[关键词]
[摘要]
目的:应用光学相干断层扫描血流成像(OCTA)定量评估1型糖尿病患者早期黄斑区的血流改变。
方法:入选20名健康人作为对照组,20例无糖尿病视网膜病变(NDR)的1型糖尿病患者,20例已经确诊伴有轻度或中度非增殖期糖尿病视网膜病变(NPDR)的1型糖尿病患者。应用OCTA检测黄斑部中央凹无血管区面积(FAZ)、FD-300、浅层毛细血管丛(SCP)和深层毛细血管丛(DCP)的血流密度等参数。
结果:与正常对照组相比,NDR组DCP的血流密度(旁中心凹区54.99%±2.27%,黄斑区为53.13%±2.15%)出现了明显下降(P<0.05)。与正常对照组相比,NPDR组FD-300,SCP和DCP的血流密度(FD-300区49.11%±4.78%,SCP的旁中心凹区48.74%±4.78%,黄斑区45.43%±3.70%; DCP的旁中心凹区53.20%±4.19%,黄斑区50.84%±3.99%)都出现了明显的下降(P<0.05)。
结论:1型糖尿病患者临床前期黄斑部的毛细血管血流密度下降首先出现在深层毛细血管。而对于确诊为轻度或中度NPDR患者,其黄斑区浅层及深层的毛细血管均会出现血流密度下降。
[Key word]
[Abstract]
AIM: To quantitatively evaluate the changes of macular blood flow in patients with type 1 diabetes mellitus using optical coherence tomography angiography(OCTA).
METHODS: Totally 20 healthy controls, 20 type 1 diabetes patients with no-diabetic retinopathy(NDR)and 20 type 1 diabetes patients with mild or moderate non-proliferative diabetic retinopathy(NPDR)were enrolled. The area of fovea avascular area(FAZ), vessel density of FD-300 and vessel density of superficial capillary plexus(SCP)and deep capillary plexus(DCP)in macular were automatic measured by built-in software.
RESULTS: The vessel density of DCP in NDR group(54.99%±2.27% in paramacular and 53.13%±2.15% in macular)decreased significantly compared with the controls(P<0.05). For the mild or moderate NPDR group, the vessel density of FD-300, SCP and DCP(49.11%±4.78% in FD-300, 48.74%±4.78% in parafovea and 45.43%±3.70% in macular of SCP, 53.20%±4.19% in parafovea and 50.84%±3.99% in macular of DCP)all decreased significantly when compared with controls(P<0.05).
CONCLUSION: In the preclinical stage of type 1 diabetes mellitus, vessels density has already started to decrease in the DCP of macular. For patients with mild or moderate NPDR, vessel density in the SCP and DCP of the macular area both decrease.
[中图分类号]
[基金项目]
江苏省科技项目-产业前瞻与共性关键技术-竞争项目(No.BE2018131)