荧光素眼底血管造影对糖尿病视网膜病变早期诊断的意义

The value of fundus fluorescence angiography in early diagnosis of diabetic retinopathy

目的总结荧光素眼底血管造影检查(FFA)对糖尿病视网膜病变(DR)早期诊断的意义。方法对2011年3月至2013年3月我院150例(278只眼)DR患者进行回顾性分析,男性79例,女性71例,平均年龄(44.2±5.64)岁,平均病程(6.81±3.44)年。所有患者给予检眼镜检查、FFA检查。结果 (1)FFA检查,I^VI期分别为11.51%、4.28%、15.65%、25.18%、12.95%、15.83%,其检出病变率262只眼(94.2%)显著高于检眼镜检出病变率165只眼(59.4%);检眼镜漏诊率34.9%(97/278)、误诊率26.3%(73/278)。(2)FFA检出DR非增生性病变59只眼(22.5%)、增生前病变78只眼(29.7%),增生性病变62只眼(23.7%),糖尿病性黄斑病变39只眼(14.9%),糖尿病性视神经乳头病变24只眼(9.2%)。结论 FFA具有检查方便、敏感度及特异度高、准确的优点。对DR早期诊断检出率明显优于检眼镜,能准确诊断DR分期,是DR筛查和早发现、早治疗的有效诊断方法。

Objective To summarize the characteristics of fundus fluorescence angiography （ FFA） in early dia-betic retinopathy （ DR） , and to evaluate the use of FFA for early detection of diabetic retinopathy.Methods Author ret-rospectively analyzed 150 cases （278 eyes） of DR from March 2011 to March 2011.There were 79 males and 71 females. Average age was 44.2 ±5.64 and average duration of diabetic retinopathy was 6.81 ±0.44 years.All patients were exam-ined with ophthalmoscope and fluorescein fundus angiography.Results （1）FFA identified DR in 11.51% （phase I）, 4.28%（phase II）, 15.65%（phase III）, 25.18%（phase IV）, 12.95%（phase V）, and 15.83%（phase VI） of the patients.The total detection rate in 262 patients was 94.2%, significantly higher than that from ophthalmoscope inspection （59.4%;P 〈0.01）.There were 34.9% cases missed and 26.3% cases were misdiagnosed with ophthalmoscope.（2） FFA could detect non-proliferative lesions in 59 cases （22.5%） , pre-proliferative lesions in 78 cases （29.7%） , prolifer-ative lesions in 62 cases （23.7%）, diabetic macular degeneration in 39 cases （14.9%）, and diabetic optic papilla le-sions in 24 cases （9.2%）.Conclusion FFA is easy to use, and it returns high degree of sensitivity and specificity for diabetic retinopathy.FFA is superior to ophthalmoscope for early diagnosis and can accurately stage the DR, therefore can facilitate early treatment for DR.