频域相干光断层扫描观察重度非增生型糖尿病视网膜病变全视网膜光凝术后脉络膜厚度的变化  

Comparison of choroidal thickness in patients with severe non-proliferative diabetic retinopathy before and after panretinal photocoagulation by spectral-domain optical coherence tomography

作　　者：黄晓菁[1,2] 魏锐利[1] 谭烨[2] 

机构地区：[1]第二军医大学长征医院眼科,上海200003 [2]上海市浦东新区公利医院眼科,上海200135

出　　处：《中国眼耳鼻喉科杂志》2017年第1期58-60,共3页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的观察重度非增生型糖尿病视网膜病变(NPDR)全视网膜光凝(PRP)术后脉络膜厚度的变化。方法前瞻性对比分析26例(30眼)确诊为重度NPDR患者的临床资料,通过频域相干光断层扫描(OCT)测量并对比患者PRP术前及术后1个月、3个月各点位脉络膜厚度的变化,其中各位点脉络膜厚度依次为水平和垂直方向的黄斑中心凹下脉络膜厚度(SFCT)、鼻侧脉络膜厚度(NCT)、颞侧脉络膜厚度(TCT)、上方脉络膜厚度(SCT)、下方脉络膜厚度(ICT)。结果 PRP术后1个月SFCT、NCT、TCT、SCT、ICT分别为(338.0±70.2)、(292.0±72.3)、(331.0±71.4)、(312.0±76.7)、(318.0±78.3)μm,均高于术前,差异有统计学意义(P值均<0.05);术后3个月SFCT、NCT、TCT、SCT、ICT分别为(305.0±75.6)、(271.0±76.3)、(302.8±78.5)、(280.0±70.5)、(291.0±73.2)μm,与术前相比均明显降低,差异有统计学意义(P值均<0.05)。结论本研究通过频域OCT直观显示DR在PRP术后黄斑区脉络膜形态学变化,提示激光光凝可能通过炎症反应及作用于色素上皮细胞,进而间接影响脉络膜厚度,从而改变视网膜灌注。Objective To observe the changes of choroidal thickness in patients with severe non proliferative diabetic retinopathy after laser photocoagulation by spectral-domain optical coherence tomography. Methods A prospective analysis of 26 cases （30 eyes） diagnosed as severe non proliferative diabetic retinopathy. Spectral domain optical coherence tomography （OCT） was used to measure the choroidal thickness before, 1 month and 3 month after panretinal photocoagulation. The choroidal thickness in order was horizontal and vertical direction of the foveal thickness （SFCT） and the nasal lateral choroidal thickness （NCT）, the temporal choroidal thickness （TCT）, the superior choroidal thickness （SCT） and the inferior choroidal thickness （ICT）. Results One month after panretinal photocoagulation, SFCT, NCT, TCT, SCT, ICT was （338.0±70.2） , （292.0±72.3）, （331.0±71.4） , （312.0±76.7 ）, （318.0 ± 78.3 ） μm respectively, which was higher than that before the operation （ P 〈 0.05 ）. Three months after the surgery, SFCT NCT, TCT, SCT, ICT was （305.0 ± 75.6）, （271.0 ± 76.3 ）, （302.8 ± 78.5）, （280.0 ± 70.5）, （291.0±73,2） μm respectively, which was significantly decreased （P 〈0.05）. Conclusions This study displayed the changes in macular ehoroidal morphology of diabetic retinopathy after panretinal photocoagulation through the spectral domain OCT, which prompt that laser photoeoagulation might through inflammatory reaction and effecting on pigment epithelial cells indirectly affects the choroidal thickness, thereby changes the retinal perfusion. （ Chin J Ophthalmol and Otorhinolaryngo1,2017,17：58-60）

关 键 词：非增生型糖尿病视网膜病变 全视网膜光凝术 频域相干光断层扫描 脉络膜厚度 

分 类 号：R587.2[医药卫生—内分泌] R779.63[医药卫生—内科学]