Li Zijing, Deng Xiaowen, Lu Tu, Zhou Lijun, Xiao Jianhui, Lan Yuqing, Jin Chenjin
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 South Xianlie Road, Guangzhou 510060, China; Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou 510020, China.
Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou 510020, China.
Photodiagnosis Photodyn Ther. 2022 Sep;39:102903. doi: 10.1016/j.pdpdt.2022.102903. Epub 2022 May 6.
The aim of this study was to investigate the vision-affected optical coherence tomography (angiography) (OCT/OCTA)-based morphological characteristics of diabetic macular edema (DME) and to explain their possible underlying mechanisms from a systemic perspective.
Diabetic patients with DME were included in this retrospective study. The clinical profiles and OCT/OCTA morphological characteristics were recorded. Linear mixed-model analyses were performed between best-corrected visual acuity (BCVA) and each OCT/OCTA morphological characteristic. Linear and logistic mixed-model analyses were performed between each vision-affected morphological characteristic and the clinical characteristics.
Eighty-five eyes of 85 patients were included. The number of hyperreflective dots (HDs) (p<0.001) and hyperreflective foci (HF) (p = 0.006) was positively correlated with LogMAR BCVA in the univariate analysis. The number of HDs (p = 0.008) remained correlated with LogMAR BCVA in the multivariate analysis. Eyes with an increased number of HF (p = 0.01) were more likely to have hard exudates within a fovea area diameter of 3 mm, while the relationship between the number of HDs and the presence of hard exudates did not reach significance. In the multivariate analysis, the increased level of total cholesterol (TC) (p = 0.004) and the reduced level of serum albumin (p = 0.014) were associated with an increased number of HDs, and the level of serum TC (p = 0.039) was positively associated with the number of HF.
Hyperreflective material may be a predictor for BCVA and serves as a potential biomarker of dyslipidemia in DME. It was postulated that HF are mainly related to hard exudates and HDs are partially associated with microglial cell activation.
本研究旨在探讨基于光学相干断层扫描血管造影（OCT/OCTA）的糖尿病性黄斑水肿（DME）影响视力的形态学特征，并从系统角度解释其可能的潜在机制。
本回顾性研究纳入了患有DME的糖尿病患者。记录临床资料和OCT/OCTA形态学特征。对最佳矫正视力（BCVA）与每个OCT/OCTA形态学特征进行线性混合模型分析。对每个影响视力的形态学特征与临床特征进行线性和逻辑混合模型分析。
纳入85例患者的85只眼。在单变量分析中，高反射点（HDs）数量（p<0.001）和高反射灶（HF）数量（p = 0.006）与LogMAR BCVA呈正相关。在多变量分析中，HDs数量（p = 0.008）仍与LogMAR BCVA相关。HF数量增加的眼（p = 0.01）在黄斑区直径3mm范围内更易出现硬性渗出，而HDs数量与硬性渗出的关系未达到显著水平。在多变量分析中，总胆固醇（TC）水平升高（p = 0.004）和血清白蛋白水平降低（p = 0.014）与HDs数量增加相关，血清TC水平（p = 0.039）与HF数量呈正相关。
高反射物质可能是BCVA的预测指标，并且是DME中血脂异常的潜在生物标志物。据推测，HF主要与硬性渗出有关，而HDs部分与小胶质细胞激活有关。
