伴有黄斑水肿的糖尿病视网膜病变患者脉络膜的光学相干断层扫描观察

目的:使用频域光学相干断层扫描仪(Optical Coherence Tomography,OCT)观测伴有黄斑水肿的糖尿病视网膜病变患者中心凹下脉络膜厚度。方法:对50名患者的30只眼、10位正常人的15只眼实施通过黄斑中心凹水平和垂直扫描。30只患眼中15眼为不伴有临床显著意义黄斑水肿(clinically significant macular edema,CSME)眼,另外15只眼为伴有CSME水肿眼。用OCT自带的测量软件人工测出水平和垂直扫描线中心凹下脉络膜厚度,计算出平均数作为该眼中心凹下脉络膜厚度。结果:伴有和不伴有CSME眼的脉络膜厚度均比正常人脉络膜厚度薄,伴有CSME眼和不伴有CSME眼之间脉络膜厚度没有差异。结论:伴有黄斑水肿的糖尿病视网膜病变患者中心凹下脉络膜厚度较正常人薄,这可能导致组织缺氧而刺激血管内皮细胞生长因子表达增加,从而破坏血-视网膜屏障的完整性,最终导致黄斑水肿。

The Observation of the Choroidal Thickness in Eyes with DR accompanied Macular Edema using SD-OCT

Purpose：To investigate choroidal thickness in eyes with diabetic retinopathy and macular edema using spectral domain optical coherence tomography （OCT）. Methods： Fifty diabetic patients with macular edema-15 eyes of 26 patients without clinically significant macular edema （CSME）, 15 eyes of 24 patients with CSME-underwent OCT examination. Ten age-matched healthy subjects （15 eyes） also underwent OCT examination. The subfoveal choroidal thickness in both vertical and horizontal sections through the cen-ter of the fovea was measured manually using the scale included in the software, and the average of the two measurements was record-ed. Result：Subfoveal choroidal thickness is 282.5＆#177;62.1μm in controls, 215.5＆#177;56.8μm in diabetic retinopathy eyes without CSME and 193.9＆#177;46.7μm in diabetic retinopathy eyes with CSME. The mean subfoveal choroidal thickness was significantly reduced in each dia-betic group compared with the control group. There is no significant difference between diabetic retinopathy eyes with or without CSME. Conclusions： The choroid in diabetic eyes with or without CSME is thinner than controls. A decreased choroidal thickness may lead to tissue hypoxia and consequently increase the level of vascular endothelial growth factor , resulting in the breakdown of the blood-retinal barrier.