不同分期糖尿病视网膜病变患者的前房角形态观察研究

摘要

目的：：运用光学相干断层扫描( OCT)技术对不同分期糖尿病视网膜病变( diabetic retinopathy,DR)患者的前房角形态开展临床研究,为糖尿病视网膜病变患者提供一种更为准确、便捷的青光眼预防措施。方法：我院诊治DR患者613例,按不同分期分为增殖期DR组353例和背景期DR组260例,另选100例糖耐量异常患者作为对照组。采用OCT收集前房角相关参数,包括房角开放距离( AOD )、小梁网虹膜空间面积( TISA )、房角隐窝面积( ARA )、房角角度( ACA )和前房深度( ACD)。结果：对照组、增殖期 DR 组和背景期 DR 组患者的AOD500,AOD750,TISA500,TISA750,ARA500和 ARA750均存在显著性差异(P<0.01),以增殖期 DR 组最小, AOD500,AOD750,TISA500,TISA750,ARA500和 ARA750分别为0.60±0.22mm,0.78±0.39mm,0.22±0.12mm2,0.45±0.19mm2,0.29±0.18mm 和0.46±0.15mm。对照组、增殖期 DR 组和背景期 DR 组患者的 ACA500, ACA750,ACD500和 ACD750均存在显著性差异( P<0.01),以增殖期 DR 组最小, ACA500, ACA750, ACD500和ACD750分别为30.29º±8.19º,21.20º±7.40º,2.32±0.23µm和2.52±0.16µm。 ROC分析显示这些指标对判断青光眼发作风险有意义。结论：OCT检测前房角形态指标参数,可很好的反应糖尿病视网膜病变的参数变化,是一种检测糖尿病视网膜病变患者更为准确、便捷的青光眼预防措施。%Abstract•AlM: To observe the anterior chamber angle shape of patients with diabetic retinopathy ( DR) at different stages using OCT, and to explore a more sensitive and accurate glaucoma preventing measure.•METHODS: A total of 613 cases of DR patients were divided into proliferation phase group ( 353 cases ) and background phase group ( 260 cases ) , another 100 cases of patients with only diabetes were selected as control group. OCT was used to detect the anterior chamber angle related parameters, including angle opening distance ( AOD) , trabecular-iris space area ( TlSA) , angle recess area ( ARA ) , anterior chamber depth ( ACD ) and anterior chamber angle ( ACA) .•RESULTS: There were significant difference among AOD500, AOD750, TlSA500, TlSA750, ARA500 and ARA750 of control group, proliferation phase group and background phase group ( P< 0. 01 ). The proliferation phase group was the lowest, AOD500, AOD750, TlSA500, TlSA750, ARA500 and ARA750 were 0. 60 ± 0. 22mm, 0. 78 ± 0. 39mm, 0. 22 ± 0. 12mm2 , 0. 45 ± 0. 19mm2 , 0. 29 ± 0. 18mm and 0. 46 ± 0. 15mm, respectively. There were significant difference among ACA500, ACA750, ACD500 and ACD750 of control group, proliferation phase group and background phase group ( P< 0. 01 ). The proliferation phase group was the lowest, ACA500, ACA750, ACD500 and ACD750 were 30. 29º ± 8. 19º, 21. 20º ± 7. 40º, 2. 32 ± 0. 23μm and 2. 52±0. 16μm, respectively. ln addition, ROC results indicated that all these indices exert significant difference on evaluating the stage of DR. •CONCLUSlON: Anterior chamber angle shape detected using OCT can reflect the change of retinopathy. OCT is an accurate and simple technique for detecting DR staging.