糖尿病视网膜病变与黄斑病变的关系探讨

目的 探讨糖尿病视网膜病变 (diabetic retinopathy, DR) 与糖尿病黄斑病变(diabetic maculopathy, DM)之间的关系,以探讨DM独立分期对指导临床治疗的意义。 方法 对眼科初诊的582例糖尿病患者行荧光素眼底血管造影 (fundus fluorescein angiography, FFA)及眼科常规检查，根据眼底改变将DR分为2型6期,DM分为4度。 结果 DM的严重程度随DR的逐渐加重而增加，但不完全平行。在无DR病例中，发生I度DM者占 5.4%；IV期DR中，III度DM发生率最高，占54.4%；Ⅴ期DR中，仍有未发生DM的病例,占5.1%。 结论 DR和DM之间不完全平行，故DM独立分期对选择黄斑区最佳治疗时机，保存黄斑功能有重要意义。 (中华眼底病杂志,2000,16:153-154)

Exploration of the relations of diabetic retinopathy and maculopathy

Purpose To clarify the relationship between diabetic retinopathy (DR) and maculopathy (DM) and explore the clinical implication of independent graduation of DM. Methods Fundus fluorescein angiography and routine ophthalmological examination were performed on 582 cases of diabetes.Their ocular fundi and macular impairments were graded. Results In general,the severity of diabetic macular impairment was accompanied by retinal involvement,but discrepancy existed between DM and DR.Degree I DM occurred in 5.4% (16/294) among cases without DR,in stage IV DR,degree Ⅲ DM accounted for the most part ,54.5%　(116/213).There were still 5.1%　(2/39)　cases without DM in stage Ⅴ DR. Conclusion The degree of the macular lesions in DM is often not in parallel with the gradation of general affections in retinal tissue other than in macular region in DR,therefore,independentg radation of diabetic maculopathy has its clinical significance for choosing the optimal period of treating maculopathy and preserving the macular function. (Chin J Ocul Fundus Dis,2000,16:153-154)