糖尿病视网膜病变患者黄斑拱环结构变化及相关影响因素分析.doc

糖尿病视网膜病变患者黄斑拱环结构变化及相关影响因素分析
【摘要】目的评价Ⅲ期、Ⅳ期糖尿病视网膜病变(Diabetic Retinopathy,DR)患者视网膜动脉、静脉及黄斑拱环结构的改变,探讨其对于理解视网膜病变严重程度的意义。方法回顾分析80例眼底荧光素血管造影(Fundus fluorescein angiography,FFA)检查、眼底光学相干断层扫描(Optical coherence tomography, OCT)等临床资料,观察分析黄斑中心凹毛细血管拱环破坏程度。按DR严重程度及是否伴随高血压进行分组,利用海德堡激光扫描眼底荧光造影系统测量软件对视网膜血管和黄斑拱环直径进行统计学分析。结果本组病例中,对于DR黄斑拱环结构研究发现,黄斑拱环结构破坏主要表现为:黄斑拱环直径缩小、黄斑拱环直径扩大、黄斑拱环结构完全破坏。±,视网膜颞上A/±, 颞下A/±。在非高血压患者中,DR分期与黄斑拱环直径相关,与AV比无关;此外,DR Ⅲ期、Ⅳ期间黄斑厚度存在差异。破坏因素包括直径改变,毛细血管网内出现微血管球瘤,部分出现侧支循环建立,环外毛细血管栓塞,大片无灌注区及出血斑等。结论糖尿病视网膜病变患者黄斑拱环结构破坏具有多种形态,相关因素与血糖水平和病程相关。
【关键词】糖尿病视网膜病变(DR) 黄斑拱环眼底荧光血管造影(FFA)
【Abstract】Objective To evaluate the structure change of arteriole, vein and capillary in stage 3 and stage 4 diabetic retinopathy ( DR), and t
o discuss its effect for monitoring in : 80 cases of diabetic retinopathy with FFA and OCT were reviewed, and then the destruction degree of macular arch were analysis. The cases were grouped by degree of DR and with HBP history or not, and using Heidelberger HRA2 measuring software to analysis the diameter of retinal vessel and macular arch in these cases. Results: In these cases, the destruction of macular arch is the diameter expand and the total disruption. The diameter of macular arch is ±, and the superior temporal A/V is ±, the inferior temporal A/V is ±. In non HBP group, the stages of DR is relative to diameter of macular arch, irrespective of A/V. In addition, there is a significant difference in macular thickness between DR stage 3 and DR stage 4. The study of macular arch morphology demonstrate that the destroy factors included diameter, micro-aneurysm in work, partially collateral circulation, capillary embolism outsides the macular ring, large area of non-perfusion and hemorrhage patches. The above all mentioned is the important references for DR : Structure change of macular arch in diabetic retinopathy has many types, and has strong relationsh