Optometry and Vision Science Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia.
Department of Ophthalmology, Hospital Shah Alam, Persiaran Kayangan, Seksyen 7, 40000 Shah Alam, Selangor, Malaysia.
Int J Environ Res Public Health. 2020 May 1;17(9):3154. doi: 10.3390/ijerph17093154.
Hyperreflective dots (HRD) are activated retinal microglial cells induced by retinal inflammation in diabetic patients. This study was conducted to compare the HRD count of normal and diabetic subjects; to determine the correlation between hemoglobin A1c (HbA1c) levels and HRD count; to determine HbA1c cut-off levels for the appearance of HRD in diabetic patients. A cross-sectional study was conducted among normal and diabetic patients. Fundus photos, SD-OCT images and HbA1c levels were taken. A total of 25 normal subjects, 32 diabetics without retinopathy and 26 mild-to-moderate nonproliferative diabetic retinopathy (NPDR) diabetics were recruited. There was a statistically significant difference between the mean count of HRD among the normal group, the diabetic without retinopathy group and the mild-to-moderate NPRD group. The mean HRD count in the inner retina layer was significantly higher compared to the outer retina layer. There was a significant linear relationship between the HbA1c levels and HRD count. Using the receiver operating curve, the HbA1c level of 5.4% was chosen as the cut-off point for the appearance of HRD. The positive linear correlation between the HbA1c levels and the appearance of HRD may indicate that hyperglycemia could activate retina microglial cells in diabetic patients.
高反射点（HRD）是糖尿病患者视网膜炎症诱导的激活的视网膜小胶质细胞。本研究旨在比较正常和糖尿病患者的 HRD 计数；确定血红蛋白 A1c（HbA1c）水平与 HRD 计数之间的相关性；确定 HbA1c 水平作为糖尿病患者出现 HRD 的截断值。本研究为横断面研究，纳入了正常和糖尿病患者。采集眼底照片、SD-OCT 图像和 HbA1c 水平。共纳入 25 名正常对照者、32 名无糖尿病视网膜病变的糖尿病患者和 26 名轻度至中度非增生性糖尿病视网膜病变（NPDR）糖尿病患者。正常组、无糖尿病视网膜病变组和轻度至中度 NPDR 组之间 HRD 计数的平均值存在统计学差异。与外视网膜层相比，内视网膜层的 HRD 计数平均值显著更高。HbA1c 水平与 HRD 计数之间存在显著的线性关系。使用受试者工作特征曲线，选择 5.4%的 HbA1c 水平作为 HRD 出现的截断值。HbA1c 水平与 HRD 出现之间的正线性相关可能表明高血糖可激活糖尿病患者的视网膜小胶质细胞。
