光学相干断层扫描血管成像在糖尿病患者早期黄斑区视网膜微循环评
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[Key words] Diabetic retinopathy； Macular area； Retinal microcirculation； Optical coherence
tomography angiography
糖尿病是一组以长期慢性高血糖为特征的代谢性疾病, 是由机体内胰岛素分泌缺陷、生物作用受损或两者兼有引 起长期慢性高血糖状态会对患者全身微血管造成不良 影响，特别是对视网膜微循环的影响。糖尿病能引起增殖性 和非增殖性视网膜病变，糖尿病视网膜病变(diabetic retinopathy,DR)以微血管病变为主，是糖尿病引起的微血管 病变中最常见的疾病，也是我国40岁以下人群最常见的致 盲眼病"6 o DR临床表现为微血管瘤、出血点、渗出、新生血 管出现以及黄斑水肿等，其中，新生血管的出现是区分非增 殖性DR与增殖性DR的主要标志。严重的DR会导致患者 视力下降，甚至失明。有研究表明，黄斑缺血在DR的发生、
【摘要】糖尿病视网膜病变是由视网膜微血管损伤引起的一系列病变，也是致盲的主要原因。 胰岛素代谢异常使糖尿病患者眼部组织、神经和血管微循环产生改变，导致视功能发生不同程度的损 伤，患者临床表现为出血斑点、动脉瘤、视网膜内微血管异常和黄斑水肿等。目前，临床上对糖尿病患 者早期黄斑区视网膜微循环检查以荧光素眼底血管造影为主，并将其视为“金标准”，但是该检查方 法具有明显的创伤性，且耗时相对较长，影响患者的依从性和耐受性。光学相干断层扫描血管成像是 一种新型的、无创的血管成像技术，但目前在糖尿病患者早期黄斑区视网膜微循环评估中的应用研究 较少。本文中笔者分析早期黄斑区视网膜微循环对糖尿病患者视网膜的彫响，并对光学相干断层扫 描血管成像在糖尿病患者早期黄斑区视网膜微循环评估中的应用进展进行综述。
Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, Chinn Corresponding author： Liu Guodan, Email: LI5249496270@ 163. com
[Abstract] Diabetic retinopathy is a series of lesions caused by microvascular damage of the retina, which is also the main cause of blindness in most patients. Abnormal insulin metabolism changes the ocular tissue, nerve and vascular microcirculation in diabetics, resulting in different degrees of visual impairment. The clinical manifestations of diabetics are bleeding spots, aneurysms, intraretinal microvascular abnormalities, and macular edema, etc. At present, fluorescein fundus angiography is the main clinical examination for the early macular retinal rnicrocirculalion in diabetics, which is regarded as "gold standardM . However, it is obviously traumatic and relatively time-consuming, leading to the poor compliance and poor tolerance for patients. Optical coherence tomography angiography is a novel, non-invasive angiography technique, but has few applications in the early detection of macular retinal microcirculation in diabetics. In this paper, the effect of early macular retinal microcirculation on the retina of diabetics was analyzed, and the application progress of optical coherence tomography angiography in the evaluation of early macular retinal microcirculation in diabetics was reviewed.
中华眼科医学杂志(电子版)2019 年6 月 第 9 卷第 3 期 Chin J Ophthalmol Med (Eleetmnic Edition), June 2019, Vol. 9, No. 3
• 187 •
.综述.
光学相干断层扫描血管成像在糖尿病患者早期黄斑区视 网膜微循环评估中的应用
李昕格丁旭晨刘国丹
【关键词】 糖尿病视网膜病n of optical coherence tomography angiography in evaluation of the early macular retinal microcirculation in diabetics Li Xinge, Ding Xuchen, Liu Guodan. Department of Ophthalmology, the
tomography angiography
糖尿病是一组以长期慢性高血糖为特征的代谢性疾病, 是由机体内胰岛素分泌缺陷、生物作用受损或两者兼有引 起长期慢性高血糖状态会对患者全身微血管造成不良 影响，特别是对视网膜微循环的影响。糖尿病能引起增殖性 和非增殖性视网膜病变，糖尿病视网膜病变(diabetic retinopathy,DR)以微血管病变为主，是糖尿病引起的微血管 病变中最常见的疾病，也是我国40岁以下人群最常见的致 盲眼病"6 o DR临床表现为微血管瘤、出血点、渗出、新生血 管出现以及黄斑水肿等，其中，新生血管的出现是区分非增 殖性DR与增殖性DR的主要标志。严重的DR会导致患者 视力下降，甚至失明。有研究表明，黄斑缺血在DR的发生、
【摘要】糖尿病视网膜病变是由视网膜微血管损伤引起的一系列病变，也是致盲的主要原因。 胰岛素代谢异常使糖尿病患者眼部组织、神经和血管微循环产生改变，导致视功能发生不同程度的损 伤，患者临床表现为出血斑点、动脉瘤、视网膜内微血管异常和黄斑水肿等。目前，临床上对糖尿病患 者早期黄斑区视网膜微循环检查以荧光素眼底血管造影为主，并将其视为“金标准”，但是该检查方 法具有明显的创伤性，且耗时相对较长，影响患者的依从性和耐受性。光学相干断层扫描血管成像是 一种新型的、无创的血管成像技术，但目前在糖尿病患者早期黄斑区视网膜微循环评估中的应用研究 较少。本文中笔者分析早期黄斑区视网膜微循环对糖尿病患者视网膜的彫响，并对光学相干断层扫 描血管成像在糖尿病患者早期黄斑区视网膜微循环评估中的应用进展进行综述。
Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, Chinn Corresponding author： Liu Guodan, Email: LI5249496270@ 163. com
[Abstract] Diabetic retinopathy is a series of lesions caused by microvascular damage of the retina, which is also the main cause of blindness in most patients. Abnormal insulin metabolism changes the ocular tissue, nerve and vascular microcirculation in diabetics, resulting in different degrees of visual impairment. The clinical manifestations of diabetics are bleeding spots, aneurysms, intraretinal microvascular abnormalities, and macular edema, etc. At present, fluorescein fundus angiography is the main clinical examination for the early macular retinal rnicrocirculalion in diabetics, which is regarded as "gold standardM . However, it is obviously traumatic and relatively time-consuming, leading to the poor compliance and poor tolerance for patients. Optical coherence tomography angiography is a novel, non-invasive angiography technique, but has few applications in the early detection of macular retinal microcirculation in diabetics. In this paper, the effect of early macular retinal microcirculation on the retina of diabetics was analyzed, and the application progress of optical coherence tomography angiography in the evaluation of early macular retinal microcirculation in diabetics was reviewed.
中华眼科医学杂志(电子版)2019 年6 月 第 9 卷第 3 期 Chin J Ophthalmol Med (Eleetmnic Edition), June 2019, Vol. 9, No. 3
• 187 •
.综述.
光学相干断层扫描血管成像在糖尿病患者早期黄斑区视 网膜微循环评估中的应用
李昕格丁旭晨刘国丹
【关键词】 糖尿病视网膜病n of optical coherence tomography angiography in evaluation of the early macular retinal microcirculation in diabetics Li Xinge, Ding Xuchen, Liu Guodan. Department of Ophthalmology, the