目的：研究和分析早期糖尿病视网膜病变患者视盘周围视网膜神经纤维层和黄斑部视网膜厚度的变化，揭示不同程度的早期糖尿病视网膜病变患者视网膜神经纤维层(RNFL)及黄斑部视网膜厚度变化的趋势。

方法：临床病例对照研究。选取我院2012-09/2013-01确诊的早期2型糖尿病视网膜病变患者60例120眼，分为无视网膜病变组(NDR)20例40眼及合并轻、中度非增殖性糖尿病视网膜病变组(NPDR)40例80眼，对照组为正常人20例40眼，应用光学相干断层成相分别以RNFL扫描模式(视盘中点为中心，直径为3.45mm环形扫描)和黄斑部视网膜厚度扫描模式(黄斑中心凹为中心。直径1 000μm的区域)； 测量正常人与早期糖尿病视网膜病变患者视盘周围RNFL厚度和黄斑区视网膜厚度。

结果：与正常对照组相比，NDR组除下象限RNFL变薄差异有统计学意义(P<0.05)； 视盘周围RNFL厚度及其它各象限差异无统计学意义(P>0.05)，轻度NPDR组视盘周围平均值、下象限RNFL厚度差异有统计学意义(P<0.05)； 中度NPDR组视盘周围平均值、上象限、下象限RNFL厚度下降差异均有统计学意义(P<0.05)。NPDR组，NDR组和对照组三组比较各象限RNFL厚度下降； NDR组、轻度NPDR与中度NPDR组相比，黄斑部视网膜厚度差异有统计学意义(P<0.05)，后者视网膜厚度逐渐增加。

结论：在早期糖尿病视网膜病变，视盘周围RNFL厚度随病变程度逐渐降低，而黄斑部视网膜厚度却逐渐增加，OCT能定性、定量地观察早期糖尿病视网膜病变的程度。

AIM: To investigate changes of retinal nerve fiber layer(RNFL)thickness and macular retinal thickness in patients with early diabetic retinopathy(DR)and disclose the changing trends of RNFL thickness and macular retinal thickness in different stages of early DR.

METHODS: It was a clinical case control study. Through selecting 60 patients(120 eyes)with early DR diagnosed with type 2 diabetes were divided into non-diabetic retinopathy(NDR)group(20 cases, 40 eyes)and mild non-proliferative diabetic retinopathy(NPDR)group(20 cases, 40eyes), moderate NPDR group(20 cases, 40 eyes). Twenty normal patients(40 eyes)were enrolled as control group. The RNFL thickness of optical nerve(with circle scan round optic nerve head, scan diameter of 3.45mm)and the retinal thickness of macular(around center point with 1000μm diameter)were measured by optical coherence tomography(OCT), to compare the RNFL thickness changes of the control and early DR patients.

RESULTS: Compared with the control group, the RNFL thickness of optical disc in the inferior quadrant was descended obviously in NDR group(P<0.05), with statistically significant difference,; there were no statistically significant difference in other quadrants(P>0.05). In mild NPDR group, the RNFL thickness of optical disc in the mean and inferior quadrant was significantly descended than that in the NDR group. In moderate NPDR group, the RNFL thickness of optical disc in the mean, superior and inferior quadrant was statistical significance descended than that in the NDR group(P<0.05). Compared with the NPDR group, NDR group and control group, the RNFL thickness of optical disc in each quadrant were descended significantly. There was statistically significant difference in macular retinal thickness among the NDR group, mild NPDR and moderate NPDR group(P<0.05), the retinal thickness was increased gradually in mild NPDR and moderate NPDR group.

CONCLUSION:With the development in the degree of early DR, RNFL thickness is gradually decreased and retinal thickness is increased, OCT can be observed qualitatively and quantitatively in DR.