基于视网膜中央视野微动脉瘤预测糖尿病视网膜病变严重程度的可行性  

Feasibility of predicting the severity of Diabetic retinopathy based on microaneurysms in central retinal field

作　　者：邢球 黄晓波 谢青 彭立 Xing Qiu;Huang Xiaobo;Xie Qing;Peng Li(Department of Ophthalmology,Haikou People’s Hospital(Haikou Affiliated Hospital of Central South University Xiangya School of Medicine),Haikou 570208,China)

机构地区：[1]海口市人民医院,中南大学湘雅医学院附属海口医院眼科,570208

出　　处：《临床眼科杂志》2024年第3期203-208,共6页Journal of Clinical Ophthalmology

基　　金：海南省卫生厅科研项目课题(21A200067);海南省自然科学基金项目(821QN1005)。

摘　　要：目的探讨视网膜微动脉瘤(MAs)预测糖尿病视网膜病变(DR)严重程度的可行性。方法回顾性临床研究。纳入我院2020年1月1日至2022年12月31日就诊的2型糖尿病患者100例(100只眼),针对受检眼均进行眼底照相和检眼镜下眼底检查,定量评估视网膜MAs、出血(Hmas)和硬性渗出(HEs)与DR程度的关系。结果无DR患者的图像中量化的MAs数量可以忽略不计,而轻、中、重度非增生性糖尿病视网膜病变(NPDR)患者的平均MAs数量随着DR严重程度的增加而显著增加。中度和重度NPDR患者均检测到Hmas,红色病变(RLs)代表MAs和Hmas平均值的组合,与单独量化MAs的趋势相同,但由于Hmas的影响,RLs的数值更高。最后,无NPDR或轻度NPDR患者未检出HEs,中度NPDR和重度NPDR患者的HEs值均检出。在所有病例中,不同严重程度的视网膜病变量化差异均有统计学意义。结论在视网膜中心区域的眼底彩色照相(CFP)图像可量化视网膜病变数量,评估DR严重程度,其间存在强大的相关性。此外,MAs和Hmas作为眼底图像中疾病严重程度的可量化变量,可以作为临床试验的相关疗效终点。Objective The aim of this study was to investigate the feasibility of using retinal microaneurysms(MAs)as predictors of the severity of diabetic retinopathy(DR).Methods This retrospective study included 100 patients(100 eyes)diagnosed with type 2 diabetes from January 1,2020,to December 31,2022,at our hospital.Fundus photography and fundus examination with ophthalmoscopy were performed on all eyes.The quantitative relationship between retinal MAs,hemorrhages(Hmas),hard exudates(HEs),and the severity of DR was evaluated.Results The quantified MAs in images of patients without DR were negligible,while the average number of MAs increased significantly with the severity of non-proliferative diabetic retinopathy(NPDR),ranging from mild to severe.Hmas were detected in patients with moderate and severe NPDR.The combined average values of MAs and Hmas,represented by RLs,followed the same trend as quantified MAs alone,but their values were higher due to the influence of Hmas.Lastly,HEs were not detected in patients without NPDR or with mild NPDR,but were present in patients with moderate and severe NPDR.There were statistically significant differences in the quantification of retinal lesions among different severity levels of DR.Conclusions In color fundus photographs(CFP)of the macula,retinal lesions can be quantified to assess the severity of DR,showing a strong correlation.Furthermore,MAs and Hmas,as quantifiable variables of disease severity in fundus images,can serve as relevant efficacy endpoints in clinical trials.

关 键 词：视网膜微动脉瘤 糖尿病视网膜病变 视网膜中央视野 预测 

分 类 号：R774.1[医药卫生—眼科] R587.2[医药卫生—临床医学]