基于OCT分析2型糖尿病患者脉络膜厚度变化及其与视网膜病变的相关性

Analysis of choroidal thickness changes in patients with type 2 diabetes mellitus based on OCT and its correlation with retinopathy

目的分析基于光学相干断层成像(OCT)检查探讨2型糖尿病患者脉络膜厚度变化及与视网膜病变的相关性。方法回顾性分析150例(150眼)2型糖尿病患者临床资料,依据早期糖尿病视网膜病变(DR)治疗标准分成无DR组43眼、增生型DR组51眼、非增生型DR组56眼。所有患者均接受OCT检查,分析脉络膜体积与脉络膜厚度变化;将非增生型DR依据疾病严重程度分成轻度、中度与重度,比较不同程度组间脉络膜厚度与脉络膜体积变化。运用Spearman相关性分析脉络膜厚度变化与疾病严重程度的相关性;并分析脉络膜厚度、脉络膜体积对疾病严重程度的识别效能。结果增生型DR组、非增生型DR组的脉络膜厚度和脉络膜体积均高于无DR组,差异均有统计学意义(t分别=4.51、2.77、5.41、3.03,P均<0.05),非增生型DR组的脉络膜厚度和脉络膜体积均低于增生型DR组,差异均有统计学意义(t分别=2.14、2.68,P均<0.05);非增生型DR组中,轻度组的脉络膜厚度和脉络膜体积高于中度组与重度组,中度组的脉络膜厚度和脉络膜体积高于重度组,差异均有统计学意义(t分别=2.20、4.11、4.43、6.58、2.26、2.30,P均<0.05)。经Spearman相关性分析,脉络膜厚度、脉络膜体积与非增生型DR的严重程度呈负相关(rs分别=-0.52、-0.48,P均<0.05)。脉络膜厚度、脉络膜体积识别非增生型DR严重程度的曲线下面积(AUC)分别为0.85、0.90。结论2型糖尿病患者DR不同阶段脉络膜厚度和脉络膜体积均会产生变化,且对于非增生型DR,随着疾病进展,脉络膜厚度可变薄,脉络膜体积变小。

Objective To analyze choroidal thickness changes in patients with type 2 diabetes mellitus based on optical coherence tomography(OCT),and its correlation with retinopathy.Methods The clinical data of 150 patients(150 eyes)with type 2 diabetes mellitus were analyzed and divided into non-DR group(43 eyes),proliferative DR group(51 eyes),and non-proliferative DR group(56 eyes)according to the criteria of early diabetic retinopathy(DR).All patients received OCT to analyze the changes in choroidal volume and choroidal thickness.Patients with non-proliferative DR were divided into mild group,moderate group and severe group according to the severity.The changes in choroidal thickness and choroidal volume were compared between different groups.The correlation between choroid thickness and the severity of the disease was analyzed by Spearman correlation analysis.The effects of choroid thickness and choroid volume on the recognition of disease severity were analyzed.Results The choroidal thickness and choroidal volume in the proliferative DR group and the non-proliferative DR group were larger than those in the non-DR group(t=4.51,2.77,5.41,3.03,P<0.05).The choroidal thickness and choroidal volume in the non-proliferative DR group were smaller than those in the proliferative DR group(t=2.14,2.68,P<0.05).The choroidal thickness and choroidal volume decreased in order from the mild group,the moderate group to the severe group(t=2.20,4.11,4.43,6.58,2.26,2.30,P<0.05).Spearman correlation analysis showed that choroidal thickness and choroidal volume were negatively correlated with the severity of non-proliferative DR(rs=-0.52,-0.48,P<0.05).The AUC values of choroidal thickness and choroidal volume to evaluate the severity of non-proliferative DR were 0.85 and 0.90.Conclusion In patients with type 2 diabetes mellitus,choroid thickness and choroid volume change at different stages of DR.For non-proliferative DR,the choroid thickness becomes thinner and the choroid volume becomes smaller with the progression of the disease.