Department of Ophthalmology, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon, 16499, Korea.
Institute of Medical Science, Ajou University School of Medicine, Suwon, Korea.
Acta Diabetol. 2020 Jul;57(7):861-866. doi: 10.1007/s00592-020-01495-8. Epub 2020 Feb 29.
Hyperreflective foci (HF), detected in the retina of diabetic patients, suggest the presence of microglial activation and migration, while controversies still remain for the origin of HF to be precursors of hard exudates. We investigated the presence of HF and their association with dyslipidemia in serous retinal detachment (SRD)-type diabetic macular edema (DME).
Forty-two eyes in 42 patients with diabetic retinopathy (DR) and 22 eyes in 22 patients with branch retinal vascular occlusion (BRVO) showing macular edema were included in this study. The medical records and OCT findings were retrospectively reviewed in patients with SRD-type DME and compared with those with BRVO. The mean number of HF, the mean choroidal thickness, and lipid profiles were analyzed and compared between groups.
The mean number of HF was significantly higher in DR group compared to BRVO group. Significant correlation of HF was noted with triglycerides (r = 0.523, P = 0.002). Triglycerides were significantly associated with HF by linear regression (β = 0.012, 95% CI 0.001-0.024, P = 0.034) and remained significantly associated by multiple linear regression (β = 0.014, 95% CI 0.003-0.025, P = 0.014).
HF on OCT of DME patients could be indicative of activated microglia. HF are associated with dyslipidemia, especially high triglycerides, suggesting inflammatory reaction from dyslipidemia in diabetic retina.
在糖尿病患者的视网膜中检测到的高反射焦点 (HF) 提示存在小胶质细胞激活和迁移，尽管 HF 是否为硬性渗出物的前体仍存在争议。我们研究了浆液性视网膜脱离 (SRD) 型糖尿病性黄斑水肿 (DME) 中小胶质细胞激活和迁移与血脂异常的关系。
本研究纳入了 42 例糖尿病性视网膜病变 (DR) 患者的 42 只眼和 22 例伴有黄斑水肿的视网膜分支血管阻塞 (BRVO) 患者的 22 只眼。回顾性分析 SRD 型 DME 患者的病历和 OCT 结果，并与 BRVO 患者进行比较。分析并比较两组患者的 HF 平均数量、脉络膜厚度和血脂谱。
与 BRVO 组相比，DR 组的 HF 平均数量明显更高。HF 与甘油三酯呈显著正相关 (r=0.523, P=0.002)。甘油三酯与 HF 的线性回归关系显著 (β=0.012, 95%CI 0.001-0.024, P=0.034)，多元线性回归分析结果仍然显著 (β=0.014, 95%CI 0.003-0.025, P=0.014)。
DME 患者 OCT 上的 HF 可能表明小胶质细胞被激活。HF 与血脂异常相关，尤其是高甘油三酯血症，表明糖尿病视网膜的血脂异常引起炎症反应。
