糖尿病视网膜病变黄斑厚度及黄斑体积定量分析

目的:研究不同分期糖尿病视网膜病变患者黄斑厚度及黄斑体积的变化特点.方法:选取2016-01-01/2017-01-01于我院眼科门诊就诊的40例78眼糖尿病视网膜病变患者作为研究对象,根据糖尿病视网膜病变(diabetic retinopathy,DR)的国际临床分类法分为非增殖期糖尿病视网膜病变(non prolifertive dibetic retinopthy,NPDR)组20例40眼,增殖期糖尿病视网膜病变(prolifertive dibetic retinopthy,PDR)组20例38眼.全部研究对象进行光学相干断层扫描(optical coherence tomography OCT)检查,以直径1、3、6mm ETDRS对黄斑区进行分区,分析随着糖尿病视网膜病变严重程度的增加,黄斑中心凹及其周围分区各象限视网膜厚度及体积的变化特点.结果:NPDR组及PDR组黄斑中心小凹的厚度(foveola thickness,FT)分别为252.57±31.36、362.47±20.81μm,分区中内环上方、鼻侧最厚,下方次之,颞侧最薄;外环鼻侧最厚,上方次之,颞侧、下方最薄;NPDR组黄斑中心凹厚度及分区各象限视网膜厚度数值均小于PDR组,差异具有统计学意义(P<0.05).NPDR组及PDR组黄斑中心小凹处体积(V)分别为0.20±0.02、0.28±0.16mm3,分区中内环上方、鼻侧最大,下方次之,颞侧最小;外环鼻侧最大,上方次之,颞侧、下方最小;NPDR组黄斑中心凹体积及分区各象限视网膜体积数值均小于PDR组,差异具有统计学意义(P<0.05).结论:糖尿病视网膜病变患者黄斑中心凹及分区各象限视网膜厚度及体积变化与糖尿病视网膜病变的病程进展有关.利用OCT对不同分期糖尿病视网膜病变患者黄斑厚度及黄斑体积进行定量分析,了解随着糖尿病视网膜病变严重程度的增加,黄斑区及其周围分区视网膜形态学变化的特点,为更好地分析不同严重程度糖尿病视网膜病变黄斑部位结构改变提供临床研究依据.

Quantitative analysis of macular retinal thickness and macular volume in diabetic retinopathy

·AIM:To evaluate and characterize the macular thickness and macular volume in patients of different stages of diabetic retinopathy with special - domain optical coherence tomography( SD-OCT) .·METHODS: Totally 40 patients ( 78 eyes ) with diabetic retinopathy were recruited in the study from January 2016 to January 2017 in our hospital. According to the international clinical classification of diabetic retinopathy, 20 cases (40 eyes) were categorized as non-proliferative diabetic retinopathy ( NPDR ) group and 20 cases proliferative diabetic retinopathy (PDR) group (38 eyes). All subjects were examined and analyzed with Early Treatment Diabetic Retinopathy Study ( ETDRS ) subfields, which were embedded in HS ( Haag-Streit ) with diameter of 1, 3 and 6mm. The changes of retinal thickness and volume of the macular center were measured.·RESULTS: The thickness of macular foveolar in NPDR group and PDR group were 252. 57 ± 31. 36μm, 362. 47 ± 20. 81μm. The retinal thickness of inner superior subfield (ISM) and inner nasal subfield(INM) were the thickest;that of inner inferior subfield ( IIM ) was next to ISM and INM, and that of inner temporal subfield was the thinnest. Of the outer subfields, the retinal thickness of outer superior subfield ( OSM ) was the thickest;that of outer nasal subfield( ONM) was next to OSM, and that of outer temporal subfield(OTM)and outer inferior subfield ( OIM ) was the thinnest. The value of macular central concave thickness and retinal thickness in each quadrant of the NPDR group were less than those of the PDR group, the difference was statistically significant ( P <0. 05). The volume (V) of macular center in NPDR group and PDR group were 0. 20±0. 02mm3, 0. 28±0. 16mm3, the upper and nasal sides of the middle part of the partition were the largest, the inferior and the temporal side were the smallest. The nasal side of the outer loop was the largest, the upper was the second, the temporal side and the inferior were the smallest. The volume of macular central fovea and the retinal volume in each quadrant of the NPDR group were smaller than those of the PDR group, the difference was statistically significant (P<0. 05).·CONCLUSION: The changes of retinal thickness and volume in macular central fovea were related with the progression of diabetic retinopathy. Using OCT to analyze the macular thickness and macular volume in different stages of diabetic retinopathy, helps physicians to understand the morphological changes of macular region and its surrounding macular degeneration with the severity of diabetic retinopathy, and provide a basis for better analysis of the changes of the structure of macular in different severity diabetic retinopathy.