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Anne-Marie Firan, Raeba Mathew, Sobha Sivaprasad; Response of Hyperreflective Foci in Diabetic Macular Edema to Laser. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2401.
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Hyperreflective foci (HRF) on Spectral Domain Ocular Coherence Tomography (SD-OCT) have been frequently observed within the neurosensory retina in patients with diabetic macular edema (DME). The aim of this study was to evaluate the relationship of HRF in DME to the central subfield thickness and response to macular laser treatment.
This is a retrospective chart analysis on 50 eyes of diabetic patients with centre-involving macular edema. Subjects were from three ethnic groups (Asian, Afro-Caribbean and Caucasian). The OCT scans were performed using a standard protocol on the Heidelberg Spectralis SD-OCT as part of routine medical care. Hyperreflective foci and central subfield thickness (CST) in the subfoveal 1 mm area were compared pre and post macular laser treatment.
In all the eyes, variable amounts of HRF were detected in the foveal and parafoveal area. The mean number of HRF reduced from 6.3 to 5.2 whereas foveal thickness reduced from 445 to 217. The HRF were seen to reduce in 64% patients, remain the same in 18% and increase in 18% of the patients. The number of HRF was not related to the initial central macular thickness. The change in central subfield thickness of the eyes showed moderate correlation with the change in number of HRF (r=0.5, p value= 0.0002). The HRF were seen to increase in eyes with worsening of macular edema following macular laser.
In diabetic macular edema, HRF are frequently present in the retinal layers on SD OCT. The numbers of HRF are seen to significantly reduce in eyes that respond to macular laser, whereas they increase in number in eyes with worsening of macular edema which may suggest that HRF may be a surrogate marker of inflammation.
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