全视网膜激光光凝术后糖尿病视网膜病变患者FAZ特征指标和脉络膜血流量及黄斑厚度的变化特征  

Changing characteristics of FAZ specific indicators,choroidal blood flow amount,and macular thickness in patients with diabetic retinopathy after panretinal photocoagulation

作　　者：孙璐 岳钟 宋森[1] SUN Lu;YUE Zhong;SONG Sen(Department of Ophthalmology,the First Central Hospital of Baoding City,Baoding 071000,Hebei,China)

机构地区：[1]保定市第一中心医院眼科,河北保定071000

出　　处：《贵州医科大学学报》2022年第7期863-868,共6页Journal of Guizhou Medical University

基　　金：保定市科技计划自筹经费项目(2141ZF259)。

摘　　要：目的探讨全视网膜激光光凝术(PRP)后糖尿病视网膜病变(DR)患者中心凹无血管区(FAZ)特征指标、脉络膜血流量及黄斑厚度的变化特征。方法DR患者72例(124眼)据DR分级标准分为增生型组[30例(45眼)]和非增生型组[42例(79眼)],分别于术前、术后1个月及术后6个月,采用国际标准视力表和球后血管血流状态彩色多普勒检测2组DR患者的最佳矫正视力(BCVA)和脉络膜血流量指标[睫状后动脉收缩期峰值血流速度(PSV)、阻力指数(RI)、舒张末期血流速度(EDV)],采用美国Bayspec光学相干断层扫描血管成像(OCTA)检查FAZ特征指标(FAZ面积、FAZ形态指数及FAZ周长)和黄斑中心凹厚度(CMT)值。结果DR患者术后6个月BCVA、FAZ形态指数、PSV及EDV分别高于术前和术后1个月,RI、CMT分别低于术前和术后1个月,差异均有统计学意义(P<0.05);非增生型组、增生型组术后6个月的BCVA高于术前,其中非增生型组术后6个月的BCVA、FAZ形态指数高于术前、术后1个月与增生型组(P<0.05);非增生型组DR患者术后6个月PSV、EDV分别高于增生型组,RI、CMT分别低于增生型组(P<0.05)。结论与术前及术后1个月比较,DR患者术后6个月BCVA、FAZ形态指数增高,脉络膜血流量改善,CMT降低,但FAZ面积和周长无明显变化;与增生型相比,非增生型DR患者术后6个月的BCVA、FAZ形态指数、脉络膜血流量及CMT的改善更为明显。Objective To explore the changing characteristics of foveal avascular zone(FAZ)specific indicators,choroidal blood flow amount and macular thickness in patients with diabetic retinopathy(DR)after panretinal photocoagulation(PRP).Methods According to DR grade,72 DR patients(124 eyes)were divided into hyperplastic group[n=30(45 eyes)]and non-hyperplastic group[n=42(79 eyes)].Before surgey,1 month and 6 months after operation,international standard visual acuity chart and color Doppler flow imaging of retrobulbar vascular flow were performed to detect best corrected visual acuity(BCVA)and choroidal blood flow indicators,including peak systolic velocity(PSV),resistance index(RI)and end-diastolic velocity(EDV)of posterior ciliary artery.Bayspec optical coherence tomography angiography(OCTA)was applied to examine FAZ specific indicators(FAZ area,FAZ morphology indexes and FAZ circumference)and central macular thickness(CMT).Results At 6 months after surgery,BCVA,FAZ morphology indexes,PSV,and EDV in DR patients were higher than those before surgery and 1 month after surgery,while RI and CMT were lower than those before surgery and 1 month after surgery(P<0.05).BCVA of two groups at 6 months after surgery was higher than that before surgery.BCVA and FAZ morphological indexes of non-hyperplastic group at 6 months after surgery were higher than those before surgery,1 month after surgery and those of hyperplastic group,while RI and CMT were less than those of hyperplastic group(P<0.05).Conclusion When compared with those before and 1 month after surgery,DR patients at 6 months after surgery had increased BCVA and FAZ morphological indexes,improved choroidal blood flow,decreased CMT,but no significant changes in FAZ area and circumference.The improvement of BCVA,FAZ morphological index,choroidal blood flow amount,and CMT in non-hyperplastic group is more obvious than those of hyperplastic group.

关 键 词：糖尿病视网膜病变 全视网膜激光光凝术 中心凹无血管区 脉络膜血流量 黄斑中心凹厚度 舒张末期血流速 

分 类 号：R774.13[医药卫生—眼科]