光学相干断层扫描血管成像在糖尿病患者早期黄斑区视网膜微循环评估中的应用

Application of optical coherence tomography angiography in evaluation of early macular retinal microcirculation in diabetics

糖尿病视网膜病变是由视网膜微血管损伤引起的一系列病变,也是致盲的主要原因。胰岛素代谢异常使糖尿病患者眼部组织、神经和血管微循环产生改变,导致视功能发生不同程度的损伤,患者临床表现为出血斑点、动脉瘤、视网膜内微血管异常和黄斑水肿等。目前,临床上对糖尿病患者早期黄斑区视网膜微循环检查以荧光素眼底血管造影为主,并将其视为"金标准",但是该检查方法具有明显的创伤性,且耗时相对较长,影响患者的依从性和耐受性。光学相干断层扫描血管成像是一种新型的、无创的血管成像技术,但目前在糖尿病患者早期黄斑区视网膜微循环评估中的应用研究较少。本文中笔者分析早期黄斑区视网膜微循环对糖尿病患者视网膜的影响,并对光学相干断层扫描血管成像在糖尿病患者早期黄斑区视网膜微循环评估中的应用进展进行综述。

Diabetic retinopathy is a series of lesions caused by microvascular damage of the retina, which is also the main cause of blindness in most patients. Abnormal insulin metabolism changes the ocular tissue, nerve and vascular microcirculation in diabetics, resulting in different degrees of visual impairment. The clinical manifestations of diabetics are bleeding spots, aneurysms, intraretinal microvascular abnormalities, and macular edema, etc. At present, fluorescein fundus angiography is the main clinical examination for the early macular retinal microcirculation in diabetics, which is regarded as "gold standard". However, it is obviously traumatic and relatively time-consuming, leading to the poor compliance and poor tolerance for patients. Optical coherence tomography angiography is a novel, non-invasive angiography technique, but has few applications in the early detection of macular retinal microcirculation in diabetics. In this paper, the effect of early macular retinal microcirculation on the retina of diabetics was analyzed, and the application progress of optical coherence tomography angiography in the evaluation of early macular retinal microcirculation in diabetics was reviewed.