【摘要】 目的利用频域光学相干断层扫描深度增强(enhanced depth imaging spectral domain optical coherence tomography,EDI SD-OCT)观察糖尿病黄斑水肿(diabetic macular edema,DME)患者脉络膜厚度(choroidal thickness,CT)的变化及结构特点,探讨DME病变程度与CT的关系。方法纳入2型糖尿病患者共123例204眼,其中69眼诊断为DME(DME组),135眼无黄斑水肿为对照组。DME眼依据OCT形态学特点进一步分为视网膜弥漫性增厚(diffuse retinal thickness,DRT)型(34眼)、黄斑囊样水肿(cystoid macular edema,CME)型(19眼)和浆液性视网膜脱离(serous retinal detachment,SRD)型(16眼),利用EDI-OCT分别测量黄斑中心凹下CT和以黄斑为中心上、下、鼻、颞500μm、1000μm、1500μm、2000μm处CT。结果 DME组黄斑中心凹下CT为(326.72±90.15)μm,对照组为(320.17±106.46)μm,两组之间无统计学差异,但黄斑中心凹下CT与视网膜厚度间具有明显正相关关系(r=0.270,P=0.025)。DME亚型CT分别为:DRT型(303.94±81.47)μm、CME型(304.42±73.98)μm和SRD型(401.63±88.80)μm,SRD型CT明显高于其他亚型(P<0.05),此外,SRD型的周边CT同样呈现均匀一致的增厚;鼻侧CT从500μm至2000μm呈距离敏感性降低(P<0.05),但SRD型鼻侧CT降低幅度明显变缓(P=0.195)。结论 SRD型黄斑水肿患者CT在中心凹下及周边部均显著增厚,CT与DME病变程度之间有一定相关性。更多还原

【Abstract】 Objective To compare the changes and structural characteristics of choroidal thickness(CT) in patients with diabetic macular edema(DME) using enhanced depth imaging spectral domain optical coherence tomography(EDI SD-OCT).Methods Totally 204 eyes from 123 type 2 diabetes patients were comprised in the study,of which 69 eyes were diagnosed with DME,and 135 for control eyes.Eyes with DME were furthermore divided into three subtypes according to the morphologic characteristic of DME with OCT,including types of diffuse retinal thickening(34 eyes,DRT),cystoid macular edema(19 eyes,CME) and serous retinal detachment(16 eyes,SRD).Subfoveal choroidal thickness(SFCT),and CT of four quadrants at 500 μm,1000 μm,1500 μm 2000 μm from the fovea were measured using the EDI-OCT.Results Mean SFCT in DME group was(326.72±90.15)μm and was(320.17±106.46)μm in the control group,and no significant difference was found in these two groups,but a significant positive correlation between the SFCT and the central retina thickness(CRT) was found using pearson correlation coefficients(r=0.270,P=0.025).SFCT for subtypes of DME were(303.94±81.47)μm for DRT-type,(304.42±73.98)μm for CME-type and(401.63 ± 88.80)μm for SRD-type,respectively,mean SFCT was significantly greater in eyes with SRD-type DME as comparison with the controls and the other two subtypes of DME(P<0.05).Except for SFCT,SRD-type DME showed a consistently increase in CT with all measured points from four quadrants.Moreover,nasal CT exerted strong sensibility with the distance,declining rapidly from 500 μm to 2000 μm(P<0.05),but it declined in a more gently mode in the SRD-type group(P=0.195).Conclusion SRD-type DME shows an overall increase in CT,both in the subfoveal and the peripheral part of macula.This study shows a positive correlation between the CT and DME.更多还原