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糖尿病患者视盘血流密度和视盘旁视网膜神经纤维层厚度的定量研究 被引量:1

Quantitative study of optic disc blood flow density and thickness of peripapillary retinal nerve fiber layer in patients with diabetes mellitus
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摘要 目的使用光学相干断层扫描血流成像(OCTA)观察不合并糖尿病视网膜病变(noDR)的糖尿病(DM)患者和合并轻-中度非增生性糖尿病视网膜病变(NPDR)的DM患者视盘微循环和神经结构变化。方法纳入noDR的DM患者52例(noDR组,97只眼)、合并轻中度NPDR的DM患者20例(轻中度NPDR组,30只眼),同时选取健康者30例(对照组,53只眼)为研究对象。采用OCTA仪行视盘区扫描。比较3组视盘区总血流密度(tVD)、毛细血管血流密度(cVD)及视盘旁视网膜神经纤维层(pRNFL)厚度;分析视盘旁cVD与pRNFL厚度的相关性。结果noDR组视盘cVD、视盘旁下半侧区cVD低于对照组,差异有统计学意义(P<0.05)。对照组、noDR组、轻中度NPDR组pRNFL厚度分别为(117.98±10.60)、(111.37±10.19)、(116.70±10.81)mm,noDR组小于对照组、轻中度NPDR组,差异有统计学意义(P<0.05)。DM患者视盘旁cVD与pRNFL厚度呈正相关。结论在DR临床前期,DM患者视盘区微血管及神经结构已经出现损害,且神经纤维层损害比微血管损害更显著。DM患者视盘神经和微血管损害之间可能存在一定的相关性。 Objective To investigate the optic disc microcirculation and neuromechanism changes in diabetic mellitus(DM) patients with non-diabetic retinopathy(noDR) and DM patients with mild-moderate non-proliferative diabetic retinopathy(NPDR) by optical coherence tomography angiography(OCTA). Methods Fifty-two DM patients with noDR(noDR group, 97 eyes) and 20 DM patients with mild-to-moderate NPDR(mild-to-moderate NPDR group, 30 eyes) were included as the study objects, while 30 healthy subjects(control group, 53 eyes) were selected. The optic disc area was scanned by OCTA instrument. Total vessel density(tVD), capillary vessel density(cVD) and thickness of peripapillary retinal nerve fiber layer(pRNFL) in the three groups were compared;the correlation between peripallary optic disc cVD and pRNFL thickness was analyzed. Results The cVD of optic disc and peripallary optic disc in the noDR group was significantly lower than that in the control group(P<0.05). The pRNFL thickness was(117.98±10.60),(111.37±10.19) and(116.70±10.81) mm in the control group, noDR group and mild-to-moderate NPDR group, respectively. The pRNFL thickness was correlated with cVD of optic disc(P<0.05). Conclusion In the early clinical stage of DR, the microvascular and nerve structure in the optic disc area of DM patients have been damaged, and the nerve fiber layer damage is more significant than the microvascular damage. There may be a correlation between optic disc nerve and microvascular damage in DM patients.
作者 吴慧慧 张雪 王艳 刘彦 罗娜 陈放 WU Huihui;ZHANG Xue;WANG Yan;LIU Yan;LUO Na;CHEN Fang(Department of Ophthalmology,Subei People′s Hospital Affiliated to Yangzhou University,Yangzhou,Jiangsu,225000;Department of Endocrinology,Subei People′s Hospital Affiliated to Yangzhou University,Yangzhou,Jiangsu,225000)
出处 《实用临床医药杂志》 CAS 2022年第7期57-61,66,共6页 Journal of Clinical Medicine in Practice
关键词 糖尿病视网膜病变 视盘 血流密度 视网膜神经纤维层 光学相干断层扫描血流成像 diabetic retinopathy optic disc vessel density retinal nerve fiber layer optical coherence tomography angiography
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