摘要
目的 观察糖尿病视网膜病变(DR)不同分期脉络膜厚度的变化。方法 临床检查确诊的2型糖尿病患者150例227只眼纳入研究。其中,男性67例 89只眼,女性83例 138只眼;平均年龄(65.6±8.0)岁;平均糖尿病病程(12.4±6.5)年。所有患者均行最佳矫正视力(BCVA)、屈光度、裂隙灯显微镜、间接检眼镜、频域光相干断层扫描(SD-OCT)检查。参照早期DR治疗研究组制定的分级诊断标准将患者分为无DR(NDR)组、非增生型DR不伴黄斑水肿(NPDR/ME-)组、非增生型DR伴黄斑水肿(NPDR/ME+)组、增生型DR不伴黄斑水肿(PDR/ME-)组、增生型DR伴黄斑水肿(PDR/ME+)组,分别为99、64、5、25、5只眼。选取既往行全视网膜激光光凝(PRP)治疗的19例29只眼作为PRP治疗(PRP-DR)组。行PRP治疗的时间距离本研究SD-OCT检查时间为0.25~18.00个月。与患者年龄匹配的正常人17例32只眼作为正常对照组。应用SD-OCT深度增强成像技术测量受检者黄斑中心凹下脉络膜厚度(SFCT)。统计分析时,因NPDR/ME+组和PDR/ME+组样本量较小,未行组间比较。结果 正常对照组、NDR组、NPDR/ME-组、PDR/ME-组、PRP-DR组SFCT分别为(310.2±54.8)、(251.1±81.4)、(262.5±83.2)、(286.2±76.8)、(327.4±83.1) μm。与正常对照组SFCT比较,NDR组、NPDR/ME-组SFCT降低,差异有统计学意义(t=2.754、2.140,P<0.05)。PDR/ME-组SFCT较NDR组增厚,差异有统计学意义(t=-2.114, P<0.05)。PRP-DR组SFCT较PDR/ME-组增厚,差异有统计学意义(U=271.500, P<0.05)。结论 早期DR患者SFCT变薄,随病变程度加重,SFCT逐渐增厚;行PRP后早期SFCT增厚。
Objective To observe the changes in choroidal thickness in type 2 diabetes patients with diabetic retinopathy (DR). Methods A total of 227 eyes from 150 type 2 diabetes patients were enrolled in this study. The patients included 67 males (89 eyes) and 83 females (138 eyes). The mean age was (65.6±8.0) years, and the mean diabetes duration was (12.4±6.5) years. All the patients were examined for best corrected visual acuity (BCVA), diopter, slit lamp ophthalmoscopy, indirect ophthalmoscopy and spectral domain optical coherence tomography (SD-OCT) examination. The patients were divided into non-DR (NDR group, 99 eyes), non-proliferative DR (PDR) without macular edema (ME) group (NPDR/ME- group, 64 eyes), non-PDR with ME group (NPDR/ME+ group, 5 eyes), PDR without ME group (PDR/ME- group, 25 eyes), PDR with ME group (PDR/ME+ group, 5 eyes) according to the Early Treatment Diabetic Retinopathy Study. The ones having a history of pan-retinal photocoagulation (PRP) were classified as PRP-DR. Age matched normal subjects were enrolled as the control group. Sub-foveal choroidal thickness (SFCT) was measured by SD-OCT with enhanced depth imaging (EDI). Results Mean SFCT was (310.2±54.8), (251.1±81.4), (262.5±83.2), (286.2±76.8) and (327.4±83.1) μm respectively in control, NDR, NPDR/ME-,PDR/ME- and PRP-DR groups. Mean SFCT decreased significantly in NDR and NPDR/ME-group (t=2.754,2.140;P〈0.05). Mean SFCT in PDR/ME-group was thicker than that in NDR (t=-2.114, P〈0.05). Mean SFCT in PRP-DR group was thicker than that in PDR/ME- group (U=271.500, P〈0.05). Conclusion SFCT decreased during the early course of diabetics and increased significantly as the severity worsened from NDR to PDR, and increased in the early duration after PRP treatment.
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2014年第2期124-127,共4页
Chinese Journal of Ocular Fundus Diseases
基金
国家自然科学基金(81170855)