Stages 4 and 5. In 46% of clinically diseased eyes, HF were localized in the fovea and in correspondence with the BVMD lesions at the level of the outer nuclear layer and outer plexiform layer. Hyperreflective foci were present in 16% of control eyes. Mean number of HF in eyes affected by clinical BVMD stood at 7.67 ± 7.35. These were predominantly small HF (6.23 ± 6.14, P0.001) localized in the outer nuclear layer (5.19 ± 5.38, P = 0.001) and presented largely in the extrafoveal, rather than the foveal area (5.21 ± 5.57 vs 2.46 ± 2.73, P = 0.001). Analysis of HF distribution revealed that the control group and Stage 1 eyes had the fewest HF; Stage 4 displayed a significant increase in the number of HF compared with Stages 2 and 3; Stage 5 also showed an increased number of HF, although this difference was statistically significant only with Stage 3 eyes. The best-corrected visual acuity was negatively related to the number of HF, with best-corrected visual acuity deteriorating as the number of HF increased in Stages 2 to 5 (P0.001).This study describes the presence of HF in BVMD using spectral domain optical coherence tomography. Our data suggest that HF identification is correlated with the progression of the disease and could represent a useful biomarker of BVMD.

Purpose: To evaluate outcome predictors of aflibercept in neovascular age-related macular degeneration pretreated with ranibizumab based on a treat-and-extend regimen (TER). Methods: We performed a retrospective evaluation of 18-month follow-up of 45 consecutive patients with limited response to ranibizumab. Results: At month 18, mean central retinal thickness and intraretinal fluid (IRF) height were significantly reduced. The recurrence-free treatment interval (RFTI) increased from 7.0 ± 1.8 to 8.5 ± 2.4 weeks (p = 0.01); visual acuity remained stable. At month 18, 58.1% of patients showed a longer RFTI. At month 12, eyes with baseline subretinal fluid (SRF) had a shorter RFTI than those without SRF (p = 0.032). Eyes with baseline IRF showed a longer RFTI than those without IRF (p = 0.037). Baseline hyperreflective foci (HRF) presence indicated improvement in SRF (p = 0.024) and IRF at month 12 (p = 0.049). Conclusion: Baseline HRF presence predicted better morphological outcome, while SRF predicted a shorter RFTI and IRF a longer RFTI after switching from ranibizumab to aflibercept within a TER.

To investigate the association between the characteristics of foveal cystoid spaces and short-term responsiveness to ranibizumab treatment for diabetic macular edema (DME) at 3 months from the initial injection. We retrospectively reviewed 66 eyes of 61 patients with center-involved DME who received three consecutive ranibizumab injections and following as-needed administrations. We evaluated the relationship between visual improvement at 3 months and the preoperative optical coherence tomography (OCT) parameters including hyperreflective foci, heterogeneous OCT reflectivity, mean levels of OCT reflectivity and height of foveal cystoid spaces. Twenty-three eyes without preoperative hyperreflective foci in the foveal cystoid spaces had significantly greater improvement in the logarithm of the minimum angle of resolution visual acuity (logMAR VA) at 3 months than 43 eyes with foci (P = 0.006). That was similar to the greater reduction in CSF thickness in eyes without lesions after treatment at the same time point (P

Purpose To determine whether disorganization of retinal inner layers (DRIL) assessed by spectral-domain optical coherence tomography (SDOCT) correlates with visual acuity (VA) in eyes with uveitic cystoid macular edema (CME). Design Secondary analysis of randomized clinical trial data. Methods Fifty-six eyes of 42 patients with uveitic CME were prospectively imaged as part of the VISUAL-1 trial (Clinicaltrials.gov identifier NCT01138657). Central subfield thickness (CFT), horizontal and vertical extent of DRIL, foveal DRIL (>500 μm DRIL) hyperreflective foci (HRF), average and largest area of intraretinal (IR) cysts, and extent of disruption of external limiting membrane (ELM) and ellipsoid zone (EZ) were determined within the 1-mm central subfield and correlated with VA at baseline and follow-up visits. Results Regression analysis adjusted for clustered observations was used to examine the association between OCT morphologic parameters and VA. Across all visits (n = 168), significant associations were found for CFT (0.080 per 100 μm, P P P P = .005), total area of IR cysts (0.204 per mm 2 , P 2 , P P = .026), and EZ disruption (0.042 per 100 μm, P = .02). ELM disruption did not show a significant association with VA (−0.013 per 100 μm, P = .61). Conclusion DRIL is a robust and easily obtained surrogate marker of VA in participants with current or resolved uveitic CME. CFT, DRIL, IR cyst area, EZ disruption, and HRF had a strong association with VA.

Age-related macular degeneration (AMD) is a leading cause of blindness in developed countries. The presence of drusen is the hallmark of early/intermediate AMD, and their sudden regression is strongly associated with the onset of late AMD. In this work we propose a predictive model of drusen regression using optical coherence tomography (OCT) based features. First, a series of automated image analysis steps are applied to segment and characterize individual drusen and their development. Second, from a set of quantitative features, a random forest classifiser is employed to predict the occurrence of individual drusen regression within the following 12 months. The predictive model is trained and evaluated on a longitudinal OCT dataset of 44 eyes from 26 patients using leave-one-patient-out cross-validation. The model achieved an area under the ROC curve of 0.81, with a sensitivity of 0.74 and a specificity of 0.73. The presence of hyperreflective foci and mean drusen signal intensity were found to be the two most important features for the prediction. This preliminary study shows that predicting drusen regression is feasible and is a promising step toward identification of imaging biomarkers of incoming regression.

[Background]: We aimed to study the retinal morphological findings associated with exudative age-related macular degeneration (AMD) and their association with visual prognosis. [Methods]: We retrospectively reviewed the medical records of 96 consecutive patients (96 eyes) with exudative AMD. Retinal structural changes were examined using optical coherence tomography (OCT). [Results]: Initial OCT examination showed cystoid macular edema in 18 eyes (18.8%), fibrin exudate in 56 eyes (58.3%), and hyperreflective foci within the neurosensory retina in 78 eyes (81.3%). Upon initial examination, an external limiting membrane (ELM) line was detected under the fovea in 64 eyes (66.7%). Using Pearson’s correlation analyses, final visual acuity (VA) was correlated with initial VA (r = 0.61, p

Purpose The purpose of this study was to evaluate the correlation between quantity of intraretinal hyperreflective foci (HRF) in the eye with intermediate AMD and progression to late AMD. Methods Volume optical coherence tomography (OCT) scans from 114 eyes of 114 patients were retrospectively reviewed. HRF were assessed both qualitatively and quantitatively. Five sequential en face slabs from midretina were thresholded to isolate the HRF. These five slabs were recombined, and HRF area was measured in the whole 6 × 6-mm image (HRFTOT) and within the central 3-mm (HRF3mm) and 5-mm (HRF5mm) regions. These measurements were correlated with the development of late AMD (defined as choroidal neovascularization [CNV] and/or complete RPE and photoreceptor atrophy [cRORA]) after 1 year of follow-up. Results HRF area in all three regions showed significant correlations with progression to late AMD: R = 0.610 for HRF3mm, R = 0.622 for HRF5mm, and R = 0.614 for HRFTOT (all P < 0.001). Correlations remained significant with progression to cRORA alone, though not for progression to CNV alone. While qualitative assessment of HRF (i.e., presence of HRF: yes or no) also showed a significant correlation with progression to late AMD (R = 0.454, P < 0.001) and atrophy alone (R = 0.445, P < 0.001), they were weaker than by HRF quantification. Conclusions The area of HRF from en face OCT in eyes with intermediate AMD correlates with the 1-year risk of progression to late AMD, and in particular with the development of atrophy.

Optic disc melanocytoma (ODM) has been considered as a benign tumor with few reports of malignant transformation. We present swept-source optical coherence tomography (SSOCT) imaging of a case of ODM. As attaining histopathology is impossible in most cases, we discuss the possibility of using SSOCT as a tool for ruling out choroidal invasion or juxtapapillary melanoma.

Purpose To investigate the correlation ofhyperreflective foci, photoreceptor integrity and visual acuity (VA) in patients with diabetic macular edema (DME). Methods Seventy-eight patients (114 eyes) with DME were analyzed retrospectively with Spectral-domain optical coherence tomography (SD-OCT). Results SD-OCT showed that 28 eyes (24.5%) had hyperreflective foci in the inner retinal layers, and 66 eyes (57.9%) had hyperreflective foci in the outer retinal layers. The logMAR VA was significantly (P

Purpose We improved our understanding of central serous chorioretinopathy (CSC), we performed an analysis of noninvasive, high-resolution retinal imaging in patients with active and resolved CSC. Methods Adaptive optics scanning light ophthalmoscopy (AOSLO) and spectral-domain optical coherence tomography (SD-OCT) were performed on five subjects with CSC. A custom AOSLO system was used to simultaneously collect confocal and split-detector images. Spectral domain-OCT volume scans were used to create en face views of various retinal layers, which then were compared to montaged AOSLO images after coregistration. Results Three distinct types of intraretinal hyperreflective clusters were seen with AOSLO. These clusters had a well-demarcated, round, and granular appearance. Clusters in active CSC over areas of serous retinal detachment were termed type-1. They were found primarily in the outer nuclear layer (ONL) and were associated with large defects in the photoreceptor mosaic and ellipsoid zone. Clusters in areas where the retina had reattached were termed type-2. They also were located primarily in the ONL but showed stability in location over a period of at least 8 months. Smaller clusters in the inner retina along retinal capillaries were termed type-3. Conclusions Retinal imaging in CSC using en face OCT and AOSLO allows precise localization of intraretinal structures and detection of features that cannot be seen with SD-OCT alone. These findings may provide greater insight into the pathophysiology of the active and resolved phases of the disease, and support the hypothesis that intraretinal hyperreflective foci on OCT in CSC are cellular in nature.

To analyze the presence of hyperreflective foci in Type 1 and Type 2 diabetic patients, separately, without clinically significant diabetic macular edema and visual impairment.Noninvasive, observational prospective study. Seventeen and 19 consecutive Type 1 and Type 2 diabetic patients (33 and 38 eyes), respectively, were recruited. All patients had no clinically significant diabetic macular edema or visual impairment. Two age- and sex-matched control groups were also included. Patients underwent an ophthalmologic examination including spectral domain optical coherence tomography. Hyperreflective foci were counted considering horizontal B-scan passing through the fovea.On spectral domain optical coherence tomography, patients affected by Type 1 and Type 2 diabetes had a mean of 7.5 ± 4.6 and 9.9 ± 4.5 hyperreflective foci, respectively. Subjects of control groups had a mean of 0.9 ± 0.8 and 1.7 ± 1.5 hyperreflective foci, respectively. Hyperreflective foci amount was statistically different between Type 1 and Type 2 diabetic groups (P = 0.032) and significantly higher in diabetic patients than in controls (P0.001). Hyperreflective foci amount was significantly higher in diabetic patients with a poor quality glycometabolic control (P0.001 and P = 0.016) or affected by hypertension (P = 0.008).We reported the presence of hyperreflective foci in diabetic patients without diabetic macular edema and visual impairment. This spectral domain optical coherence tomography finding might be a useful marker for the diagnosis and the follow-up in the early stage of diabetic retinopathy.

Purpose: Spectral-domain optical coherence tomography (SD-OCT) enables high-resolution analysis of retinal layers and previously unseen hyperreflective dots (HRD). HRD morphological characteristics, evolution, possible origin and prognostic value are discussed. Methods: We conducted a prospective study of 100 patients with exudative age-related macular degeneration (AMD), who were treated and followed up with monthly imaging examinations. Statistical correlations between visual acuity (VA) and pre-/post- treatment HRD characteristics were evaluated. Results: HRD were present in all cases, mainly in the outer retinal layers but also elsewhere. After treatment, HRD regressed in a few days, 1 month (p < 0.04) and 3 months (p < 0.01). Regression was evident in all VA and morphological subsets. Resolution was associated with better final VA (p < 0.001). Conclusions: Presence of initial/recurrent HRD, rapid treatment response and the growing role that early biological inflammatory reaction plays in AMD suggests HRD are activated microglia cells. The correlation between VA and HRD could make HRD a clinical marker for early decisions about treatment and retreatment.

Objective To combine “extramacular” and “enhanced depth” optical coherence tomographic (OCT) scanning protocols to facilitate enhanced characterization of patients with birdshot chorioretinopathy. Methods Spectral-domain OCT images were prospectively collected from 24 eyes of 12 patients with birdshot chorioretinopathy. The images were acquired both from the macula and from 4 peripheral locations: superior and inferior to the temporal vascular arcades, nasal to the optic disc, and temporal to the macula. All images were obtained using enhanced depth scanning protocols. Qualitative and quantitative assessments were performed and compared with those from healthy, age-matched controls. Results Generalized loss of the photoreceptor inner segment/outer segment junction was seen more frequently on extramacular OCT image sets. Focal loss of the inner segment/outer segment junction was seen most commonly on inferior extramacular images. Generalized thinning and loss of retinal architecture, accompanied by outer retinal hyperreflective foci, were also commonly seen on extramacular scans. Assessment of choroidal morphology included thinning/absence of the Sattler layer, generalized thinning, discrete hyperreflective foci, focal depigmentation, and the presence of suprachoroidal hyporeflective space. The mean (SD) foveal choroidal thickness was significantly less for patients with birdshot chorioretinopathy (276 [101] μm) than for controls (337 [74] μm) (P = .04). Conclusions The OCT images obtained outside the macula often show significant retinal and choroidal changes in cases for which conventional OCT scans appear unremarkable. Use of extramacular scanning may thus allow improved phenotyping of uveitic disorders such as birdshot chorioretinopathy. Evaluation of the photoreceptor inner segment/outer segment junction, using this approach, may be of value for monitoring disease activity in clinical practice and as a surrogate end point in clinical trials.