早期糖尿病患者黄斑区光学相干断层扫描的分析

Analysis of macular thickness in early diabetic patients by optical coherence tomography

目的利用光学相干断层扫描（OCT）测量并分析早期糖尿病（DM）患者的黄斑区视网膜厚度。方法正常对照组30例60只眼,其中男性15例,女性15例;年龄38~71岁,平均年龄51岁。DM组60例120只眼,其中男性30例,女性30例;年龄32~73岁,平均年龄54.5岁。患有DM但不伴或伴有轻微视网膜病变的患者被纳入研究,并分为尿正常组（组1）和微量白蛋白尿组（组2）,组1 30例,组2 30例。采用OCT观察早期DM患者黄斑区图像特征,应用黄斑地形图分析软件测量黄斑部9个分区及黄斑中央小凹（CP）的视网膜厚度,进行早期糖尿病患者和正常人黄斑部厚度之间的数据分析。结果直径1 mm的中央区视网膜平均厚度（CSF）,DM组1（226.0±23.0）μm,DM组2（235.0±22.1）μm,正常对照组（225.0±16.1）μm。CP视网膜平均厚度,DM组1（172.2±10.3）μm,DM组2（179.7±20.1）μm,正常对照组（172.1±11.9）μm。DM组1与正常对照组CSF之间差异不具有统计学意义（P〉0.05）,DM组2与正常对照组之间的差异具有统计学意义（P〈0.05）。结论 OCT能定量定性地检测DM患者的黄斑变化,有利于诊断和监控早期糖尿病视网膜病变。

Objective To analyze the macular thickness in early diabetic mellitus（DM） patients by optical coherence tomography（OCT） measurements.Methods A total of 60 eyes（30 cases） in normal control group,male 15 and female 15,aged 38-71 years old,mean aged 51 yeas old;120 eyes（60 cases） in DM group,male 30 and female 30;aged 32-73 years old,mean age 54.4 years old.The diabetic patients with or without slight diabetic retinopathy,were divided into 2 groups： normal urine group（group 1） and microalbuminuria group（group 2）,and 30 cases in each group.For each eye,macular thickness at central point（CP） and nine different sectors（a foveal sector,four parafoveal sectors,and four extrafoveal sectors） were measured and analyzed.Results The average retinal thickness at central subfield（CSF） with 1 mm diameter were（226.0 ± 23.0） μm in group 1,（235.0 ± 22.1） μm in group 2 and（225.0 ± 16.1） μm in control group respectively.The CP thickness were（172.2 ± 10.3） μm in group 1,（179.7 ± 20.1） μm in group 2 and（172.1 ± 11.9） μm in control group respectively.There was no significant difference in CP and CSF between group 1 and control group（P 0.05）.But there were statistically significant differences between group 2 and control group（P 0.05）.Conclusion It is demonstrated that OCT could detect macular thickness changes in eyes with early DM patients.It is helpful for diagnosing and monitoring of early stages of diabetic retinopathy.