非增生型糖尿病视网膜病变患眼黄斑区外层视网膜光密度改变及其与视网膜血流密度的相关性研究  

Correlation study of alterations of macular outer retinal reflectivity and the associations with macular vesseldensityin nonproliferative diabetic retinopathy

作　　者：张峰 梁安怡[1] 曹丹 余洪华 胡一骏[1] Zhang Feng;Liang Anyi;Cao Dan;Yu Honghua;Hu Yijun(Department of Ophthalmology,Guangdong Eye Institute,Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou 510080,China;Department of Ophthalmology,Linyi People's Hospital,Linyi 276034,China)

机构地区：[1]南方医科大学附属广东省人民医院(广东省医学科学院)眼科,广州510080 [2]临沂市人民医院眼科,临沂276034

出　　处：《中华眼底病杂志》2023年第11期904-912,共9页Chinese Journal of Ocular Fundus Diseases

基　　金：国家自然科学基金(面上项目)(82171075、81870663);广东省人民医院“登峰计划”杰出青年培育人才项目(KJ012019087)。

摘　　要：目的观察非增生型糖尿病视网膜病变(NPDR)患眼黄斑区外层视网膜光密度(ORR)改变及其与视网膜血流密度的相关性。方法回顾性临床研究。2021年8月至2022年3月于广东省人民医院眼科检查确诊的NPDR患者63例63只眼(NPDR组)纳入研究。其中,男性39例39只眼,女性24例24只眼;年龄60(52,68)岁。选取同期年龄、性别匹配的健康志愿者66名66只眼作为对照组。其中,男性40名40只眼,女性26名26只眼;年龄58(52,67)岁。所有患眼均行光相干断层扫描(OCT)、OCT血管成像(OCTA)检查。OCT检查:采用Image J软件计算ORR,包括椭圆体带(EZ)、光感受器外节(OS)、光感受器内节(IS)、外核层(ONL)光密度。采样位点为水平、垂直扫描黄斑中心凹以及鼻侧、侧、上方、下方分别距离黄斑中心凹500μm(鼻侧_(500)、颞侧_(500)、上方_(500)、下方_(500))、1000μum(鼻侧_(1000)、颞侧_(1000)、上方_(1000)、下方_(1000))、2000μm(鼻侧_(2000)、颞侧_(2000)、上方S_(2000)、下方_(2000))区域。黄斑区CTA检查:软件自动将黄斑中心凹6mm范围内视网膜划分为直径为1mm的中心凹区,1~3mm的旁中心凹区,3~6mm的中心凹周围区。采用设备自带软件测量黄斑区6mm×6mm范围内不同分区浅层毛细血管丛、深层毛细血管丛血流密度。采用Spearman相关性分析法分析ORR与血流密度的相关性。结果与对照组比较,NPDR组EZ光密度在除中心凹外的其他位点均显著降低,OS光密度在鼻侧_(2000)、颞侧_(2000)、上方_(2000)、上方_(1000)处显著降低,IS光密度在上方_(1000)、上方_(500)、下方_(500)处显著降低,ONL光密度在黄斑中心凹处显著降低,差异均有统计学意义(P<0.05)。ORR与血流密度普遍呈正相关,NPDR组相关系数比对照组低。多因素线性回归分析结果显示,上方、颞侧部分ORR与血流密度相关(P<0.05)。结论与对照组比较,NPDR患眼ORR与视网膜血流密度的相关性降低;ORR在颞侧和上方更易受�Objective To observe alterations of macular outer retinal reflectivity(ORR)and the associations with macular vessel density in patients with nonproliferative diabetic retinopathy(NPDR).Methods A retrospective cross-sectional study.From August 2021 to March 2022,a total of 63 NPDR patients with 63 eyes(NPDR group)diagnosed by Department of Ophthalmology of Guangdong Provincial People's Hospital were included in the study.There were 39 males with 39 eyes and 24 females with 24 eyes.Age was 60(52,68)years.A total of 66 eyes of 66 healthy volunteers matching age and sex were selected as the control group.Among them,40 men had 40 eyes and 26 women had 26 eyes.Age was 58(52,67)years.Optical coherence tomography(OCT)and OCT angiography(OCTA)were performed in all affected eyes.Image J software was used to calculate ORR,including the optical density of ellipsoid zone(EZ),photoreceptor outer segment(OS),photoreceptor inner segment(IS)and outer nuclear layer(ONL)by OCT examination.The sampling sites were horizontal and vertical scanning ofthe fovea of the macula on 500μm(nasal_(500)temporal_(500).superir_(500),inferir_(500)),100μm(nasa_(1000) tmpral_(1000),uperir_(1000),inferir_(1000))and 2000μm(nasa_(1000).tempora 1000,superior_(2000),inferior_(2000)).The software automatically divided the retina within 6 mm of the macular fovea into the fovea with a diameter of 1 mm,the parafovea with a diameter of 1-3 mm,and the perifovea with a diameter of 3-6 mm by macular OCTA examination.The blood density of superficial capillary plexus and deep capillary plexus in different zones in the macular area were measured by the built-in software of the device.Spearman correlation analysis was used to analyze the correlation between ORR and blood flow density.Results Compared with the control group,retinal reflectivity of EZ in NPDR group was significantly decreased at other sites except the fovea,retinal reflectivity of OS was significantly decreased at nasal 0,temporal 0o superior 00 and superiori oo retinal reflectivity ofIS was signif

关 键 词：糖尿病视网膜病变 视网膜光密度 光相干断层扫描 光相干断层扫描血管成像 视网膜血流密度 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]