多方位光相干断层扫描血管成像对Ⅳ期糖尿病视网膜病变患眼视网膜及视盘新生血管的检出分析  

Detection of retinal and optic disc neovascularization in patients with stage 4 diabetic retinopathy by multidirectional optical coherence tomography angiography

作　　者：刘长颖[1] 王杰[1] 陈芳[1] 赵旭峥 梁丽[1] 韩亚楠 Liu Changying;Wang Jie;Chen Fang;Zhao Xuzheng;Liang Li;Han Yanan(Tangshan Ophthalmological Hospital,Tangshan 063000,China)

机构地区：[1]唐山市眼科医院,063000

出　　处：《中华眼底病杂志》2020年第5期349-353,共5页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的观察多方位OCT血管成像(OCTA)对Ⅳ期糖尿病视网膜病变(DR)患眼视网膜及视盘新生血管的检出情况。方法回顾性研究。2018年9~10月在唐山市眼科医院临床确诊为Ⅳ期DR的46例患者50只眼纳入研究。其中,男性18例19只眼,女性28例31只眼;年龄31~78岁,平均年龄(56.64±10.64)岁。所有患眼均行医学验光、散瞳眼底、FFA及多方位OCTA检查。OCTA检查选择Angiography 6 mm×6 mm扫描模式。分别扫描黄斑区、视盘、视盘鼻上方、视盘上方、黄斑区上方、黄斑区颞上方、黄斑区颞侧、视盘鼻下方、视盘下方、黄斑区下方及黄斑区颞下方的视网膜区域。所有检查图像由同一名医师拍摄,由两名医师独立阅片;排除两名医师意见不一致者。以FFA检查结果为标准,计算OCTA对Ⅳ期DR患眼视盘及视网膜新生血管的检出率。结果FFA检出视盘新生血管8只眼;OCTA检出视盘新生血管15只眼,检出率100%。FFA未检出视盘新生血管的42只眼中,OCTA检出7只眼,均位于视盘表面;其中4只眼位于视杯处,呈线状、分枝状,面积均小于1/4个视盘面积。FFA检出视网膜新生血管50只眼;OCTA检出视网膜新生血管43只眼,检出率86%。在OCTA检出的43只眼中,检出视网膜新生血管芽3只眼,于FFA中未检出。OCTA未检出的视网膜新生血管均位于视网膜中周部,超出多方位OCTA所能检查范围。结论多方位OCTA对Ⅳ期DR患眼视盘新生血管的检出率为100.0%,对视网膜新生血管的检出率为86.0%。Objective To observe and analyze the detection rate of optical disc and retinal neovascularization in stageⅣdiabetic retinopathy by multidirectional OCT angiography(OCTA).Methods A retrospective study.From September to October 2018,50 eyes of 46 patients with diabetic retinopathy of stageⅣdiagnosed in Tangshan Ophthalmological Hospital were included in the study.Among them,there were 18 males(19 eyes)and 28 females(31 eyes).The age ranged from 31 to 78 years,with an average age of 56.64±10.64 years.All patients underwent medical optometry,mydriasis fundus examination and FFA examination.All patients met the diagnostic criteria of stageⅣdiabetic retinopathy.All patients underwent multidirectional OCTA examination on the same day after mydriasis fundus examination and FFA examination.Angiography 6 mm×6 mm scanning mode was selected for OCTA examination.The retinal areas of macular area,optic disc,superior nasal disc,superior optic disc,superior macular area,superior temporal macular area,temporal macular area,inferior nasal disc,inferior optic disc,inferior macular area and inferior temporal macular area were scanned respectively.All images were taken by the same physician and read by two physicians independently.Cases with inconsistent opinions between the two physicians were not included in this study.The optical disc and retinal neovascularization in patients with stageⅣdiabetic retinopathy were observed on FFA and multidirectional OCTA images.Results In 50 eyes,the positive number of screening optic disc neovascularization using FFA was 8 eyes,OCTA was 15 eyes(100%).In the 42 eyes without optic disc neovascularization detected by FFA,OCTA detected 7 eyes,all located on the optic disc surface.Four of the eyes were located in the optic cup,linear and branching,with an area of less than 1/4 optic disc.In 50 eyes,the positive number of screening retinal neovascularization using FFA was 50 eyes,the positive number of OCTA was 43 eyes.In 43 eyes with detected by OCTA,retinal neovascularization buds were det

关 键 词：糖尿病视网膜病变/诊断 体层摄影术 光学相干 荧光素血管造影术 

分 类 号：R77[医药卫生—眼科] R587[医药卫生—临床医学]