Algorithm for the Measure of Vitreous Hyperreflective Foci in Optical Coherence Tomographic Scans of Patients With Diabetic Macular Edema

Korot, Edward; Comer, Grant M.; Steffens, Timothy; Antonetti, David A.

doi:10.1001/jamaophthalmol.2015.3949

Cited by 28 publications

(25 citation statements)

References 16 publications

(16 reference statements)

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“…When monitoring the retina of wet AMD patients using spectral domain optical coherence tomography (SD‐OCT), small, dense particles—thereby referred to as hyper‐reflective foci (HF)—were identified (Framme et al, ; Altay et al, ). Similarly, HF were found in eyes of patients with different stages of diabetic retinopathy (De Benedetto et al, ; Korot et al, ), and a positive correlation between HF number, hard exudate size, disease severity, and inflammation has been recognized (Bolz et al, ; Lammer et al, ; Niu et al, ). Interestingly, the appearance and resolution of HF can be used to complement current diagnostic tools and predict disease progression and therapeutic success (Gallagher et al, ; Coscas et al, ; Abri Aghdam et al, ).…”

Section: Targeting Mononuclear Phagocytes In Retinal Degenerative Dismentioning

confidence: 86%

Modulation of three key innate immune pathways for the most common retinal degenerative diseases

et al. 2018

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This review highlights the role of three key immune pathways in the pathophysiology of major retinal degenerative diseases including diabetic retinopathy, age‐related macular degeneration, and rare retinal dystrophies. We first discuss the mechanisms how loss of retinal homeostasis evokes an unbalanced retinal immune reaction involving responses of local microglia and recruited macrophages, activity of the alternative complement system, and inflammasome assembly in the retinal pigment epithelium. Presenting these key mechanisms as complementary targets, we specifically emphasize the concept of immunomodulation as potential treatment strategy to prevent or delay vision loss. Promising molecules are ligands for phagocyte receptors, specific inhibitors of complement activation products, and inflammasome inhibitors. We comprehensively summarize the scientific evidence for this strategy from preclinical animal models, human ocular tissue analyses, and clinical trials evolving in the last few years.

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Section: Targeting Mononuclear Phagocytes In Retinal Degenerative Dismentioning

confidence: 86%

Modulation of three key innate immune pathways for the most common retinal degenerative diseases

et al. 2018

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“…The presence of intraretinal fluid (IRF), subretinal fluid (SRF), subretinal hemorrhage (SRH), hyperreflective foci (HF) at outer retinal layer, and presence of retinal pigment epithelium detachment (PED) was recorded. Greatest linear diameter (GLD) of lesion, maximal retinal thickness (MRT), defined as the maximal vertical distance between the ILM and the surface of the RPE (including the height of subretinal fluid and subretinal hemorrhages), maximal neurosensory thickness (MNT), defined as the maximal vertical distance between inner limiting membrane (ILM) and outer surface of the retinal photoreceptors were measured as described in prior reports 12 34 35 36 .…”

Section: Methodsmentioning

confidence: 99%

Macrophage polarization in experimental and clinical choroidal neovascularization

Liu

Tang

et al. 2016

Sci Rep

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Macrophages play an important role in the development of age-related macular degeneration (AMD). In this study, the spatial and temporal changes and the polarization of macrophages in murine laser-induced choroidal neovascularization (CNV) were investigated, and the polarized M1 and M2 biomarkers in the aqueous humors of neovascular AMD (nAMD) patients were studied. Macrophages, the main infiltrating inflammatory cells in CNV lesions, were evidenced by a significant increase in F4/80 mRNA expression and by the infiltration of F4/80+ cells in the lesions and the vicinity of laser-induced CNV. The mRNA expressions of M1-related markers were dramatically upregulated in the early stage, while the M2-related markers were slightly upregulated in the middle stage and sustained until the late stage. The results of immunostaining showed a similar early-but-transient M1 pattern and a delayed-but-sustained M2 pattern in laser-induced CNV. In addition, a higher M2/M1 ratio was found in both the murine models (Arg-1/iNOS and CCL22/CXCL10) and the aqueous humors of nAMD patients (CCL22/CXCL10) than in the controls. Our results suggested that the dynamic patterns of M1 and M2 were different in both the experimental and clinical CNV. The M2 macrophages were predominant and may play a more important role in the development of CNV.

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“…Previously, HF were suspected as subclinical features of lipoprotein extravasation or migrating pieces of retinal pigmented epithelium [36,37]. However, recent reports suggested that HF can be activated forms of microglia and markers of inflammation [38,39]. On the other hand, EZ integrity reflects the health of the photoreceptor layer; EZ disruption is associated with a poor visual prognosis in DME patients [40].…”

Section: Discussionmentioning

confidence: 99%

Glucose-Regulated Protein 78 in the Aqueous Humor of Patients with Diabetic Macular Edema

Choi

Kwon

2020

Journal of Diabetes Research

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Purpose. We identified the associations between levels of aqueous glucose-regulated protein 78 (GRP78) and systemic or ocular factors in patients with center-involving diabetic macular edema (CIDME). Methods. We measured the aqueous concentrations of GRP78, interleukin- (IL-) 1β, IL-2, IL-8, IL-10, and IL-17, placental growth factor, and vascular endothelial growth factor (VEGF). We explored the associations between aqueous GRP78 levels and those of other aqueous factors, optical coherence tomography (OCT) findings, and systemic parameters in CIDME patients. Results. In multivariate regression analysis, aqueous GRP78 levels were associated with aqueous VEGF levels (p=0.007), length of EZ disruption (p<0.001), and duration of diabetes (p=0.002). However, no significant relationship was observed between GRP78 levels and those of other systemic and ocular factors including inflammatory cytokines in the aqueous humor. In terms of responsiveness, the number of hyperreflective foci (≥8) was significantly associated with the responsiveness of three consecutive monthly intravitreal bevacizumab injections (OR=0.34, p=0.046), but not the aqueous GRP78 levels. Conclusions. Aqueous GRP78 levels correlated with VEGF levels in the aqueous humor and EZ disruption on OCT. However, GRP78 levels were not associated with those of inflammatory biomarkers in the aqueous humor or OCT findings. Additionally, GRP78 could not serve as a biomarker to predict short-term prognosis of anti-VEGF agent.

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Algorithm for the Measure of Vitreous Hyperreflective Foci in Optical Coherence Tomographic Scans of Patients With Diabetic Macular Edema

Cited by 28 publications

References 16 publications

Modulation of three key innate immune pathways for the most common retinal degenerative diseases

Modulation of three key innate immune pathways for the most common retinal degenerative diseases

Macrophage polarization in experimental and clinical choroidal neovascularization

Glucose-Regulated Protein 78 in the Aqueous Humor of Patients with Diabetic Macular Edema

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