Sen Sagnik, Khalid Hagar, Udaya Prithviraj, Raman Rajiv, Rajendram Ranjan, ElHousseini Zein, Nicholson Luke, Kannan Naresh Babu, Ramasamy Kim, Kumaragurupari Thandavarayan
Department of Medical Retina, Moorfields Eye Hospital, London, UK.
Department of Vitreoretina, St Thomas Hospital, London, UK.
Indian J Ophthalmol. 2025 Jan 1;73(Suppl 1):S7-S23. doi: 10.4103/IJO.IJO_878_24. Epub 2024 Dec 24.
Diabetic macular edema (DME) is a vision-threatening complication of diabetic retinopathy and causes significant morbidity in patients. Anti-vascular endothelial growth factor (VEGF) agents are the mainstay of treatment for DME, with steroid implants being used for the treatment of anti-VEGF resistant eyes. Over the years, several classification systems have been devised to describe the patterns of DME using optical coherence tomography (OCT). With the advent of effective treatments, it has become imperative that imaging cues are not merely used for classifying the disease but also as biomarkers for prognostication of disease activity and treatment response. In this aspect, newer imaging findings such as hyperreflective dots, photoreceptor integrity, and disorganization of retinal inner layers have been characterized in detail by several authors. Macular perfusion analysis using OCT angiography is the latest in the armamentarium for imaging DME. In this narrative review, we have summarized all relevant literature related to the ultrastructural imaging-based biomarkers of DME and their correlation to treatment.
糖尿病性黄斑水肿（DME）是糖尿病视网膜病变的一种威胁视力的并发症，会给患者带来显著的发病率。抗血管内皮生长因子（VEGF）药物是DME治疗的主要手段，类固醇植入物则用于治疗对抗VEGF耐药的眼睛。多年来，人们设计了几种分类系统，利用光学相干断层扫描（OCT）来描述DME的模式。随着有效治疗方法的出现，不仅要将成像线索用于疾病分类，还应将其作为疾病活动和治疗反应预后的生物标志物，这一点变得至关重要。在这方面，一些作者已经详细描述了诸如高反射点、光感受器完整性和视网膜内层紊乱等新的成像发现。使用OCT血管造影进行黄斑灌注分析是DME成像设备中的最新技术。在这篇叙述性综述中，我们总结了所有与基于超微结构成像的DME生物标志物及其与治疗的相关性相关的文献。
