SD-OCT上的高反射点：预测糖尿病黄斑水肿治疗结果的意义。

IF 3.3 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Diagnostics Pub Date : 2025-10-09 DOI:10.3390/diagnostics15192539

Siying Li, Muzi Li, Aimin Sun, Hongwei Zhang

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引用次数: 0

摘要

目的：探讨糖尿病性黄斑水肿（DME）患者玻璃体内注射雷尼单抗或地塞米松治疗后，光谱域光学相干断层扫描（SD-OCT）观察到的高反射点（HRDs）与预后的关系。方法：这项回顾性研究的重点是患有糖尿病黄斑水肿（DME）的个体，他们接受了连续三次玻璃体内注射雷尼单抗。根据治疗反应，将眼睛分为两组：反应者和无反应者。无反应组随后接受玻璃体内地塞米松（IVO）植入。通过BCVA、HRD数和中央黄斑厚度（CMT）的变化来评估治疗结果。结果：这项研究涉及78名被诊断患有二甲醚的参与者的112只眼睛。73只眼睛（65%）被确定为雷尼单抗应答，39只眼睛（35%）被确定为雷尼单抗无应答。在对雷尼单抗反应不佳并随后接受玻璃体内地塞米松植入治疗的39例患者中，26只眼（66.67%）表现出良好反应，而13只眼（33.33%）表现出反应不足。IVR应答者在BCVA（0.54±0.73 ~ 0.35±0.40 logMAR vs. 0.52±0.61 ~ 0.47±0.38 logMAR）和CMT（456.53±109.73 μm ~ 235.47±49.13 μm vs. 468.99±127.10 μm ~ 427.45±52.91 μm）降低方面表现出更大的改善。基线分析显示，与应答者相比，IVR无应答者的视网膜内外部hrd计数更高（分别为9.09±3.38 vs. 7.07±2.32和5.46±2.03 vs. 4.27±1.87,p < 0.05）。初始视网膜内、外、下HRDs数量较高的眼睛对地塞米松治疗的反应显著增强（分别为9.03±3.18 vs. 7.55±2.72,6.55±2.46 vs. 4.79±1.88,0.27±0.54 vs. 0.21±0.47,p < 0.05）。结论：HRDs可能作为一种预测性生物标志物，用于评估抗vegf治疗DME的有效性。表现出更多视网膜hrd的患者往往对抗vegf治疗反应较差，但地塞米松治疗效果较好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Hyperreflective Dots on SD-OCT: Implications for Predicting Treatment Outcomes in Diabetic Macular Edema.

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Hyperreflective Dots on SD-OCT: Implications for Predicting Treatment Outcomes in Diabetic Macular Edema.

Objectives: To evaluate the relationship between hyperreflective dots (HRDs) observed on spectral-domain optical coherence tomography (SD-OCT) and the outcomes following treatment with intravitreal ranibizumab or dexamethasone injections in patients with diabetic macular edema (DME). Methods: This retrospective study focused on individuals suffering from diabetic macular edema (DME) who underwent a sequence of three intravitreal ranibizumab injections. Based on treatment response, the eyes were categorized into two groups: responders and non-responders. The non-responder group subsequently received intravitreal dexamethasone (IVO) implants. Treatment results were evaluated by changes in BCVA, HRD number, and central macular thickness (CMT). Results: This research involved 112 eyes from 78 participants who had been diagnosed with DME. Seventy-three eyes (65%) were identified as ranibizumab responders and 39 eyes (35%) as ranibizumab non-responders. Of the 39 individuals who had suboptimal response to ranibizumab and subsequently received treatment with an intravitreal dexamethasone implant, 26 eyes (66.67%) exhibited a favorable response, while 13 eyes (33.33%) showed an insufficient response. IVR responders demonstrated significantly greater improvements in BCVA (0.54 ± 0.73 to 0.35 ± 0.40 logMAR vs. 0.52 ± 0.61 to 0.47 ± 0.38 logMAR) and CMT (456.53 ± 109.73 μm to 235.47 ± 49.13 μm vs. 468.99 ± 127.10 μm to 427.45 ± 52.91 μm) reduction. Baseline analysis revealed IVR non-responders had higher counts of both inner and outer retinal HRDs compared to responders (9.09 ± 3.38 vs. 7.07 ± 2.32 and 5.46 ± 2.03 vs. 4.27 ± 1.87, p < 0.05, respectively). Eyes with initially higher numbers of inner retinal HRDs, outer retinal HRDs, and subretinal HRDs demonstrated a significantly enhanced response to dexamethasone therapy (9.03 ± 3.18 vs. 7.55 ± 2.72, 6.55 ± 2.46 vs. 4.79 ± 1.88 and 0.27 ± 0.54 vs. 0.21 ± 0.47, p < 0.05, respectively). Conclusions: HRDs could potentially be used as a predictive biomarker to assess the effectiveness of anti-VEGF therapy in treating DME. Patients exhibiting a greater number of retinal HRDs tend to have less favorable reactions to anti-VEGF treatments but experience improved results with dexamethasone.

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来源期刊

Diagnostics Biochemistry, Genetics and Molecular Biology-Clinical Biochemistry

CiteScore

4.70

自引率

8.30%

发文量

2699

审稿时长

19.64 days

期刊介绍： Diagnostics (ISSN 2075-4418) is an international scholarly open access journal on medical diagnostics. It publishes original research articles, reviews, communications and short notes on the research and development of medical diagnostics. There is no restriction on the length of the papers. Our aim is to encourage scientists to publish their experimental and theoretical research in as much detail as possible. Full experimental and/or methodological details must be provided for research articles.