摘要
目的通过相干光层析眼底血管成像术(OCTA),检测尚处于临床前期的糖尿病视网膜病变(DR)患者的眼底放射状视盘周围毛细血管(RPC)血流密度及视网膜神经纤维层(RNFL)厚度改变,以期发现更早期DR。方法检测安徽医科大学第一附属医院2019年4月至2020年4月的受试者,以尚未出现视网膜病变的2型糖尿病患者22例(36只眼)为糖尿病组(观察组),另选择同时期体检健康者26例(35只眼)为对照组,完成视盘OCTA检查,采集视乳头周围区域及每个扇区的血流密度以及RNFL厚度进行比较分析。结果对照组视盘周围区域RPC平均血流密度为54.00±2.31,观察组为52.83±3.23,两组之间比较差异无显著性(P>0.05);鼻下区及下颞区RPC血流密度,观察组与对照组比较差异有显著性(P均<0.05),其它扇区两组间差异无显著性(P均>0.05)。对照组视盘周围区域RNFL层厚度为120.20±9.60,观察组为113.69±9.24,两组之间比较差异有显著性(P<0.01);鼻上区、鼻下区、颞上区、上颞区内RNFL厚度两组之间比较差异有显著性(P均<0.05);下鼻区、下颞区、颞下区、上鼻区内RNFL层厚度两组之间比较差异无显著性(P均>0.05)。结论DR临床前期阶段,存在眼底视盘RPC血流密度及RNFL厚度下降的迹象。提示2型糖尿病患者在未出现视网膜病变前,早期出现眼底微血管及神经病变征象,是更早期发现DR的靶向研究方向。
Objective To analyze retinal peripapillary retinal nerve fiber layer(RNFL)thickness variation in patients with preclinical diabetic retinopathy(DR)by optical coherence tomography angiography(OCTA)examination technology,and try to discover early DR.Methods The examined patients come from the first affiliated hospital of Anhui Medical University from April 2019 to April 2020.In which,22 patients(36 eyes)Type 2 diabetes mellitus patients without retinopathy were selected as observation group,and at the same time 26 healthy persons(35 eyes)were selected as control group,all cases in both groups were examined by OCTA.The blood flow density and RNFL thickness in the area around the papilla and each sector were detect for comparative analysis.Results the mean blood flow density of RPC in the region around the optic disc was 54.002.31 in the control group and 52.833.23 in the diabetes group,and the difference between the two groups was not statistically significant(P>0.05).The blood flow density of RPC in the inferior nasal region and the inferior temporal region showed statistically significant differences between the diabetes group and the control group(all P<0.05),while there was no statistically significant difference between the two groups in other sectors(all p were>0.05).The RNFL layer thickness in the region around the optic disc of the control group was 120.209.60,and that in the diabetes group was 113.699.24.The difference between the two groups was statistically significant(P<0.01).There were statistically significant differences in RNFL thickness between the two groups(P<0.05).There was no statistically significant difference in RNFL layer thickness between the two groups(P≥0.05).Conclusion OCTA can quantitatively analyze the retinal retinal disc RPC blood flow density and RNFL thickness in diabetic patients.The thinning of retinal disc RNFL in DR preclinical patients was earlier than the reduction of RPC blood flow density,which provides a new direction for further understanding the relationship between retinal microvessels and neuropathy in diabetic patients.
作者
许亚静
高健
刘伦
Xu Yaijing;Gao Jian;Liu Lun(Department of Ophthalmology,The First Affilated Hospital of Anhui Medical of University,Hefei,Anhui 230022,China)
出处
《临床眼科杂志》
2020年第4期308-311,共4页
Journal of Clinical Ophthalmology
