OCTA观察增生性糖尿病视网膜病变治疗前后不同形态视盘新生血管的变化  

Changes of optic disc neovascularization with different morphologic features on OCTA during the treatment of proliferative diabetic retinopathy

作　　者：王光鑫 刘伦[1] 高健[1] 廖荣丰[1] Wang Guangxin;Liu Lun;Gao Jian;Liao Rongfeng(Department of Ophthalmology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China)

机构地区：[1]安徽医科大学第一附属医院眼科,合肥230022

出　　处：《临床眼科杂志》2021年第5期391-395,共5页Journal of Clinical Ophthalmology

摘　　要：目的使用相干光层析血管成像术(OCTA)观察增生性糖尿病视网膜病变(PDR)不同形态的视盘新生血管(NVD)在治疗期间的形态学特征及其变化。方法对16例(19只眼)有NVD的PDR患者进行回顾性分析。所有患眼均接受玻璃体腔内注射0.5 mg康柏西普及全视网膜光凝治疗。收集治疗前及视网膜光凝完成后1个月的NVD的OCTA图像,并使用ImageJ软件对其进行分析。结果使用OCTA鉴别出两种不同形态学特征的新生血管。17只眼NVD表现出旺盛的血管增生(EVP),另2只眼NVD表现出丝状新生血管环,无EVP。与治疗前相比,治疗后发现患眼的NVD面积和累积光密度(IntDen)值显著降低(均P<0.001)。其中,有EVP的NVD消退显著,并在随访期间保持稳定。然而,2只无EVP的NVD眼未观察到明显新生血管消退。结论OCTA可应用于观察PDR眼在治疗过程中NVD的形态学特征及NVD变化的定量分析。Objective To observe the characteristics and changes of neovascularization in the optic disc(NVD)with different morphologic features during treatment in patients with proliferative diabetic retinopathy(PDR)using optical coherence tomography angiography(OCTA).Methods A total of 16 PDR patients(19 eyes)with NVD who were treated with intravitreal injection of 0.5 mg conbercept and panretinal photocoagulation(PRP)were retrospectively analyzed.The OCTA images of NVD before and at 1 month after the treatment were collected for analyzed using the ImageJ software.Results Two distinct morphologic features of neovascularization were identified using OCTA,including exuberant vascular proliferations(EVP)(17 eyes),and filamentous neovascularization ring without EVP(2 eyes).Compared with that before the treatment,the NVD area and IntDen of the affected eyes decreased significantly after the treatment(all P<0.001).Among them,NVD with EVP significantly regressed and kept stable during the follow-up,while no significant neovascular regression was observed in the 2 NVD eyes without EVP.Conclusions OCTA can be used to observe the detailed characteristics of NVD and quantitatively analyze the NVD changes in eyes with PDR during the treatment.

关 键 词：相干光层析血管成像术 增生性糖尿病性视网膜病变 血管内皮生长因子 视盘新生血管 

分 类 号：R58[医药卫生—内分泌]