糖尿病患者脉络膜造影特征分析

Analysis of choroid radiographic characteristics of diabetics

目的:观察糖尿病患者的脉络膜循环特点,探讨糖尿病患者脉络膜循环的改变及其与DR发生发展的关系。方法:选取糖尿病患者45例分为NDR、NPDR、PDR三组,并选择20例健康正常人作为对照。采用德国海德堡共焦激光眼底扫描系统对所有糖尿病患者及正常对照同步进行FFA及ICGA,对比观察两种影像特点,阐述糖尿病患者脉络膜循环病变特点。结果:(1)DR各组患者视网膜中央动脉充盈时间与正常组相比无显著差异;脉络膜动脉充盈时间均较正常对照组减慢,有显著性差异(P<0.05)。(2)各组DR患者中,病变程度越重,发生充盈倒置的比例越大。(3)随着病变程度加重,造影早期脉络膜充盈不良及晚期斑点状强荧光的比例逐渐增多。结论:糖尿病患者进行ICGA揭示了脉络膜循环状态的异常,是FFA的一个重要补充,并且研究提示在DR发生之前已有脉络膜循环的异常,充分证明了糖尿病脉络膜病变的存在。

AIM： To observe the characteristic of choroidal circulation in diabetics and investigate its changes as well as the relationship between it and the development and progression of diabetic retinopathy（ DR）.METHODS： All 45 diabetics were divided into 3 groups：no diabetic retinopathy（ NDR）,nonproliferative diabetic retinopathy（ NPDR）, proliferative diabetic retinopathy（ PDR）; and 20 health people were selected to be control group. All subjects were examined by FFA and indocyaine green angiography（ ICGA）（ Heidelberg retina tomography, Germany） at the same time. The characteristics of angiograph results were comparatively observed and the feature of diabetic choroidapathy were analyzed.RESULTS：（ 1） There were no significant differences between DR groups and control group in the central retinal artery（ CRA） filling time. There were significant decreases of the choroidal artery filling time in DR groups,compared to the control group（ P〈0. 05）.（ 2） In all DR groups, the more serious DR, the bigger proportion of reverse filling.（ 3） With more serious DR,the ratio increased gradually in early phase of choroidal filling deficiency angiograph and in the late phase of spot hyperfluorescence.CONCLUSION： ICGA may be a useful adjunct to FFA in the evaluation of choroidal vascular changes in DR. The research provides that the diabetic choroidal circulation was abnormal before the occurrence of DR,which fully proved the presence of diabetic choroidopathy.