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The correlation between intracystic reflectivity and intraocular inflammation in diabetic macular edema: a novel
Tahsin Uzundede1, Akın Çakır2, Eren Vurgun3
1Department of Ophthalmology, Prof Dr Cemil Taşcıoğlu City Hospital, Kaptanpaşa District, Istanbul, 34384, Turkey. tahsinuzundede@gmail.com.
Purpose:
To investigate the association between intracystic hyperreflectivity (ICH) observed in macular optical cohorence tomography (OCT) and aqueous cytokine levels in patients with diabetic macular edema (DME), and to evaluate the impact of cataract surgery and intravitreal agents on these parameters.
Methods:
This prospective, open-label observational study included DME patients undergoing cataract surgery with simultaneous intravitreal injection. Based on prior treatment history, patients were assigned to either the aflibercept or dexamethasone groups. Aqueous humor samples were collected during surgery for cytokine analysis. ICH in macular OCT was measured on postoperative day 1 and month 1 using ImageJ software. Correlations between ICH and cytokine levels, as well as longitudinal changes based on injection type and OCT biomarkers, were analyzed.
Results:
Fifty-six patients (28 per group) were included. Significant correlations were found between ICH and IL-1β, IL-6, IL-8, and IL-10 (p = 0.039, R = 0.277; p = 0.003, R = 0.395; p < 0.001, R = 0.506; p = 0.049, R = 0.265). ICH also correlated with OCT biomarkers and increased after surgery, with a less pronounced rise in the dexamethasone group (p < 0.001; p = 0.013; p = 0.145).
Conclusion:
ICH is strongly associated with intraocular inflammatory cytokines and may serve as a potential OCT-based biomarker of inflammation in DME.
