OCTA定量分析S-NPDR全视网膜激光光凝前后神经血管单元变化

To quantitatively analyze the changes of neurovascular unit before and after panretinal photocoagulationr in severe non-proliferative diabetic retinopathy with OCTA

目的 应用光学相干断层扫描血管成像(OCTA)定量分析重度非增殖期糖尿病视网膜病变(S-NPDR)行全视网膜激光光凝(PRP)前后血管神经单元(NVU)的变化。方法 选取2023年1月~2023年12月在山东第二医科大学附属医院就诊的糖尿病视网膜病(DR)患者60例和健康体检者30例为研究对象,分为对照组(n=30眼)、S-NPDR组(n=30眼)以及S-NPDR行PRP治疗后(S-NPDR-PRP)组(n=30眼);通过OCTA定量测量并比较不同组别受试者NVU的变化,包括视神经和视网膜血管各项参数;用SPSS22.0软件分析数据。结果 (1)三组受试者RNFL厚度、RNFL血流密度、上半球厚度、下半球厚度、颞侧厚度、鼻侧厚度差异均有统计学意义(P<0.05);各组间比较,对照组>S-NPDR组>S-NPDR-PRP组(P<0.05)。(2)三组受试者24mm×20mm视网膜血管密度、FAZ300密度、内层厚度、外层厚度、黄斑中心凹厚度、脉络膜中心凹厚度差异均有统计学意义(P<0.05);各组间比较,对照组>S-NPDR组>S-NPDR-PRP组(P<0.05)。结论 通过OCTA定量测量,S-NPDR患者视网膜NVU各项参数均明显降低,PRP治疗S-NPDR,给患者带来正向治疗作用的同时,会导致视网膜NVU的萎缩,为临床治疗方案的选择提供参考。

Objective To quantitatively analyze the changes of neurovascular unit(NVU)before and after panretinal photocoagu-lationr in severe non-proliferative diabetic retinopathy with Optical coherence tomography angiography.Methods A total of 60 patients with diabetic retinopathy(DR)and 30 healthy subjects were selected from the Affiliated Hospital of Shandong Second Medical University from Jan-uary 2023 to December 2023.They were divided into control group(n=30 eyes),S-NPDR group(n=30 eyes)and S-NPDR after PRP treat-ment(S-NPDR-PRP)group(n=30 eyes).Through OCTA quantitative measurement,the changes of neurovascular unit of subjects in different groups were compared,including the parameters of optic nerve and retinal vessel.The data were analyzed by SPSS22.O software.Results①There were significant differences in RNFL thickness,RNFL blood density,upper hemisphere thickness,lower hemisphere thickness,temporal thickness and nasal thickness among three groups(P<0.05).The results were as follows:control group>S-NPDR group>S-NPDR-PRP group(P<0.05).②The 24mm×20mm retinal vascular density,FAZ300 density,inner layer thickness,outer layer thickness,macular fovea thick-ness and choroidal fovea thickness of the three groups were statistically significant(P<0.05).The results were as follows:control group>S-NPDR group>S-NPDR-PRP group(P<0.05).Conclusion As measured quantitatively by OCTA,all parameters of retinal NVU in S-NPDR patients are significantly reduced.PRP surgery can bring positive therapeutic effect to patients,while aggravate the atrophy of the vascular nerve unit in the retina of S-NPDR patients,which provided a reference for the selection of clinical treatment.