Quantitative evaluation of hard exudates in diabetic macular edema by multicolor imaging and their associations with serum lipid levels

Gong, Ruowen; Han, Ruyi; Guo, Jingli; Liu, Wei; Xu, Gezhi

doi:10.1007/s00592-021-01697-8

Cited by 5 publications

(2 citation statements)

References 26 publications

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“…Besides, the combined use of Confocal Scanning Laser Ophthalmoscopy (CSLO) and Spectral-Domain Optical Coherence Tomography (SD-OCT) platforms enables the capture of multimodal images, facilitating more reliable examinations of changes in macular edema and HE pre-and post-surgery. Research by Gong et al also found that MCI surpasses traditional CFP in detecting HEs and analyzing the correlation between HEs and lipid levels in DME [13].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Dexamethasone Implants in Treating Diabetic Macular Edema with Hard Exudates: A Clinical Observation

Zhao,

Liang,

Zhang

2024

Preprint

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Objective This study seeks to explain the relationship between systemic conditions and hard exudate formations in diabetic macular edema (DME) patients. Besides, the study aimed to quantitatively examine changes in the area, location, and impact on visual function of hard exudates following intravitreal dexamethasone implant injections. Methods A retrospective analysis was conducted, including 40 patients (40 eyes) diagnosed with non-proliferative diabetic retinopathy and concurrent macular edema between January 1, 2022, and January 1, 2024. Preoperative evaluations included glycated hemoglobin, lipid profile, and renal function examinations. Selected eyes were subject to pre- and postoperative examinations, including best-corrected visual acuity (BCVA), intraocular pressure (IOP), slit-lamp biomicroscopy, scanning laser ophthalmoscopy (SLO), optical coherence tomography (OCT), and multifocal electroretinography (mf-ERG). Following screening and examination, patients received an immediate intravitreal injection of the DEX implant, with an injection administered at the four-month mark. Hard exudate (HE) areas were measured utilizing SLO fundus imaging. Results Total cholesterol, low-density lipoprotein, and triglyceride levels were found to be positively correlated with the presence of HE. Following surgical intervention, all patients demonstrated an improvement in BCVA. The mean BCVA increased from a preoperative measurement of 0.79 ± 0.04 to 0.39 ± 0.02 at the six-month follow-up, indicating a statistically significant difference (p < 0.001). The baseline HE area for the entire patient cohort was 2.28 ± 0.22. One month post-operation, the HE area exhibited a slight increase to 2.27 ± 0.22. However, by the six-month follow-up, the HE area had significantly decreased to 0.8 ± 0.87, representing a 35.09% reduction from the baseline measurement (p < 0.001). It is worth noting that Patient P1 did not exhibit a statistically significant difference between preoperative and six-month postoperative HE area (p = 0.032). Preoperative BCVA measurements for Group A and Group B were 0.81 ± 0.03 and 0.77 ± 0.03, respectively, with no statistically significant intergroup difference (p = 0.333). The baseline HE area for Group A was 2.61 ± 0.16, which decreased to 0.38 ± 0.20 at the six-month follow-up, representing a 14.60% reduction from the baseline total area. For Group B, the baseline HE area was measured at 1.95 ± 0.09, then decreasing to 1.21 ± 0.13 at the six-month follow-up, indicating a 62.05% reduction from the baseline total area. A statistically significant difference in the postoperative six-month HE area was observed between Group A and Group B (p < 0.001). In Group A, the reduction in HE area (initial HE area-final HE area) was positively correlated with the improvement in P1 (initial P1-final P1) (r = 0.610, p = 0.004). In Group B, a similar positive correlation was found (initial HE area-final HE area with initial P1-final P1) (r = 0.488, p = 0.029). In Group B, the reduction in HE area (initial HE area-final HE area) correlated positively with the improvement in BCVA (initial BCVA-final BCVA) (r = 0.615, p = 0.004). Additionally, in Group B, the reduction in HE area (initial HE area-final HE area) was positively correlated with the improvement in CMT (initial CMT-final CMT) ("R"=-0.725, "P"<0.001). Aggravated cataracts were observed in thirteen eyes during a follow-up examination six months later. Conclusion HE formation is associated with lipid levels. Dexamethasone implants demonstrate effectiveness in reducing HE areas in the short term, reducing macular edema, improving retinal structure, and enhancing visual function. The incidence of postoperative complications such as cataracts and glaucoma remains low.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Dexamethasone Implants in Treating Diabetic Macular Edema with Hard Exudates: A Clinical Observation

Zhao,

Liang,

Zhang

2024

Preprint

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“…In this table, we summarized the observations of MCI and its advantages found in published papers. The list is not exhaustive; however, it highlights the salient features of different retinal and choroidal disorders [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38].…”

Section: Discussionmentioning

confidence: 99%

Multi-color imaging in a unilateral central retinal artery occlusion following dengue fever: A case report and literature review

Sanjay¹,

Kawali²,

Gopalakrishnan³

et al. 2022

Med Hypothesis Discov Innov Optom

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Background: Dengue fever is associated with various sight-threatening ocular manifestations, some of which can occur several months after fever. These include subconjunctival hemorrhage, vitreous hemorrhage, retinal hemorrhage, cotton wool spots, central and branch retinal artery occlusion, central scotoma, papilledema, optic neuropathy, retinal vasculitis, retinitis, retinal pigment epithelium mottling, foveolitis, choroidal effusion, exudative retinal detachment, anterior uveitis, endogenous endophthalmitis, and panophthalmitis. Herein, we report a patient with unilateral central retinal artery occlusion (CRAO) and raised dengue immunoglobulin G (IgG) titers who underwent serial multimodal imaging with fundus photography, spectral domain optical coherence tomography (SD-OCT), optical coherence tomography angiography (OCTA), and multi-color imaging (MCI). Furthermore, we reviewed recent publications highlighting different eye diseases and the role of MCI in their diagnosis and serial monitoring. Case presentation: A 53-year-old Asian Indian woman complained of blurring of vision in the right eye (OD) two months after a bout of fever. Her best-corrected distance visual acuity was finger counting close to the face in the OD and 20/40 in the left eye. CRAO of the OD was diagnosed. Systemic investigations were normal except for elevated dengue IgG levels. Optical coherence tomography and fluorescein angiography confirmed this diagnosis. MCI and SD-OCT using Spectralis™ performed before and after treatment with oral steroids demonstrated improvement. MCI served as a noninvasive ancillary tool for monitoring the CRAO. In addition to the case report, we summarize articles pertaining to MCI published during the years 2018–2022. The list is not exhaustive but highlights salient features of different retinal and choroidal disorders evaluated using MCI. Our summary highlights the role of MCI in the diagnosis and serial monitoring of eye diseases. Conclusions: A diagnosis of post-dengue fever retinal artery occlusion should be made after ruling out other causes of retinal artery vascular occlusion. We demonstrated retinal changes using serial imaging. MCI can be a useful tool, along with SD-OCT, to monitor clinical improvement. Optometrists can follow up patients with retinal vascular occlusions using noninvasive methods.

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Retinal Hard Exudates

Gupta,

Bansal,

Sharma

et al. 2023

Ophthalmic Signs in Practice of Medicine

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Quantitative evaluation of hard exudates in diabetic macular edema by multicolor imaging and their associations with serum lipid levels

Cited by 5 publications

References 26 publications

Effectiveness of Dexamethasone Implants in Treating Diabetic Macular Edema with Hard Exudates: A Clinical Observation

Effectiveness of Dexamethasone Implants in Treating Diabetic Macular Edema with Hard Exudates: A Clinical Observation

Multi-color imaging in a unilateral central retinal artery occlusion following dengue fever: A case report and literature review

Retinal Hard Exudates

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