非增生期糖尿病视网膜病变患者眼轴长度对眼底血管充盈状态的影响

Effects of axial length on retinal vascular filling state in non-proliferative diabetic retinopathy

目的观察眼轴长度对非增生期糖尿病视网膜病变（diabetic retinopathy,DR）患者眼底血管充盈状态的影响。设计前瞻性病例系列。研究对象甘肃省第二人民医院眼科及内分泌科住院的无视网膜病变的糖尿病及非增生期DR患者254例（254眼）。方法所有患者均行荧光素眼底血管造影观察记录臂-视网膜循环时间、荧光动脉期、动静脉期及静脉期时间,记录视网膜荧光动脉期-静脉期（视网膜A-V）荧光充盈期平均时间。采用眼科A超测量眼轴长度,根据眼轴长度分为三组：正常组（22～24 mm）,长眼轴组（〉24 mm且〈26 mm）,超长眼轴组（≥26 mm）。对比观察不同眼轴长度组眼底血管充盈状态异同。主要指标臂-视网膜循环时间、视网膜A-V荧光充盈期平均时间及眼轴长度。结果眼轴正常组、长眼轴组和超长眼轴组臂-视网膜循环时间平均分别为（10.94±0.46）s、（10.42±0.51）s和（10.36±0.64）s（F=1.289,P=0.252）;视网膜A-V荧光充盈期平均分别为（13.56±2.04）s、（9.15±1.36）s和（6.36±1.15）s（F=103.364,P=0.000）;超长眼轴组与眼轴正常组比较眼底血管充盈时间变快（F=108.863,P=0.000）,超长眼轴组与长眼轴组比较眼底血管充盈时间变快（F=175.516,P=0.000）。结论随着非增生期DR患者的眼轴长度增加眼底血管充盈时间缩短,血流充盈变快,从一个侧面反映了眼轴长度对非增生性DR患者视网膜血流动力学的影响。

Objective Observe the effects of axial length on the retinal vascular filling state in non-proliferative diabetic retinopathy （NPDR）. Design prospective case series. Participants 254 cases （254 eye） of Diabetes without retinopathy and NPDR patients hospitalized in the department of Ophthalmology and Endocrinology in the Gansu second people＇s Hospital were included. Methods All patients underwent fluorescence fundus angiography （FFA） and optical coherence tomography （OCT） examination. The axial length was measured using A type ultrasonic diagnostic apparatus. And the participants was divided into three groups according to the axial length： normal group（22～24 mm）, long axial group （〉24 mm and 〈26 mm）, extr-long axial group（26 mm or more）. Each group of patients underwent FFA retinal vascular filling indicators, which for comparison to observe the different hemodynamic parameters in patients with different axial shaft length. Main Outcome Measures Arm - retinal circulation time, retinal A-V fluorescence filling time, and axial length. Results The arm-retinal circulation time averaged （12.94±0.46）s, （10.42±0.51）s, and （10.36±0.64）s in normal, long axial, and extra-long axial group, respectively （F=1.289,P=0.252）. The retinal A-V fluorescence filling time averaged （13.56±2.04）s, （9.15±1.36）s, and （6.36±1.15）s, respectively in the three groups （F=103.364,P=-0.000）. The vascular filling time in extr-long axial group faster than the normal group （F=108.863,P=0.000）, and the long axial group （F=175.516,P=0.000）. Conclusion The longer the axial length,the shorter the retinal vascular filling time, and the faster the retinal vascular filling, in the patients with NPDR. Which reflects, in a certain aspect, the effects of the axial lenth on the retinal hemodynamic state in the NPDR patients.