Vitreoretinal Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India.
Indian J Ophthalmol. 2021 May;69(5):1197-1202. doi: 10.4103/ijo.IJO_2627_20.
The aim of this study was to analyze the factors associated with hyperreflective foci (HRF) in diabetic macular edema (DME) in treatment naïve eyes.
This retrospective observational study included 131 eyes of 91 treatment naïve patients with DME. Details of ophthalmological examination with duration of vision loss and systemic parameters were noted. The spectral-domain optical coherence tomography (SD-OCT) images were analyzed for number and location of HRF and the associated imaging biomarkers.
Inner retinal (IR) HRF were seen in 88 eyes (67%), outer retinal (OR) in 28 (21%), and subretinal (SR) in 12 (9%). The IR had (7.1 ± 7) HRF, the OR (6.5 ± 4.8), and SR (3.9 ± 2.9). A greater proportion of eyes with HRF also had subretinal fluid (SRF), significantly higher blood pressure and lower serum triglycerides. Univariate linear regression analysis showed women (3 HRF greater vs. men, P = 0.04), eyes with cystoid spaces (2.95 more HRF vs. no cystoid spaces, P = 0.02), and SRF (2.96 more HRF vs. no SRF, P = 0.007) had more HRF, whereas higher triglycerides (1 HRF lesser per 50 mg lower TGL, P = 0.03) had lesser.
Our study highlights the importance of HRF as an imaging biomarker in DME suggesting an inflammatory origin. Long-term observations of large cohorts with automated analysis can give more insights.
本研究旨在分析治疗初治糖尿病性黄斑水肿（DME）患者中与高反射焦点（HRF）相关的因素。
这是一项回顾性观察性研究，纳入了 91 例治疗初治 DME 患者的 131 只眼。记录了眼科检查的详细信息，包括视力丧失持续时间和全身参数。对频域光相干断层扫描（SD-OCT）图像进行分析，以确定 HRF 的数量和位置以及相关的成像生物标志物。
88 只眼（67%）出现内视网膜（IR）HRF，28 只眼（21%）出现外视网膜（OR）HRF，12 只眼（9%）出现视网膜下（SR）HRF。IR 有（7.1±7）个 HRF，OR 有（6.5±4.8）个，SR 有（3.9±2.9）个。有 HRF 的眼更多地出现视网膜下液（SRF），血压显著升高，血清甘油三酯水平降低。单因素线性回归分析显示，女性（比男性多 3 个 HRF，P=0.04）、存在囊样空泡（比无囊样空泡多 2.95 个 HRF，P=0.02）和存在 SRF（比无 SRF 多 2.96 个 HRF，P=0.007）的眼 HRF 更多，而甘油三酯较高（每降低 50mg 甘油三酯，HRF 减少 1 个，P=0.03）的眼 HRF 更少。
本研究强调了 HRF 作为 DME 成像生物标志物的重要性，提示其具有炎症起源。对大样本进行长期观察和自动分析可以提供更多的见解。
