糖尿病视网膜病变早期Bruch膜开口-盘沿最小宽度的变化  

Change of Bruch’s membrane opening-minimum rim width in early diabetic retinopathy

作　　者：周隽[1] 娄炜 王相宁[1] 吴强[1] ZHOU Jun;LOU Wei;WANG Xiang-ning;WU Qiang(Department of Ophthalmology,Shanghai Sixth People’s Hospital,Shanghai Jiao Tong University,Shanghai 200233,China)

机构地区：[1]上海交通大学附属第六人民医院眼科,上海200233

出　　处：《海军军医大学学报》2022年第4期391-397,共7页Academic Journal of Naval Medical University

摘　　要：目的研究糖尿病视网膜病变(DR)早期患者Bruch膜开口-盘沿最小宽度(BMO-MRW)的变化。方法采用观察性横断面研究方法。选取2020年3月至12月于我院就诊的2型糖尿病患者123例(208眼)及同期健康志愿者66名(121眼)作为研究对象,依据国际临床DR严重程度分级标准,将2型糖尿病患者分为无DR组(non-DR组,n=72)和轻度DR组(mild-DR组,n=51)。应用频域光学相干断层成像(SD-OCT)进行以视盘为中心的24条放射状B扫描及视乳头周围环形扫描,所有扫描结果均相对于该眼特定的黄斑-Bruch膜开口中心轴(FoBMO轴)获得。测量24条B扫描径线上的BMO-MRW值及环形扫描的视网膜神经纤维层(RNFL)厚度值,并进一步分为鼻上、鼻侧、鼻下、颞上、颞侧、颞下6个象限进行统计分析。结果正常对照组、non-DR组、mild-DR组平均BMO-MRW及各象限BMO-MRW均呈依次变薄趋势。non-DR组、mild-DR组的平均BMO-MRW分别为(304.64±36.67)μm、(299.39±41.27)μm,相较于正常对照组[(315.14±41.60)μm]变薄(P=0.040,P=0.005)。non-DR组、mild-DR组颞上象限BMO-MRW分别为(308.35±52.40)μm、(304.60±53.33)μm,相较于正常对照组[(324.82±52.40)μm]变薄(P=0.012,P=0.005);颞下象限BMO-MRW分别为(339.49±51.39)μm、(331.48±47.21)μm,相较于正常对照组[(358.58±48.94)μm]变薄(P=0.003,P<0.001)。平均BMO-MRW和平均RNFL厚度呈正相关(r=0.187,P=0.001),各象限BMO-MRW与RNFL厚度呈中等相关至无相关性,其中颞下象限相关性最高(r=0.333,P<0.001),颞侧象限无相关性(r=0.087,P=0.115)。结论糖尿病患者的BMO-MRW较正常人变薄,且与RNFL厚度改变呈正相关,提示BMO-MRW可以作为DR早期神经退行性改变的观察指标。Objective To study the change of Bruch’s membrane opening-minimum rim width(BMO-MRW)inpatients with early diabetic retinopathy(DR).Methods This was an observational cross-sectional study.A total of 123 patients(208 eyes)with type 2 diabetes mellitus and 66(121 eyes)healthy volunteers(normal control group)in our hospital from Mar.to Dec.2020 were enrolled.According to the international clinical DR severity grading scale,type 2 diabetes mellitus patients were divided into non-DR group(n=72)and mild-DR group(n=51).Spectral-domain optical coherence tomography(SD-OCT)was used to perform 24 radial B-scan centered on the optic disc and peripapillary circular scan.All scanning results were obtained relative to the specific axis of the fovea-BMO center(FoBMO axis)of the eye.The values of BMO-MRW and circular retinal nerve fiber layer(RNFL)thickness on 24 B-scan lines were measured,and the data were analyzed in 6 sectors(superonasal,nasal,inferonasal,superotemporal,temporal,and inferotemporal)for statistical analysis.Results The mean BMO-MRW values and each sector BMO-MRW values of the normal control group,non-DR group and mild-DR group showed a decreasing trend.The mean BMO-MRW values of the non-DR group and mild-DR group were(304.64±36.67)μm and(299.39±41.27)μm,which were significantly thinner than that of the normal control group([315.14±41.60]μm)(P=0.040 and 0.005,respectively).The BMO-MRW values in the superotemporal sector of the non-DR group and mild-DR group were(308.35±52.40)μm and(304.60±53.33)μm,which were significantly thinner than that of the normal control group([324.82±52.40]μm)(P=0.012 and 0.005,respectively).The BMO-MRW values in the inferotemporal sector of the non-DR group and mild-DR group were(339.49±51.39)μm and(331.48±47.21)μm,which were also significantly thinner than that of the normal control group([358.58±48.94]μm)(P=0.003 and P<0.001,respectively).The mean BMO-MRW was significantly positively correlated with the mean RNFL thickness(r=0.187,P<0.001).The correlation between BMO

关 键 词：糖尿病视网膜病变 光学相干断层成像 Bruch膜开口-盘沿最小宽度 视网膜神经纤维层厚度 

分 类 号：R587.2[医药卫生—内分泌]