荧光素血管造影与光学相干断层扫描血管成像对比研究糖尿病视网膜病变  

A comparative study of fundus fluorescein angiography and optical coherence tomography angiography in diabetic retinopathy

作　　者：李小凤 高健[1] 廖荣丰[1] Li Xiaofeng;Gao Jian;Liao Rongfeng(Dept of Ophthalmology,The First Ailiated Hospital of Anhui Medical University,Hefei 230022)

机构地区：[1]安徽医科大学第一附属医院眼科,合肥230022

出　　处：《安徽医科大学学报》2020年第8期1290-1294,共5页Acta Universitatis Medicinalis Anhui

基　　金：安徽省自然科学基金项目(编号:1808085QH280)。

摘　　要：目的比较眼底荧光素血管造影(FFA)与光学相干断层扫描血管成像(OCTA)在糖尿病视网膜病变(DR)诊断中的特点,分析两者对DR病变检出一致性。方法选取该医院眼科就诊的糖尿病患者86例(166眼),进行FFA和OCTA检查,进一步将FFA检查后未见眼底改变的糖尿病患者26例(26眼)纳入实验组,另选取年龄、性别相匹配的无眼底疾病者15例(25眼)作为对照组,进行OCTA检查。获得两种检查图像以及两组OCTA旁中心凹300μm血流密度(FD-300)、旁中心凹浅层及深层视网膜、视盘周围区域血流密度等一系列参数。结果FFA与OCTA诊断DR一致性一般(Kappa=0.514,P<0.001);FFA检出黄斑区拱环结构改变、黄斑水肿、视网膜微血管瘤、视网膜新生血管、无灌注区分别是74、59、138、112、115只眼,OCTA分别是81、52、125、103、101只眼,差异无统计学意义(P>0.05)。其中实验组与对照组OCTA比较,FD-300、浅层旁中心凹血流密度、深层旁中心凹血流密度及视盘周围区域血流密度均降低,差异有统计学意义(P<0.05)。结论FFA与OCTA诊断糖尿病视网膜病变的病变一致性一般,而OCTA可检出无眼底改变的糖尿病患者部分血流参数变化,可为早期无眼底改变的糖尿病患者提供新的观察指标。Objective To compare the fundus fluorescein angiography(FFA)and optical coherence tomography angiography(OCTA)in diabetic retinopathy(DR)in the diagnosis of characteristics,and to analyze the consistency in the detection of DR lesions between the two methods.Methods FFA and OCTA examination was carried out in 86 diabetic patients(166 eyes),and 26 diabetic patients(26 eyes)who had no eye fundus changes after FFexamination were included in the experimental group,and 15 patients(25 eyes)with age and sex matching withofundus disease were selected as the control group for OCTA examination.Two examination images were obtainedas well as a series of parameters such as blood flow density of 300μm paracentral fovea(FD-300),central foveshallow layer,deep blood flow density and surrounding area of optic disc blood flow density.Results FFA waconsistent with OCTA diagnosis DR(Kappa=0.514,P<0.001).Based on FFA,foveal avascular zone changwas found in 74 eyes,macular edema was found in 59 eyes,retinal microhemangioma was found in 138 eyes,retnal neovascularization was found in 112 eyes,nonperfused areas was found in 115 eyes.Based on OCTA,the above fundus diseases were found in 81,52,125,103,101 eyes,with no statistically significant difference(P 0.05).Compared with the control group,the density of FD-300,the blood flow density in the shallow layer,thdensity of the blood flow in the central fovea concave depression and the surrounding area of optic disc decreasedwith statistically significant difference(P<0.05).Conclusion FFA and OCTA were generally consistent in diagnosing diabetic retinopathy,while OCTA can detect the changes of partial blood flow parameters of DR without detecting macular and optic disc lesions in FFA,providing a new index for early DM patients without changes of fundus.

关 键 词：糖尿病视网膜病变 眼底荧光素血管造影 光学相干断层扫描血管成像 

分 类 号：R774.1[医药卫生—眼科]