Abstract
Purpose :
Several biomarkers on OCT, such as disorganization of retinal inner layers (DRIL), retinal hyperreflective foci (HRF) and increased inner nuclear layer (INL) thickness, have been found to be related to inflammation in prior studies. We investigated clinical factors associated with these inflammation-related biomarkers on OCT in patients with DME.
Methods :
This is a cross-sectional study including patients with DME between February 1, 2019, and March 31, 2023 without intravitreal anti-VEGF injection within the prior 6 months. We reviewed each patient’s medical record for age, sex, race and ethnicity, most recent glycated hemoglobin level (HbA1c), visual acuity (VA), and central macular thickness (CMT). Inflammation-related OCT biomarkers, including DRIL (horizontal extent in µm), HRF (number), hyperreflective choroidal foci (HCF, presence), subfoveal neuroretinal detachment (SND, area in mm2), ganglion cell layer (GCL) thickness (µm), and INL thickness (µm) were evaluated by graders masked to patients’ clinical characteristics. We performed multivariable regression models with each OCT biomarker as the dependent variable and age, sex, HbA1c, and CMT as independent variables.
Results :
In multivariate analyses, we found older age to be associated with fewer HRF (incidence rate ratio [IRR] = 0.92 for each additional decade of age, 95% confidence interval [CI] = 0.89 – 0.95) and fewer HCF (odds ratio [OR] = 0.62 for each additional decade of age, 95% CI = 0.47 – 0.82). Male patients tended to have more HRF (IRR = 1.19, 95% CI = 1.10 – 1.29), more HCF (OR = 2.01, 95% CI = 1.12 – 3.64), and thicker INL (7 µm thicker in males, 95% CI = 2–12). Patients with higher HbA1c were more likely to have more HRF (IRR = 1.02 per 1 point increase, 95% CI = 1.00 – 1.04).
Conclusions :
This study found that OCT parameters thought to be correlated with inflammation in DME were more common in patients who were younger, male, and had less controlled blood sugar, after controlling for the degree of DME disease. Further studies are needed to evaluate the potential implications for individualized treatment.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.