Evaluation of hyper-reflective foci and their association with visual status in diabetic macular edema
Abstract
Background: This study aimed to know the association of visual status and hyperreflective foci in patients with diabetic macular edema (DME).
Material and methods: This observational cross-sectional study included patients with diabetes mellitus type 2 (DM2) with DME or non-proliferative diabetic retinopathy (NPDR). Baseline assessment included: ophthalmic examinations such as best-corrected visual acuity (LogMAR), color vision, contrast sensitivity, intraocular pressure (IOP), fundus examination by direct, indirect ophthalmoscopy, slit-lamp biomicroscopy with 90D, and spectraldomain — optical coherence tomography (SD-OCT) [counting of hyperreflective foci (HF) were done manually]. Retina specialists performed counting and classification of HF. The correlation was calculated to establish the association between HF with visual status. p-value < 0.05 was considered statistically significant.
Results: In majority of the patients (46.67%), HF was < 50 followed by 51–100 (30.83%) and > 100 (17.50%). With increasing HF, there was a significantly decreasing trend of best-corrected visual acuity (BCVA) (0.2 in no HF to 0.5 in HF > 100, p = 0.001) and contrast (1.58 in no HF to 1.35 in HF > 100, p = 0.0004). HF were found to significantly increase with increasing duration of the disease (4 in no HF to 17 in HF > 100, p = 0.0001). The lab parameters such as glycated haemoglobin (HbA1c), serum urea, serum creatinine, triglycerides, very low-density lipoproteins (VLDL), low-density lipoproteins (LDL), and high-density lipoproteins (HDL) showed significant derangement with increasing HF (p < 0.05).
Conclusion: The presence of HF in patients with DME negatively affects BCVA and contrast sensitivity. The severity of HF may increase with the increasing duration of DME and altered glycemic index.
Keywords: diabetic macular edemahyperreflective focivisual acuity
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