Purpose

To assess the clinical significance of suspended scattering particles in motion (SSPiM) and different cystic phenotypes in diabetic macular oedema (DME) treated with dexamethasone implant (DEX-i).

Methods

A retrospective review of type 2 diabetic patients with DME treated with a DEX-i was conducted. Swept-source optical coherence tomography angiography (OCTA, PLEX Elite 9000) with a 3-mm volume cube was performed. Regions of interest were delineated with Fiji software (version 2.1.0/1.53.c) in the superficial vascular complex (SVC) and deep capillary plexus (DCP) at baseline, 2- and 4-months after DEX-i. SSPiM was defined as regions of variable reflectivity with a decorrelation signal. Without a detectable decorrelation signal, its counterpart was addressed as ‘corpuscular,’ while hyporeflective cysts were optical empty without hyperreflective material enclosed.

Results

After treatment, the hyporeflective component demonstrated substantial reabsorption in the SVC (–95.4% at 2- and –84.4% at 4-months, p < 0.01 both) and DVC (–84.4%, 2-months), with a less critical decrease of the corpuscular component in the SVC (2-months: –41.9%, p = 0.001 and 4 months: –1.8%, p = 0.73), and not significant in the DVC. SSPiM did not significantly change in the SVC and DVC neither at 2- and 4-months (p > 0.05, all).

Conclusions

After a single DEX-i, the clearance of different cystic phenotypes proceeds with resorption of hyporeflective, followed by corpuscular components. SSPiM demonstrated minimal response, indicating a severe BRB breakdown that may require repeated treatment to reach a satisfactory anatomical response.

中文翻译：

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糖尿病性黄斑水肿地塞米松植入后囊肿特征的差异及其对解剖学反应的相关影响

目的

评估运动中悬浮散射颗粒 (SSPiM) 和不同囊性表型在用地塞米松植入物 (DEX-i) 治疗的糖尿病性黄斑水肿 (DME) 中的临床意义。

方法

对使用 DEX-i 治疗的 2 型糖尿病 DME 患者进行了回顾性研究。扫描源光学相干断层扫描血管造影术（OCTA，PLEX Elite 9000）使用 3 毫米立方体进行。在基线、DEX-i 后 2 个月和 4 个月时，使用 Fiji 软件（2.1.0/1.53.c 版）在浅表血管复合体 (SVC) 和深部毛细血管丛 (DCP) 中划定感兴趣区域。SSPiM 被定义为具有去相关信号的可变反射率区域。没有可检测到的去相关信号，它的对应物被称为“微粒”，而低反射囊肿是光学空洞，没有封闭高反射材料。

结果

治疗后，低反射成分在 SVC（2 个月时为 –95.4% 和 4 个月时为 –84.4%，均p < 0.01）和 DVC（2 个月时为 –84.4%）中表现出显着的重吸收，并且下降幅度较小SVC 中的红细胞成分（2 个月：–41.9%，p = 0.001 和 4 个月：–1.8%，p = 0.73），在 DVC 中不显着。在 2 个月和 4 个月时，SSPiM 在 SVC 和 DVC 中都没有显着变化（p > 0.05，全部）。

结论

在单次 DEX-i 后，不同囊性表型的清除伴随着低反射的再吸收，随后是红细胞成分。SSPiM 表现出最小的反应，表明严重的 BRB 分解可能需要重复治疗才能达到令人满意的解剖学反应。