糖尿病性黄斑水肿OCT和FFA形态学分类的对比分析

目的探讨糖尿病性黄斑水肿相干光断层扫描(OCT)和眼底荧光素血管造影(FFA)的形态学特征、分类及相互关系。设计前瞻性病例系列。研究对象临床有意义糖尿病性黄斑水肿(CSME)患者102例177眼。方法分别对CSME组患者进行OCT及FFA检查,观察两种分类之间的相互关系,并与中心凹中心厚度、最佳矫正视力等临床资料进行对比分析。主要指标CSME患者的OCT及FFA类型、中心凹中心厚度、最佳矫正视力。结果FFA分类的局限水肿型在OCT1型中所占的比例为70.6%,高于弥漫水肿型(27.2%)和囊样水肿型(2.2%)(P<0.05)。FFA弥漫水肿型在OCT2型中占47.9%,明显高于局限水肿型(25.0%)和囊样水肿型(27.1%)(P<0.05)。FFA分类的囊样水肿型在OCT3型(3A型 3B型)中占56.8%,明显高于局限水肿型(10.8%)和弥漫水肿型(32.4%)(P<0.05)。OCT1型及FFA局限水肿型的矫正视力最好,黄斑中心凹中心厚度值最小(P<0.05)。结论CSME患者OCT与FFA的形态学类型密切相关。结合两种检查方法,可更加全面地反映CSME患者黄斑区视网膜的变化,为揭示糖尿病性黄斑水肿的病理机制、寻求每种类型的最佳治疗方案提供参考。

The correlation between the features of optical coherence tomography and fundus fluorescein angiography in diabetic macular edema

s Objective To assess the correlation between the features of optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) in clinically significant diabetic macular edema. Design Prospective case series. Participants 102 patients(177 eyes) with clinically significant diabetic macular edema. Methods Optical coherence tomography and fluorescein angiography typing were done separately in a double-masked manner in each case of clinically significant macular edema. The correlation between FFA types and OCT types were analyzed, and their associations with the best visual acuity, central foveal thickness were evaluated. Main Outcome Measures The FFA features and OCT features of clinically significant diabetic macular edema, central foveal thickness, best visual acuity. Results The prevalence of focal leakage type was higher in the OCT type 1 (70.6%) than in the diffuse leakage type (27.2%) and diffuse cystoid leakage type (2.2%) of fluorescein angiography (P<0.05). The prevalence of diffuse leakage type was higher in the OCT type 2 (47.9%) than in the focal leakage type (25.0%) and diffuse cystoid leakage type (27.1%; P < 0.05). The prevalence of diffuse cystoid leakage type was higher in the OCT type 3(56.8%) than in the focal leakage type (10.8%) and diffuse leakage type (32.4%; P< 0.05). Optical coherence tomography type 1 and the focal leakage type of fluorescein angiography showed the least central foveal thickness and with the best visual acuity (P< 0.05). Conclusion There was a significant correlation between the features of OCT and FFA in diabetic macular edema. The analysis of clinically significant macular edema based on both OCT and fluorescein angiography can provide information that may be useful to disclose the pathogenesis of the edema and to optimize the treatment for each type.