Kamalnayan Bajaj Sankara Nethralaya, Kolkata, West Bengal, India.
Indian J Ophthalmol. 2021 Nov;69(11):3203-3206. doi: 10.4103/ijo.IJO_1585_21.
Choroidal hyperreflective foci (HCF) are novel spectral-domain optical coherence tomography (SDOCT) biomarkers in diabetic macular edema (DME). The present study intended to validate HCF and assess their role in the treatment outcome.
It was a retrospective, longitudinal, records-based pilot study recruiting consecutive patients of nonproliferative diabetic retinopathy with treatment naïve DME. Patients were treated with three intravitreal anti-vascular endothelial growth factor injections and followed by a pro re nata regimen.
A total of 43 eyes of 28 patients were included in the study. Eyes were divided into two groups. Group A (n = 19) comprised eyes with retinal hyperreflective foci (HRF) and group B (n = 24) had eyes with both HRF and HCF. The mean age of patients in group A and B was 58.5 ± 2.1 years and 55.2 ± 8.8 years, respectively. Mean best-corrected visual acuity at presentation was 0.38 ± 0.25 in group A and 0.59 ± 0.29 in group B (P = 0.01). Final BCVA was 0.35 ± 0.39 in group A and 0.47 ± 0.34 in group B (P = 0.3). External limiting membrane was intact in 19 out of 19 eyes in group A and two (8.3%) eyes in group B (P = 0).
Presence of HCF meant significantly worse initial BCVA compared to the eye that had HRF alone. The final BCVA was also worse in eyes with HCF compared to those with HRF and without HCF; however, the difference did not reach a significance level, probably pointing toward the fact that HCF and HRF are pathophysiologically identical. Further studies with a larger sample size and prospective design are needed to take these findings forward.
脉络膜高反射焦点（HCF）是糖尿病性黄斑水肿（DME）的新型光谱域光相干断层扫描（SDOCT）生物标志物。本研究旨在验证 HCF，并评估其在治疗结果中的作用。
这是一项回顾性、纵向、基于记录的试点研究，招募了未经治疗的非增生性糖尿病性视网膜病变伴 DME 的连续患者。患者接受了三次玻璃体内抗血管内皮生长因子注射治疗，并随后采用按需治疗方案。
共有 28 名患者的 43 只眼纳入了本研究。将眼睛分为两组。A 组（n = 19）包括有视网膜高反射焦点（HRF）的眼睛，B 组（n = 24）包括有 HRF 和 HCF 的眼睛。A 组和 B 组患者的平均年龄分别为 58.5 ± 2.1 岁和 55.2 ± 8.8 岁。A 组和 B 组患者就诊时的平均最佳矫正视力分别为 0.38 ± 0.25 和 0.59 ± 0.29（P = 0.01）。A 组的最终 BCVA 为 0.35 ± 0.39，B 组为 0.47 ± 0.34（P = 0.3）。A 组 19 只眼中有 19 只眼的外部限制膜完整，B 组有 2 只眼（8.3%）的外部限制膜完整（P = 0.0001）。
与仅有 HRF 的眼睛相比，HCF 的存在意味着初始 BCVA 显著下降。与仅有 HRF 且无 HCF 的眼睛相比，HCF 存在的眼睛最终 BCVA 也较差；然而，差异没有达到显著性水平，这可能表明 HCF 和 HRF 在病理生理学上是相同的。需要进一步进行更大样本量和前瞻性设计的研究来推进这些发现。
