应用EDI-SDOCT观察全视网膜光凝对糖尿病视网膜病变黄斑区脉络膜厚度的影响  

Effects observation of panretinal photocoagulation on macular choroidal thickness of diabetic retinopathy by EDI-SDOCT

作　　者：景作乾[1] 柳力敏[1] 陈蕾[1] 

机构地区：[1]中国医科大学附属第一医院眼科,辽宁省沈阳市110001

出　　处：《眼科新进展》2015年第9期839-843,共5页Recent Advances in Ophthalmology

基　　金：辽宁省科学技术计划项目(编号:JH2)~~

摘　　要：目的应用深层成像谱域光学相干断层扫描(enhanced depth imaging spectral-domain optical coherence tomography,EDISDOCT)观察全视网膜光凝(panretinal photocoagulation,PRP)对非增生性糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)患眼黄斑区脉络膜厚度的影响。方法对35例(59眼)NPDR患者行PRP术,以42例(59眼)正常眼作为对照组。应用EDI-SDOCT分别在PRP术前和术后1周测量对照组和光凝组黄斑区各点位脉络膜厚度,比较术后1周较术前的变化,各点标记为:中心凹下脉络膜厚度(subfoveal choroidal thickness,SFCT),各扫描线上距离中心凹750μm、1500μm处的鼻侧脉络膜厚度(nasal choroidal thickness,NCT)、颞侧脉络膜厚度(temporal choroidal thickness,TCT)、上方脉络膜厚度(superior choroidal thickness,SCT)、下方脉络膜厚度(inferior choroidal thickness,ICT)、平均黄斑区脉络膜厚度(average macular choroidal thickness,AMCT)。结果光凝组术前、术后1周的SFCT、NCT750、TCT750、SCT750、ICT750、NCT1500、TCT1500、SCT1500、ICT1500、AMCT均明显低于对照组(均为P<0.05);术后1周SFCT和AMCT明显高于术前(均为P<0.05);除TCT750和TCT1500术后与术前无明显差异外(均为P>0.05),余各点位术后均明显高于术前(均为P<0.05)。其中10眼术后各值低于术前,2眼可观察到术后脉络膜血管孔径较术前增加。结论 NPDR会导致黄斑区脉络膜变薄,PRP术短期内能够明显增加黄斑区脉络膜厚度,同时一定程度上增加脉络膜的血管孔径。EDI-SDOCT是用于评价NPDR患者疗效和预后的有效无创检测手段。Objective To observe the effects of panretinal photocoagulation（PRP） on macular choroidal thickness（CT）of non-proliferative diabetic retinopathy（NPDR） by enhanced depth imaging spectral-domain optical coherence tomography（EDI-SDOCT）.Methods Fifity-nine NPDR eyes of 35 patients were underwent PRP,and 59 normal eyes of 42 normal ones were chosen as control.EDI-SDOCT was used to measure CT before PRP and1 week after PRP at the point of 750μm and 1500μm on both of the horizontal and vertical scan lines in nasal,temporal,superior and inferior directions.The measured values were defined as subfoveal CT（SFCT）,nasal CT750（NCT750）,nasal CT1500（NCT1500）,temporal CT750（TCT750）,temporal CT1500（TCT1500）,superior CT750（SCT750）,superior CT1500（SCT1500）,inferior CT750（ICT750）,inferior CT750（ICT1500）,average macular choroidal thickness（AMCT）.Results SFCT,NCT750,TCT750,SCT750,ICT750,NCT1500,TCT1500,SCT1500,ICT1500,AMCT at pre-operation and 1 week after PRP in the PRP group were significant lower than those in the control group（all P〈0.05）.SFCT and AM CT at postoperative 1 week in PRP group were higher than those at pre-operation（all P〈0.05）.TCT750 and TCT1500showed no significant difference between pre-operation and post-operation（all P〉0.05）,while the postoperative SFCT,NCT750,SCT750,ICT750,NCT1500,SCT1500,ICT1500 and AMCT in PRP group were significant higher than pre-operation（all P〈0.05）.Above values lower than pre-operation were in 10 eyes.A increase of vessels diameter were observed in 2 eyes.Conclusion NPDR induce a decrease in macular CT,while PRP induce a significant increase in a short term and expand the vessel diameter in a certain extent.EDI-SDOCT can be used as an effective and non-invasive method for evaluating the efficacy and prognosis of NPDR.

关 键 词：糖尿病视网膜病变 全视网膜光凝 光学相干断层扫描 脉络膜厚度 

分 类 号：R587.2[医药卫生—内分泌]