基于SS-OCT/SS-OCTA探究玻璃体视网膜界面改变对2型糖尿病视网膜病变的影响  

Vitreoretinal Interface Changes In Type 2 Diabetic Retinopathy Based On Swept-source Optical Coherence Tomography/Swept-source Optical Coherence Tomography Angiography

作　　者：卢佩瑶 陈若瑜 曹丹[3] 张良[3] LU Peiyao;CHEN Ruoyu;CAO Dan;ZHANG Liang(Guangdong Cardiovascular Institute//Guangdong Provincial People’s Hospital//Guangdong Academy of Medical Sci-ences,Guangzhou 510080,China;Guangdong Provincial People’s Hospital affiliated to South Medical University//South Medical University,Guangzhou 510080,China;Guangdong Provincial People’s Hospital//Guangdong Academy of Medical Sciences//Guangdong Cardiovascular Institute,Guangzhou 510080,China)

机构地区：[1]广东省心血管病研究所//广东省人民医院//广东省医学科学院,广东广州510080 [2]南方医科大学附属广东省人民医院//南方医科大学,广东广州510080 [3]广东省人民医院//广东省医学科学院//广东省心血管病研究所,广东广州510080

出　　处：《中山大学学报（医学科学版）》2024年第5期826-834,共9页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省自然科学基金(2022A1515220080)。

摘　　要：【目的】基于超广角扫频光学相干断层扫描(UWF SS-OCT)及超广角光学相干断层血管成像技术(UWF SS-OCTA)探讨玻璃体视网膜界面改变对2型糖尿病视网膜病变(DR)的影响。【方法】本研究以143例糖尿病患者作为研究对象,对258只眼睛的SS-OCT图像以及69个增殖期糖尿病视网膜病变(PDR)的SS-OCTA图像进行分析,运用Goodman-Kruskal’s Gamma方法评估玻璃体后脱离(PVD)与DR严重程度的关系,并统计不同PVD程度下PDR患眼视网膜新生血管的生长情况。【结果】随着DR严重程度进展,PVD的程度与DR的严重程度呈负相关(Gamma=-0.294,P<0.001),即玻璃体与视网膜粘连程度增加,DR程度更加严重。其中,糖尿病病程10年以上的患眼PVD程度与DR严重程度的负相关更加显著(Gamma=-0.620,P<0.001),且视网膜新生血管更倾向于在视网膜玻璃体粘连区域生长。【结论】玻璃体视网膜粘连程度与DR严重程度密切相关,在DR患者管理中运用SS-OCT评估玻璃体视网膜界面具有较高的应用价值。【Objective】To observe and analyze the vitreoretinal interface changes in type 2 diabetic retinopathy(DR)by using ultra-wide field swept-source optical coherence tomography(UWF SS-OCT)/swept-source optical coherence tomography angiography(SS-OCTA).【Methods】This study enrolled 143 patient with diabetic mellitus.We performed SS-OCT on 258 eyes and OCTA on 69 eyes with proliferative diabetic retinopathy(PDR),then analyzed the images to assess the relationship between posterior vitreous detachment(PVD)and DR severity,and to measure the growth of retinal neovascularization in PDR eyes with different stages of PVD.【Results】PVD stage was negatively correlated with DR severity(Gamma=-0.294,P<0.001),that is,the more extensive the vitreoretinal adhesion,the more severe the DR.The negative correlation between PVD stage and DR severity was more evident in patients with diabetes duration more than 10 years(Gamma=-0.620,P<0.001).Retinal neovascularization occurred more commonly in the area of vitreoretinal adhesion.【Conclusions】The degree of vitreoretinal adhesion is closely related to the DR severity.It is very important to use SS-OCT to evaluate the vitreoretinal interface in the management of DR patients.

关 键 词：扫频源光学相干断层扫描/扫频源光学相干断层血管成像 糖尿病视网膜病变 玻璃体后脱离 玻璃体视网膜粘连 玻璃体视网膜界面 

分 类 号：R77[医药卫生—眼科]