摘要
目的观察并初步探讨不同分期糖尿病视网膜病变(DR)患眼视网膜无灌注区(NP)分布特征及其随DR进展的变化特征。方法回顾性临床研究。2018年10月至2020年12月于武汉大学人民医院眼科检查确诊的DR患者118例175只眼纳入研究。其中,男性64例93只眼,女性54例82只眼;平均年龄(56.61±8.99)岁。非增生型DR(NPDR)95只眼,其中轻度、中度、重度分别为25、47、23只眼;增生型DR(PDR)80只眼。并据此分组。采用英国Optos 200Tx成像系统行超广角荧光素眼底血管造影检查,利用Image J软件将眼底图像分为后极部、中周部、远周部并计算各区域内缺血指数(ISI)。比较不同DR分期组视网膜不同及相同区域ISI差异。不同DR分期组各区域ISI比较采用Kruskal-Wallis检验,组间两两比较采用Kruskal-Wallis单因素方差分析。结果中度NPDR组、重度NPDR组、PDR组患眼后极部ISI显著大于远周部,差异有统计学意义(χ^(2)=6.551、3.540、6.614,P=0.000、0.002、0.000)。重度NPDR组、PDR组患眼中周部ISI显著大于远周部,差异有统计学意义(χ^(2)=3.027、3.429,P=0.015、0.004)。中度NPDR组患眼中周部、远周部ISI比较,差异无统计学意义(χ^(2)=2.597,P=0.057)。中度NPDR组、PDR组患眼后极部ISI显著大于中周部,差异有统计学意义(χ^(2)=3.955、3.184,P=0.000、0.009)。重度NPDR组患眼后极部、中周部ISI比较,差异无统计学意义(χ^(2)=0.514,P=1.000)。与轻度NPDR组、中度NPDR组比较,PDR组患眼全视网膜、后极部、中周部、远周部ISI均较大,差异有统计学意义(χ^(2)=-7.064、-6.349、-6.999、-5.869、-6.695、-6.723、-3.459、-4.098,P=0.000、0.000、0.000、0.000、0.000、0.000、0.003、0.000)。结论不同DR分期患眼NP主要分布于后极部与中周部;DR严重程度越高,后极部和中周部NP越大。
Objective To observe and preliminarily discuss the distribution characteristics of the non-perfusion area(NP)of the retina in different stages of diabetic retinopathy(DR)and its changes with the progression of DR.Methods A retrospective clinical study.From October 2018 to December 2020,118 cases of 175 eyes of DR patients diagnosed in Eye Center of Renmin Hospital of Wuhan University were included in the study.Among them,there were 64 males with 93 eyes and 54 females with 82 eyes;the average age was 56.61±8.99 years old.There were 95 eyes of non-proliferative DR(NPDR),of which 25,47,and 23 eyes were mild,moderate,and severe;80 eyes were proliferative DR(PDR).Ultra-wide-angle fluorescein fundus angiography was performed with the British Optos 200Tx imaging system,and the fundus image was divided into posterior,middle,and distal parts with Image J software,and the ischemic index(ISI)was calculated.The difference of the retina in different DR staging groups and the difference of ISI were compared in the same area.The Kruskal-Wallis test was used to compare the ISI between the different DR staging groups and the Kruskal-Wallis one-way analysis of variance was used for the pairwise comparison between the groups.Results The ISI of the posterior pole of the eyes in the moderate NPDR group,severe NPDR group,and PDR group were significantly greater than that in the distal periphery,and the difference was statistically significant(χ^(2)=6.551,3.540,6.614;P=0.000,0.002,0.000).In severe NPDR group and PDR group,the ISI of the middle and peripheral parts of the eyes was significantly greater than that of the distal parts,and the difference was statistically significant(χ^(2)=3.027,3.429;P=0.015,0.004).In the moderate NPDR group,there was no significant difference in ISI between the peripheral and distal parts of the eye(χ^(2)=2.597,P=0.057).The ISI of the posterior pole of the eyes in the moderate NPDR group and the PDR group was significantly greater than that in the middle periphery,and the difference was statistically
作者
付梅
陈长征
蒋婧文
孙功鹏
王晓玲
易佐慧子
Fu Mei;Chen Changzheng;Jiang Jingwen;Sun Gongpeng;Wang Xiaoling;Yi Zuohuizi(Eye Center,Renmin Hospital of Wuhan University,Wuhan 430060,China)
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2021年第10期784-789,共6页
Chinese Journal of Ocular Fundus Diseases
基金
国家自然科学基金(青年基金)(81500744)。
