【摘要】 目的 应用光学相干断层描血管成像技术(optical coherence tomog-raphy angiography, OCTA)观察无眼底病变的2型糖尿病患者的黄斑区微血管改变。方法 收集2型糖尿病患者89例入研究组，包括轻度非增殖期组(NPDR组)66例114眼，无眼底病变者(0期组)23例37眼，另收集正常39例61眼入对照组。应用OCTA对所有受试者黄斑区行3 mm×3 mm范围模式扫描，分别测量表层毛细血管丛(superficial capillary plexuses, SCP)、深层毛细血管丛(deep capillary plexuses, DCP)黄斑中心凹无血管区(foveal avascular zone, FAZ)面积以及SCP层、DCP层和脉络膜毛细血管层黄斑血流密度及血流密度百分比。结果 0期组SCP层、DCP层FAZ面积分别为(0.39±0.14)、(0.69±0.20),NPDR组分别为(0.44±0.16)、(0.80±0.32),对照组为(0.38±0.12)、(0.64±0.21),NPDR组各层FAZ面积高于对照组(t=2.89、3.66,P=0.013、0.001)。0期组SCP层、DCP层和脉络膜毛细血管层黄斑血流密度分别为(1.71±0.23)、(1.80±0.26)、(3.21±0.22),NPDR组分别为(1.63±0.21)、(1.76±0.42)、(3.19±0.26),对照组分别为(1.70±0.36)、(2.09±0.34)、(3.19±0.22),0期组及NPDR组DCP层黄斑血流密度均值低于对照组(t=3.726、5.535,P<0.001)。0期组SCP层、DCP层和脉络膜毛细血管层黄斑血流密度百分比分别为(14.06±2.74)、(15.33±2.95)、(35.42±6.00),NPDR组分别为(13.41±2.56)、(14.35±4.21)、(35.40±6.97),对照组分别为(13.33±3.71)、(17.98±4.24)、(35.18±6.21),0期组及NPDR组DCP层黄斑血流密度百分比均值低于对照组(t=-3.76、-5.46,P<0.05)。在糖尿病患者中，病程5～10年以及≥10年的患者SCP层FAZ面积均值高于病程<5年的均值(t=-2.93、-2.41,P=0.012、0.017)。结论 OCTA检查有助于发现早期糖尿病视网膜病变(diabetic retinopathy, DR)。更多还原

【Abstract】 Objective To investigate the macular microvascular changes in type 2 diabetic patients without retinopathy observed by using optical coherence tomography angiography(OCTA).Methods A total of 89 patients with type 2 diabetes mellitus were enrolled as research subjects, including 66 patients(114 eyes) in NPDR group, and 23 patients(37 eyes) without retinopathy in phase 0 group, at the same time, the other 39 healthy subjects(61 eyes) were enrolled as control group.All the subjects underwent the 3 mm×3 mm scanning of macular retina by OCTA.The foveal avascular zone(FAZ) area in superficial capillary plexuses(SCP) and deep capillary plexuses(DCP) was measured, and the macular blood flow density and the percentage of macular blood flow density in SCP,DCP and choroid capillary plexuses were measured.Results The mean FAZ areas of SCP and DCP in phase 0 group were 0.39±0.14,0.69±0.20,respectively, which in NPDR group were 0.44±0.16,0.80±0.32,respectively, and which in control group were 0.38±0.12,0.64±0.21,respectively.The area of FAZ in each layer of NPDR group was significantly higher than that in control group(P<0.05).The macula lutea blood flow densities in DCP layer in phase 0 group and NPDR group were significantly lower than those in control group(P<0.05). Moreover the percentages of macula lutea blood flow densities in DCP layer in phase 0 group and NPDR group were significantly lower than those in control group(P<0.05).In addition the FAZ area of SCP layer in diabetic patients whose course of disease was during 5～10 years or more than 10 years was significantly higher than that of patients whose course of disease was less than 5 years(P<0.05).Conclusion OCTA is helpful to detect early diabetic retinopathy.更多还原