Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States.
Invest Ophthalmol Vis Sci. 2021 Aug 2;62(10):2. doi: 10.1167/iovs.62.10.2.
To quantitatively characterize macrophage-like cells (MLCs) at the vitreoretinal interface in different severity stages of diabetic retinopathy (DR) using optical coherence tomography angiography (OCTA).
The study included 72 eyes of 72 subjects: 18 healthy controls, 22 diabetes mellitus (DM) without DR, 17 nonproliferative DR (NPDR), and 15 proliferative DR (PDR). We obtained repeated (average, 6.5; range, 3-10) macular OCTA scans for each eye. We registered and averaged the 3-µm OCT slab above the vitreoretinal interface to visualize MLCs. Using a semiautomated method, we binarized and quantified MLCs and compared MLC densities among groups. We also evaluated MLC distribution relative to underlying superficial capillary plexus vasculature and quantified MLCs overlying blood vessels within the perivascular 30-µm watershed region and within ischemic zones (defined as >30 µm from the nearest vessel).
MLC density was 2.8- to 3.8-fold higher in PDR compared with all other groups (P < 0.05 for all). MLC density in PDR was most increased in perivascular areas (3.3- to 4.2-fold; P < 0.05 vs. all) and on blood vessels (3.0- to 4.0-fold; P < 0.05 vs. all), and elevated to a lesser extent in ischemic areas (2.3- to 3.4-fold; P < 0.05 vs. all). MLCs were more likely to localize on blood vessels in DM without DR, NPDR, and PDR (P < 0.05 for all), but not healthy eyes.
MLC density was significantly increased in PDR. MLCs clustered on blood vessels in diabetic but not in healthy eyes. Further studies are needed to confirm the origin, identity, and function of MLCs during DR.
利用光相干断层扫描血管造影术（OCTA）定量描述不同严重程度糖尿病视网膜病变（DR）患者玻璃体视网膜界面处的巨噬细胞样细胞（MLCs）。
该研究纳入了 72 只眼的 72 名受试者：18 名健康对照者、22 名无 DR 的糖尿病患者、17 名非增生性 DR（NPDR）患者和 15 名增生性 DR（PDR）患者。我们对每只眼进行了重复（平均 6.5 次；范围 3-10 次）黄斑 OCTA 扫描。我们在玻璃体视网膜界面上方注册并平均了 3µm OCT 切片以可视化 MLCs。使用半自动方法，我们对 MLCs 进行二值化并进行量化，并比较各组之间的 MLC 密度。我们还评估了 MLC 分布与下方浅层毛细血管丛血管的关系，并量化了血管周围 30µm 流域区域和缺血区域（定义为距离最近血管 >30µm）内的 MLCs。
与所有其他组相比，PDR 中的 MLC 密度高 2.8-3.8 倍（所有 P<0.05）。PDR 中的 MLC 密度在血管周围区域（3.3-4.2 倍；与所有组相比 P<0.05）和血管上（3.0-4.0 倍；与所有组相比 P<0.05）增加最多，在缺血区域增加较少（2.3-3.4 倍；与所有组相比 P<0.05）。在无 DR 的糖尿病患者、NPDR 患者和 PDR 患者中，MLCs 更有可能定位于血管上（所有 P<0.05），而不是健康眼中。
在 PDR 中，MLC 密度显著增加。在糖尿病患者中，MLCs 聚集在血管上，但在健康眼中则不然。需要进一步的研究来确认 DR 期间 MLC 的来源、身份和功能。
