摘要
目的 应用光学相干断层扫描血管成像(OCTA)观察眼底不同分期的2型糖尿病患者黄斑区脉络膜和视网膜血流密度变化。方法 收集蚌埠医学院第一附属医院2型糖尿病患者150例150眼纳入研究,依据国际临床糖尿病视网膜病变(DR)严重程度分级标准将患眼分为5组,无DR组和轻、中、重度非增生型DR(NPDR)组及增生型DR(PDR)组,每组各30例30眼。OCTA对所有受试者行黄斑部6 mm×6 mm区域的扫描,测量视网膜浅层、深层和脉络膜毛细血管层的血流密度,观察不同分期DR患者脉络膜及视网膜血流密度的变化,分析血流密度与病变程度的相关性。结果 随着DR患者的严重程度加深,视网膜浅层、深层和脉络膜毛细血管层血流密度均呈显著减少趋势(均为P<0.001);但不同分层血流密度中,中度NPDR组与重度NPDR组比较差异均无统计学意义(P=0.216、0.896、0.350)。视网膜浅层、深层和脉络膜毛细血管层血流密度与病变程度均呈正相关(均为P<0.001)。视网膜深层血流密度识别DR严重程度的能力(敏感性和特异性分别为92.5%和93.1%)优于视网膜浅层和脉络膜毛细血管层。结论 OCTA可精确观察到不同分期DR脉络膜及视网膜血流密度的变化,视网膜深层血流密度可作为监测DR进展的敏感指标。
Objective To observe the changes in choroidal and retinal blood flow density in the macular area of type 2 diabetic patients at different stages by optical coherence tomography angiography(OCTA). Methods A total of 150 eyes of 150 patients with type 2 diabetes mellitus in the First Affiliated Hospital of Bengbu Medical College were included in the study. According to the international clinical severity grading standard of diabetic retinopathy(DR), the affected eyes were divided into five groups: non-DR group, mild, moderate and severe non-proliferative diabetic retinopathy(NPDR) groups, and proliferative diabetic retinopathy(PDR) group, with 30 eyes of 30 patients in each group. OCTA was performed on the macular area(6 mm×6 mm) to measure the blood flow density of the superficial retinal, deep retinal, and choroid capillary layers. The changes in choroidal and retinal blood flow density of DR patients in different stages were observed, and the correlation between blood flow density and the degree of DR was analyzed. Results With the increase in the severity of DR, the blood flow density of the superficial retinal, deep retinal and choroid capillary layers decreased significantly(all P<0.001). However, there was no significant difference in blood flow density between the moderate NPDR group and the severe NPDR group(P=0.216, P=0.896 and P=0.350, respectively). The blood flow density of the superficial retinal layer, deep retinal layer and choroid capillary layer was positively correlated with the severity of the disease(all P<0.001). The ability of deep retinal blood flow density to identify the severity of DR(sensitivity and specificity were 92.5% and 93.1%, respectively) was better than that of the superficial retinal and choroid capillary layers. Conclusion OCTA can accurately observe the changes in choroidal and retinal blood flow density in different stages of DR, and the deep retinal blood flow density can be used as a sensitive indicator to monitor the progress of DR.
作者
谭心格
高自清
TAN Xinge;GAO Ziqing(Department of Ophthalmology,Bengbu Third People’s Hospital Affiliated to Bengbu Medical College,Bengbu 233000,Anhui Province,China;Department of Ophthalmology,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,Anhui Province,China)
出处
《眼科新进展》
CAS
北大核心
2023年第3期230-233,共4页
Recent Advances in Ophthalmology
