增生型糖尿病视网膜病变前后段联合手术后脉络膜厚度的变化  

Changes of choroidal thickness after anterior-posterior joint surgery in patients with proliferative diabetic retinopathy

作　　者：李聪 蔺媛媛[2] 童念庭[2] 李亚男 潘麟 周占宇[2] 

机构地区：[1]潍坊医学院,中国山东省潍坊市261000 [2]中国山东省青岛市市立医院眼科中心,266000

出　　处：《国际眼科杂志》2018年第3期506-510,共5页International Eye Science

摘　　要：目的:观察前后段联合手术对增生型糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)患者的脉络膜厚度的影响。方法:采用回顾性病例对照研究。将在青岛市市立医院确诊为PDR且具备前后段联合手术条件的患者60例60眼纳入研究。并根据是否伴有有临床意义的黄斑水肿(clinical significant macular edema,CSME)将PDR组分为CSME(+)组31例31眼和CSME(-)组29例29眼。将27例27眼与患者年龄及性别匹配的正常眼作为对照组。所有PDR患眼均行前后段联合手术。使用频域光学相干断层扫描的增强深部成像技术(enhanced depth imaging spectral domain optical coherence tomography,EDI-SDOCT)对对照组和PDR组术后1wk,1、3、6mo进行扫描,并测量黄斑中心凹(subfoveal choroidal thickness,SFCT)及距黄斑中心凹鼻侧(nasal choroidal thickness,NCT)、颞侧(temporal choroidal thickness,TCT)各1500μm的脉络膜厚度。比较前后段联合手术后患眼脉络膜厚度的变化。结果:CSME(+)组和CSME(-)组前后段联合术后1mo SFCT、NCT、TCT较术后1wk,3、6mo均增加,且差异有统计学意义(均P<0.05),术后6mo SFCT、NCT、TCT较术后1wk,1、3mo均减少,且差异具有统计学意义(均P<0.05)。CSME(+)组和CSME(-)组术后1wk,1、3mo的SFCT、NCT、TCT均大于对照组,且差异有统计学意义(均P<0.05),术后6mo的SFCT、NCT、TCT与对照组相比差异均无统计学意义(P>0.05)。分别比较CSME(+)组与CSME(-)组术后1wk,1、3、6mo SFCT、NCT、TCT差异均无统计学意义(均P>0.05)。结论:PDR患者前后段联合术后1mo内脉络膜厚度是增加的,1mo之后脉络膜厚度是降低的,术后6mo脉络膜厚度接近正常状态。PDR是否伴有CSME对术后脉络膜厚度无明显影响。AIM:To determine the effect of anterior-posterior joint surgery on choroidal thickness in patients with proliferative diabetic retinopathy(PDR). METHODS:A retrospective,case-control study enrolled 60 eyes of 60 patients with PDR diagnosed at Qingdao Municipal Hospital.The patients,who had conditions that warranted anterior-posterior joint surgery,were divided into a clinically significant macular edema group(PDR/CSME+;31 patients,31 eyes) and a non-CSME group(PDR/CSME-;29 patients,29 eyes).Twenty-seven eyes of 27 normal patients were included in the control group.All affected eyes underwent anterior-posterior joint surgery.After surgery,the subfoveal choroidal thickness(SFCT),and the nasal choroidal thickness(NCT) and temporal choroidal thickness(TCT),which were obtained at a distance of1500μm from the fovea in the nasal and temporal directions,respectively,were measured in the control and PDR groups by enhanced depth imaging spectral domain optical coherence tomography(EDI-SDOCT) at1 wk,1,3,and 6 mo after surgery.Changes in choroidalthickness after anterior-posterior joint surgery were compared between the groups.RESULTS:The SFCT,NCT,and TCT were significantly thicker at 1 mo than at 1 wk,3,and 6 mo after surgery in the PDR/CSME+ and PDR/CSME-groups(P<0.05).The SFCT,NCT,and TCT were significantly thinner at 6 mo than at 1 wk,1,and 3 mo after surgery in the PDR/CSME+and PDR/CSME-groups(P<0.05).The SFCT,NCT,and TCT in the PDR/CSME+ and PDR/CSME-groups at 1 wk,1,and 3 mo after surgery were significantly thicker than those in the control group(all P<0.05),but the SFCT,NCT,and TCT at 6 mo after surgery showed no significant difference compared with the control group(all P>0.05).There was no significant difference in the SFCT,NCT,or TCT at 1 wk,1,3,or 6 mo between the PDR/CSME+ and PDR/CSME-groups(P>0.05).CONCLUSION:The choroidal thickness of PDR patients increases within 1 mo after surgery,and decreased after1 mo,but is not significantly different between the control group and the PDR groups at 6 mo after surgery.Wh

关 键 词：糖尿病视网膜病变 光学相干断层扫描 脉络膜厚度 全视网膜激光光凝 玻璃体视网膜手术 

分 类 号：R587.2[医药卫生—内分泌] R779.6[医药卫生—内科学]