OCT与FFA在糖尿病视网膜病变临床前期的应用比较

Comparison of OCT and FFA application in preclinical diabetic retinopathy

目的光学相干断层扫描（optical coherence tomography,OCT）与眼底荧光血管造影（fundus fluorescein angiography,FFA）在糖尿病视网膜病变临床前期的应用比较。方法 以2型糖尿病病史10～15a尚处于DR临床前期的患者76例为研究对象进行OCT和FFA检查,以及糖化血红蛋白（glycosylated hemoglobins A1c,HbAlc）、空腹血糖（fasting blood-glucose,FBG）等检测,记录患者视盘周围视网膜神经纤维层（retinal nerve fiber layer,RNFL）的厚度变化和视网膜微血管的异常情况,结合HbAlc、FBG等检测结果分析两者的关系。结果 OCT或FFA检查异常者共31例（占40.8%）,其中19例兼有OCT检查异常（RNFL变薄）和FFA检查异常（出现异常荧光）,10例仅表现为OCT检查异常,2例仅表现为FFA检查异常。OCT的阳性检出率（29例,38.2%）高于FFA（21例,27.6%）,差异有统计学意义（P≤0.05）;OCT检查阳性者29例HbAlc的检测值（6.98±1.01）%高于检查阴性者47例（6.52±0.86）%,差异也有统计学意义（P〈0.05）;OCT检查阳性者FBG检测值（7.51±0.81）mmol·L^-1与阴性者（7.38±0.72）mmol·L^-1比较差异无统计学意义（P〉0.05）。结论 OCT和FFA是发现早期DR的有效检查手段,两者相比较OCT更为敏感,而且为无创性检查,更适用于DR筛查和随访复检。

Objective To compare the diversities of optical coherence tomography （OCT） and hindus fluorescein angiography （FFA） application in preclinical diabetic retinopathy（DR）. Methods A total of 76 patients with preclinical DR and type II diabetes for 10 - 15 years were checked by OCT and FFA,respectively. In addition, fasting blood glucose （ FBG ） and glycosylated hemoglobin Alc （ HbAlc ） were detected, and the changes of retinal nerve fiber layer （RNFL） and microvascular lesions abnormality were recorded. Results The results of OCT or FFA examination in 31 patients＇ （40.8%） were abnormal. Among them, both OCT （thinning RNFL） and FFA （ abnormal fluorescent） abnormality were in 19 cases, single OCT abnormality were in 10 patients,and only FFA abnormality were in 2 patients. The positive rates of OCT examination （29 patients, 38. 1% ） was much higher than that of FFA （21 patients, 27.6% ） ,there was statistical difference（P≤0.05）. At the same time,the value of HbAlc in 29 patients with positive OCT examination （6.98 ± 1.01 ）% was higher than that in 47 patients with negative OCT examination （6.52 ±0.85）% ,there was statistical difference （P 〈 0.05 ）. There was no statistical difference in FBG value between patients with positive and negative OCT examination （P 〉 0.05 ）. Conclusion Although OCT and FFA are effective in preclinical DR examination, OCT is more sensitive with no damage, which is suitable for screening and following up for DR.