频域光学相干断层扫描增强技术观察糖尿病视网膜病变激光光凝术前后黄斑区脉络膜体积的变化

摘要

Objective:To observed the changes in macular choroidal volume (MCV) before and atfer laser treatment for diabetic retinopathy (DR) with enhanced depth imaging spectral-domain optical coherence tomography (OCT-EDI). Methods:Clinical data of 30 patients (51 eyes) diagnosed severe non-proliferative (NPDR) and early proliferative diabetic retinopathy (PDR) with macular edema by examinations of optical coherence tomography (OCT) and fundus fluorescein angiography (FFA). All eyes were treated with grid laser photocoagulation and underwent panretinal photocoagulation (PRP) 1 week atfer treatment. hTe eyes were scanned by OCT-enhanced-depth imaging (EDI) at the time of before treatment of laser, 1 week, 1 month and 3 months atfer macular grid photocoagulation and PRP. Data of MCV were measured. Results:MCV were (6.38±0.69) mm3 before treatment of laser, MCV were (7.79±0.70) mm3 atfer macular grid photocoagulation, (1.56±0.32) mm3 larger than before treatment and with significant difference (t=3.265, P<0.05). MCV were (7.01±0.71) mm3 after PRP 1 month later, (1.21±0.31) mm3 larger than before treatment and with signiifcant difference (t=3.237, P<0.05), MCV were (6.11±0.57) mm3 atfer PRP 3 months later, (0.87±0.22) mm3 smaller than before treatment and with signiifcant difference (t=3.305, P<0.05). Conclusion:MCV increased significantly after macular grid photocoagulation 1 week later and PRP 1 month later, MCV decreased after PRP 3 months later. OCT-EDI can noninvasively and intuitively observe the choroidal changes of macular.%目的：应用频域光学相干断层扫描增强技术(enhanced-depth imaging optical coherence tomography， OCT)观察糖尿病视网膜病变(diabetic retinopathy，DR)在视网膜激光光凝术前后黄斑区脉络膜体积(macular choroidal volume，MCV)的变化情况。方法：经眼底血管造影(fundus fluorescein angiography，FFA)和光学相干断层扫描(optical coherence tomography，OCT)确诊重度非增殖期糖尿病视网膜病变(non-proliferative diabetic retinopathy，NPDR)和早期增殖期糖尿病视网膜病变(proliferative diabetic retinopathy，PDR)伴黄斑水肿(diabetic macular edema，DME)的患者30例(51只眼)纳入研究。所有患眼均先行黄斑区格栅样激光光凝治疗，然后1周后行全视网膜激光光凝术(panretinal photocoagulation，PRP)。治疗前、黄斑区格栅样激光光凝完成后1周及PRP全部治疗完成后1个月和三个月，分别采用频域OCT增强深部成像技术(enhanced-depth imaging，EDI)技术对所有患眼黄斑区脉络膜进行水平扫描，测量计算出MCV值。结果：治疗前MCV值为(6.38±0.69) mm3，黄斑区格栅样激光光凝术后1周MCV值为(7.79±0.70) mm3，较治疗前增大(1.56±0.32) mm3，差异有统计学意义(t=3.265，P<0.05)，PRP术后一个月MCV值为(7.01±0.71) mm3，较治疗前增大(1.21±0.31) mm3，差异有统计学意义(t=3.237，P<0.05)，PRP术后3个月MCV值为(6.11±0.57) mm3，较治疗前减小(0.87±0.22) mm3，差异有统计学意义(t=3.305，P<0.05)。结论：黄斑区格栅激光后1周及PRP术后1个月DR患者MCV值增大，3个月MCV值减小。OCT-EDI可以无创地、直观地观察到黄斑区脉络膜结构的变化。