全视网膜光凝术后DR患者黄斑区与光斑区脉络膜厚度变化

摘要

目的:探讨糖尿病性视网膜病变(diabetic retinopathy,DR)患者全视网膜光凝术(panretinal photocoagulation,PRP)治疗前后黄斑区与光斑区脉络膜厚度变化.方法:选取我院2015-01/2017-01就诊DR患者40例78眼,行PRP治疗,采用眼底光学相干断层扫描技术(optical coherence tomography,OCT)观察患者治疗前后黄斑区与光斑区脉络膜厚度变化.结果:PRP术后1mo黄斑中心凹下脉络膜厚度(subfoveal choroidal thickness, SFCT)、鼻侧脉络膜厚 度 (nasal choroidal thickness,NCT)、颞侧脉络膜厚度(temporal choroidal thickness,TCT)、上方脉络膜厚度(superior choroidal thickness, SCT)、下方脉络膜厚度 (inferior choroidal thickness,ICT)均显著高于术前,差异有统计学意义(t=2.016、2.017、2.001、2.264、2.229,P<0.05);术后3mo时 SFCT、NCT、TCT、SCT、ICT 与术前比较均显著减低,差异有统计学意义(t=2.048、2.051、2.092、2.010、2.273,P<0.05).术后光斑区基线水平的脉络膜平均厚度(227.6 ± 44.9μm)显著高于术后1mo 脉络膜厚度(207.1 ± 41.6μm),差异有统计学意义(t=2.118,P<0.05);术后3mo脉络膜平均厚度(206.5 ±41.3μm)显著低于基线水平的脉络膜平均厚度(227.6 ±44.9μm),差异有统计学意义(t=2.188,P<0.05).结论:PRP术后短期内可明显增加黄斑区脉络膜厚度,而光斑区脉络膜厚度明显减少,提示术后脉络膜血流情况进行了重新分布.%AIM: To investigate the choroidal thickness changes in macular area and facular area of patients with diabetic retinopathy ( DR) after panretinal photocoagulation (PRP). METHODS: Totally 40 cases (78 eyes) of DR patients with PRP in our hospital from January 2015 to January 2017 were selected, and optical coherence tomography (OCT) was conducted for preoperative and postoperative choroidal thickness in macular area and facular area. RESULTS: At 1mo after PRP, the subfoveal choroidal thickness (SFCT), nasal choroidal thickness (NCT), the temporal choroidal thickness (TCT), superior choroidal thickness (SCT),inferior choroidal thickness(ICT) were sharply higher than those before operation, the difference was statistically significant(t=2.016,t=2 017, t=2.001, t=2.264, t=2.229;P<0.05). SFCT,NCT,TCT, SCT and ICT at postoperative 3mo sharply decreased when compared to those before operation, showing statistical significance (t=2.048, t=2.051, t=2.092, t=2 010, t=2.273; P<0.05). Postoperative baseline level average choroidal thickness in facular area of 227. 6士44 9μ m was evidently higher than that at postoperative 1mo (207.1士41.6μ m),the difference had statistical points (t=2.118, P<0.05). The mean thickness at postoperative 3mo (206. 5士41. 3μ m) was apparently lower than the baseline level mean choroidal thickness 227.6士44.9μ m, the difference showed statistical significance(t=2.188,P<0.05). CONCLUSION: The choroid thickness at macular region rises obviously for short term after PRP, while that in facula area reduces markedly, which shows choroidal blood flow redistribution after operation.