糖尿病视网膜病变患者角膜神经纤维和视网膜神经纤维层变化与病情严重程度的相关性  

Correlation between changes of corneal nerve fiber and retinal nerve fiber layer and disease severity of patients with diabetes retinopathy

作　　者：陆婷婷 周熠 郭建新 LU Tingting;ZHOU Yi;GUO Jianxin(Department of Ophthalmology,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221004,Jiangsu,China)

机构地区：[1]徐州医科大学附属医院眼科,江苏徐州221004

出　　处：《贵州医科大学学报》2024年第12期1830-1834,共5页Journal of Guizhou Medical University

基　　金：江苏省自然科学基金项目(BK20210972)。

摘　　要：目的探讨糖尿病视网膜病变(DR)患者角膜神经纤维和视网膜神经纤维层(RNFL)变化与病情严重程度的相关性。方法96例2型糖尿病患者根据DR分期标准分为无DR(NDR)组32例、非增生性DR(NPDR)组32例、增生性DR(PDR)组32例,另选取32例(32眼)健康对照;比较各组患者的RNFL、黄斑无血管区面积(FAZ)、视网膜浅层毛细血管血流密度(SCL)、视网膜深层毛细血管血流密度(DCL)及角膜神经纤维长度(NFL)、角膜神经弯曲度(NT)、角膜神经纤维密度(NFD)、角膜神经纤维分支密度(NFB)水平,评估各项指标与DR分期的相关性,以及RNFL与NFL、NT、NFD、NFB的相关性。结果对照组、NDR组、NPDR组、PDR组患者的RNFL、SCL、DCL逐渐减小(P<0.05),FAZ逐渐增大(P<0.05);对照组、NDR组、NPDR组、PDR组患者的NFL、NFD、NFB逐渐减小(P<0.05),NT逐渐增大(P<0.05);RNFL、SCL、DCL与DR分期呈负相关(P<0.05),FAZ与DR分期呈正相关(P<0.05);NFL、NFD、NFB与DR分期呈负相关(P<0.05),NT与DR分期呈正相关(P<0.05);RNFL与NFL、NFD、NFB呈正相关(P<0.05),与NT呈负相关(P<0.05)。结论随着DR患者病情严重程度的增加,RNFL与NFL均逐渐减小。Objective To explore the correlation between the changes of corneal nerve fibers and retinal nerve fiber layer(RNFL)and the severity of diabetes retinopathy(DR).Methods A total of 96 patients with type 2 diabetes were divided into three groups based on the DR stage,including 32 cases without diabetic retinopathy(NDR group),32 cases with non-proliferative diabetic retinopathy(NPDR group),and 32 cases with proliferative diabetic retinopathy(PDR group).Additionally,32 healthy subjects(32 eyes)were selected as the control group.Comparison was made among the groups regarding RNFL,foveal avascular zone area(FAZ),superficial capillary density(SCL),deep capillary density(DCL),as well as corneal nerve fiber length(NFL),corneal nerve tortuosity(NT),corneal nerve fiber density(NFD),and corneal nerve fiber branch density(NFB).The study was aimed to evaluate the correlation between these parameters and DR staging,as well as the correlation between RNFL and NFL,NT,NFD,and NFB.Results The RNFL,SCL,and DCL of the control group,NDR group,NPDR group,and PDR group gradually decreased(P<0.05),while FAZ gradually increased(P<0.05).The NFL,NFD,and NFB of the control group,NDR group,NPDR group,and PDR group gradually decreased(P<0.05),while NT gradually increased(P<0.05).RNFL,SCL,DCL were negatively correlated with DR staging(P<0.05),while FAZ was positively correlated with DR staging(P<0.05).NFL,NFD,NFB were negatively correlated with DR staging(P<0.05),while NT was positively correlated with DR staging(P<0.05).NFL,NFD,NFB were positively correlated with RNFL(P<0.05),and negatively correlated with NT(P<0.05).Conclusion As the severity of DR patients increases,both RNFL and NFL gradually decrease.

关 键 词：糖尿病 视网膜 病情严重程度 角膜神经纤维 视网膜神经纤维层 活体共聚焦显微镜 光学相关断层成像 相关性 

分 类 号：R774.1[医药卫生—眼科]