多模式眼底影像联合房水细胞因子检测对糖尿病视网膜病变患者黄斑水肿严重程度的诊断价值  

Value of multi-mode fundus imaging combined with aqueous humor cytokines in severity diagnosis of macular edema in patients with diabetic retinopathy

作　　者：郭莹[1] 杨世琳[1] 杨冬妮[1] 赵伟[1] 陆楠 王伟[1] GUO Ying;YANG Shilin;YANG Dongni;ZHAO Wei;LU Nan;WANG Wei(Department of Ophthalmology,Qinhuangdao First Hospital,Qinhuangdao 066000,Hebei,China)

机构地区：[1]秦皇岛市第一医院眼科,河北省秦皇岛市066000

出　　处：《中南医学科学杂志》2022年第6期890-893,933,共5页Medical Science Journal of Central South China

基　　金：秦皇岛市卫生健康委员会(201902A193)。

摘　　要：目的探讨多模式眼底影像联合房水细胞因子检测对糖尿病视网膜病变患者黄斑水肿(ME)严重程度的诊断价值。方法将糖尿病视网膜病变患者68例(122眼)分为无ME组、轻度ME组、中度ME组、重度ME组。患眼均经过荧光素眼底血管造影(FFA)和光学相干断层扫描(OCT),测量新生血管密度、黄斑中心凹厚度。采集房水检测白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、血管内皮生长因子(VEGF)。检测患眼的LogMAR矫正视力。结果以FFA作为金标准,OCT与金标准的一致性较高,OCT诊断ME的准确率为94.26%。4组患眼的LogMAR矫正视力、新生血管密度、黄斑中心凹厚度比较差异均有显著性(P<0.05)。新生血管密度、黄斑中心凹厚度与ME严重程度呈正相关(P<0.05)。4组患眼的VEGF、IL-1β、IL-6水平比较差异有显著性(P<0.05)。VEGF、IL-1β、IL-6水平与ME严重程度呈正相关(P<0.05)。结论FFA、OCT对黄斑水肿的诊断一致性较高,新生血管密度、黄斑中心凹厚度以及房水细胞因子IL-1β、IL-6、VEGF与黄斑水肿严重程度具有相关性,可为黄斑水肿严重程度的诊断提供参考。Aim To investigate the value of multi-mode fundus imaging combined with aqueous humor cytokines in severity diagnosis of macular edema(ME)in patients with diabetic retinopathy.Methods Totally 68 patients(122 eyes)with diabetic retinopathy were selected and divided into non-ME group(18 cases,32 eyes),mild ME group(20 cases,37 eyes),moderate ME group(16 cases,29 eyes)and severe ME group(14 cases,24 eyes).All the patients underwent fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)to measure the density of new blood vessels and the thickness of fovea.Aqueous humor was collected to detect interleukin-1β(IL-1β),interleukin-6(IL-6)and vascular endothelial growth factor(VEGF).The LogMAR corrected visual acuity of af-fected eyes was tested.Results With FFA as the golden standard,OCT was highly consistent with the golden standard(Kappa=0.853),and the accuracy of OCT for diagnosing ME was 94.26%.There were statistically significant differences in LogMAR corrected visual acuity,neovascular density and central foveal thickness among the four groups(P<0.05).Neovascular density and central foveal thickness were positively correlated with the severity of ME(r=0.503,r=0.568).There were statistically significant differences in the levels of VEGF,IL-1βand IL-6 among the four groups(P<0.05).The levels of VEGF,IL-1βand IL-6 were positively correlated with the severity of ME(r=0.611,r=0.529,r=0.668).Conclusion FFA and OCT are highly consistent in the diagnosis of ME.The measured neovas-cular density,central foveal thickness and aqueous humor cytokines IL-1β,IL-6 and VEGF are related to the severity of ME,which provides reference for severity diagnosis of ME.

关 键 词：黄斑水肿 糖尿病视网膜病变 眼底影像 细胞因子 

分 类 号：R774.5[医药卫生—眼科]