中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
Chinese Journal of Practical Ophthalmology
2015年
10期
1141-1145
,共5页
糖尿病视网膜病变(DR)%黄斑拱环%眼底荧光血管造影(FFA)
糖尿病視網膜病變(DR)%黃斑拱環%眼底熒光血管造影(FFA)
당뇨병시망막병변(DR)%황반공배%안저형광혈관조영(FFA)
Diabetic retinopathy%Macular arch%Fundus fluorescein angiography
目的 观测Ⅲ期、Ⅳ期糖尿病视网膜病变(DR)患者黄斑拱环结构的改变,探讨其与视网膜动脉、静脉直径及DR严重程度的相关性.方法 对2005～2010年在沈阳市儿童医院就诊的80例Ⅲ期、Ⅳ期DR患眼、眼底照相、底荧光素血管造影(FFA)检查结果,观察分析黄斑中心凹毛细血管拱环直径变化与破坏程度.按DR严重程度及是否伴随高血压进行分组,利用海德堡激光扫描眼底荧光造影系统测量软件对视网膜血管和黄斑拱环直径进行测量,并行统计学分析.结果 观察的病例中,视网膜颞上A/V之比为0.59±0.12,颞下A/V比为0.61±0.11,拱环直径为(0.43±0.048) mm.黄斑拱环结构破坏主要表现为:黄斑拱环直径缩小或扩大,黄斑拱环结构完全破坏.在非高血压患者中,DR分期与黄斑拱环直径相关,与A、V比无关.拱环破坏因素包括血糖水平,糖尿病病程,毛细血管网内出现微血管球瘤,部分出现侧支循环建立,环外毛细血管栓塞,大片无灌注区及出血斑等.结论 DR患者黄斑拱环结构破坏具有多种形态,其直径与DR严重程度相关.
目的 觀測Ⅲ期、Ⅳ期糖尿病視網膜病變(DR)患者黃斑拱環結構的改變,探討其與視網膜動脈、靜脈直徑及DR嚴重程度的相關性.方法 對2005～2010年在瀋暘市兒童醫院就診的80例Ⅲ期、Ⅳ期DR患眼、眼底照相、底熒光素血管造影(FFA)檢查結果,觀察分析黃斑中心凹毛細血管拱環直徑變化與破壞程度.按DR嚴重程度及是否伴隨高血壓進行分組,利用海德堡激光掃描眼底熒光造影繫統測量軟件對視網膜血管和黃斑拱環直徑進行測量,併行統計學分析.結果 觀察的病例中,視網膜顳上A/V之比為0.59±0.12,顳下A/V比為0.61±0.11,拱環直徑為(0.43±0.048) mm.黃斑拱環結構破壞主要錶現為:黃斑拱環直徑縮小或擴大,黃斑拱環結構完全破壞.在非高血壓患者中,DR分期與黃斑拱環直徑相關,與A、V比無關.拱環破壞因素包括血糖水平,糖尿病病程,毛細血管網內齣現微血管毬瘤,部分齣現側支循環建立,環外毛細血管栓塞,大片無灌註區及齣血斑等.結論 DR患者黃斑拱環結構破壞具有多種形態,其直徑與DR嚴重程度相關.
목적 관측Ⅲ기、Ⅳ기당뇨병시망막병변(DR)환자황반공배결구적개변,탐토기여시망막동맥、정맥직경급DR엄중정도적상관성.방법 대2005～2010년재침양시인동의원취진적80례Ⅲ기、Ⅳ기DR환안、안저조상、저형광소혈관조영(FFA)검사결과,관찰분석황반중심요모세혈관공배직경변화여파배정도.안DR엄중정도급시부반수고혈압진행분조,이용해덕보격광소묘안저형광조영계통측량연건대시망막혈관화황반공배직경진행측량,병행통계학분석.결과 관찰적병례중,시망막섭상A/V지비위0.59±0.12,섭하A/V비위0.61±0.11,공배직경위(0.43±0.048) mm.황반공배결구파배주요표현위:황반공배직경축소혹확대,황반공배결구완전파배.재비고혈압환자중,DR분기여황반공배직경상관,여A、V비무관.공배파배인소포괄혈당수평,당뇨병병정,모세혈관망내출현미혈관구류,부분출현측지순배건립,배외모세혈관전새,대편무관주구급출혈반등.결론 DR환자황반공배결구파배구유다충형태,기직경여DR엄중정도상관.
Objective To evaluate the structure change of arteriole, vein and capillary in stage 3 and stage 4 diabetic retinopathy (DR), and to discuss its effect for monitoring in DR.Methods Eighty cases of diabetic retinopathy with FFA and OCT were reviewed, and then the destruction degree of macular arch were analysis.The cases were grouped by degree of DR and with HBP history or not, and using Heidelberger HRA2 measuring software to analysis the diameter of retinal vessel and macular arch in these cases.Results In these cases, the destruction of macular arch was the diameter expand and the total disruption.The diameter of macular arch was 0.43±0.048mm, and the superior temporal A/V was 0.59±0.12, the inferior temporal A/V was 0.61±0.11.The destruction of macular arch was the diameter expand, shorten and the total disruption.In non HBP group, the stages of DR were relative to diameter of macular arch, irrespective of A/V.The study of macular arch morphology demonstrate that the destroy factors included blood glucose degree, course of diabetic mellitus, micro-aneurysm in capillary network, partially collateral circulation, capillary embolism outsides the macular ring, large area of non-perfusion and hemorrhage patches.Conclusions Structure change of macular arch in diabetic retinopathy has many types, and has strong relationship between the diameter and the DR series.
