全域OCTA定量分析非增殖性糖尿病性视网膜病变患者视盘参数的临床研究

Clinical study on quantitative analysis of optic disc parameters in patients with non-proliferative diabetic retinopathy by global OCTA

目的应用全域光学相干断层扫描血管成像(OCTA)定量分析非增殖期糖尿病性视网膜病变(NPDR)患者的视盘参数。方法收集右江民族医学院附属医院2022年9月至2023年9月收治的糖尿病(diabetes mellitus,DM)患者临床资料,按患者眼底病变情况分非增殖期糖尿病性视网膜病变(Non proliferative diabetic retinopathy,NPDR)组及无临床明显可见糖尿病性视网膜病变(No diabetic retinopathy,NDR)组,同时选取健康体检者纳入健康组。3组受检者均行全域OCTA成像扫描检查,计算及比较各组视盘视网膜神经纤维厚度(peripapillary retinal nerve fiber layer,pRNFL)、视盘旁放射状毛细血管网血流密度(peripapillary capillaries vessel density,ppVD)等指标,分析DM患者pRNFL与ppVD的相关性。结果NDR组和NPDR组的杯盘面积比及垂直面积比均大于健康组(P<0.05),NPDR组的水平面积比大于健康组(P<0.05)。NDR组的平均、下半侧、下侧pRNFL厚度均低于健康组(P<0.05)。NPDR组的平均、下半侧、下侧、ST象限、SN象限、IN象限pRNFL厚度低于健康组(P<0.05)。NDR组的上半侧、下半侧及TU象限ppVD低于健康组(P<0.05)。NPDR组的平均、上半侧、下半侧、上侧、TU象限、ST象限、IT象限、TL象限ppVD低于健康组(P<0.05)。DM患者pRNFL厚度与对应ppVD的相关性分析中几乎呈正相关。结论DM早期即可出现视盘损害,随着病情进展将会出现微血管及神经病变,pRNFL厚度与对应ppVD有密切关联。

Objective To quantitatively analyze the optic disc parameters of patients with non proliferative diabetes retinopathy(NPDR)using global optical coherence tomography angiography(OCTA).Methods This study collected the clinical data of DM patients admitted to our hospital from September 2022 to September 2023 and divided the patients into NPDR group and no diabetic retinopathy(NDR)group.At the same time,healthy individuals were selected to form the healthy group.All subjects underwent global OCTA imaging to assess optic disc parameters,including the thickness of peripapillary retinal nerve fiber layer(pRNFL)and peripapillary capillaries vessel density(ppVD)of the optic disc.Correlation analyasis between pRNFL and ppVD in DM patients was conducted.Results The cup-to-disc ratio and vertical area ratio were higher in the NDR and NPDR groups compared to the healthy group(P<0.05),with the NPDR group exhibiting a higher horizontal area ratio(P<0.05).The average,lower half side,and lower side pRNFL thickness were lower in the NDR group compared to the healthy group(P<0.05).The average pRNFL thickness and the pRNFL thinckness in the lower half side,lower side,ST quadrant,SN quadrant,and IN quadrant in the NPDR group were lower than those in the healthy group(P<0.05).Similarly,The NDR group had lower ppVD in the upper half side,lower half side,and TU quadrant than the healthy group(P<0.05).The NPDR group also had lower ppVD in the average,upper half side,lower half side,upper side,TU quadrant,ST quadrant,IT quadrant,and TL quadrant than the healthy group(P<0.05).Correlation analysis revealed a positive correlation between pRNFL thickness and ppVD in DM patients.Conclusion Optic disc damage can occur in the early stages of diabetes mellitus,progressing to microvascular and neuropathic changes.The thickness of pRNFL is closely associated with ppVD.