糖尿病黄斑缺血患者黄斑中心凹下脉络膜厚度特征分析

目的　观察糖尿病黄斑缺血（diabetic macular ischemia,DMI）患者黄斑区脉络膜厚度特征。方法　回顾性病例对照研究。经FFA检查确诊的糖尿病视网膜病变（diabetic retinopathy,DR）不伴糖尿病黄斑水肿患者80例102眼纳入本研究。其中DR伴DMI患者37例47眼为DMI组，DR不伴DMI患者43例55眼为NDMI组；选择同期年龄、性别相匹配的经散瞳检查明确眼底无明显DR的2型糖尿病患者33例50眼作为对照组（NDR组）。所有患者均利用EDI-OCT测量黄斑中心凹下脉络膜厚度（subfoveal choroidal thickness,SFCT）。采用单因素方差分析及LSD-t检验比较三组间SFCT差异。结果　三组间性别及年龄比较，差异均无统计学意义（χ²=1.412，P=0.494；F=0.784，P=0.459）。EDI-OCT检查结果显示，DMI组、NDMI组及NDR组SFCT分别为（357.13±101.41）μm、（296.00±95.88）μm、（342.68±80.76）μm，三组相比差异有统计学意义（F=6.137，P=0.003）。组间两两比较结果显示，与NDMI组比较，DMI组SFCT明显增厚，差异有统计学意义（t=3.308，P=0.001）；与NDR组比较，NDMI组SFCT明显变薄，差异有统计学意义（t=2.568，P=0.011）；DMI组与NDR组SFCT比较，差异无统计学意义（t=0.765，P=0.446）。结论　DR患者SFCT变化与是否存在DMI有关，DMI患眼较不伴DMI患眼SFCT明显增厚。

Characteristics of subfoveal choroidal thickness in patients with diabetic macular ischemia

Objective To investigate the macular choroidal thickness in eyes of patients with diabetic macular ischemia(DMI).Methods Retrospective case-control study was conducted.The study enrolled 80 patients(102 eyes)with diabetic retinopathy(DR)but without diabetic macular edema(DME)diagnosed by FFA,including 37 DR patients(47 eyes)with DMI(DMI group)and 43 DR patients(55 eyes)without DMI(NDMI group).Thirty-three age-and gender-matched type 2 diabetes mellitus(T2DM)patients(50 eyes)without DR were selected as the control group(NDR group).All patients underwent EDI-OCT to measure the subfoveal choroidal thickness(SFCT).One-way ANOVA and LSD-t test were adopted to compare the differences of SFCT among three groups.Results There was no significant difference in gender and age among the three groups(χ2=1.412,P=0.494;F=0.784,P=0.459).EDI-OCT results showed that SFCT of DMI group,NDMI group and NDR group were(357.13±101.41)μm,(296.00±95.88)μm,(342.68±80.76)μm,respectively.Statistical difference was found in SFCT among three groups(F=6.137,P=0.003).Results of two-two comparison showed that SFCT in DMI group was significantly higher than that in NDMI group(t=3.308,P=0.001),and SFCT in NDMI group was obviously lower than that in NDR group(t=2.568,P=0.011).There was no significant difference in SFCT between DMI group and NDR group(t=0.765,P=0.446).Conclusion The change of SFCT in DR patients is associated with the presence or absence of DMI.The SFCT in DMI eyes is significantly thicker than that in non-DMI eyes.