摘要
目的利用光相干断层扫描血管成像技术(OCTA)探究早期不同分期糖尿病视网膜病变(DR)患者的黄斑区局部血流密度及其结构特征。方法采用横断面研究设计,选取2017年6月至2018年8月在广东省人民医院就诊的非糖尿病视网膜病变的糖尿病(NDR)患者27例40眼、轻度非增生性DR(NPDR)患者24例40眼以及中度NPDR患者28例40眼,同期纳入正常体检者40名40眼作为正常对照组。利用RTVue-XR OCTA扫描受检者黄斑区中心6 mm×6 mm范围量化浅层毛细血管丛(SVC)及深层毛细血管丛(DVC)血流密度,中心凹无血管区(FAZ)面积、周长、非圆度指数(AI)及FAZ旁300 μm环形区域(FD300)的血流密度等参数。分析各组黄斑区SVC、DVC血流密度及结构的特征,及其与疾病进程的关系。结果随着DR的程度加重,黄斑区SVC及DVC血流密度呈下降趋势。正常对照组、NDR组、轻度NPDR组及中度NPDR组SVC血流密度分别为(51.25±3.27)%、(48.81±3.99)%、(47.00±3.49)%和(45.73±3.35)%,DVC血流密度分别为(53.89±6.30)%、(49.94±6.05)%、(46.69±4.87)%和(44.78±4.30)%,总体比较差异均有统计学意义(F=18.33、21.53,均P<0.01)。NDR组、轻度NPDR组及中度NPDR组黄斑区SVC及DVC血流密度均明显低于正常对照组,差异均有统计学意义(均P<0.01)。轻度NPDR组及中度NPDR组FD300血流密度均明显低于正常对照组,差异均有统计学意义(均P<0.01)。正常对照组、NDR组、轻度及中度NPDR组的FAZ面积分别为(0.31±0.11)、(0.32±0.09)、(0.34±0.13)和(0.37±0.10)mm2;各组FAZ面积总体比较,差异无统计学意义(F=2.18,P=0.09)。中度NPDR组FAZ周长及AI均大于正常对照组,差异均有统计学意义(均P<0.05)。结论在糖尿病患者出现临床可见眼底病变前,OCTA即可发现黄斑区视网膜血流密度明显下降。早期DR已出现黄斑区SVC及DVS血流密度下降,DVC血流密度可能是提示DR的敏感指标。轻度NPDR出现FD300血流密度下降,而中度NPDR出现FAZ面积�
Objective To investigate the characteristics of macular perfusion and structures in patients with early stages of diabetic retinopathy(DR)using optical coherence tomography angiography(OCTA).Methods A cross-sectional study was performed.Forty eyes of 27 diabetic patients without diabetic retinopathy(NDR),forty eyes of 24 patients with mild non-proliferative diabetic retinopathy(NPDR)and forty eyes of 28 patients with moderate NPDR were recruited in Guangdong Provincial People's Hospital from June 2017 to August 2018.RTVue-XR OCTA was used to scan a 6 mm×6 mm area centered in the fovea and the superficial vascular complex(SVC)and deep vascular complex(DVC)vessel density,fovea avascular zone(FAZ)area,FAZ perimeter,acircularity index(AI),and vessel density of a 300μm wide ring area around FAZ(FD300)were quantified.The associations among stages of DR and macular vessel density,structures were analyzed.This study was approved by the Ethics Committee of the Guangdong Provincial People's Hospital(No.2016232A).Results The vessel density of SVC and DVC tended to decrease as the progression of DR.The vessel density of SVC was(51.25±3.27)%,(48.81±3.99)%,(47.00±3.49)%,(45.73±3.35)%,and the vessel density of DVC was(53.89±6.30)%,(49.94±6.05)%,(46.69±4.87)%and(44.78±4.30)%in the control group,NDR group,mild NPDR group,and moderate NPDR group,respectively.The vessel densities of SVC and DVC were statistically different among the four groups(F=18.33,21.53;both at P<0.01).The vessel density of SVC and DVC in the NDR group,mild NPDR group,moderate NPDR group was significantly lower than that in the control group(all at P<0.01).The vessel densities of FD300 in the mild NPDR group and moderate NPDR group were significantly lower than that in the control group(all at P<0.01).The FAZ area of the control group,NDR group,mild NPDR group,and moderate NPDR group was(0.31±0.11),(0.32±0.09),(0.34±0.13),and(0.37±0.10)mm 2,respectively.There was no significant difference in the FAZ area among the four groups(F=2.18,P=0.09).The F
作者
曾运考
杨大卫
曹丹
余洪华
卢曼虹
庄雪楠
张良
Zeng Yunkao;Yang Dawei;Cao Dan;Yu Honghua;Lu Manhong;Zhuang Xuenan;Zhang Liang(Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 515100,China)
出处
《中华实验眼科杂志》
CAS
CSCD
北大核心
2020年第9期783-787,共5页
Chinese Journal Of Experimental Ophthalmology
基金
国家自然科学基金项目(81500737)
广州市科技计划项目(201607010343)。
