摘要
目的通过相干光层析血管成像术(OCTA)观察2型糖尿病患者视神经乳头及盘周毛细血管血流密度(RPCVD)及神经纤维层(RNFL)厚度的变化。方法横断面研究。入组44例为无临床可见糖尿病视网膜病变(DR),48例非增生期糖尿病视网膜病(NDR)患者。同时选取45例健康受试者作为对照组。使用OCTA对所有受试者应用OCTA视盘区4.5 mm×4.5 mm血流模式进行检查,软件自动计算各断面的视乳头周毛细血管密度和视乳头周为RNFL厚度。采用SPSS 25.0统计学软件对数据进行分析。结果(1)与对照组相比,44例NDR组RPCVD在整体(47.88±1.59)、视盘内(47.56±1.86)及上颞(ST)(51.80±1.94)3个区域血管密度降低,P<0.05,差异均有统计学意义。NDR组RNFL厚度差异无统计学意义(P>0.05)。(2)与对照组相比,48例NPDR组整体(45.77±2.28)、视盘内(44.03±1.58)、视盘旁(47.26±1.48)、鼻上(NS)(45.90±2.78)、鼻下(NI)(45.90±2.78)、下鼻(IN)(47.44±2.17)、下颞(IT)(51.75±5.27)、颞下(TI)(49.38±3.74)、颞上(TS)(53.48±3.32)、上颞(ST)(54.27±3.17)以及上鼻(SN)(45.47±2.24),所有区域观察到视乳头周毛细血管密度差异均有统计学意义(均P<0.05)。RNFL厚度在下鼻(IN)(118.79±12.23)μm、下颞(IT)(134.81±13.55)μm,2个区域差异无统计学意义(均P>0.05)。结论视神经乳头区域毛细血管血流密度可能为早期DR中神经损伤前微血管已经改变提供了证据。视盘内血流灌注的减少可能是早期DR检测的重要标志之一。在ONH血流模式下,OCTA可能是DR筛查中更有前途的工具。
Objective To observe the changes of blood flow density and nerve fiber layer thickness around optic papilla(ONH)in type 2 diabetes patients by optical coherence tomography angiography(OCTA).Methods It was a crosssectional study.44 patients with no clinically visible diabetic retinopathy(NDR)and 48 patients with non-proliferative dia⁃betic retinopathy(NPDR)were enrolled.At the same time,45 healthy subjects were selected as the control group.All sub⁃jects underwent OCTA to examine the 4.5 mm×4.5 mm blood flow pattern in the optic disc area,and the software automati⁃cally calculated the peripapillary capillary density and the nerve fiber layer around the papilla in each section(retinal nerve fibre layer,RNFL)thickness.Statistical softwareSPSS 25.0was used to analyze the data.Results The blood flow density of capillaries around the optic nerve papilla and the thickness of nerve fiber layer in the control group,NDR and NPDR groups were compared respectively.1.In the NDR group,radial peripapillary capillaries vascular density(RPCVD)de⁃creased in(47.88±1.59)%overall,(47.56±1.86)%intra-optic disc and(51.80±1.94)%superior temporal(ST)(P=0.04,0.02,0.007,all P<0.05,respectively).The thickness of RNFL in NDR group was decreased but(P>0.05.2).Compared with the control group,the 48 cases of NPDR group were overall(45.77±2.28)%,intra-optic(44.03±1.58)%,para-optic(47.26±1.48)%,supranasal(NS)(45.90±2.78)%,subnasal(NI)(45.90±2.78)%,inferior nasal(IN)(47.44±2.17)%,infe⁃rior temporal(IT)(51.75±5.27)%,inferior temporal(TI)(49.38±3.74)%,superior temporal(TS)(53.48±3.32)%,superior temporal(ST)(54.27±3.17)%and upper nasal(SN)(45.47±2.24)%,the peripapillary capillary density was significantly decreased in all areas(P<0.05).The thickness of RNFL IN inferior nasal(IN)(118.79±12.23)μm,inferior temporal(IT)(134.81±13.55)μm,inferior nasal(IN)(P=0.023),inferior temporal(IT)(P=0.035)two areas(P<0.05),the thickness of RNFL decreased,the difference was statistically significant.Conclusions Capillary blood flow density in the optic nerve head region may provide evidence that microvasculature has changed before nerve injury in early DR.The reduction of blood perfusion in the optic disc may be one of the important signs of early DR detection.OCTA may be a more promising tool in DR screening in ONH flow patterns.
作者
谢书萍
高自清
Xie Shuping;Gao Zhiqing(Departmentof Ophthalmology,the First Affiliated Hos-pital of Bengbu Medical College,Bengbu 233004,China)
出处
《临床眼科杂志》
2024年第1期16-20,共5页
Journal of Clinical Ophthalmology
作者简介
通讯作者:高自清(Email:gaozq70@163.com)。
