Hyperreflective foci in OCT image as a biomarker of poor prognosis in diabetic macular edema patients treating with Conbercept in China

Abstract

Purpose To investigate the dynamic changes of hyperreflective foci (HF) in diabetic macular edema (DME) patients during the intravitreal Conbercept treatment in China. Methods DME Patients receiving intravitreal Conbercept (IVC) injections during the year 2016–2017 were retrospectively investigated. Thirteen patients (26 eyes) were recruited in this study. They received IVC once a month for 3 consecutive months. The number and location of HFs, the best-corrected visual acuity (BCVA) and central macular thickness (CMT) at each visit were analyzed and compared. Results After the first injection, BCVA (LogMAR) was increased from 0.75 ± 0.48 to 0.43 ± 0.24 ( p < 0.05), CMT improved from 575.9 ± 191.9 to 388.2 ± 198.5 μm ( p = 0.014). However, the BCVA and CMT had no statistical difference after the second and third injection as compared with those after the first injection respectively. The baseline number of HFs was 5.39 ± 4.24, 5.15 ± 5.17 and 0.88 ± 1.90 in the inner retinal, outer retinal and subretinal layer respectively. The number of HFs in these three retinal layers decreased significantly after the first injection ( p = 0.0045, p < 0.0001 and p = 0.0045, respectively). However, after the second injection, only the number of HFs in the inner retinal layer experienced a further decrease. After the third injection, no statistically significant HFs changes was observed in each retinal layers. Correlation analysis showed that there was a positive significant correlation between the baseline number of HFs in the inner retina, outer retina, subretina and final BCVA (r = 0.571, p = 0.002; r = 0.464, p = 0.017; r = 0.405, p = 0.04 respectively). There was also a significant positive correlation between outer retinal HFs reduction, total retinal HFs reduction and increase of BCVA (r = 0.40, p = 0.043 and r = 0.393, p = 0.04 respectively). There were no severe ocular adverse reactions or systemic adverse events. Conclusions Conbercept is effective and safe in the treatment of DME. HFs can act as a biomarker of poor final visual outcome.

Efficacy of intravitreal injection of conbercept on non-proliferative diabetic retinopathy: a retrospective study

“…Conbercept is a new type of anti-VEGF drug that can bind to all subtypes of VEGF; 28 it also exhibits high affinity and strong durability. 29 Intravitreal injection of conbercept has been successful in treatment of many vision-related diseases, such as diabetic macular edema, 30 neovascular age-related macular degeneration, 31 chronic central serous chorioretinopathy, 20 central retinal vein occlusion, 32 and proliferative diabetic retinopathy. 33 The findings in the present study further support the results of the prior analyses.…”

Role of Epithelial-Mesenchymal Transition in Retinal Pigment Epithelium Dysfunction

“…Hyperreflective foci (HRF) are well-circumscribed lesions with equal or greater reflectivity than the RPE band that spread over various retinal and choroidal layers in spectral domain optical coherence tomography (SD-OCT) images ( Liu S. et al, 2019 ; Roy et al, 2019 ). Numerous clinical studies have shown that retinal HRF appear in optical coherence tomography OCT images in retinal diseases, including age-related macular degeneration (AMD), inherited rod-cone degenerations, and inherited macular degenerations ( Kuroda et al, 2014 ; Piri et al, 2015 ; Miura et al, 2017 ).…”

Role of hyper-reflective spots in predicting outcomes of intravitreal therapy in diabetic macular edema: A systematic review and meta-analysis

“…Nineteen studies were identified (thirteen were retrospective cohort studies, 12,[15][16][17]24,26,[30][31][32][33][34][35][36] three were prospective cohort studies, 37,38,41 two were case series 14,39 and one was a case-control study 40 ). The quality score of the studies is shown in Table 1.…”

“…15,17 The model of spectral domain OCT used, varied among the studies: 14 used SpectralisOCT™ (Heidelberg Engineering, Heidelberg, Germany), 12,[14][15][16][17]24,26,[30][31][32]34,35,38,39 3 used Cirrus HD-OCT™ (Carl Zeiss Meditec, Dublin, CA, USA), 33,37,41 1 each Retina scan™ (RS-3000 advance; Nidek) 40 and DRI-SSOCT Triton plus™ (Topcon Medical Systems Europe, Milano, Italy). 36 The measurement of HRS was done over different area sizes in the macula (12 studies used 3000µm area, 12,[14][15][16][17]26,[32][33][34]36,38,41 4 studies used 1000µm area, 24,30,35,39 2 studies used 1500µm area 31,37 and 1 study used area between 500-1500µm from the center of the fovea). 40…”