不同级别的非增生性糖尿病视网膜病变和黄斑水肿患者的脉络膜厚度变化

摘要

Objective To observe the changes of subfoveal choroidal thickness(SFCT)in patients with non-pro-liferative diabetic retinopathy(NPDR)and macular edema of different clinical grades.Methods cross-sectional observa-tion study.A total of 138 eyes of 89 diabetics were scanned with enhanced depth imaging optical coherence tomography (EDI-OCT).No obvious diabetic retinopathy(DR),mild non-proliferative DR(NPDR),moderate NPDR and severe NP-DR were divided to form4 groups.NPDR eyes were further divided into two subgroups:eyes with diabetic macular edema (DME)and eyes without DME.Measurement with SFCT was compared to that in healthy control subjects.Results In pa-tients with no obvious DR,mild NPDR,moderate NPDR and severe NPDR,SFCT were(265.80 ±66.15)μm,(304.23 ± 70.29)μm,(295.32 ±84.32)μm,(249.91 ±72.38)μm respectively.There was no significant difference between the no significant DR eyes and the normal eyes.SFCT was significantly larger in mild NPDR eyes than in no significant DR eyes. There was no significant difference between moderate NPDR eyes and mild NPDR eyes.Severe NPDR eyes were significant-ly thinner than moderate NPDR eyes.Eyes with DME had significantly thinner SFCT than eyes without DME.Conclusions With the occurrence and exacerbation of diabetic retinopathy,SFCT thickened at the beginning and then thinned.SFCT was thicker in eyes with DME than in those without.%目的 观察国际临床分级下的不同级别非增生性糖尿病视网膜病变(NPDR)和黄斑水肿患者的黄斑中心凹下脉络膜厚度(SFCT)的变化.方法 横断面观察研究.利用相干光断层扫描仪的增强深度成像功能对89例(138只眼)糖尿病患者进行扫描.根据国际分级标准将其分为无明显糖尿病视网膜病变(DR)、轻度NPDR、中度NPDR、重度NPDR 4组,并将NPDR眼分为伴糖尿病性黄斑水肿(DME)和不伴糖尿病性黄斑水肿两组,测量出各组患者的SFCT,并与健康人对照组的SFCT值进作对比.结果 无明显DR、轻度NPDR、中度NPDR、重度NP-DR 4组平均SFCT分别为(265.80 ±66.15)μm、(304.23 ±70.29)μm、(295.32 ±84.32)μm、(249.91 ±72.38)μm;无明显DR眼的SFCT较正常人无显著差异,轻度NPDR眼的SFCT较无明显DR眼显著增厚,中度NPDR眼较轻度NPDR眼无显著差异,重度NPDR眼的SFCT较中度NPDR眼显著变薄,伴DME眼较不伴DME眼显著变薄.结论伴随着DR的发生和加重,SFCT先增厚,然后变薄,伴DME眼比不伴DME眼更薄.