Tetraphenylethene-based mononuclear aggregation-induced emission (AIE)-active mechanofluorochromism gold(I) complexes with different auxiliary ligands.

In this study, a series of tetraphenylethene-containing gold(I) complexes with different auxiliary ligands have been synthesized. These complexes were characterized using a variety of techniques including nuclear magnetic resonance spectroscopy, mass spectrometry, and single crystal X-ray diffraction. Their aggregation-induced emission (AIE) behaviors were investigated through ultraviolet/visible and photoluminescence spectrum analyses, and dynamic light scattering measurements. Meanwhile, their mechanofluorochromic properties were also studied via solid-state photoluminescence spectroscopy. Intriguingly, all these mononuclear gold(I) molecules functionalized by tetraphenylethene group demonstrated AIE phenomena. Furthermore, five gold(I) complexes possessing diverse auxiliary ligands exhibited distinct fluorescence changes in response to mechanical grinding. For luminogens 2-5, their solids showed reversible mechanofluorochromic behaviors triggered by the mutual transformation of crystalline and amorphous states, while for luminogen 1, blue-green-cyan three-color solid fluorescence conversion was realized by sequential mechanical grinding and solvent fumigation. Based on this stimuli-responsive tricolored fluorescence feature of 1, an information encryption system was successfully constructed.

Association between choroidal thickness and diabetic macular edema: a meta-analysis.

AIMS: To evaluate the association between subfoveal choroidal thickness (SFCT) and diabetic macular edema (DME). DESIGN: A systematic review and meta-analysis. METHODS: A retrospective or prospective study comparing SFCT in diabetic retinopathy (DR) patients with and without DME was included. The data were collected from published studies retrieved from PubMed, Web of Science, Embase, Ovid Medline, and Cochrane Library. The final search was conducted on July 2, 2023. Heterogeneity was assessed using I2 statistics, and a random-effects model was used for the meta analysis. This study calculated the weighted mean difference (WMD) and 95% confidence interval (CI) for SFCT. RESULTS: A total of 26 relevant studies were identified, involving a combined sample size of 3201 eyes (1302 DR-DME eyes and 1899 DR-no DME eyes). The results showed no significance between DR-DME and DR-no DME (WMD = - 3.57 µm; 95% CI -26.54 to 19.41 µm; P = 0.76). Sub-analysis based on nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) subgroups showed that the SFCT of NPDR-DME was significantly thinner than that of NPDR-no DME eyes (WMD = - 19.80 µm; 95% CI - 34.55 to - 5.04 µm; P = 0.009), while there was no significance in SFCT between PDR-DME and PDR-no DME (WMD = - 26.45 µm; 95% CI - 104.00 to 51.11 µm; P = 0.50). CONCLUSION: The SFCT was thinner in NPDR-DME eyes compared to NPDR-no DME eyes. Thinning SFCT might cause retinal hypoxia, and play an important role in DME occurrence. Additionally, this study highlights the importance of considering DR grades and treatment history when evaluating SFCT between DME and no DME.

Risk factors of moderate-severe Post-thrombotic syndrome within 2 years in patients with subacute thrombosis: A case-control study.

OBJECTIVE: To study the risk factors influencing the occurrence of moderate-severe post-thrombotic syndrome (PTS) within 2 years in patients with subacute lower extremity deep vein thrombosis (DVT). METHODS: Seventy patients who developed moderate-severe PTS within 2 years after subacute lower extremity DVT from June 2018 to June 2022 were retrospectively selected as the case group. They were matched 1:1 by sex and age (±5 years) with 70 patients who did not develop moderate- severe PTS during the same follow-up period as the control group. Multiple logistic regression, stratified analysis, and interaction analyses were used to explore the risk factors for moderate-severe PTS. RESULTS: The multiple logistic regression model showed that patients with iliofemoral vein thrombosis had a significantly increased risk of developing moderate-severe PTS within 2 years. Patients who underwent intraluminal intervention treatment during hospitalization had a significantly reduced risk. The odds ratios (ORs) were 4.000 (95%CI 1.597∼10.016) for the femoral-popliteal vein thrombosis and 0.262 (95%CI 0.106∼0.647) for the anticoagulation treatment group. The stratified analysis showed that intraluminal intervention treatment was a protective factor against moderate-severe PTS within 2 years across different strata of hypertension, thrombus type, BMI, duration of anticoagulation, and wearing compression stockings. Additionally, there was an interaction between thrombus type and treatment method, with intraluminal intervention treatment having a more pronounced effect on preventing moderate-severe PTS in patients with iliofemoral vein thrombosis. CONCLUSION: Iliofemoral vein thrombosis is a risk factor for the development of moderate-severe PTS within 2 years in patients with subacute lower extremity DVT. Intraluminal intervention treatment can reduce the risk of moderate-severe PTS, especially in patients with iliofemoral vein thrombosis.

A novel means of capitate distraction lengthening for end-stage Kienböck's disease.

We present a patient with Kienböck's disease treated with a novel technique of capitate distraction lengthening using two wires in the proximal capitate and two in the ulna.

Changes in the choroid detected by ultrawide-field optical coherence tomography angiography in type 2 diabetes mellitus patients without diabetic retinopathy.

AIM: The study objective was to investigate the choroidal changes in type 2 diabetes mellitus (T2DM) patients without diabetic retinopathy (DR). METHODS: This was a cross-sectional study. Controls without diabetes and T2DM patients without DR (NDR) were included. Ultrawide-field (24 × 20 mm2) optical coherence tomography angiography (OCTA) was performed to analyse choroidal thickness and vessel density. All OCTA images were divided into 3 × 3 grids. The grid centre was considered the central area, while the rest was defined as the peripheral area. RESULTS: No differences between groups were observed in the flow density of the choriocapillaris (CC), choroidal thickness (ChT) and choroidal vascular index (CVI) of the large and medium choroidal vessel (LMCV) in the central area. In the eight peripheral areas, the mean flow density of the CC did not differ between the groups, while the mean CVI and ChT were decreased in the NDR group (P< 0.05). In each peripheral area, the mean CVI and ChT were decreased in the NDR group (P< 0.05, except in the infratemporal area and nasal area for ChT and in the infratemporal area for CVI). In the correlation analysis, both mean peripheral CVI and ChT correlated with age and the duration of diabetes. CONCLUSION: Early choroidal lesions tended to be peripheral in the LMCV in patients with diabetes without DR and correlated with age and the duration of diabetes.

[Analysis of the effectiveness of sequential plate internal fixation in correction of Madelung deformity after ulnar osteotomy and shortening].

Objective: To investigate the effectiveness of sequential plate internal fixation in the correction of Madelung deformity after ulnar osteotomy and shortening. Methods: The clinical data of 13 patients with Madelung deformity admitted between September 2015 and July 2021 were retrospectively analyzed. There were 5 males and 8 females with an average age of 18.3 years ranging from 17 to 23 years. The disease duration ranged from 12 to 24 months, with an average of 17 months. Three cases had a clear history of trauma. All patients had external radial deviation deformity and limited movement of the ulnar deviation, and the ulnar impact pain was significant during ulnar deviation movement; 9 patients had limited wrist joint supination movement, and the supination movement was normal. In the first stage, ulnar osteotomy and shortening combined with external fixator were used to correct wrist deformity in 13 patients. After operation, bone transfer was performed 6 times per day, with adjustments made every 4 hours, which was 1 mm per day. After the osteotomy was in place, the ulnar plate internal fixation was performed to reconstruct the ulnar stability in the second stage. The Cooney wrist joint score was used to assess the pain, function, range of motion, flexion and extension range of motion, and grip strength of the wrist joint before operation and before the removal of internal fixator. The subjective feeling and appearance satisfaction of patients were recorded. Results: After the second-stage operation, all the 13 patients were followed up 10-22 months, with an average of 15 months. The deformity of wrist joint disappeared after operation, and the flexion, extension, and ulnar deviation were basically normal. There was no complication such as ulnar impingement sign, nonunion or infection. Wrist function, pain, and range of motion were significantly improved after operation, except for 1 patient who had no significant improvement in rotation and pain. The ulnar internal fixator was removed at 10-18 months after the second-stage operation. The scores of pain, function, range of motion, flexion and extension range of motion, and grip strength in the Cooney wrist score before removal of internal fixator significantly improved when compared with those before operation ( P<0.05). Subjective and appearance satisfaction of patients were excellent in 9 cases, good in 3 cases, and fair in 1 case. Conclusion: Ulnar osteotomy and shortening with sequential plate internal fixation for correction of Madelung deformity, with mild postoperative pain, can effectively avoid bone nonunion, improve wrist joint function, and have significant effectiveness.

The association between decreased choriocapillary flow and electroretinogram impairments in patients with diabetes.

PURPOSE: To evaluate the association between choriocapillary flow (CCF) and electroretinogram (ERG) in patients with diabetes. METHOD: This was a cross-sectional study. Patients with type 2 diabetes and healthy controls who had undergone both flicker ERG and optical coherence tomography angiography (OCTA) were included, while patients with severe diabetic retinopathy (DR) and macular edema were excluded. Correlations among OCTA and ERG parameters were conducted by generalized linear mixed models (GLMM). RESULT: One hundred ninety-four eyes of 102 patients with diabetes and fifty-six eyes of 28 controls were included. The implicit time of 30-Hz flicker ERG successively increased, while the amplitudes, inner-retina vessel density and CCF were decreased from the control to the nondiabetic retinopathy (NDR) to DR group. In patients with diabetes, all GLMM models of ERG parameters had statistically significance (P<0.05), and CCF was correlated with ERG parameters (coefficient index=-0.601, P< 0.001 with 16 Td-s implicit time; coefficient index=-0.687, P< 0.001 with 32 Td-s implicit time; coefficient index=0.933, P=0.035 with 32 Td-s amplitude) and the thickness of retinal pigment epithelium, while in the GLMM model of CCF, it was correlated with the thickness of retinal pigment epithelium and the level of glycosylated hemoglobin(both P= 0.001). CONCLUSION: CCF decreased in patients with diabetes, and it was related with ERG. Choroidopathy and its functional impairment in the retina may occur very early in patients with diabetes by influencing the outer retina.

A diagnostic model based on color vision examination for dysthyroid optic neuropathy using Hardy-Rand-Rittler color plates.

PURPOSE: To investigate color vision deficiency and the value of Hardy-Rand-Rittler (HRR) color plates in monitoring dysthyroid optic neuropathy (DON) to improve the diagnosis of DON. METHODS: The participants were divided into DON and non-DON (mild and moderate-to-severe) groups. All the subjects underwent HRR color examination and comprehensive ophthalmic examinations. The random forest and decision tree models based on the HRR score were constructed by R software. The ROC curve and accuracy of different models in diagnosing DON were calculated and compared. RESULTS: Thirty DON patients (57 eyes) and sixty non-DON patients (120 eyes) were enrolled. The HRR score was lower in DON patients than in non-DON patients (12.1 ± 6.2 versus 18.7 ± 1.8, p < 0.001). The major color deficiency was red-green deficiency in DON using HRR test. The HRR score, CAS, RNFL, and AP100 were found to be important factors in predicting DON from random forest and selected by decision tree to construct the multifactor model. The sensitivity, specificity, and the area under the curve (AUC) of the HRR score were 86%, 72%, and 0.87, respectively. The HRR score decision tree had a sensitivity, specificity, and AUC of 93%, 57%, and 0.75, respectively, with an accuracy of 82%. The data of the multifactor decision tree were 90%, 89%, and 0.93 for sensitivity, specificity, and AUC, respectively, with an accuracy of 91%. CONCLUSION: The HRR test was valid as screening method for DON. The multifactor decision tree based on the HRR test improved the diagnostic efficacy for DON. An HRR score of less than 12 and red-green deficiency may be characteristic of DON.

The Outcomes of Balanced Orbital Decompression for Dysthyroid Optic Neuropathy: Focusing on Choroiretinal Folds with and without Optic Disc Edema.

Purpose: To assess the outcomes of balanced orbital decompression for chorioretinal folds (CRFs) with and without optic disc edema (ODE) in dysthyroid optic neuropathy (DON). Method: A retrospective, interventional study was performed at Sun Yat-sen Memorial Hospital from April 2018 to November 2021. We collected the medical records of 13 patients (24 eyes) with DON and CRFs. Then, we divided them into the ODE group (15 eyes, 62.5%) and the non-ODE group (NODE group, 9 eyes, 37.5%). The valid ophthalmic examination parameters of 8 eyes in each group after balanced orbital decompression were compared at the 6-month follow-up. Results: The mean best corrected visual acuity (BCVA, 0.29 ± 0.27) and visual field-mean deviation (VF-MD, -6.55 ± 3.71 dB) in the ODE group were significantly worse than those in the NODE group (0.06 ± 0.15 and -3.49 ± 1.56 dB; all p < 0.01). Six months after orbital decompression, all parameters were found to have significantly improved in both groups, including BCVA and VF-MD (all p < 0.05). Moreover, the improvement amplitude of BCVA (p = 0.020) in the ODE group was significantly greater than that in the NODE group. There was no difference in BCVA between the ODE group (0.13 ± 0.19) and the NODE group (0.10 ± 0.13). The disc edema of all eyes (8/8 eyes, 100%) in the ODE group was completely mitigated after orbital decompression. The CRF resolution of 2 eyes (2/8 eyes, 25%) in the ODE group and no eyes in the NODE group was mitigated. Conclusions: Balanced orbital decompression can significantly improve visual functions and eliminate optic disc edema in DON patients, whether CRF relieves or not.

[Pollution Characteristics and Health Risk Assessment of Heavy Metals in PM2.5 of Different Air Masses During Heating Season in Tianjin].

In order to explore the pollution characteristics and health risks of heavy metals in PM2.5 in Tianjin, heavy metal samples (Pb, Cd, Cr, As, Zn, Mn, Co, Ni, Cu, and V) in PM2.5 were analyzed from November 2020 to March 2021 using the Xact-625 heavy metal online analyzer. The spatial and temporal distribution characteristics were analyzed using the HYSPLIT model, and the health risks of heavy metals were analyzed using the US EPA risk assessment model. The results indicated that the average total concentration of the 10 heavy metal elements was (261.56±241.74) ng·m-3, among which the concentrations of Cr ï¼»converted Cr(Ⅵ)ï¼½ and As were higher than the annual average limit of the National Ambient Air Quality Standard (GB 3095-2012). According to the back trajectory results, the medium-distance transmissions from northwest areas (NO.1), the long-distance transmissions from northwest areas (NO.2), the transmissions from southwest areas (NO.3), and the transmissions from northeast areas (NO.4) were the major sources in Tianjin City. The heavy metals of different air masses presented different pollution characteristics and health risks; the concentration of PM2.5, the total concentration of the 10 heavy metal elements, and the total carcinogenic risk of the five heavy metal elements of the NO.3 air mass were the highest, whereas the total non-carcinogenic risk of the 10 heavy metal elements of the NO.2 air mass was higher than that of the other two air mass. The health risk assessment showed that Mn posed non-carcinogenic risks to children, and Cr and As presented carcinogenic risk. Meanwhile, Cd of the NO.3 air masses also presented carcinogenic risk.

Multi-factor analysis of failure for modified single-session Angiojet rheolytic thrombectomy in treatment of acute iliofemoral venous thrombosis from iliac vein compression syndrome.

PURPOSE: To explore the risk factors of failure for modified single-session Angiojet rheolytic thrombectomy combined with directed iliac vein stenting, directed filter retrieval in the treatment of iliac vein compression with iliofemoral vein thrombosis. METHODS: During September 2017 to September 2021, 278 patients with DVT were retrospectively analyzed and 203 were eligible for inclusion. All patients were tried to take modified single-session Angiojet rheolytic thrombectomy combined with directed iliac vein stenting, directed filter retrieval treatment. The perioperative factors were analyzed between groups: group 1-modified single-session therapy succeed, and group 2-modified single-session therapy failed. The high risk factors of failure group were evaluated by logistic regression analysis. RESULTS: 48 patients failed in modified single-session therapy, up to 23.64%. Single factor analysis indicated that there were five independent risk factors related with the failure (p < 0.05), including course of disease longer than 7 days, lumbar degeneration-related iliac vein compression syndrome (dIVCS), antegrade vein access, balloon-assisted cracking thrombus, and suction time. Logistic regression analysis indicated that course of disease longer than 7 days (OR = 19.642.95%CI:6.776∼56.933), dIVCS (OR = 11.586.95%CI:4.016∼33.427) were high risk factors for modified single-session therapy failed, antegrade vein access (OR = 0.171.95%CI:0.047∼0.614) and balloon-assisted cracking thrombus (OR = 0.157.95%CI:0.045∼0.542) were protective factors for therapy failure (p < 0.05). CONCLUSIONS: Long course of disease and dIVCS are the high risk factors for failure of modified single-session Angiojet rheolytic thrombectomy combined with directed iliac vein stenting, directed filter retrieval in the treatment of iliac vein compression syndrome (IVCS). But, antegrade vein access and balloon-assisted cracking thrombus intraoperatively may improve the success rate of modified single-session treatment.

Engineering solid nanochannels with macrocyclic host-guest chemistry for stimuli responses and molecular separations.

Biological channels in the cell membrane play a critical role in the regulation of signal transduction and transmembrane transport. Researchers have been committed to building biomimetic nanochannels to imitate the above significant biological processes. Unlike the fragile feature of biological channels, numerous solid nanochannels have aroused extensive interests for their controllable chemical properties on the surface and superior mechanical properties. Surface functionalization has been confirmed to be vital to determine the properties of solid nanochannels. Macrocyclic hosts (e.g., the crown ethers, cyclodextrins, calix[n]arenes, cucurbit[n]urils, pillar[n]arenes, and trianglamine) can be tailored to the interior surface of the nanochannels with the performance of stimuli response and separation. Macrocycles have good reversibility and high selectivity toward specific ions or molecules, promoting functionalies of solid nanochannels. Hence, the combination of macrocyclic hosts and solid nanochannels is conducive to taking both advantages and achieving applications in functional nanochannels (e.g., membranes separations, biosensors, and smart devices). In this review, the most recent advances in nanochannel membranes decorated by macrocyclic host-guest chemistry are briefed. A variety of macrocyclic hosts-based responsive nanochannels are organized (e.g., the physical stimuli and specific molecules or ions stimuli) and nanochannels are separated (e.g., water purifications, enantimerseparations, and organic solvent nanofiltration), respectively. Hopefully, this review can enlighten on how to effectively build functional nanochannels and facilitate their practical applications in membrane separations.

Carbazole-based aggregation-induced phosphorescent emission-active gold(I) complexes with various phosphorescent mechanochromisms.

A series of carbazole-containing gold(I) complexes modified with different substituents were successfully designed and synthesized, and their molecular structures were characterized by nuclear magnetic resonance spectroscopy and mass spectrometry. The aggregation-induced behaviors of these gold(I) complexes were studied by ultraviolet/visible and photoluminescence spectroscopy. Meanwhile, their mechanical force-responsive emissive properties were also investigated via solid-state photoluminescence spectroscopy. Interestingly, all these gold(I)-based luminogenic molecules were capable of exhibiting aggregation-induced phosphorescent emission phenomena. Furthermore, their solids of three gold(I) complexes displayed contrasting mechano-responsive phosphorescence features. More specifically, trifluoromethyl or methoxyl-substituted luminophores 1 and 3 demonstrated mechanochromic behaviors involving blue-shifted phosphorescence changes, and their mechanoluminochromic phenomena were reversible. However, the solid-state phosphorescence of phenyl-substituted luminophor 2 was not sensitive to external mechanical force.

Eye Habits Affect the Prevalence of Asthenopia in Patients with Myopia.

Purpose: This study aims to explore the risk factors of asthenopia in the myopic population. Methods: In this cross-sectional study, myopia patients were inquired about their eye habits and were requested to complete an asthenopia questionnaire and ocular examinations. Age, gender, occupation, anisometropia, eye care education, weekly outdoor activity time, duration of continuous near work, daily screen time, dry eye, near phoria, and binocular accommodative facility were calculated using the Student's test-test, Mann Whitney U test, and Pearson's chi-square test. Spherical equivalents and astigmatism were calculated using a generalized estimating equation. Binary logistic regression was performed on factors with a p-value <0.05. Results: Of the 65 myopic patients, 57% showed asthenopia, 52% experienced blurry vision, 37% felt their eyes hurt or sore, and 28% felt tired when performing close work. Asthenopia patients were older than patients without asthenopia (Z = -2.887, p=0.004). Daily screen time, continuous near-work time, eye care education, and dry eye were positively correlated with asthenopia (χ 2 = 8.64, p=0.003; χ2 = 13.873, p < 0.001, χ2 = 9.643, p=0.002; χ2 = 7.035, p=0.008). After eliminating collinearity, eye care education and continuous near-work time were identified as independent risk factors of asthenopia, with odds ratios of 0.115 and 4.227, respectively. Conclusion: This study shows that receiving eye care education from schools and hospitals and limiting near-work duration to less than 45 minutes per session could reduce the occurrence of asthenopia in myopic patients. This approach may be a more economical and convenient way for myopic people to relieve asthenopia.

Triphenylamine, Carbazole or Tetraphenylethylene-Functionalized Benzothiadiazole Derivatives: Aggregation-Induced Emission (AIE), Solvatochromic and Different Mechanoresponsive Fluorescence Characteristics.

The development of mechanochromic fluorophors with high-brightness, solid-state fluorescence is very significant and challenging. Herein, highly solid-state emissive triphenylamine, carbazole and tetraphenylethylene-functionalized benzothiadiazole derivatives were developed. These compounds showed remarkable aggregation-induced emission and solvatochromic fluorescence characteristics. Furthermore, these fluorogenic compounds also displayed different mechanically triggering fluorescence responses.

[Characteristics and Meteorological Factors of PM2.5-O3 Compound Pollution in Tianjin].

The characteristics, pollutant concentration distribution, and key meteorological factors of PM2.5-O3 compound pollution in Tianjin were analyzed based on the high-resolution online monitoring data of PM2.5, O3,and meteorological data observed in Tianjin from 2013 to 2019. Total PM2.5-O3 compound pollution was 94 days and showed a decreasing trend by year; a significant decreasing trend of PM2.5-O3 compound pollution days were observed in the early stage, with a decline rate of 52.2% from 2013 to 2015. By contrast, in the later period from 2016 to 2019, a fluctuating increasing trend of PM2.5-O3 compound pollution days of 16.7% was observed. PM2.5-O3 compound pollution days mainly occurred from March to September each year with substantial variation by year, mainly occurring in June to August from 2013 to 2016 and in April and September from 2017 to 2019. The peak value of ρ(O3) (301-326 µg·m-3) appeared when ρ(PM2.5) ranged from 75 µg·m-3 to 85 µg·m-3. PM2.5-O3 compound pollution days accounted for 34.4% of total O3 pollution events in Tianjin, which showed a decreasing trend by year. The peak O3 concentration and average O3 concentration during PM2.5-O3 compound pollution were higher than those during simplex O3 pollution, and the number of days with PM2.5 and O3 as the primary pollutant decreased and increased in compound pollution days by year, respectively. The weather situation of PM2.5-O3 compound pollution was categorized into five weather types, namely low pressure, weak high pressure, rear of high pressure, front of cold front, and equalized pressure. The low pressure, front of cold front, and weak high pressure were observed most frequently, accounting for 92.5% of the total weather situation. The occurrence of PM2.5-O3 compound pollution was most probable when the dominant wind direction was the southwest and south, the average wind speed was less than 2 m·s-1, the temperature was between 20-35℃, and the humidity was between 40%-60%.

Nomogram-based prediction of clinically significant macular edema in diabetes mellitus patients.

AIMS: The aim of the study was to construct and validate a risk nomogram for clinically significant macular edema (CSME) prediction in diabetes mellitus (DM) patients using systemic variables. METHODS: In this retrospective study, DM inpatients who underwent routine diabetic retinopathy screening were recruited and divided into training and validation sets according to their admission date. Ninety-three demographic and systemic variables were collected. The least absolute shrinkage and selection operator was used to select the predictive variables from the training set. The selected variables were used to construct the CSME prediction nomogram. Internal and external validations were performed. The C-index, calibration curve and decision curve analysis (DCA) were reported. RESULTS: A total of 349 patients were divided into the training set (240, 68.77%) and the validation set (109, 31.23%). The presence of diabetic peripheral neuropathy (DPN) symptoms, uric acid, use of insulin only or not for treatment, insulin dosage, urinary protein grade and disease duration were chosen for the nomogram. The C-index of the prediction nomogram was 0.896, 0.878 and 0.837 in the training set, internal validation and external validation, respectively. The calibration curves of the nomogram showed good agreement between the predicted and actual outcomes. DCA demonstrated that the nomogram was clinically useful. CONCLUSIONS: A nomogram with good performance for predicting CSME using systemic variables was developed. It suggested that DPN symptoms and renal function may be crucial risk factors for CSME. Moreover, this nomogram may be a convenient tool for non-ophthalmic specialists to rapidly recognize CSME in patients and to transfer them to ophthalmologists for early diagnosis and treatment.

Hyperreflective material serves as a potential biomarker of dyslipidemia in diabetic macular edema.

PURPOSE: The aim of this study was to investigate the vision-affected optical coherence tomography (angiography) (OCT/OCTA)-based morphological characteristics of diabetic macular edema (DME) and to explain their possible underlying mechanisms from a systemic perspective. METHODS: Diabetic patients with DME were included in this retrospective study. The clinical profiles and OCT/OCTA morphological characteristics were recorded. Linear mixed-model analyses were performed between best-corrected visual acuity (BCVA) and each OCT/OCTA morphological characteristic. Linear and logistic mixed-model analyses were performed between each vision-affected morphological characteristic and the clinical characteristics. RESULTS: Eighty-five eyes of 85 patients were included. The number of hyperreflective dots (HDs) (p<0.001) and hyperreflective foci (HF) (p = 0.006) was positively correlated with LogMAR BCVA in the univariate analysis. The number of HDs (p = 0.008) remained correlated with LogMAR BCVA in the multivariate analysis. Eyes with an increased number of HF (p = 0.01) were more likely to have hard exudates within a fovea area diameter of 3 mm, while the relationship between the number of HDs and the presence of hard exudates did not reach significance. In the multivariate analysis, the increased level of total cholesterol (TC) (p = 0.004) and the reduced level of serum albumin (p = 0.014) were associated with an increased number of HDs, and the level of serum TC (p = 0.039) was positively associated with the number of HF. CONCLUSION: Hyperreflective material may be a predictor for BCVA and serves as a potential biomarker of dyslipidemia in DME. It was postulated that HF are mainly related to hard exudates and HDs are partially associated with microglial cell activation.