基于en face OCT的视网膜前巨噬细胞样细胞在眼底病中的研究进展  

Research progress in epiretinal macrophage-like cells characterized by en face OCT in ocular fundus diseases

作　　者：曾运考 陈婉霓(综述) 文峰(审校)[2] ZENG Yunkao;CHEN Wanni;WEN Feng(Department of Ophthalmology,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China;State Key Laboratory of Ophthalmology,Zhongshan Ophthalmic Center,Sun Yat-sen University,Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science,Guangzhou 510060,China)

机构地区：[1]广州医科大学附属第二医院眼科,广州510260 [2]中山大学中山眼科中心,眼病防治全国重点实验室,广东省眼科视觉科学重点实验室,广州510060

出　　处：《眼科学报》2025年第2期202-207,共6页Eye Science

基　　金：广州市教育局高校科研项目(2024312084)。

摘　　要：巨噬细胞样细胞(macrophage-like cells, MLC)指起源、功能与巨噬细胞类似的免疫细胞,包括小胶质细胞、玻璃体细胞及巨噬细胞。将en face OCT显示层面设置在视网膜表明即可观测到视网膜表明的MLC(epiretinal MLC, eMLC),随后利用Image J软件即可对细胞进行提取和量化。研究表明,eMLC在炎症情况下均可出现细胞募集及活化现象,但在不同眼底病中各具特点。在糖尿病视网膜病变、视网膜静脉阻塞等视网膜缺血缺氧性疾病中,eMLC密度越高,黄斑水肿可能越严重。此外,eMLC密度更高的视网膜静脉阻塞患者抗VEGF疗效更差,视力预后不佳,提示基于en face OCT的eMLC不仅可用于评估视网膜炎症情况,而且还能充当提示疾病疗效及预后的标志物。在葡萄膜炎等免疫炎症性疾病中,en face OCT亦可观测到eMLC密度、形态等改变。白塞病葡萄膜炎患者视网膜血管渗漏程度与eMLC密度相关性强,故eMLC密度可充当无创评估视网膜血管渗漏程度的新指标。然而,目前提取和量化eMLC的方法及标准不统一,降低了各研究间的可比性。因此,亟需制定统一的操作规范和评估标准。此外eMLC所代表的具体细胞类型及功能仍需进一步探究。未来,研究者可以利用en face OCT对眼底炎症地进行无创评估。基于en face OCT的eMLC还能作为基础研究与临床研究之间的桥梁,为揭示疾病的致病机制提供重要参考。Macrophage-like cells(MLC)refer to immune cells that originate from and function similarly to macrophages,including microglia,hyalocytes,and macrophages themselves.By setting the display level of en face OCT to the retinal surface,epiretinal MLC(eMLC)can be observed and subsequently extracted and quantified using ImageJ software.Studies indicate that eMLC can exhibit cell recruitment and activation in inflammatory conditions,each displaying distinct characteristics in different retinal diseases.In ischemic and hypoxic retinal conditions such as diabetic retinopathy and retinal vein occlusion,higher densities of eMLC are associated with more severe macular edema.Moreover,patients with retinal vein occlusion showing higher eMLC densities tend to have poorer responses to anti-VEGF treatments and worse visual prognoses,suggesting that eMLC identified via en face OCT can be used not only to assess retinal inflammation but also as biomarkers for disease efficacy and prognosis.In immune-inflammatory diseases like uveitis,changes in eMLC density and morphology can also be observed through en face OCT.In patients with Behçet's disease,a strong correlation exists between the degree of retinal vascular leakage and eMLC density,making eMLC density a potential non-invasive marker for assessing retinal vascular leakage.However,the current methods and standards for extracting and quantifying eMLC are not unified,significantly reducing comparability between studies.Therefore,there is an urgent need to establish uniform operational protocols and assessment standards.Furthermore,the specific cell types and functions represented by eMLC observed via en face OCT require further investigation.In the future,en face OCT could be utilized for non-invasive assessment of retinal inflammation.eMLC based on en face OCT could also serve as a bridge between basic research and clinical studies,providing valuable insights into the pathogenic mechanisms of diseases.

关 键 词：en face OCT 巨噬细胞样细胞 眼底病 炎症 

分 类 号：R774.5[医药卫生—眼科] R774.11[医药卫生—临床医学] R770.4