Hyperreflective Walls in Foveal Cystoid Spaces as a Biomarker of Diabetic Macular Edema Refractory to Anti-VEGF Treatment
Hyperreflective Walls in Foveal Cystoid Spaces as a Biomarker of Diabetic Macular Edema Refractory to Anti-VEGF Treatment
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DOI：
10.1038/s41598-020-64332-6
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发表时间：
2020-04
影响因子：
4.6
通讯作者：
N. Terada;T. Murakami;A. Uji;Yoko Dodo;Yuki Mori;A. Tsujikawa
中科院分区：
文献类型：
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作者：
N. Terada;T. Murakami;A. Uji;Yoko Dodo;Yuki Mori;A. Tsujikawa
抗 VEGF 药物耐药的糖尿病性黄斑水肿 (DME) 是一种社会经济负担。在这项回顾性研究中，我们研究了 DME 缓解与中心凹囊样腔高反射壁之间的关系，这是 DME 谱域光学相干断层扫描 (SD-OCT) 图像的新发现。在一项横断面研究中，我们评估了 110 名 DME 患者的 110 只眼睛的中心凹囊样腔高反射壁与其他 OCT 结果之间的关系。 171 个中心凹囊样空间中的 27 个描绘了高反射壁。与没有这些发现的眼睛相比，中心凹囊样间隙中具有高反射壁的眼睛的视力较差，感光器破坏更严重（分别为P= 0.008和P< 0.001）。在另一项纵向研究中，我们评估了这一发现与接受按需雷珠单抗注射治疗 24 个月的 51 名 DME 患者的 54 只眼睛的缓解之间的关系。具有高反射壁的中心凹囊样间隙通常是持续性的，18个月时，有和没有高反射壁的眼睛的DME累积缓解率分别为7.7%（1只眼）和48.8%（20只眼）（风险比，0.092；P= 0.025）。我们对中心凹囊样间隙的高反射壁进行了表征，并将其指定为雷珠单抗注射后 DME 无缓解的预测因子。
Diabetic macular edema (DME) refractory to anti-VEGF drugs is a socioeconomic burden. In this retrospective study, we investigated the relationship between DME remission andhyperreflective walls in foveal cystoid spaces, a novel finding on spectral domain optical coherence tomography (SD-OCT) images in DME. In a cross-sectional study, we assessed the relationship between hyperreflective walls in foveal cystoid spaces and other OCT findings in 110 eyes of 110 DME patients. Hyperreflective walls were delineated in 27 of 171 foveal cystoid spaces. Eyes with hyperreflective walls in foveal cystoid spaces had poorer visual acuity and more severe photoreceptor disruption than did those without such findings (P= 0.008 andP< 0.001, respectively). In the other longitudinal study, we evaluated the relationship between this finding and the remission in 54 eyes of 51 DME patients treated with as-needed ranibizumab injections for 24 months. Foveal cystoid spaces with hyperreflective walls were often persistent, and the cumulative rates of DME remission among eyes with and without the hyperreflective walls were 7.7% (1 eye) and 48.8% (20 eyes) at 18 months (hazard ratio, 0.092;P= 0.025). We characterizedhyperreflective walls in foveal cystoid spacesand designated them as a predictor of no DME remission under ranibizumab injections.