The Natural Course of Age-Related Scattered Hypofluorescent Spots on Late-Phase ICGA (ASHS-LIA): Structural…

Cohort studyInvestigative ophthalmology & visual science· Jun 2026

The Natural Course of Age-Related Scattered Hypofluorescent Spots on Late-Phase ICGA (ASHS-LIA): Structural Evolution and Neovascular Complications.

Federico Formenti, Lorenzo Bianco, Valeria Lecca … Maria Vittoria Cicinelli

RetinaCohort studyPrognosisQ1IF 4.2

Retinal structure changed over time in 11% of eyes with these AMD-related spots.

The Natural Course of Age-Related Scattered Hypofluorescent Spots on Late-Phase ICGA (ASHS-LIA): Structural Evolution and Neovascular Complications.

Federico Formenti … Maria Vittoria Cicinelli

Investigative ophthalmology & visual science · Jun 2026 · Q1 in Ophthalmology

Purpose

The purpose of this study was to characterize the longitudinal evolution and prognostic associations of age-related scattered hypofluorescent spots on late-phase indocyanine green angiography (ICGA; ASHS-LIA), a putative marker of early retinal pigment epithelium/Bruch's membrane (RPE/BM) dysfunction, in a Caucasian cohort.

Methods

Retrospective longitudinal study of patients with ASHS-LIA who underwent optical coherence tomography (optical coherence tomography) and ICGA.

n = 278 eyes

Results

11%

eye's inner layers shifted structurally over years of follow-up

n = 278 eyes

More results

A total of 278 eyes of 144 patients (mean age = 69.5 ± 9.3 years, 53% male patients) were followed for a mean of 6.2 years.

At baseline, 56% of eyes were S0, 31% were S1, and 14% were S2, with age and ASHS-LIA extension increasing stepwise across structural categories (P < 0.001).

More results

During follow-up, 16 incident choroidal neovascularization lesions were identified, showing heterogeneous presentations, including aneurysmal type 1 choroidal neovascularization in drusen-free eyes and mixed types 1 and 2 choroidal neovascularization in eyes with larger drusen.

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Conclusion · 1 of 2

ASHS-LIA is associated with long-term structural changes and neovascular complications in eyes exhibiting this phenotype.

Conclusion · 2 of 2

These findings support its role as a risk stratification feature within ASHS-LIA-positive eyes, although its relationship with AMD progression cannot be established from the present study.

The Natural Course of Age-Related Scattered Hypofluorescent Spots on Late-Phase ICGA (ASHS-LIA): Structural Evolution and Neovascular Complications.

The Natural Course of Age-Related Scattered Hypofluorescent Spots on Late-Phase ICGA (ASHS-LIA): Structural Evolution and Neovascular Complications.

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