目的：应用频域光学相干断层扫描(optical coherence tomography，OCT)在健康人群及各期糖尿病视网膜病变患者中测量外核层(ONL)、内节和外节层(IS/OS)、光感受器细胞层的厚度。

方法：选择健康人群50例100眼作为对照组，选择2型糖尿病患者178例300眼为研究对象，分为3组：糖尿病正常视网膜组(NDR)100眼、非增生性糖尿病视网膜病变组(NPDR)100眼、增生性糖尿病视网膜病变组(PDR)100眼。用频域OCT对4组进行测量中心凹和旁中心凹(鼻侧、颞侧)ONL、IS/OS层、光感受器细胞层的厚度。

结果：对照组、NPDR组、PDR组中心凹、旁中心凹颞侧ONL、光感受器细胞层厚度比较差异均有统计学意义(P<0.05)； NDR组中心凹、旁中心凹颞侧各层与对照组比较差异无统计学意义(P>0.05)； 中心凹、旁中心凹颞侧各组IS/OS层厚度比较差异无统计学意义(P>0.05)； 旁中心凹鼻侧各组各层比较差异无统计学意义(P>0.05)。

结论：黄斑中心凹和旁中心凹颞侧ONL、光感受器细胞层在DR中均有增厚，随DR病程的进展呈动态变化； 光感受器细胞层厚度的变化主要发生在ONL层，IS/OS层无变化； 旁中心凹颞侧的改变显于鼻侧； 频域OCT能定量定性地观察糖尿病患者黄斑区的细微变化，为糖尿病患者黄斑病变早期诊断及治疗提供可靠的检测手段。

METHODS: Totally 100 eyes of 50 healthy people were selected as control group. According to conventional mydriasis for examination of fundus and fundus fluorescein angiography(FFA)examination, all diabetic cases were divided into 3 groups: normal retina group(NDR), non-proliferative diabetic retinopathy group(NPDR), proliferative diabetic retinopathy group(PDR). Using OCT measure the thickness of ONL, IS/OS and photoreceptor cell layer of fovea and parafovea(nasal side and temporal side)in the four groups.

RESULTS: Compared with the control group, the ONL and photoreceptor cell layer's thickness of macular fovea and temporal parafovea in NPDR group and PDR group were statistically significant(all P<0.05). The differences between ONL and photoreceptor cell layer's thickness of macular fovea and temporal parafovea in NDR group and PDR group were not statistically significant(P>0.05). The IS/OS of macular fovea and temporal parafovea was not significantly different among those groups(P>0.05). The thickness of different layers of nasal parafovea were not different(P>0.05).

CONCLUSION: The thickness of macular fovea and temporal parafovea has relation with degree of DR; the change of photoreceptor cell layer's thickness occurs mainly in ONL, but IS/OS no change; the change in temporal parafovea more obvious than in nasal parafovea. Frequency-domain OCT can quantitatively and qualitatively observe the subtle diabetic macular changes in diabetic patients with macular disease, and provides a reliable detection for the early diagnosis and treatment.