Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
National Clinical Research Center for Ophthalmic Diseases, Shanghai, China.
Dis Markers. 2021 Oct 13;2021:3510036. doi: 10.1155/2021/3510036. eCollection 2021.
Retinal vein occlusion (RVO) is the second most common vision-threatening retinal vascular disease. Intravitreal dexamethasone implant has been applied to treat macular edema secondary to RVO (RVO-ME). However, the alteration of morphologic features detected with optical coherence tomography angiography (OCTA) has not been fully studied in RVO-ME patients before and after the treatment.
This study is aimed at identifying potential therapeutic targets in RVO with integrative bioinformatic analysis and compares the OCTA characteristics alterations in patients with RVO-ME receiving injection of dexamethasone intravitreal implant.
Bioinformatic analysis was analyzed in GSE101398 dataset from the Gene Expression Omnibus database. Multiple functional enrichment analyses were performed, and protein-protein interaction network was constructed to visualize the key node genes. Eleven eyes with RVO-ME were examined with OCTA before and after intravitreal dexamethasone implant. The OCTA parameters, including macular thickness, vessel density, foveal avascular zone parameters, the number of hyperreflective foci (HRF), area of cystoid edema, and subretinal fluid (SRF), were compared. The correlation was analyzed between best-corrected visual acuity (BCVA) and OCTA parameters.
A total of 79 differentially expressed genes were identified. Functional enrichment analyses revealed the enriched inflammatory events in RVO. In RVO-ME, Pearson correlation revealed that baseline BCVA was positively correlated with the area of SRF and central macular thickness, while no correlation was detected between baseline BCVA and HRF number or the area of cystoid edema. The visual acuity improved, and the central macular thickness was decreased after intravitreal dexamethasone implant injection. Besides, the number of HRF, the area of cystoid edema, and SRF were significantly alleviated after dexamethasone intravitreal injection.
Retinal inflammation plays a crucial role in RVO pathogenesis. The imaging biomarkers of RVO including Müller glial intracellular edema, and retinal pigment epithelium dysfunction, could be assessed in OCTA and attenuated by intravitreal dexamethasone implant effectively.
视网膜静脉阻塞（RVO）是第二大致盲性视网膜血管疾病。玻璃体内注射地塞米松植入物已被用于治疗 RVO 引起的黄斑水肿（RVO-ME）。然而，在接受玻璃体内注射地塞米松植入物治疗前后，RVO-ME 患者的光学相干断层扫描血管造影（OCTA）检测到的形态特征变化尚未得到充分研究。
本研究旨在通过整合生物信息学分析确定 RVO 的潜在治疗靶点，并比较接受玻璃体内注射地塞米松植入物治疗的 RVO-ME 患者的 OCTA 特征改变。
从基因表达综合数据库（GEO）中 GSE101398 数据集进行生物信息学分析。进行了多个功能富集分析，并构建了蛋白质-蛋白质相互作用网络，以可视化关键节点基因。对 11 只 RVO-ME 眼进行了 OCTA 检查，在玻璃体内注射地塞米松植入物前后进行了 OCTA 检查。比较了黄斑厚度、血管密度、中心无血管区参数、高反射焦点（HRF）数量、囊样水肿面积和视网膜下液（SRF）等 OCTA 参数。分析了最佳矫正视力（BCVA）与 OCTA 参数之间的相关性。
共鉴定出 79 个差异表达基因。功能富集分析显示，RVO 中存在丰富的炎症事件。在 RVO-ME 中，Pearson 相关分析显示，基线 BCVA 与 SRF 面积和中央黄斑厚度呈正相关，而与 HRF 数量或囊样水肿面积无相关性。玻璃体内注射地塞米松植入物后视力提高，中央黄斑厚度降低。此外，玻璃体内注射地塞米松后 HRF 数量、囊样水肿面积和 SRF 均明显减轻。
视网膜炎症在 RVO 的发病机制中起着关键作用。OCTA 可评估包括 Müller 胶质细胞细胞内水肿和视网膜色素上皮功能障碍在内的 RVO 影像学生物标志物，并可通过玻璃体内注射地塞米松植入物有效减轻。
