CAJ | 학술논문

目的：通过对糖尿病患者荧光素眼底血管造影（ FFA）结果进行分析，探讨该检查患者的眼底疾病构成，以及对糖尿病视网膜病变（ DR）临床诊疗的意义。方法选取2011年1月至2013年2月我科行FFA检查的糖尿病患者565例（1063只眼），诊断患者视网膜病变情况和分级，并根据诊断结果指导治疗。结果565例糖尿病患者1063只眼中DR 697只眼（65．6％）、老年黄斑病变37只眼（3．5％）、视网膜静脉阻塞20只眼（1．9％）、高度近视眼底改变10只眼（0．9％）、视神经炎9只眼（0．8％）、视网膜色素变性6只眼（0．6％）、中心性浆液性脉络膜视网膜病变3只眼（0．3％）、其他3只眼（0．3％），未发生DR 366只眼（34．4％），正常眼底278只眼（26．1％）；除外视网膜其他病变，共计975只眼，其中无明显视网膜病变（28．5％）、轻度非增生性糖尿病视网膜病变（ NPDR）（16.7％）、中度NPDR（14．4％）、重度NPDR（22．1％）、增生性糖尿病视网膜病变（PDR）（18．3％）；局限性黄斑水肿（33．1％）、弥漫性黄斑水肿（35．1％）、囊样黄斑水肿（23．1％）、缺血性黄斑水肿（3．8％）、增生性黄斑水肿（4.9％）；随着糖尿病病程的延长，DR的发病率逐渐增加（χ2＝54．927 P ＜0．05）；随着患者年龄的增加，DR的发病率也逐渐增加（χ2＝11．798 P ＜0．05）；随着DR严重程度的增加，黄斑水肿的程度增加（χ2＝63．15 P ＜0．05）。结论 FFA能够及早发现程度不同的DR和糖尿病性黄斑水肿（ DME）改变以及是否伴随其它的视网膜病变，可更好的指导临床诊疗工作；增加糖尿病患者对DR的认知能力，对预防患者视力下降及失明具有重要意义。
목적：통과대당뇨병환자형광소안저혈관조영（ FFA）결과진행분석，탐토해검사환자적안저질병구성，이급대당뇨병시망막병변（ DR）림상진료적의의。방법선취2011년1월지2013년2월아과행FFA검사적당뇨병환자565례（1063지안），진단환자시망막병변정황화분급，병근거진단결과지도치료。결과565례당뇨병환자1063지안중DR 697지안（65．6％）、노년황반병변37지안（3．5％）、시망막정맥조새20지안（1．9％）、고도근시안저개변10지안（0．9％）、시신경염9지안（0．8％）、시망막색소변성6지안（0．6％）、중심성장액성맥락막시망막병변3지안（0．3％）、기타3지안（0．3％），미발생DR 366지안（34．4％），정상안저278지안（26．1％）；제외시망막기타병변，공계975지안，기중무명현시망막병변（28．5％）、경도비증생성당뇨병시망막병변（ NPDR）（16.7％）、중도NPDR（14．4％）、중도NPDR（22．1％）、증생성당뇨병시망막병변（PDR）（18．3％）；국한성황반수종（33．1％）、미만성황반수종（35．1％）、낭양황반수종（23．1％）、결혈성황반수종（3．8％）、증생성황반수종（4.9％）；수착당뇨병병정적연장，DR적발병솔축점증가（χ2＝54．927 P ＜0．05）；수착환자년령적증가，DR적발병솔야축점증가（χ2＝11．798 P ＜0．05）；수착DR엄중정도적증가，황반수종적정도증가（χ2＝63．15 P ＜0．05）。결론 FFA능구급조발현정도불동적DR화당뇨병성황반수종（ DME）개변이급시부반수기타적시망막병변，가경호적지도림상진료공작；증가당뇨병환자대DR적인지능력，대예방환자시력하강급실명구유중요의의。
Objective To analyze the results of fundus fluorescein angiography ( FFA) in diabetic patients , and to explore clinical features of diabetic retinal diseases .Methods Fundus fluorescein angiography was performed in 565 pa-tients (1063 eyes) presented to our department between January 2011 amd February 2013.The degrees of retinal lesion and DR grades were determined and used to guide treatment .Results In 1063 eyes, 697 eyes (65.6%) were diagnosed with DR, and 366 eyes (34.4%) did not meet the criteria of DR.Among those eyes without DR, 278 eyes (26.1%) presented with normal fundus , while the remaining were found to have conditions that were irrelevant to this study , inclu-ding age-related macular degeneration (37 eyes, 3.5%), retinal vein occlusion (20 eyes, 1.9%), high myopia fundus degeneration (10 eyes, 0.9%), optic neuritis (9 eyes, 0.8%), retinitis pigmentosa (6 eyes, 0.6%), central serous chorioretinopathy (3 eyes, 0.3%), and others fundus diseases (3 eyes, 0.3%), and thus were excluded from further dis-cussion.Among the 975 eyes that were interested, 28.5%had no significant retinopathy, 16.7%presented with mild NP-DR, 14.4% with moderate NPDR, 22.1% with severe NPDR, and 18.3% with PDR.Limited macular edema (33. 1%), diffuse macular edema (35.1%), cystoid macular edema (23.1%), ischemic macular edema (3.8%), prolifera-tive macular edema (4.9%) were also noticed.Incidence of DR gradually increased with the duration of diabetes (χ2 =54.927, P <0.05) and age (χ2 =11.798, P <0.05).The severity of DR is related to the degree of macular edema (χ2=63.15, P <0.05).Conclusions FFA can detect varying degrees of DR and DME changes as well as other retinopa-thies in early stage .It is a good tool to guide clinical prevention .Education of the patients with the knowledge of DR , vi-sion loss, and blindness prevention is important .