不同分期DR患者视网膜神经纤维层厚度和视网膜厚度及血流密度的变化  

Changes of retinal nerve fiber layer thickness,retinal thickness and blood flow density in different stages of diabetic retinopathy patients

作　　者：张树军[1] 黄帅 李佳佳 裴松波 李钰泓 Zhang Shujun;Huang Shuai;Li Jiajia;Pei Songbo;Li Yuhong(Handan City Eye Hospital(The Third Hospital of Handan),Handan 056001,Hebei Province,China)

机构地区：[1]河北省邯郸市眼科医院(邯郸市第三医院),056001

出　　处：《国际眼科杂志》2025年第5期714-717,共4页International Eye Science

基　　金：河北省医学科学研究课题(No.20241204)。

摘　　要：目的:探讨基于光相干断层扫描血管成像技术(OCTA)观察不同分期糖尿病视网膜病变(DR)患者视网膜神经纤维层厚度(RNFL)、视网膜厚度及血流密度变化。方法:回顾性分析。选取2023-02/2024-02在我院确诊为DR患者382例382眼,依据分期标准,将患者分为轻度组(121例121眼)、中度组(133例133眼)、重度组(72例72眼)、增生组(56例56眼),比较四组患者的一般临床资料;采用OCTA对所有患者进行扫描收集数据,比较四组患者的RNFL、视网膜厚度以及血流密度。结果:轻度组、中度组、重度组、增生组患者年龄、性别、高血压、慢性肾病、随机血糖比较均无差异(均P>0.05);随着DR分期的加重,病程逐渐延长(P<0.05)。RNFL厚度(上方、下方、颞侧、鼻侧、平均厚度)和视网膜厚度均随DR严重程度增加而显著升高(均P<0.001),中度组与轻度组下方RNFL厚度比较无差异(P>0.05)。视网膜浅层、深层及脉络膜毛细血管层血流密度随DR进展显著降低(均P<0.05),中度组与重度组视网膜浅层血流密度比较无差异(P>0.05)。结论:OCTA可精确观察到不同分期DR患者RNFL、视网膜厚度及血流密度的变化,这三者可作为监测DR进展的敏感指标。AIM:To investigate the changes of retinal nerve fiber layer(RNFL)thickness,retinal thickness and blood flow density in different stages of diabetic retinopathy(DR)patients based on optical coherence tomography angiography(OCTA).METHODS:A retrospective analysis was conducted on 382 patients(382 eyes)diagnosed with DR in our hospital from February 2023 to February 2024.According to the staging criteria,the patients were divided into mild group(n=121),moderate group(n=133),severe group(n=72),and proliferative group(n=56).The general clinical data of the four groups of patients was compared;OCTA was used to scan and collect data from all patients,and the RNFL thickness,retinal thickness,and blood flow density were compared among the four groups of patients.RESULTS:There was no statistically significant difference in age,gender,hypertension,chronic kidney disease,and random blood glucose among patients in the mild,moderate,severe,and proliferative groups(all P>0.05).As the stage of DR worsened,the duration of the disease gradually prolonged(P<0.05).The thickness of the RNFL(superior,inferior,temporal,nasal,and average thickness)and retinal thickness significantly increased with the severity of DR(all P<0.001);however,there was no statistically significant difference in inferior RNFL thickness between the moderate and mild groups(P>0.05).The blood flow density in the superficial and deep retinal layers,as well as in the choroidal capillary layer,significantly decreased with the progression of DR(all P<0.05).Nevertheless,there was no statistically significant difference in superficial retinal blood flow density between the moderate and severe groups(P>0.05).CONCLUSION:OCTA can accurately observe the changes in RNFL thickness,retinal thickness,and blood flow density in patients with DR at different stages,which can serve as sensitive indicators for monitoring DR progression.

关 键 词：光相干断层扫描血管成像技术 糖尿病视网膜病变(DR) 视网膜神经纤维层厚度 视网膜厚度 血流密度 

分 类 号：R774.1[医药卫生—眼科]