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    Local and Systemic Inflammatory Biomarkers of Diabetic Retinopathy: An Integrative Approach. Vujosevic Stela,Simó Rafael Investigative ophthalmology & visual science Purpose:To review the usefulness of local and systemic inflammatory biomarkers of diabetic retinopathy (DR) to implement a more personalized treatment. Methods:An integrated research (from ophthalmologist and diabetologist point of view) of most significant literature on serum, vitreous, and aqueous humor (AH) biochemical biomarkers related to inflammation at early and advanced stages of DR (including diabetic macular edema [DME] and proliferative DR) was performed. Moreover, novel imaging retinal biomarkers of local "inflammatory condition" were described. Results:Multiple inflammatory cytokines and chemokines are increased in DR in both serum as well as in the eye (vitreous and AH). Nevertheless, local rather than systemic production of proinflammatory cytokines seems more relevant in the pathogenesis of both DR and DME. In the eye, retinal glia cells (macroglia and microglia) together with RPE are major sources of proinflammatory and angiogenic modulators. Retinal imaging allows for noninvasive clinical evaluation of retinal inflammatory response induced by diabetes mellitus. Conclusions:Proinflammatory cytokines/chemokines play an essential role in the pathogenesis of DR. Therefore, circulating biomarkers and retinal imaging aimed at assessing inflammation have emerged as useful tools for monitoring the onset and progression of DR. In addition, "liquid biopsy" of AH seems a good option in patients with advanced stages of DR requiring intravitreous injections. This strategy may permit us to implement a more personalized treatment with better visual function outcome. Further evaluation and validation of circulating and local biomarkers, as well as multimodal imaging is needed to gain new insights into this issue. 10.1167/iovs.17-21769
    Inflammatory and angiogenic biomarkers in diabetic retinopathy. Kaštelan Snježana,Orešković Ivana,Bišćan Filip,Kaštelan Helena,Gverović Antunica Antonela Biochemia medica Diabetic retinopathy (DR) is one of the most common microvascular complications of diabetes mellitus (DM) and a leading cause of blindness in working-age adults in developed countries. Numerous investigations have recognised inflammation and angiogenesis as important factors in the development of this complication of diabetes. Current methods of DR treatment are predominantly used at advanced stages of the disease and could be associated with serious side effects. Therefore, new diagnostic methods are needed in order to identify the initial stages of DR as well as monitoring the effects of applied therapy. Biochemical biomarkers are molecules found in blood or other biological fluid and tissue that indicate the existence of an abnormal condition or disease. They could be a valuable tool in detecting early stages of DR, identifying patients most susceptible to retinopathy progression and monitoring treatment outcomes. Biomarkers related to DR can be measured in the blood, retina, vitreous, aqueous humour and recently in tears. As the retina represents a small part of total body mass, a circulating biomarker for DR needs to be highly specific. Local biomarkers are more reliable as indicators of the retinal pathology; however, obtaining a sample of aqueous humour, vitreous or retina is an invasive procedure with potential serious complications. As a non-invasive novel method, tear analysis offers a promising direction in further research for DR biomarker detection. The aim of this paper is to review systemic and local inflammatory and angiogenic biomarkers relevant to this sight threatening diabetic complication. 10.11613/BM.2020.030502
    Changes in aqueous and vitreous inflammatory cytokine levels in proliferative diabetic retinopathy: a systematic review and meta-analysis. Eye (London, England) BACKGROUND:Diabetic retinopathy is a major complication of diabetes mellitus, where in its most advanced form ischemic changes lead to the development of retinal neovascularization, termed proliferative diabetic retinopathy (PDR). While the development of PDR is often associated with angiogenic and inflammatory cytokines, studies differ on which cytokines are implicated in disease pathogenesis and on the strength of these associations. We therefore conducted a systematic review and meta-analysis to quantitatively assess the existing body of data on intraocular cytokines as biomarkers in PDR. METHODS:A comprehensive search of the literature without year limitation was conducted to January 18, 2021, which identified 341 studies assessing vitreous or aqueous cytokine levels in PDR, accounting for 10379 eyes with PDR and 6269 eyes from healthy controls. Effect sizes were calculated as standardized mean differences (SMD) of cytokine concentrations between PDR and control patients. RESULTS:Concentrations (SMD, 95% confidence interval, and p-value) of aqueous IL-1β, IL-6, IL-8, MCP-1, TNF-α, and VEGF, and vitreous IL-2, IL-4, IL-6, IL-8, angiopoietin-2, eotaxin, erythropoietin, GM-CSF, GRO, HMGB-1, IFN-γ, IGF, IP-10, MCP-1, MIP-1, MMP-9, PDGF-AA, PlGF, sCD40L, SDF-1, sICAM-1, sVEGFR, TIMP, TNF-α, and VEGF were significantly higher in patients with PDR when compared to healthy nondiabetic controls. For all other cytokines no differences, failed sensitivity analyses or insufficient data were found. CONCLUSIONS:This extensive list of cytokines speaks to the complexity of PDR pathogenesis, and informs future investigations into disease pathogenesis, prognosis, and management. 10.1038/s41433-022-02127-x
    Increased levels of cytokines in the aqueous humor correlate with the severity of diabetic retinopathy. Song Shuang,Yu Xiaobing,Zhang Peng,Dai Hong Journal of diabetes and its complications AIMS:To determine the associations between the levels of certain cytokines in the aqueous humor and the severity of diabetic retinopathy. METHODS:A total of 103 patients (one eye per patient) who received intravitreal injection with ranibizumab for diabetic retinopathy were enrolled and divided into 3 groups: nonproliferative diabetic retinopathy (NPDR) with macular edema group (42 eyes), proliferative diabetic retinopathy (PDR) group (40 eyes) and neovascular glaucoma due to PDR (NVG-PDR) group (21 eyes). The concentrations of interleukin (IL)-6, IL-8, IL-10, vascular endothelial growth factor (VEGF), transforming growth factor-β (TGF-β), vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), and monocyte chemoattractant protein-1 (MCP-1) in the aqueous humor were measured. RESULTS:In this study, 42, 40 and 21 patients (one eye per patient) were included in the NPDR, PDR and NVG-PDR groups, respectively. The median concentrations of IL-6, IL-8, IL-10, VEGF, TGF-β, VCAM-1, ICAM-1 and MCP-1 in the groups were measured. The levels of these 8 cytokines increased with the severity of diabetic retinopathy, especially in the NVG-PDR group. Compared with those in the NPDR group, the aqueous concentrations of these 8 cytokines were higher in the PDR group and were the highest in the NVG-PDR group. There were significant differences in all cytokines among the three groups (P < 0.05). Multivariate analysis showed that in the NPDR and PDR groups, the risk of PDR associated with elevated levels of TGF-β (P = 0.0004, OR 1.11, 95% CI [1.05-1.18]) and ICAM-1 (P = 0.0408, OR 10.75, 95% CI [1.10-104.61]). In the PDR and NVG groups, the risk of NVG associated with elevated levels of IL-10 (P = 0.0486, OR 0.7040, 95% CI [0.4966, 0.9979]), VEGF (P = 0.0279, OR 0.9963, 95% CI [0.9931, 0.9996]), and VCAM-1 (P = 0.0316, OR 0.9998, 95% CI [0.9996, 0.99998]). In the three groups, the risk of developing NVG associated with elevated levels of TGF-β (P < 0.001, OR 1.04, 95% CI [1.02, 1.05]). CONCLUSIONS:The levels of these eight cytokines in the aqueous humor increased with the severity of diabetic retinopathy, especially in NVG-PDR. This study suggests that TGF-β, ICAM-1, IL-10, VEGF, and VCAM-1 may play a role in the progression of diabetic retinopathy, especially TGF-β, which may plays a significant role in NVG-PDR. These cytokines potentially may be used as biomarkers to predict the progress of diabetic retinopathy, contribute to the choice of treatment options and/or monitor treatment responses. 10.1016/j.jdiacomp.2020.107641
    Aqueous Level of ANGPTL4 Correlates with the OCTA Metrics of Diabetic Macular Edema in NPDR. Journal of diabetes research PURPOSE:To investigate the aqueous levels of angiogenic factors in nonproliferative diabetic retinopathy (NPDR) patients with diabetic macular edema (DME) and to ascertain their association with optical coherence tomography angiography (OCTA) metrics. METHODS:This study enrolled 21 NPDR eyes with DME (NPDR/DME+), 17 NPDR eyes without DME (NPDR/DME-), and 16 diabetic eyes without retinopathy (DWR). Luminex bead-based multiplex array was used to measure the levels of 25 cytokines. OCTA system with a scan area of 3 × 3 mm was used to measure retinal thickness (RT), retinal volume (RV), superficial vessel density (SVD), deep vessel density (DVD), foveal avascular zone (FAZ) area, perimeter and acircularity index. RESULTS:The levels of ANGPTL4 were significantly different among the three groups ( < 0.05), in which NPDR/DME+ group had the highest level and NPDR/DME- group had a higher level than the DWR group (all, < 0.0167). OCTA examination showed that, compared with DWR and NPDR/DME- group, RT and RV increased and the whole/parafoveal DVD decreased in NPDR/DME+ group (all, < 0.05). Meanwhile, NPDR/DME- group had lower parafoveal DVD than the DWR group ( < 0.05). Correlation analysis showed that the levels of ANGPTL4 were positively correlated with foveal/parafoveal RT and RV and negatively correlated with whole/parafoveal DVD in NPDR patients (all, < 0.05). As the influencing factor of RT, RV, and DVD, every additional 10 pg/ml of ANGPTL4 was associated with an increase in foveal and parafoveal RT of 4.299 m and 3.598 m, respectively. Every additional 10 pg/ml of ANGPTL4 was associated with an increase in foveal and parafoveal RV of 3.371 mm and 17.705 mm, respectively. Every additional 10 pg/ml of ANGPTL4 was associated with a decrease in whole and parafoveal DVD of 1.705% and 1.799%, respectively. CONCLUSIONS:The level of ANGPTL4 in aqueous humor of NPDR patients with DME was significantly increased and ANGPTL4 might predict RT, RV, and parafoveal DVD of DME in NPDR patients. 10.1155/2022/8435603
    Oxidative Stress, Ocular Disease and Diabetes Retinopathy. Tangvarasittichai Orathai,Tangvarasittichai Surapon Current pharmaceutical design BACKGROUND:Oxidative stress is caused by free radicals or oxidant productions, including lipid peroxidation, protein modification, DNA damage and apoptosis or cell death and results in cellular degeneration and neurodegeneration from damage to macromolecules. RESULTS:Accumulation of the DNA damage (8HOdG) products and the end products of LPO (including aldehyde, diene, triene conjugates and Schiff's bases) were noted in the research studies. Significantly higher levels of these products in comparison with the controls were observed. Oxidative stress induced changes to ocular cells and tissues. Typical changes include ECM accumulation, cell dysfunction, cell death, advanced senescence, disarrangement or rearrangement of the cytoskeleton and released inflammatory cytokines. It is involved in ocular diseases, including keratoconus, Fuchs endothelial corneal dystrophy, and granular corneal dystrophy type 2, cataract, age-related macular degeneration, primary open-angle glaucoma, retinal light damage, and retinopathy of prematurity. These ocular diseases are the cause of irreversible blindness worldwide. CONCLUSIONS:Oxidative stress, inflammation and autophagy are implicated in biochemical and morphological changes in these ocular tissues. The development of therapy is a major target for the management care of these ocular diseases. 10.2174/1381612825666190115121531
    Status of higher TGF-β1 and TGF-β2 levels in the aqueous humour of patients with diabetes and cataracts. Gao Chao,Lin Xiaolei,Fan Fan,Liu Xin,Wan Huijuan,Yuan Ting,Zhao Xinrong,Luo Yi BMC ophthalmology BACKGROUND:Transforming growth factor (TGF) is a cytokine that acts on the proliferation, migration, differentiation, and apoptosis of cells and the accumulation of extracellular matrix components. Very few studies have precisely evaluated the concentration of TGF-β in the aqueous humour (AH) of diabetic and cataract (DMC) eyes due to the low expression of proteins in the AH or other reasons. The concentrations of TGF-β1, -β2, and -β3 in the AH of the DMC group were compared with those of the age-related cataract (ARC) group. METHODS:We collected AH and lens epithelium samples from 33 DMC patients and 36 ARC patients. Luminex liquid suspension chip detection was applied to detect the concentration of TGF-β1, -β2, and -β3 in the AH samples. The expression of TGFB1/2/3 in lens epithelium samples was determined by quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS:The concentrations of TGF-β1 and TGF-β2 in AH samples of DMC eyes were higher than those of ARC eyes. The differences in TGF-β1 and TGF-β2 between the two groups were statistically significant (P value = 0.001 for TGF-β1, P value = 0.023 for TGF-β2). The difference of the correlation between TGF-β1 and glycosylated haemoglobin was significant (P value = 0.011, and Pearson correlation coefficient = 0.306). The difference of the correlation between TGF-β2 and glycosylated haemoglobin was significant (P value = 0.026, and Pearson correlation coefficient = 0.269). The mRNA expression levels of TGFB1 and TGFB2 were upregulated in DMC epithelium samples compared with ARC epithelium samples. The differences in TGFB1 and TGFB2 between the two groups were statistically significant (P value for TGFB1 = 0.041, P value for TGFB2 = 0.021). CONCLUSIONS:The concentrations of TGF-β1 and TGF-β2 in AH samples were significantly higher in DMC eyes than in ARC eyes. The higher the glycosylated haemoglobin was, the higher the concentrations of TGF-β1 and -β2 were. The mRNA expression of TGFB1 and TGFB2 was significantly upregulated in DMC epithelial samples compared with ARC epithelial samples, suggesting the proinflammatory status of the anterior chamber of DMC eyes. 10.1186/s12886-022-02317-x
    Comparison of aqueous humor cytokine and chemokine levels in diabetic patients with and without retinopathy. Cheung Chui Ming Gemmy,Vania Maya,Ang Marcus,Chee Soon Phaik,Li Jing Molecular vision PURPOSE:To compare the aqueous humor levels of proinflammatory and angiogenic factors of diabetic patients with and without retinopathy. METHODS:Aqueous humor was collected at the start of cataract surgery from diabetic subjects and non-diabetic controls. The presence and severity of diabetic retinopathy were graded with fundus examination. Levels of 22 different inflammatory and angiogenic cytokines and chemokines were compared. RESULTS:Aqueous humor samples from 47 diabetic patients (20 without retinopathy, 27 with retinopathy) and 24 non-diabetic controls were included. Interleukin (IL)-2, IL-10, IL-12, interferon-alpha (IFN-α), and tumor necrosis factor (TNF)-α were measurable in significantly fewer diabetic samples, and where measurable, were at lower levels than in non-diabetic controls. IL-6 was measurable in significantly more diabetic samples, and the median levels were significantly higher in the eyes with retinopathy than the eyes without retinopathy and the non-diabetic eyes. The vascular endothelial growth factor (VEGF) level was significantly higher in the diabetic eyes with and without retinopathy compared to the non-diabetic controls. The IL-6 level positively correlated with the monocyte chemotactic protein-1 (CCL2) and interleukin-8 (CXCL8) levels and negatively with the TNF-α level. The VEGF level negatively correlated with the IL-12 and TNF-α levels. CONCLUSIONS:The aqueous humor cytokine profile of diabetic patients without retinopathy was similar to that of patients with diabetic retinopathy. These cytokines may be useful biomarkers for early detection and prognosis of diabetic retinopathy. Compared to diabetic patients without retinopathy, only the IL-6 and VEGF levels were significantly higher in diabetic patients with retinopathy.
    Association between Aqueous Cytokines and Diabetic Retinopathy Stage. Wu Hailiang,Hwang De-Kuang,Song Xudong,Tao Yong Journal of ophthalmology PURPOSE:To measure the concentrations of various cytokines in the aqueous humor from patients with different stages of diabetic retinopathy. METHODS:All selected cataract patients were categorized into 4 groups: the control group (patients without diabetes), nonretinopathy (NDR) group (diabetic patients without retinopathy), nonproliferative diabetic retinopathy (NPDR) group, and proliferative diabetic retinopathy (PDR) group. The aqueous concentrations of interleukin- (IL-) 1, IL-2, IL-4, IL-5, IL-6, IL-10, interferon-, tumor necrosis factor-, and vascular endothelial growth factor (VEGF) from patients were measured using the cytometric bead array technique. RESULTS:In this study, 10, 22, 15, and 14 patients were included in the control, NDR, NPDR, and PDR groups, respectively. No difference was observed in the aqueous concentrations of all cytokines between the control group and the NDR group. By contrast, comparison of these groups revealed that the aqueous concentrations of most inflammatory cytokines were significantly higher in the PDR and NPDR groups. In addition, the concentrations of IL-2, IL-5, and VEGF were higher in the PDR group than those in the NPDR group. CONCLUSIONS:Aqueous concentrations of various cytokines increased with the severity of patients' diabetic retinopathy. This finding implies that these cytokines might play a role in the progression of diabetic retinopathy. 10.1155/2017/9402198
    Levels of Inflammatory Cytokines IL-1, IL-6, IL-8, IL-17A, and TNF- in Aqueous Humour of Patients with Diabetic Retinopathy. Feng Songfu,Yu Honghua,Yu Ying,Geng Yu,Li Dongli,Yang Chun,Lv Qingjun,Lu Li,Liu Ting,Li Guodong,Yuan Ling Journal of diabetes research Diabetic retinopathy is the leading cause of blindness in working age individuals in developed countries. However, the role of inflammation in the pathogenesis of DR is not completely understood. This is an observational clinical research enrolling 80 type II diabetic patients who had undergone cataract surgeries either with DR or without DR. All cases were further categorized by the proliferative stages of retinal neovascularization and by the lengths of diabetic history. The levels of inflammatory cytokines including IL-1, IL-6, IL-8, IL-17, and TNF- in aqueous humour were tested. Results in this study indicated that these cytokine levels were increased in DR patients and might have a synergistic effect on the pathogenesis of this disease. They were also elevated along with the progression of neovascularization, reflecting the severity of DR. The results also suggested that for diabetic patients, the higher these levels are, the sooner retinal complications might appear. In conclusion, the levels of inflammatory cytokines IL-1, IL-6, IL-8, IL-17A, and TNF- in aqueous humour may be associated with the pathogenesis, severity, and prognosis of DR. 10.1155/2018/8546423
    Aqueous cytokines as predictors of macular edema in patients with diabetes following uncomplicated phacoemulsification cataract surgery. Dong Ning,Xu Bing,Wang Bingsong,Chu Liqun,Tang Xin BioMed research international This study aims to ascertain whether cytokines in the aqueous humor can predict macular edema (ME) in diabetic patients following uncomplicated phacoemulsification cataract surgery. Undiluted aqueous humor samples were obtained from 136 consecutive type 2 diabetic patients who underwent cataract surgery. The concentrations of 27 cytokines were measured in aqueous humor using the multiplex bead immunoassay. At the final follow-up examination, 116 patients completed 4 weeks of follow-up, and the incidence of macular edema was 29.31% (34 patients) 4 weeks after cataract surgery. Compared to the ME (-) patients, the concentrations of interleukin-1β (IL-1β) (P < 0.001), IL-6 (P < 0.001), IL-8 (P < 0.001), interferon-induced protein-10 (IP-10) (P = 0.003), monocyte chemotactic protein-1 (MCP-1) (P < 0.001), and vascular endothelial growth factor (VEGF) (P < 0.001) in the ME (+) patients were significantly higher. In addition, the aqueous levels of IL-1β (r = 0.288), IL-6 (r = 0.345), IL-8 (r = 0.256), IP-10 (r = 0.377), MCP-1 (r = 0.423), and VEGF (r = 0.279) were positively correlated with the postoperative foveal center point thickness (FCPT). However, the aqueous levels of IL-10 (P = 0.003) and IL-12 (P = 0.017) were significantly lower in patients with ME. These results suggest IL-1β, IL-6, IL-8, IL-10, IL-12, IP-10, MCP-1, and VEGF may be potential predictors of postoperative macular thickness in patients with diabetes following uncomplicated phacoemulsification cataract surgery. 10.1155/2015/126984
    Comparison of inflammatory cytokines levels in the aqueous humor with diabetic retinopathy. Zhang Haijiang,Liang Liang,Huang Rong,Wu Ping,He Liye International ophthalmology PURPOSE:Evidence has accumulated suggesting that various inflammatory cytokines are involved in the progress of diabetic retinopathy (DR), but there are few studies concerning the relationship between individual cytokines levels in the aqueous humor (AH) and the severity of DR. This study aimed to explore the differences of interleukin (IL)-23, IL-17, IL-10 and transforming growth factor (TGF)-β in AH form patients with different proliferative stages of DR. METHODS:From June 2016 to June 2019, patients for senile cataract surgery were enrolled with the informed consent. All cases were graded into 4 groups: the control group (patients without diabetes), non-retinopathy (NDR) group (diabetic patients without retinopathy), non-proliferative diabetic retinopathy (NPDR) group, and proliferative diabetic retinopathy (PDR) group. The concentrations of IL-23, IL-17, IL-10, and TGF-β in AH were measured using ELISA and compared them within four groups by ANOVA. RESULTS:In this study, 20 (28.57%), 18 (25.71%), 17 (24.29%), and 15 (21.43%) patients were included in the control, NDR, NPDR, and PDR groups, respectively. There had no significant differences in demographic characteristics (P > 0.05). Comparison of these cytokines within four groups revealed: the IL-23 level was increased in NDR group initially and raised along with the progression of DR (P < 0.01). The IL-17 level was significantly higher in NPDR and PDR groups compared to NDR and the control groups, and positively correlated with more-severe DR (P < 0.01). By contrast, The IL-10 level was significantly lower in diabetic patients than in non-diabetic controls, and decreased as the severity of DR increased (P < 0.05). In addition, TGF-β was also elevated in diabetic patients, but showed no differences based on the presence or severity of DR (P > 0.05). CONCLUSIONS:The over-expression of IL-23 and IL-17 in AH might have a synergistic effect on the pathogenesis well before the proliferative stage, and was typical positively correlated with the severity of DR. These results offer a novel early therapeutic target for DR. 10.1007/s10792-020-01463-9
    Transient reduction in macular deep capillary density on optical coherence tomography angiography after phacoemulsification surgery in diabetic patients. Wang Zaowen,Wang Erqian,Chen Youxin BMC ophthalmology BACKGROUND:To evaluate macular microvascular changes and associated factors in diabetic patients following uncomplicated phacoemulsification surgery. METHODS:In this prospective observational study, we enrolled diabetic patients and non-diabetic controls who underwent phacoemulsification surgery. Participants were examined at postoperative day 1 (POD1), 10 (POD10), 30 (POD30), and 90 (POD90), using macular 3x3mm OCT angiography scan (RTVue-XR Avanti; Optovue, Inc., Fremont, CA). Integrated automated algorithms were used to quantify parafoveal vessel density (VD) in superficial capillary plexus (SCP) and deep capillary plexus (DCP). To minimize measurement bias, subjects with corneal edema or capsular opacity at any postoperative visit were excluded. RESULTS:The study included 21 eyes of 21 diabetic patients and 21 eyes of 21 non-diabetic controls. In diabetic patients, no significant change in SCP-VD could be detected (P = 0.57); DCP-VD reduced from 50.24 ± 2.33% at POD1 to 48.33 ± 3.07% at POD30 (P = 0.019), and restored to 50.74 ± 3.44% at POD90 (P = 1.00). The DCP-VD change at POD30 in diabetic patients (- 1.90 ± 2.61%) was significantly different from that in controls (1.31 ± 2.61%) (P < 0.001). The amount of DCP-VD reduction was correlated with foveal and parafoveal thickening (r = 0.431, P = 0.051 and r = 0.514, P = 0.017, respectively), high cumulative dissipated energy (P = 0.032) and increased hemoglobin A1c concentration (P = 0.037). CONCLUSIONS:Phacoemulsification in diabetic patients caused transient reduction in DCP-VD, which was associated with poor glycemic control, surgical trauma, and postoperative macular thickening. Our results added a new dimension to our understanding of the complex biologic effects of cataract surgery in diabetic subjects. 10.1186/s12886-020-01605-8
    Macular Vascular Density Changes following Cataract Surgery in Diabetic Patients: An Optical Coherence Tomography Angiography Study. Feng Le,Azhati Guliqiwaer,Li Tingting,Liu Fang Journal of ophthalmology Purpose:Cataracts and diabetes very commonly coexist. The aim of the present study was to quantify the effect of uncomplicated phacoemulsification on retinal microvasculature in diabetic patients by using optical coherence tomography angiography (OCTA). Methods:A prospective observational study of diabetic and nondiabetic patients at baseline and 1 day, 1 week, 1 month, and 3 months after cataract surgery was performed by using OCTA. We measured the macular thickness (MT), superficial capillary plexus (SCP), deep capillary plexuses (DCP), and foveal avascular zone (FAZ) in the 3 × 3 mm macular images. Results:A total of 32 eyes of 32 type 2 diabetic patients and 40 eyes of 40 nondiabetic patients were assessed. There was a significant increase in MT at 1 month and 3 months after surgery in both groups (all < 0.05), but there was no significant difference between the two groups (=0.217). At 3 months postoperatively, the SCP level in the diabetic group was significantly higher than that at baseline ( < 0.05). The MT and SCP were negatively correlated with logMAR best-corrected visual acuity (BCVA), while the FAZ area and perimeter were positively correlated with logMAR BCVA in the diabetic group. Conclusions:Our study demonstrated that phacoemulsification can increase macular thickness in both diabetic and nondiabetic patients and increase SCP in diabetic patients within 3 months after surgery. Whether these changes persist for a longer period still needs to be investigated. 10.1155/2021/6641944
    Early retinal and choroidal OCT and OCT angiography signs of inflammation after uncomplicated cataract surgery. Pilotto Elisabetta,Leonardi Francesca,Stefanon Giuseppe,Longhin Evelyn,Torresin Tommaso,Deganello Davide,Cavarzeran Fabiano,Miglionico Giacomo,Parrozzani Raffaele,Midena Edoardo The British journal of ophthalmology PURPOSE:To evaluate, by means of optical coherence tomography (OCT) and OCT angiography (OCTA), early retinal, choroidal and macular perfusion changes induced by a local inflammatory reaction secondary to uncomplicated cataract surgery. METHODS:Selected eyes undergoing cataract surgery were enrolled in a prospective study. OCT and OCTA were performed before cataract surgery (T0) and at day: 1 (T1), 7 (T7), 30 (T30) and 90 (T90). Inner (IR) and outer retinal (OR) volumes, choroidal volume, hyper-reflective retinal spots (HRS) in IR and OR changes were measured at OCT. Macular perfusion was analysed in superficial (SCP), intermediate (ICP) and deep retinal capillary plexuses (DCP). RESULTS:Nine eyes of nine selected patients were consecutively enrolled. Mean IR volume changed after surgery (p=0.0001), increasing progressively from 4.391±0.231 mm³ at T0 to 4.573±0.241 mm³ at T30, p=0.0002. Both mean OR and choroidal volume increased, mainly at T30, but not significantly (p=0.4360 and p=0.2300, respectively). Mean HRS changed during follow-up, increasing at first in IR and later in OR (at T1 and T7, respectively, both p<0.0001). Macular ICP and DCP perfusion increased at T1, whereas macular SCP perfusion did not change. At T90, all OCT and OCTA parameters had almost reached baseline levels. CONCLUSIONS:The increase of HRS at first in IR and later in OR seems to confirm their inflammatory nature. Early OCTA changes (underline) underscore a selective susceptibility of DCP and ICP to a localised inflammatory reaction induced by cataract surgery. 10.1136/bjophthalmol-2018-312461