糖尿病性黄斑水肿眼底自荧光异常模式的分类研究

Classification of abnormal fundus autofluorescence patterns in diabetic macular edema

目的探究糖尿病性黄斑水肿患者的眼底自发荧光(FAF)检测结果,并对检测结果进行分型研究。方法选取80例(148眼)糖尿病性黄斑水肿患者,均进行FAF检查和眼底荧光血管造影,对眼底相片结果和眼底荧光血管造影结果进行分析,分析病变不同的影像学特征并将其分型。结果患者的平均最佳矫正视力为(0.3±0.1);平均对比灵敏度为(7.0±3.5);平均中央凹厚度为(356.3±123.5)μm;平均黄斑体积为(10.9±0.9)mm3;平均黄斑厚度为(363.9±93.9)μm。FAF分型结果:(1)20眼(13.51%)为降低型,多数位于黄斑中心凹的周围或中心凹旁区;(2)60眼(40.54%)为正常型,正常型在中央凹区域没有高自发或低自发荧光面积;(3)24眼(16.22%)表现为自发荧光单点增强型,在此类型中检测到中央凹区域有不同面积的斑点,并且伴随着其他区域的自发荧光的增加;(4)32眼(21.62%)为多点增强型,观察到多处高自发荧光点,有些高自发荧光点可能是由于视网膜硬性渗出导致,尤其在那些有强屈光表现的照片中;(5)12眼(8.11%)为斑块状增加型,中央凹区域观察到均匀的超自发荧光区。结论对糖尿病性黄斑水肿患者的FAF进行不同的分型,可对患者的预后进行更好的预测,对糖尿病患者的临床试验设计提供帮助。

Objective To investigate the results of fundus autofluorescence(FAF)in patients with diabetic macular edema,and to classify the results.Methods 80 patients(148 eyes)with diabetic macular edema were selected for FAF examination and fundus fluorescein angiography.The results of fundus photographs and fundus fluorescein angiography were analyzed,and the different imaging characteristics of the lesions were analyzed and classified.Results The mean best corrected visual acuity was(0.3±0.1),the average contrast sensitivity was(7.0±3.5),the mean fovea thickness was(356.3±123.5)μm,the mean macular volume was(10.9±0.9)mm3,and the mean macular thickness was(363.9±93.9)μM.FAF typing results:①20 eyes(13.50%)were reduced type,most of which were located around or near the fovea;②60 eyes(40.54%)were normal type,and normal type had no high or low autofluorescence area in the fovea area;③24 eyes(16.22%)were single-spot enhanced type,of which spots of different areas were detected in the fovea area,which was accompanied by an increase in autofluorescence in other areas;④32 eyes(21.62%)were multi-spot enhanced type,and many high autofluorescence spots were observed.Some high autofluorescence spots may be caused by hard retinal exudation,especially in those photos with strong refractive manifestations;⑤12 eyes(8.11%)were plaque-like increase type,and uniform super spontaneous fluorescence area was observed in fovea.Conclusion Different types of fundus autofluorescence in patients with diabetic macular edema can predict the prognosis of patients better and help the clinical trial design of diabetic patients.