Department of Ophthalmology, Helios HSK Wiesbaden, Wiesbaden, Germany.
Department of Ophthalmology, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany.
BMC Ophthalmol. 2023 Jul 17;23(1):324. doi: 10.1186/s12886-023-03060-7.
Retinal breaks (RB) are emergencies that require treatment to prevent progression of rhegmatogenous retinal detachment. Vitreal hyperreflective foci (VHF) representing migration of RPE cell clusters or interphotoreceptor matrix from the RB are potential biomarkers. The aim of this study is to investigate VHF in RB-patients using SD-OCT.
The retrospective cross-sectional study included RB patients from our Department of Ophthalmology, HSK Wiesbaden who underwent macular SD-OCT (SPECTRALIS®, Heidelberg Engineering, Germany) on both eyes. VHF, defined and quantified as foci that differ markedly in size and reflectivity from the background speckle pattern, were assessed for presence and frequency. The RB-affected eyes were the study group (G1), the partner eyes the control group (G2).
160 consecutive patients with RB were included. Age was 60 ± 10.2 years (52% female). 89.4% of G1 and 87.5% of G2 were phakic (p = 0.73). 94.4% (n = 151) were symptomatic. Symptom duration was 8.0 ± 10.1 days in G1, 94.4% (n = 151) showed VHF versus 5.6% (p < 0.0001) in G2, of which 75% (n = 6) showed asymptomatic lattice degenerations. Detectable VHF showed a strong association of OR = 320 (95% CI, 110-788, p < 0.0001)) with respect to symptomatic RB. Sensitivity and specificity were 94.7% and 94.7%, respectively.
Most eyes with symptomatic RB show vitreal VHF in SD-OCT. Detected VHF are strongly associated with RB, and our semi-automated greyscale reflectivity analysis indicates that VHF likely originate from photoreceptor complexes torn out of the RB area that migrate into the vitreous cavity. The presence of VHF may indicate RB and should lead to a thorough fundus examination in both symptomatic and asymptomatic cases.
视网膜裂孔 (RB) 是一种紧急情况，需要治疗以防止孔源性视网膜脱离的进展。玻璃体高反射焦点 (VHF) 代表 RPE 细胞团或光感受器基质从 RB 的迁移，是潜在的生物标志物。本研究旨在使用 SD-OCT 研究 RB 患者的 VHF。
这项回顾性横断面研究纳入了我院眼科的 RB 患者，他们对双眼进行了黄斑 SD-OCT（SPECTRALIS®，德国海德堡工程公司）。VHF 定义为大小和反射率明显不同于背景斑点图案的焦点，并评估其存在和频率。受 RB 影响的眼睛为研究组（G1），对侧眼为对照组（G2）。
纳入了 160 例连续 RB 患者。年龄为 60±10.2 岁（52%为女性）。G1 中 89.4%（n=143）和 G2 中 87.5%（n=142）为晶状体眼（p=0.73）。94.4%（n=151）有症状。G1 的症状持续时间为 8.0±10.1 天，94.4%（n=151）出现 VHF，而 G2 中只有 5.6%（p<0.0001）出现 VHF，其中 75%（n=6）出现无症状的格子样变性。可检测到的 VHF 与有症状的 RB 具有很强的相关性，OR=320（95%CI，110-788，p<0.0001）。灵敏度和特异性分别为 94.7%和 94.7%。
大多数有症状的 RB 眼在 SD-OCT 中显示玻璃体 VHF。检测到的 VHF 与 RB 密切相关，我们的半自动灰度反射率分析表明，VHF 可能源自从 RB 区域撕裂并迁移到玻璃体腔的光感受器复合物。VHF 的存在可能表明存在 RB，并且应该导致对有症状和无症状病例进行彻底的眼底检查。
