ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2025-2-339-346ophthalmology-2661Research ArticleКЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯCLINICAL STUDIESОКТ-биомаркеры в диагностике увеального и постлучевого макулярного отекаOCT Biomarkers in Diagnostic of Uveitic and Radiation-induced Macular Edemahttps://orcid.org/0000-0001-7443-4555ПановаИ. Е.PanovaI. E.

Панова Ирина Евгеньевна доктор медицинских наук, профессор, заместитель директора  по научной работе, профессор кафедры

ул. Ярослава Гашека, 21, Санкт-Петербург, 192283

ул. Кирочная, 41, Санкт-Петербург, 191015

Университетская наб., 7–9, Санкт-Петербург, 199034

Panova Irina E. PhD, MD, Professor, deputy director 

Yaroslav Gashek str., 21, Saint Perersburg, 192283

Kirochnaya str., 41, Saint-Petersburg, 191015

Universitetskaya emb., 7–9, Saint Petersburg, 199034

https://orcid.org/0000-0002-2765-0332ГвазаваВ. Г.GvazavaV. G.

Гвазава Виктория Гиевна врач‑офтальмолог, врач ультразвуковой диагностики

ул. Ярослава Гашека, 21, Санкт-Петербург, 192283

Gvazava Viktoriya G. ophthalmologist, ultrasonic diagnostician 

Yaroslav Gashek str., 21, Saint Perersburg, 192283

gvazava-sochi@mail.ruhttps://orcid.org/0000-0003-1559-2793БыховскийА. А.BykhovskyA. A.

Быховский Арсений Андреевич врач‑офтальмолог

ул. Ярослава Гашека, 21, Санкт-Петербург, 192283

Bykhovsky Arseny A. ophthalmologist 

Yaroslav Gashek str., 21, Saint Perersburg, 192283

https://orcid.org/0000-0002-3503-6009ЗакараияТ. Г.ZakaraiiaT. G.

Закараия Тамрико Годерзиевна офтальмолог

ул. Ярослава Гашека, 21, Санкт-Петербург, 192283

Zakaraiia Tamriko G. ophthalmologist 

Yaroslav Gashek str., 21, Saint Perersburg, 192283

Санкт-Петербургский филиал ФГАУ НМИЦ «МНТК “Микрохирургия глаза” имени академика С.Н. Федорова» Министерства здравоохранения Российской Федерации; ФГБОУ ВО «Северо-Западный государственный медицинский университет имени И. И. Мечникова» Министерства здравоохранения Российской Федерации; ФГБОУ ВО «Санкт-Петербургский государственный университет»РоссияSaint Petersburg Branch of S. Fyodorov Eye Microsurgery Federal State Institution; North-Western State Medical University named after I.I. Mechnikov; Saint-Petersburg State UniversityRussian FederationСанкт-Петербургский филиал ФГАУ НМИЦ «МНТК “Микрохирургия глаза” имени академика С.Н. Федорова» Министерства здравоохранения Российской ФедерацииРоссияSaint Petersburg Branch of S. Fyodorov Eye Microsurgery Federal State InstitutionRussian Federation202527062025222339346Copyright © Панова И.Е., Гвазава В.Г., Быховский А.А., Закараия Т.Г., 20252025Панова И.Е., Гвазава В.Г., Быховский А.А., Закараия Т.Г.Panova I.E., Gvazava V.G., Bykhovsky A.A., Zakaraiia T.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ophthalmojournal.com/opht/article/view/2661

Цель: установить характерные ОКТ-биомаркеры при впервые выявленном и рецидивирующем течении макулярного отека увеального и постлучевого генеза и определить их значимость в оценке МКОЗ. Пациенты и методы. Всего в исследование были включены 48 пациентов (56 глаз) с постлучевым (24 глаза) и увеальным (32 глаза) макулярным отеком. Всем пациентам выполняли ОКТ на приборе Optovue RTVue XR Avanti. При оценке ОКТ-морфоструктурных характеристик оценивали следующие биомаркеры: эверсию фовеа, отслойку нейроэпителия, гиперрефлективные точки, нарушение эллипсоидной зоны, дезорганизацию внутренних слоев сетчатки (DRIL — disorganization of retinal inner layers), эпиретинальный фиброз. Для анализа ОКТ-морфометрических характеристик измеряли центральную толщину сетчатки. Результаты. При сравнительном анализе частоты ОКТ-морфометрических и морфоструктурных характеристик МО различного генеза достоверные различия между группами наблюдались только в отношении эпиретинального фиброза — в группе постлучевого макулярного отека данный ОКТ-биомаркер встречался чаще (р = 0,041). Установлено, что при постлучевом и увеальном макулярном отеках наличие гиперрефлективных точек, нарушение эллипсоидной зоны и DRIL были связаны с более низкой МКОЗ (р < 0,001). Для впервые выявленного МО характерно преобладание отслойки нейроэпителия (р = 0,002), в то время как при рецидивирующем МО имели место бо́льшая центральная толщина сетчатки в макулярной зоне наряду с такими морфоструктурными изменениями сетчатки, как нарушение эллипсоидной зоны сетчатки (р = 0,029) и DRIL (р = 0,036). Выводы. Постлучевой и увеальный макулярный отеки достоверно не отличаются по их ОКТ-морфоструктурным характеристикам и центральной толщине сетчатки. Для рецидивирующего течения постлучевого и увеального макулярного отеков характерно наличие нарушения эллипсоидной зоны и DRIL, а также бо´льшая центральная толщина сетчатки. Нарушение эллипсоидной зоны, DRIL и гиперрефлективные точки статистически значимо взаимосвязаны с более низкой МКОЗ у пациентов с увеальным и постлучевым МО.

Objective

Objective: tо evaluate characteristic OCT biomarkers of onset and recurrent uveitic and radiation-induced macular edema (ME) and determine their significance in assessing best corrected visual acuity (BCVA).

Patients and methods

Patients and methods. 48 patients (56 eyes) with radiation-induced (24 eyes) and uveitic (32 eyes) ME were enrolled in the study. All patients underwent OCT on Optovue RTVue XR Avanti. The following biomarkers were assessed to evaluate OCT morphostructural characteristics: foveal eversion, subretinal detachment, hyperreflective foci, ellipsoid zone disruption, disorganization of retinal inner layers (DRIL), and epiretinal membrane. Central retinal thickness was measured to analyze OCT morphometric characteristics.

Results

Results. There was no statistically significant difference in OCT biomarkers between uveitic and radiation-induced ME except for epiretinal membrane — this OCT biomarker was more common in radiation ME (p = 0.041). The presence of hyperreflective foci, ellipsoid zone disruption and DRIL in radiation-induced and uveitic ME were associated with lower BCVA (p < 0.001). The presence of subretinal detachment was characteristic for the onset ME (p = 0.002), while recurrent ME associated with a greater central retinal thickness, ellipsoid zone disruption (p = 0.029) and DRIL (p = 0.036).

Conclusion

Conclusion. Radiation-induced and uveitic ME do not differ significantly in their OCT morphostructural characteristics and central retinal thickness. The recurrent course of radiation-induced and uveitic ME is characterized by the presence of ellipsoid zone disruption and DRIL, as well as greater central retinal thickness. Ellipsoid zone disruption, DRIL, and hyperreflective foci associated with lower BCVA in patients with uveitic and radiation-induced ME.

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The authors declare that there are no conflicts of interest present.