糖尿病视网膜病变黄斑区血流密度和黄斑中心凹无血管区面积的变化及其意义

【目的】探讨糖尿病视网膜病变(diabetic retinopathy,DR)黄斑区血流密度(macular vascular density,MVD)和黄斑中心凹无血管区(foveal avascular zone,FAZ)面积的变化及其意义。【方法】选取2015年2月至2017年2月在本院就诊的74例糖尿病患者(DM组)及同期40例健康查体者(CON)的临床资料,糖尿病患者根据眼科检查分为无DR组(No-DR组)、非增殖性糖尿病DR组(NPDR组)和增殖性糖尿病DR组(PDR组)。光学相干断层扫描血管成像技术(optical coherence tomography angiography,OCTA)检测各组MVD和FAZ横径、竖径和面积并比较。【结果】DM组共有135只眼,其中No-DR组共71只,NPDR组共53只眼,PDR组共11只眼,正常CON共80只眼。PDR组、NPDR组在表层、内层视网膜及脉络膜毛细血管层的MVD均明显低于CON(均P<0.05)。No-DR组在表层、内层视网膜的MVD均明显低于CON(均P<0.05);PDR组、NPDR组在表层、内层视网膜及脉络膜毛细血管层MVD明显低于No-DR组(均P<0.05)。与CON相比,PDR组FAZ竖径、横径及面积明显较大(均P<0.05);No-DR组、NPDR组FAZ面积明显较大(P=0.000),而FAZ竖径、横径无显著差别(均P>0.05)。【结论】DR患者FAZ面积扩大及MVD降低,对早期诊断DR具有重要临床价值。

Change of Blood Flow Density and No-vessel Area in Macular Fovea in dDiabetic Retinopathy and its Significance

【Objective】To investigate the changes of macular vascular density(MVD)and foveal avascular zone(FAZ)in diabetic retinopathy(DR).【Methods】From February 2015 to February 2017,74 diabetic patients(DM group)and 40 healthy controls(CON)were selected.Diabetic patients were divided into no DR group,NPDR group and PDR group.The transverse,vertical and area of MVD and FAZ were measured and compared by optical coherence tomography(OCTA).【Results】There were 135 eyes in the DM group,71 in the no-DR group,53 in the NPDR group,11 in the PDR group and 80 in the normal CON group.MVD of the PDR group and the NPDR group was significantly lower than that of con group(P<0.05).The MVD of the surface and inner retinas of the No-DR group was significantly lower than that of the CON(all P<0.05),and that of the PDR group and the NPD group was significantly lower than that of the No-DR group(all P<0.05).Compared with the CON,the vertical diameter,horizontal diameter and area of FAZ in the PDR group were significantly larger(P0.05).【Conclusion】The expansion of FAZ area and the decrease of MVD in DR patients have im portant clinical value for early diagnosis of DR.