糖尿病视网膜病变毛细血管无灌注区与视野关系的研究  

The relationship of visual field and capillary non-perfusion in preproliferative and early proliferative diabetic retinopathy

作　　者：黄杜茹[1] 黄中宁[2] 尹东明[2] 

机构地区：[1]中山大学附属第一医院东山区医院眼科,广州510080 [2]广东省人民医院眼科,广州510080

出　　处：《广州医药》2007年第2期25-28,共4页Guangzhou Medical Journal

摘　　要：目的研究糖尿病视网膜病变的毛细血管无灌注区与视野光敏感度关系。方法对处于增殖前期或早期糖尿病视网膜病变15例28眼进行视野检查,以没有或背景性糖尿病视网膜病15例21眼作对照组,得出中心视野光敏感度平均缺损(mean defect,MD)、视野指数矫正模式标准差(corrected pattern standard deviation,CPSD)。毛细血管无灌注区用眼底荧光造影确定。用计算机整合视野和荧光造影图观察毛细血管无灌注区对应的视野改变。结果26眼(26/28,92.9%)增殖前期或增殖早期糖尿病视网膜病变病人有毛细血管无灌注区,多位于中周部,表现为片状,而位于后极部多为小灶状,表现为中心视野光敏感度下降。在对照组未发现毛细血管无灌注区。增殖前期或早期糖尿病视网膜病变病人MD为(-11±8)dB,CPSD为(6.1±2.8)dB。MD和CPSD与正常参比值比较的P值小于0.05有27眼(27/28,96.4%);对照组MD为(-0.8±1.6)dB,CPSD为(1.8±0.6)dB,MD与正常参比值比较的P值小于0.05有6眼(6/21,28.6%),CPSD有4眼(4/21,19.0%)。两组差异有统计学意义(P<0.05)。Spearman’s分析发现毛细血管无灌注区的严重程度与MD呈负相关(γ=-0.736,P<0.01),与CPSD呈正相关(γ=0.593,P=0.001)。结论增殖前期和早期糖尿病视网膜病变病人的毛细血管无灌注区相对应的视野区光敏感度下降,视野检查可提示视网膜的缺血性改变。Objective To study the relationship of retinal light sensitivity in visual fields and capillary non-perfusion zone in preproliferative retinopathy （PPDR） or early proliferative diabetic retinopathy （PDR） . Methods Central visual fields of 28 eyes in 15 patients with PPD or PDR were examined using 30-2 full threshold program in Humphrey visual analyzer to calculate the visual field indexes including mean defect （ MD）, corrected pattern standard deviation （CPSD） . Twenty-one eyes in 15 patients without background diabetic retinopathy （BDR） or without （NDR） were used as the control group. Capillary nonperfusion zone was confirmed by fluorescence angiography. The image of visual field was superimposed with fluorescence angiog- raphy by computer to observe the visual field changes of capillary non-perfusion zone. The relationship between serious degrees of capillary non-perfusion and visual field indexes was analyzed with the rank correlation analysis. Results Capillary non-perfusion zones were found in 26 eyes （26/28, 92. 9% ） in PPDR or PDR, but not found in control group. Capillary non-perfusion zones located most in the equatorial retina were represented as laminated shape, while those located in the posterior retina, as small piece. The retinal light sensitivities in capillary non-perfusion zones were decreased significantly. MD and CPSD were （ -11 ± 9 ） and （6.1 ± 2.8）, respectively, in patients with PPDR or PDR, while （4）. 8 ± 1.6） and （ 1.8 ± 0. 6 ）, respectively, in control （ P 〈 0. 05） . As compared with normal reference values, MD and CPSD with P value of less than 0. 05 occupied the same rate of 96% （27/28 eyes） in PPDR or PDR, but only 29% （6/21） and 19% （4/21 ） respecitvely in control （ P 〈 0. 05 ） . Spearman analysis showed that the serious scale of capillary non-perfusion was correlated with MD （7 = 4）. 736, P 〈 0. 01 ） or with CPSD （7 =0. 593, P = 0. 001 ） . Conclusion Retinal light sensitivities in capillary non-pe

关 键 词：糖尿病视网膜病变 增殖前期和增殖早期 眼底荧光血管造影 毛细血管无灌注区 视野 光敏感度 

分 类 号：R587.2[医药卫生—内分泌]