IRCCS-Fondazione Bietti, Rome, Italy.
UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy.
Eye (Lond). 2022 Jun;36(6):1329-1331. doi: 10.1038/s41433-021-01857-8. Epub 2021 Nov 24.
To assess the clinical significance of suspended scattering particles in motion (SSPiM) and different cystic phenotypes in diabetic macular oedema (DME) treated with dexamethasone implant (DEX-i).
A retrospective review of type 2 diabetic patients with DME treated with a DEX-i was conducted. Swept-source optical coherence tomography angiography (OCTA, PLEX Elite 9000) with a 3-mm volume cube was performed. Regions of interest were delineated with Fiji software (version 2.1.0/1.53.c) in the superficial vascular complex (SVC) and deep capillary plexus (DCP) at baseline, 2- and 4-months after DEX-i. SSPiM was defined as regions of variable reflectivity with a decorrelation signal. Without a detectable decorrelation signal, its counterpart was addressed as 'corpuscular,' while hyporeflective cysts were optical empty without hyperreflective material enclosed.
After treatment, the hyporeflective component demonstrated substantial reabsorption in the SVC (-95.4% at 2- and -84.4% at 4-months, p < 0.01 both) and DVC (-84.4%, 2-months), with a less critical decrease of the corpuscular component in the SVC (2-months: -41.9%, p = 0.001 and 4 months: -1.8%, p = 0.73), and not significant in the DVC. SSPiM did not significantly change in the SVC and DVC neither at 2- and 4-months (p > 0.05, all).
After a single DEX-i, the clearance of different cystic phenotypes proceeds with resorption of hyporeflective, followed by corpuscular components. SSPiM demonstrated minimal response, indicating a severe BRB breakdown that may require repeated treatment to reach a satisfactory anatomical response.
评估患有糖尿病黄斑水肿（DME）的患者在接受地塞米松植入物（DEX-i）治疗后，运动中悬浮散射颗粒（SSPiM）和不同囊样形态的临床意义。
对接受 DEX-i 治疗的 2 型糖尿病 DME 患者进行回顾性研究。使用扫频源光学相干断层扫描血管造影（OCTA，PLEX Elite 9000）进行 3mm 体积立方扫描。使用 Fiji 软件（版本 2.1.0/1.53.c）在基线、DEX-i 治疗后 2 个月和 4 个月时在浅层血管复合体（SVC）和深层毛细血管丛（DCP）中划定感兴趣区域。SSPiM 被定义为具有去相关信号的可变反射率区域。如果没有检测到去相关信号，则将其对应物称为“颗粒状”，而低反射性囊肿则是光学空的，没有包含高反射性物质。
治疗后，SVC（2 个月时-95.4%，4 个月时-84.4%，均 p<0.01）和 DVC（-84.4%，2 个月时）中的低反射性成分明显吸收，而 SVC 中的颗粒状成分减少程度较小（2 个月时-41.9%，p=0.001，4 个月时-1.8%，p=0.73），DVC 中则无显著变化。SVC 和 DVC 中的 SSPiM 在 2 个月和 4 个月时均无显著变化（均 p>0.05）。
单次 DEX-i 后，不同囊样形态的清除过程为先吸收低反射性成分，再吸收颗粒状成分。SSPiM 反应最小，表明严重的 BRB 破裂，可能需要重复治疗才能达到满意的解剖学反应。
