光学相干断层扫描血管成像生物图像的量化分析在早期1型糖尿病视网膜病变微血管变化中的应用  

Application of quantification analysis biological image of optical coherence tomography angiography in the observation of microvascular changes in early type 1 diabetic retinopathy

作　　者：施彦 林鹏耀 华闪闪 阮薏蒙 李波[1] SHI Yan;LIN Pengyao;HUA Shanshan(Department of Ophthalmology,The First Affiliated Hospital of Ningbo University,Ningbo 315010,China)

机构地区：[1]宁波大学附属第一医院眼科中心,浙江宁波315010

出　　处：《全科医学临床与教育》2023年第11期968-971,共4页Clinical Education of General Practice

基　　金：宁波市自然科学基金项目(2018A610362)。

摘　　要：目的 应用光学相干断层扫描血管成像(OCTA)的生物图像进行量化分析早期1型糖尿病视网膜病变(DR)患者黄斑区微血管的变化。方法 采用前瞻性病例研究,选择35例60眼的1型糖尿病受试者,行眼底荧光血管造影(FFA)后并根据DR国际分级标准分为:无糖尿病视网膜病变30眼(NoDR组),非增殖糖尿病视网膜病变30眼(NPDR组)。另外再选取与年龄相匹配的18例30眼健康受试者作为对照组。比较三组黄斑部的视网膜微循环的变化差异。结果 NPDR组与NoDR组的黄斑中心凹无血管区(FAZ)面积大于对照组,FAZ圆度指数(CI)、区域内分支数量(NoB)和区域内单个分支长度的总和(tBL)指标均低于对照组,差异均有统计学意义(t分别=-2.45、-10.10、2.31、12.80、10.90、11.31、2.69、15.94,P均<0.05);且NPDR组的FAZ面积大于NoDR组,FAZ CI、NoB和tBL指标低于NoDR组,差异均有统计学意义(t分别=-0.83、12.29、3.45、15.03,P均<0.05)。黄斑区OCTA图像显示,从对照组、NoDR组到NPDR组,随着病程的进展,黄斑区OCTA图像的FAZ面积逐渐变大,FAZ CI逐渐下降,即从规则图形变化为不规则图形,区域内的分支血管网结构逐渐稀疏化,均出现了不同程度的改变。结论 1型糖尿病患者在眼底还没出现改变时,黄斑部的视网膜微循环已经开始出现变化,且随着病情的进展而变化。可以通过OCTA进行量化分析1型糖尿病患者早期的视网膜变化。Objective To analyze the changes of macular microvessels in patients with early type 1 diabetic retinopa-thy(DR)using optical coherence tomography angiography(OCTA).Methods A prospective case study was conducted in 35 patients with type 1 diabetes with 60 eyes who underwent fundus fluorescence angiography(FFA),and they were divided into 30 eyes without diabetic retinopathy(NoDR group)and 30 eyes without proliferative diabetic retinopathy(NPDR group)according to the international classification standard of DR.In addition,18 age-matched healthy subjects with 30 eyes were selected as the control group.The changes of retinal microcirculation in macula were compared among the three groups.Results The FAZ area of NPDR and NoDR groups were larger than those of control group,and the FAZ CI,NoB and tBL indexes were lower than those of control group with statistical significance(t=-2.45,-10.10,2.31,12.80,10.90,11.31,2.69,15.94,P<0.05).In addition,FAZ area of NPDR group was higher than that in NoDR group,and FAZ CI,NoB and tBL indexes were lower than those in NoDR group with statistical significance(t=-0.83,12.29,3.45,15.03,P<0.05).OCTA images of the macular region show that with the progression of disease,the FAZ area of OCTA images of macular region gradually increased,and the FAZCI gradually decreased,that is mean the pattern changed from regular pattern to irregular pattern,and the structure of branch blood vessel network in the region gradually sparse,with varying degrees of change.Conclusion In patients with type 1 diabetes,the retinal microcirculation in the macula has begun to change when the fundus has not changed,and changes as the disease progresses.OCTA en-ables quantitative analysis of early retinal changes in patients with type 1 diabetes.

关 键 词：光学相干断层扫描血管成像 量化分析 1型糖尿病视网膜病变 

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