Zhang-Rong Yang, Chang Li, Dong-Jun Xing, Gao-Xu Wei, Ce-Ce Zhao, Miao Zhou, Xiao-Han Ma, Yi Zhao, Shu Yang, Rong-Guo Yu, Zhi-Qing Li
{"title":"探讨高反射壁作为黄斑囊样水肿管理的生物标志物的作用。","authors":"Zhang-Rong Yang, Chang Li, Dong-Jun Xing, Gao-Xu Wei, Ce-Ce Zhao, Miao Zhou, Xiao-Han Ma, Yi Zhao, Shu Yang, Rong-Guo Yu, Zhi-Qing Li","doi":"10.18240/ijo.2025.09.11","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To investigate the prevalence and clinical implications of hyperreflective walls (HRW) in foveal cystoid spaces in patients with cystoid macular edema (CME) caused by retinal diseases and noninfectious uveitis (NIU).</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 443 eyes with CME secondary to diabetic macular edema (DME), retinal vein occlusion (RVO), retinitis pigmentosa (RP), neovascular age-related macular degeneration (nAMD), and NIU. Demographic data, HRW features, and other spectral domain optical coherence tomography (SD-OCT) biomarkers were analyzed.</p><p><strong>Results: </strong>HRW was observed in 40.9% of DME eyes (present, <i>n</i>=77, 38 males, 58.30±12.04y; absent, <i>n</i>=111, 50 males, 55.95±10.56y), 32.5% of RVO eyes (present, <i>n</i>=49, 22 males, 64.53±11.90y; absent, <i>n</i>=102, 42 males, 60.67±11.73y), 31.4% of nAMD eyes (present, <i>n</i>=16, 8 males, 70.13±7.75y; absent, <i>n</i>=35, 13 males, 73.91±9.11y), 57.1% of RP eyes (present, <i>n</i>=12, 4 males, 40.50±12.06y; absent, <i>n</i>=9, 4 males, 44.11±14.32y), and 18.8% of uveitic macular edema (UME) eyes (present, <i>n</i>=6, 3 males, 30.83±16.23y; absent, <i>n</i>=26, 12 males, 43.46±17.58y). HRW was significantly associated with vitreoretinal abnormalities [odds ratio (OR), 2.202; 95% confidence interval (95%CI), 1.342-3.613; <i>P</i>=0.002], hyperreflective foci (OR, 3.33; 95%CI, 1.884-5.883; <i>P</i><0.001), inner retinal layer disorganization (OR, 1.816; 95%CI, 1.087-3.035; <i>P</i>=0.023), external limiting membrane disruptions (OR, 3.476; 95%CI, 1.839-6.574; <i>P</i><0.001), and disrupted ellipsoid zone length (OR, 1.001; 95%CI, 1.000-1.002; <i>P</i>=0.04), and a high HRW height in the foveal cystoid spaces (OR, 1.003; 95%CI, 1.001-1.006; <i>P</i>=0.003).</p><p><strong>Conclusion: </strong>HRW in foveal cystoid spaces is a common OCT finding in CME and is associated with more severe retinal structural damage and worse visual acuity. HRW may be utilized as a prognostic OCT biomarker for disease severity and treatment response in patients with CME. This study suggests that early detection of HRW and optimization of treatment strategies may improve patient prognosis.</p>","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"18 9","pages":"1697-1704"},"PeriodicalIF":1.8000,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378682/pdf/","citationCount":"0","resultStr":"{\"title\":\"Exploring the role of hyperreflective walls as a biomarker for the management of cystoid macular edema.\",\"authors\":\"Zhang-Rong Yang, Chang Li, Dong-Jun Xing, Gao-Xu Wei, Ce-Ce Zhao, Miao Zhou, Xiao-Han Ma, Yi Zhao, Shu Yang, Rong-Guo Yu, Zhi-Qing Li\",\"doi\":\"10.18240/ijo.2025.09.11\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>To investigate the prevalence and clinical implications of hyperreflective walls (HRW) in foveal cystoid spaces in patients with cystoid macular edema (CME) caused by retinal diseases and noninfectious uveitis (NIU).</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 443 eyes with CME secondary to diabetic macular edema (DME), retinal vein occlusion (RVO), retinitis pigmentosa (RP), neovascular age-related macular degeneration (nAMD), and NIU. Demographic data, HRW features, and other spectral domain optical coherence tomography (SD-OCT) biomarkers were analyzed.</p><p><strong>Results: </strong>HRW was observed in 40.9% of DME eyes (present, <i>n</i>=77, 38 males, 58.30±12.04y; absent, <i>n</i>=111, 50 males, 55.95±10.56y), 32.5% of RVO eyes (present, <i>n</i>=49, 22 males, 64.53±11.90y; absent, <i>n</i>=102, 42 males, 60.67±11.73y), 31.4% of nAMD eyes (present, <i>n</i>=16, 8 males, 70.13±7.75y; absent, <i>n</i>=35, 13 males, 73.91±9.11y), 57.1% of RP eyes (present, <i>n</i>=12, 4 males, 40.50±12.06y; absent, <i>n</i>=9, 4 males, 44.11±14.32y), and 18.8% of uveitic macular edema (UME) eyes (present, <i>n</i>=6, 3 males, 30.83±16.23y; absent, <i>n</i>=26, 12 males, 43.46±17.58y). HRW was significantly associated with vitreoretinal abnormalities [odds ratio (OR), 2.202; 95% confidence interval (95%CI), 1.342-3.613; <i>P</i>=0.002], hyperreflective foci (OR, 3.33; 95%CI, 1.884-5.883; <i>P</i><0.001), inner retinal layer disorganization (OR, 1.816; 95%CI, 1.087-3.035; <i>P</i>=0.023), external limiting membrane disruptions (OR, 3.476; 95%CI, 1.839-6.574; <i>P</i><0.001), and disrupted ellipsoid zone length (OR, 1.001; 95%CI, 1.000-1.002; <i>P</i>=0.04), and a high HRW height in the foveal cystoid spaces (OR, 1.003; 95%CI, 1.001-1.006; <i>P</i>=0.003).</p><p><strong>Conclusion: </strong>HRW in foveal cystoid spaces is a common OCT finding in CME and is associated with more severe retinal structural damage and worse visual acuity. HRW may be utilized as a prognostic OCT biomarker for disease severity and treatment response in patients with CME. This study suggests that early detection of HRW and optimization of treatment strategies may improve patient prognosis.</p>\",\"PeriodicalId\":14312,\"journal\":{\"name\":\"International journal of ophthalmology\",\"volume\":\"18 9\",\"pages\":\"1697-1704\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-09-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378682/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International journal of ophthalmology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.18240/ijo.2025.09.11\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.18240/ijo.2025.09.11","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Exploring the role of hyperreflective walls as a biomarker for the management of cystoid macular edema.
Aim: To investigate the prevalence and clinical implications of hyperreflective walls (HRW) in foveal cystoid spaces in patients with cystoid macular edema (CME) caused by retinal diseases and noninfectious uveitis (NIU).
Methods: This retrospective cross-sectional study included 443 eyes with CME secondary to diabetic macular edema (DME), retinal vein occlusion (RVO), retinitis pigmentosa (RP), neovascular age-related macular degeneration (nAMD), and NIU. Demographic data, HRW features, and other spectral domain optical coherence tomography (SD-OCT) biomarkers were analyzed.
Results: HRW was observed in 40.9% of DME eyes (present, n=77, 38 males, 58.30±12.04y; absent, n=111, 50 males, 55.95±10.56y), 32.5% of RVO eyes (present, n=49, 22 males, 64.53±11.90y; absent, n=102, 42 males, 60.67±11.73y), 31.4% of nAMD eyes (present, n=16, 8 males, 70.13±7.75y; absent, n=35, 13 males, 73.91±9.11y), 57.1% of RP eyes (present, n=12, 4 males, 40.50±12.06y; absent, n=9, 4 males, 44.11±14.32y), and 18.8% of uveitic macular edema (UME) eyes (present, n=6, 3 males, 30.83±16.23y; absent, n=26, 12 males, 43.46±17.58y). HRW was significantly associated with vitreoretinal abnormalities [odds ratio (OR), 2.202; 95% confidence interval (95%CI), 1.342-3.613; P=0.002], hyperreflective foci (OR, 3.33; 95%CI, 1.884-5.883; P<0.001), inner retinal layer disorganization (OR, 1.816; 95%CI, 1.087-3.035; P=0.023), external limiting membrane disruptions (OR, 3.476; 95%CI, 1.839-6.574; P<0.001), and disrupted ellipsoid zone length (OR, 1.001; 95%CI, 1.000-1.002; P=0.04), and a high HRW height in the foveal cystoid spaces (OR, 1.003; 95%CI, 1.001-1.006; P=0.003).
Conclusion: HRW in foveal cystoid spaces is a common OCT finding in CME and is associated with more severe retinal structural damage and worse visual acuity. HRW may be utilized as a prognostic OCT biomarker for disease severity and treatment response in patients with CME. This study suggests that early detection of HRW and optimization of treatment strategies may improve patient prognosis.
期刊介绍：
· International Journal of Ophthalmology-IJO (English edition) is a global ophthalmological scientific publication
and a peer-reviewed open access periodical (ISSN 2222-3959 print, ISSN 2227-4898 online).
This journal is sponsored by Chinese Medical Association Xi’an Branch and obtains guidance and support from
WHO and ICO (International Council of Ophthalmology). It has been indexed in SCIE, PubMed,
PubMed-Central, Chemical Abstracts, Scopus, EMBASE , and DOAJ. IJO JCR IF in 2017 is 1.166.
IJO was established in 2008, with editorial office in Xi’an, China. It is a monthly publication. General Scientific
Advisors include Prof. Hugh Taylor (President of ICO); Prof.Bruce Spivey (Immediate Past President of ICO);
Prof.Mark Tso (Ex-Vice President of ICO) and Prof.Daiming Fan (Academician and Vice President,
Chinese Academy of Engineering.
International Scientific Advisors include Prof. Serge Resnikoff (WHO Senior Speciatist for Prevention of
blindness), Prof. Chi-Chao Chan (National Eye Institute, USA) and Prof. Richard L Abbott (Ex-President of
AAO/PAAO) et al.
Honorary Editors-in-Chief: Prof. Li-Xin Xie(Academician of Chinese Academy of
Engineering/Honorary President of Chinese Ophthalmological Society); Prof. Dennis Lam (President of APAO) and
Prof. Xiao-Xin Li (Ex-President of Chinese Ophthalmological Society).
Chief Editor: Prof. Xiu-Wen Hu (President of IJO Press).
Editors-in-Chief: Prof. Yan-Nian Hui (Ex-Director, Eye Institute of Chinese PLA) and
Prof. George Chiou (Founding chief editor of Journal of Ocular Pharmacology & Therapeutics).
Associate Editors-in-Chief include:
Prof. Ning-Li Wang (President Elect of APAO);
Prof. Ke Yao (President of Chinese Ophthalmological Society) ;
Prof.William Smiddy (Bascom Palmer Eye instituteUSA) ;
Prof.Joel Schuman (President of Association of University Professors of Ophthalmology,USA);
Prof.Yizhi Liu (Vice President of Chinese Ophtlalmology Society);
Prof.Yu-Sheng Wang (Director of Eye Institute of Chinese PLA);
Prof.Ling-Yun Cheng (Director of Ocular Pharmacology, Shiley Eye Center, USA).
IJO accepts contributions in English from all over the world. It includes mainly original articles and review articles,
both basic and clinical papers.
Instruction is Welcome Contribution is Welcome Citation is Welcome
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International Council of Ophthalmology(ICO), PubMed, PMC, American Academy of Ophthalmology, Asia-Pacific, Thomson Reuters, The Charlesworth Group, Crossref,Scopus,Publons, DOAJ etc.
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