目的：分析超广角眼底荧光血管造影(UWFA)对糖尿病视网膜病变(DR)的诊断价值。

方法：对2016-10/2018-06在西安市第三医院就诊的DR患者45例90眼进行回顾性分析。其中男25例，女20例，年龄45～76(平均59.52±15.78)岁。所有患者均经直接或间接检眼镜以及UWFA检查。

结果：依据检眼镜检查，在12眼内未见DR，42眼诊断为非增殖性糖尿病视网膜病变(NPDR)，36眼诊断为增殖性糖尿病视网膜病变(PDR)。在90眼中，22眼接受视网膜激光光凝治疗，其中8眼接受过广泛视网膜激光光凝(PRP)。依据UWFA检查，12只无DR的眼中有8眼(67%)存在视网膜微动脉瘤，42只诊断为NPDR眼中有4眼(10%)被发现视网膜新生血管(RNV)及血管渗漏，36只诊断为PDR的眼中仍有12眼(33%)存在周边RNV。在诊断为NPDR和PDR的眼中，分别有28眼(67%)和26眼(72%)存在周边视网膜无灌注区。另外，在8只已接受广泛视网膜激光光凝的眼中有4眼(50%)仍有周边RNV及无灌注区。

结论：UWFA能够更全面地对糖尿病患者的周边视网膜进行检查，有助于发现常规影像学检查难于察觉的周边部糖尿病视网膜病变，尤其利于对视网膜激光光凝后的DR患者病情的随访观察。

METHODS: Forty-five cases(90 eyes)with DR in Xi'an No.3 Hospital from October 2016 to June 2018 were analyzed retrospectively, including 25 males and 20 females, aged from 45-76(59.52±15.78)years. There were 25 males and 20 females. Average age were 59.5 years. All patients were examined with ophthalmoscope and UWFA.

RESULTS: Depending on ophthalmoscope, 12 eyes with no DR, 42 eyes with nonproliferative diabetic retinopathy(NPDR), and 36 eyes with proliferative diabetic retinopathy(PDR), diagnosed by the standard method. 22 eyes of 90 eyes received retinal photocoagulation, including 8 eyes received panretinal photocoagulation(PRP). Depending on UWFA images, peripheral microaneurysms were demonstrated in 8(67%)of 12 eyes with no DR. Peripheral retinal neovascularizations were detected in 4(10%)of 42 eyes with NPDR and in 12(33%)of 36 eyes with PDR. Peripheral vascular nonperfusions were found in 28(67%)of 42 eyes with NPDR and in 26(72%)of 36 eyes with PDR. Peripheral vascular nonperfusions and peripheral retinal neovascularizations also were found in 4(50%)of 8 eyes, which treated by PRP.

CONCLUSION: UWFA demonstrates peripheral lesions beyond standard fields, which can allow early detection of DR, and a close evaluation of eyes with retinal photocoagulation.