黄斑区视网膜深层微血管变化对糖尿病性黄斑水肿的影响  

Effect of deep-capillary-layer alterations in macular area on diabetic macular edema

作　　者：周婕 张学东[1] ZHOU Jie;ZHANG Xuedong(Department of Ophthalmology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第一医院眼科,重庆市400010

出　　处：《眼科新进展》2021年第5期479-483,共5页Recent Advances in Ophthalmology

基　　金：国家自然科学基金项目(编号:81870673)。

摘　　要：近年来光学相干断层扫描血管成像(OCTA)作为一项新型的成像技术,通过探测血管内移动的信号来使血流显影,其量化血管参数的优势使其可监测糖尿病视网膜病变(DR)发生发展过程中视网膜毛细血管的变化,从而预测DR的发生发展。许多研究表明,早期DR患者各层视网膜血管参数均发生了变化,且深层毛细血管丛的变化较浅层毛细血管丛明显,而这种变化在糖尿病性黄斑水肿(DME)中更为显著,由此推测黄斑水肿首先发生于深层毛细血管丛中。而玻璃体内注射抗血管内皮生长因子(VEGF)药物后能明显减轻黄斑水肿,提高患者视力,影响黄斑区视网膜微血管。本文通过总结应用OCTA观察DR和DME患者病程发展中以及抗VEGF治疗后黄斑区视网膜深层微血管的变化,从深层微血管的改变对DME发生发展及预后的影响进行综述。In recent years,optical coherence tomography angiography is a new imaging technology that visualizes blood flow by detecting signals moving in the vessel.The advantage of quantifying vascular parameters makes it possible to monitor the changes of retinal capillaries during the development of diabetic retinopathy(DR),thereby predicting the occurrence and development of DR.Many studies have shown that in early DR patients,retinal vascular parameters have changed in all layers,and the changes in the deep capillary plexusare are more obvious than in the superficial vascular plexusare,and this change is more significant in diabetic macular edema(DME),so it suggests that macular edema may first occurred in deep capillary plexusare.Intravitreal injection of anti-vascular endothelial growth factor can significantly reduce edema,improve patients'vision,and affect retinal microvascular.This article summarizes the application of OCTA technology to observe the changes of deep capillary plexusare in the macular area during the disease course of DR and DME and after anti-VEGF treatment,and reviews the effects of changes in deep capillary plexusare on the development and prognosis of DME.

关 键 词：糖尿病性黄斑水肿 光学相干断层扫描血管成像 深层微血管丛 抗血管内皮生长因子治疗 

分 类 号：R774.1[医药卫生—眼科]