应用OCT对不同程度糖尿病视网膜病变患者神经纤维层厚度及视网膜厚度的观察  

Application of OCT scan in observation retinal nerve fiber layer thickness and retinal thickness in patients with different severity of diabetic retinopathy

作　　者：范小霞[1] 张敬超 汪国锋 Fan Xiaoxia;Zhang Jingchao;Wang Guofeng(Department of Ophthalmology,Jinhua People’s Hospital,Jinhua 321000,China)

机构地区：[1]金华市人民医院眼科,金华321000

出　　处：《中华眼外伤职业眼病杂志》2024年第3期213-218,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察应用光学相干断层扫描成像(OCT)测量不同程度糖尿病视网膜病变(DR)患者视网膜神经纤维层(RNFL)及黄斑视网膜厚度。方法回顾性病例对照研究。纳入2021年5月至2023年5月在金华市人民医院收治的糖尿病患者117例(234眼),根据检眼镜和眼底荧光血管造影检查结果分为无糖尿病视网膜病变(NDR)组(32例,64眼)、轻度非增生型糖尿病视网膜病变(NPDR)组(46例,92眼)、中度NPDR组(39例,78眼)。所有患者均行OCT检查,比较各组平均RNFL(鼻侧、颞侧、上方、下方和视盘周围)、黄斑视网膜厚度和中心区厚度,分析其与DR严重程度关系。结果NDR组、轻度NPDR组、中度NPDR组鼻侧RNFL厚度为(85.92±8.12)、(81.35±6.28)、(76.41±5.20)μm,颞侧为(88.54±6.74)、(84.16±5.39)、(80.27±7.18)μm,视盘周围为(112.34±10.05)、(108.57±11.26)、(102.71±10.29)μm,上方为(126.67±13.43)、(118.31±12.72)、(111.89±10.50)μm,下方为(125.91±14.23)、(116.42±13.84)、(106.07±12.33)μm,总体差异有统计学意义(F=37.66、29.33、15.02、25.66、38.46,均P<0.001),其中轻度NPDR组、中度NPDR组均低于NDR组(均P<0.05)。NDR组、轻度NPDR组、中度NPDR组黄斑区视网膜厚度为(229.78±15.64)、(240.56±16.08)、(269.22±17.41)μm,中心区厚度为(175.82±13.05)、(184.90±14.11)、(197.43±14.75)μm,总体差异有统计学意义(F=113.69、42.69,均P<0.001)。其中轻度NPDR组及中度NPDR组均高于NDR组(均P<0.05)。DR病情严重程度与平均RNFL(鼻侧、颞侧、上方、下方和视盘周围)厚度呈负相关,与黄斑区视网膜厚度和中心区视网膜厚度呈正相关(r=-0.53、-0.45、-0.61、-0.63、-0.53、0.59、0.55,均P<0.001)。结论应用OCT扫描能早期评估DR患者病变严重程度,且随着疾病严重程度加重,视盘周围RNFL厚度呈下降改变,黄斑区视网膜厚度逐渐升高。Objective To observe the application of optical coherence tomography(OCT)in measuring retinal nerve fiber layer(RNFL)thickness and retinal thickness in patients with different severity of diabetic retinopathy(DR).Methods In this retrospective case-control study,117 patients(234 eyes)with diabetes mellitus in Jinhua People′s Hospital were enrolled from May 2021 to May 2023.Based on examination results of ophthalmoscope and fluorescence fundus angiography,they were divided into a non-diabetic retinopathy(NDR)group(32 cases,64 eyes),a mild non-proliferative diabetic retinopathy(NPDR)group(46 cases,92 eyes)and a moderate NPDR group(39 cases,78 eyes).All patients underwent OCT examination.The mean RNFL(nasal side,temporal side,above,below and around optic disk),macular retinal thickness and central retinal thickness in different groups were compared,and their relationship with DR severity was analyzed.Results In the NDR group,the mild NPDR group and the moderate NPDR group,RNFL thickness at nasal side was(85.92±8.12),(81.35±6.28)and(76.41±5.20)μm;RNFL thickness at temporal side was(88.54±6.74),(84.16±5.39)and(80.27±7.18)μm;RNFL thickness around optic disk was(112.34±10.05),(108.57±11.26)and(102.71±10.29)μm;RNFL thickness above optic disk was(126.67±13.43),(118.31±12.72)and(111.89±10.50)μm;RNFL thickness below optic disk was(125.91±14.23),(116.42±13.84)and(106.07±12.33)μm.The overall differences were statistically significant(F=37.66,29.33,15.02,25.66,38.46;all P<0.001),and the above indexes in the mild and moderate NPDR groups were lower than those in the NDR group(all P<0.05).In the NDR group,the mild NPDR group and the moderate NPDR group,macular retinal thickness was(229.78±15.64),(240.56±16.08)and(269.22±17.41)μm,central thickness was(175.82±13.05),(184.90±14.11)and(197.43±14.75)μm.The overall differences were statistically significant(F=113.69,42.69;all P<0.001),and the above indexes in the mild and moderate NPDR groups were higher than those in the NDR group(all P<0.05).The severity

关 键 词：体层摄影术 光学相干 糖尿病视网膜病变 神经纤维 视网膜 黄斑 

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