糖尿病患者荧光素眼底血管造影结果分析

目的：通过对糖尿病患者荧光素眼底血管造影（ FFA）结果进行分析，探讨该检查患者的眼底疾病构成，以及对糖尿病视网膜病变（ DR）临床诊疗的意义。方法选取2011年1月至2013年2月我科行FFA检查的糖尿病患者565例（1063只眼），诊断患者视网膜病变情况和分级，并根据诊断结果指导治疗。结果565例糖尿病患者1063只眼中DR 697只眼（65．6％）、老年黄斑病变37只眼（3．5％）、视网膜静脉阻塞20只眼（1．9％）、高度近视眼底改变10只眼（0．9％）、视神经炎9只眼（0．8％）、视网膜色素变性6只眼（0．6％）、中心性浆液性脉络膜视网膜病变3只眼（0．3％）、其他3只眼（0．3％），未发生DR 366只眼（34．4％），正常眼底278只眼（26．1％）；除外视网膜其他病变，共计975只眼，其中无明显视网膜病变（28．5％）、轻度非增生性糖尿病视网膜病变（ NPDR）（16.7％）、中度NPDR（14．4％）、重度NPDR（22．1％）、增生性糖尿病视网膜病变（PDR）（18．3％）；局限性黄斑水肿（33．1％）、弥漫性黄斑水肿（35．1％）、囊样黄斑水肿（23．1％）、缺血性黄斑水肿（3．8％）、增生性黄斑水肿（4.9％）；随着糖尿病病程的延长，DR的发病率逐渐增加（χ2＝54．927 P ＜0．05）；随着患者年龄的增加，DR的发病率也逐渐增加（χ2＝11．798 P ＜0．05）；随着DR严重程度的增加，黄斑水肿的程度增加（χ2＝63．15 P ＜0．05）。结论 FFA能够及早发现程度不同的DR和糖尿病性黄斑水肿（ DME）改变以及是否伴随其它的视网膜病变，可更好的指导临床诊疗工作；增加糖尿病患者对DR的认知能力，对预防患者视力下降及失明具有重要意义。

Analysis of fundus fluorescein angiography in the diabetics

Objective To analyze the results of fundus fluorescein angiography （ FFA） in diabetic patients , and to explore clinical features of diabetic retinal diseases .Methods Fundus fluorescein angiography was performed in 565 pa-tients （1063 eyes） presented to our department between January 2011 amd February 2013.The degrees of retinal lesion and DR grades were determined and used to guide treatment .Results In 1063 eyes, 697 eyes （65.6%） were diagnosed with DR, and 366 eyes （34.4%） did not meet the criteria of DR.Among those eyes without DR, 278 eyes （26.1%） presented with normal fundus , while the remaining were found to have conditions that were irrelevant to this study , inclu-ding age-related macular degeneration （37 eyes, 3.5%）, retinal vein occlusion （20 eyes, 1.9%）, high myopia fundus degeneration （10 eyes, 0.9%）, optic neuritis （9 eyes, 0.8%）, retinitis pigmentosa （6 eyes, 0.6%）, central serous chorioretinopathy （3 eyes, 0.3%）, and others fundus diseases （3 eyes, 0.3%）, and thus were excluded from further dis-cussion.Among the 975 eyes that were interested, 28.5%had no significant retinopathy, 16.7%presented with mild NP-DR, 14.4% with moderate NPDR, 22.1% with severe NPDR, and 18.3% with PDR.Limited macular edema （33. 1%）, diffuse macular edema （35.1%）, cystoid macular edema （23.1%）, ischemic macular edema （3.8%）, prolifera-tive macular edema （4.9%） were also noticed.Incidence of DR gradually increased with the duration of diabetes （χ2 =54.927, P 〈0.05） and age （χ2 =11.798, P 〈0.05）.The severity of DR is related to the degree of macular edema （χ2=63.15, P 〈0.05）.Conclusions FFA can detect varying degrees of DR and DME changes as well as other retinopa-thies in early stage .It is a good tool to guide clinical prevention .Education of the patients with the knowledge of DR , vi-sion loss, and blindness prevention is important .