糖尿病视网膜病变硅油取出术后黄斑区灌注参数的变化  

The changes of macular perfusion parameters in patients with diabetic retinopathy after silicone oil removal

作　　者：曲申[1] 毕燕龙[1] 周祁[1] 林梦真 牛耘丽[1] 刘歆[1] 张语珊[1] 荣翱[1] Qu Shen;Bi Yanlong;Zhou Qi;Lin Mengzhen;Niu Yunli;Liu Xin;Zhang Yushan;Rong Ao(Department of Ophthalmology,Tongji Hospital Affiliated to Tongji University,Shanghai 200065,China)

机构地区：[1]同济大学附属同济医院眼科,上海200065

出　　处：《中华眼外伤职业眼病杂志》2021年第9期651-655,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察增生型糖尿病性视网膜病变硅油取出术后短期内黄斑区灌注参数的变化。方法回顾性分析同济大学附属同济医院2018年1至12月增生型糖尿病性视网膜病变进行玻璃体切除硅油填充术32例(32只眼)的临床资料。所有患者均在玻璃体视网膜手术后6个月行硅油取出术,并在硅油取出术前后行光学相干断层扫描血管成像(OCTA)检查,观察视网膜浅层、深层血管密度、黄斑中心区无血管区面积及视力。结果术前1周、术后1周、1个月及3个月视网膜浅层血管密度分别为(31.41±3.20)%、(35.31±3.45)%、(36.64±3.38)%及(37.11±2.24)%;视网膜深层血管密度分别为(23.67±3.10)%、(27.10±4.13)%、(28.09±4.32)%及(28.64±3.88)%;黄斑中心区无血管区面积分别为(0.39±0.04)mm^(2)、(0.35±0.14)mm^(2)、(0.33±0.73)mm^(2)及(0.34±0.25)mm^(2)。所有患者视网膜浅层血管密度、视网膜深层血管密度及黄斑中心区无血管区面积术后各时间点与术前相比,差异均有统计学意义(P>0.05)。术后3个月视力(BCVA,logMAR)1.18±0.65,与术前的0.86±0.57相比,差异无统计学意义(P>0.05)。结论硅油取出术后短期内,增生型糖尿病性视网膜病变患者的视网膜黄斑区血管密度逐渐增加、无血管区面积逐渐缩小,但并非影响术后视力的决定性因素。Objective To observe the changes of macular perfusion parameters in patients with proliferative diabetic retinopathy after silicone oil removal in short terms.Methods The clinical data of 32 eyes of 32 patients with proliferative diabetic retinopathy who received vitrectomy combined with silicone oil tamponade from Jan.2018 to Dec.2018 in Tongji Hospital Affiliated to Tongji University were retrospectively analyzed.All patients underwent silicone oil removal at 6 months after vitrectomy,and optical coherence tomography angiography(OCTA)examination was performed before and after silicone oil removal.The vessel density of superficial and deep retinal layer,central macular avascularzone,and visual acuity were observed.Results The vessel density of superficial retinal layer was(31.41±3.20)%,(35.31±3.45)%,(36.64±3.38)%and(37.11±2.24)%respectively at 1 week before surgery,1 week,1 month and 3 months after surgery.The vessel density of deep retinal layer was(23.67±3.10)%,(27.10±4.13)%,(28.09±4.32)%and(28.64±3.88)%,respectively.The central macular avascular zone was(0.39±0.04)mm^(2),(0.35±0.14)mm^(2),(0.33±0.73)mm^(2) and(0.34±0.25)mm^(2),respectively.The three parameters at postoperative time points were statistically significant compared with those before operation(P>0.05).At 3 months postoperatively,the BCVA(logMAR)was 1.18±0.65,and the difference was not statistically significant compared with the 0.86±0.57 before surgery.Conclusion In the short term after silicone oil removal,the vascular density in the macular area of proliferative diabetic retinopathy gradually increases and the central macular avascular zone area gradually decreases,but it is not the decisive factor affecting the postoperative visual acuity.

关 键 词：糖尿病 视网膜病变 增生型 硅油类 眼 参数 灌注 黄斑区 光学相干断层扫描血管成像 

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