Abstract:AIM:To find the sensitive targets by observing the changes of early fundus detection in function and structure and correlation of systemic monitoring indicators on non-proliferative diabetic retinopathy.
METHODS: Totally 20 normal peoples(40 eyes)in normal control group and 105 in-patients(210 eyes)in diabetic group, which was divided into two groups, 24 cases(48 eyes)in no diabetic retinopathy(NDR)group, 81 cases(162 eyes)in non-proliferative diabetic retinopathy(NPDR)group. The NPDR group was divided into three groups: mild NPDR group 30 cases(60 eyes), moderate NPDR group 26 cases(52 eyes)and severe NPDR group 25 cases(50 eyes). The retinal blood flow(RBF)of Heidelberg retinal flowmeter(HRF), the OS2 amplitude of oscillatory potentials(OPs)and the subfoveal choroidal thickness(SFCT)of OCT were measured in normal control group and diabetic group. The duration of diabetes, blood pressure, fasting blood glucose, hemoglobin, blood lipids and coagulation were also examined in each group. All test results in each group were compared and analyzed statistically.
RESULTS: HRF: the value of RBF in NDR and NPDR group was significantly lower than that in the normal control group(P<0.05); the value of RBF in moderate NPDR group was obviously higher than that in the other groups(P<0.05); the value of RBF in the temporal side of the optic disc was higher than that in the nasal side of the optic disc in NPDR group(P<0.05). OPs: the amplitude of OS2 in NDR and NPDR group was significantly lower than that in the normal control group(P<0.05); the amplitude of OS2 of the severe NPDR group and moderate NPDR group were significantly lower than that in mild NPDR group and NDR group(P<0.05). OCT: with the progression of DR, the value of SFCT were thinner and thinner(P<0.05). The duration of diabetes without therapy, diastolic blood pressure, fasting blood glucose, hemoglobin, cholesterol, low density lipoprotein, fibrinogen, D-dimer positively positive correlated with degree of DR(rs=0.722, 0.791, 0.864, 0.473, 0.611, 0.735, 0.591, 0.554, P<0.05). The occurrence of DR was consistent with other microvascular complications.
CONCLUSION:The detection of HRF, OPs and OCT can be used as sensitive indicators for the early diagnosis of DR. They can earlier and more accurately reflect the changes of microcirculation function and structure of the fundus. The duration of diabetes, blood pressure, fasting blood glucose, hemoglobin, blood lipids, coagulation status are positive correlated in DR progression. The monitoring of these indicators and disseminating timely healthy information own important clinical value in primary medical care.
