OCT对糖尿病视网膜病变光感受器细胞层的检测
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山西省重点研发计划项目(No.201603D321076)


Thickness measurement of frequency domain OCT on photoreceptor cell layer in diabetic retinopathy
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Shanxi Provincial Key Research Project(No.201603D321076)

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    摘要:

    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。

    Abstract:

    AIM: To compare the outer nuclear layer(ONL), inner and outer segments(IS/OS), photoreceptor cell layer in healthy people and diabetic retinopathy by frequency-domain optical coherence tomography(OCT).

    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.

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谢英,杨晓伟,张薇,等. OCT对糖尿病视网膜病变光感受器细胞层的检测.国际眼科杂志, 2017,17(12):2345-2347.

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  • 收稿日期:2017-07-15
  • 最后修改日期:2017-10-23
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  • 在线发布日期: 2017-11-20
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