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糖尿病视网膜病变患者眼部毛细血管无灌注区域的视网膜敏感性丧失和结构紊乱。

Retinal sensitivity loss and structural disturbance in areas of capillary nonperfusion of eyes with diabetic retinopathy.

作者信息

Unoki Noriyuki, Nishijima Kazuaki, Sakamoto Atsushi, Kita Mihori, Watanabe Daisuke, Hangai Masanori, Kimura Tetsushi, Kawagoe Naoaki, Ohta Masahumi, Yoshimura Nagahisa

机构信息

Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.

出版信息

Am J Ophthalmol. 2007 Nov;144(5):755-760. doi: 10.1016/j.ajo.2007.07.011. Epub 2007 Sep 14.

Abstract

PURPOSE

To assess light sensitivity and morphologic changes of capillary nonperfused areas in diabetic retinopathy.

DESIGN

Prospective, observational cross-sectional study.

METHODS

Seventeen consecutive patients (20 eyes) with areas of capillary nonperfusion resulting from severe nonproliferative or proliferative diabetic retinopathy were included in the study. All eyes underwent fluorescent angiography and fundus-related microperimetry. Nonperfused areas of the retina were scanned with optical coherence tomography (OCT).

RESULTS

In all 20 diabetic eyes, areas of capillary nonperfusion detected by fluorescein angiography were associated with the loss of retinal sensitivity. At the edges of the nonperfused area, retinal sensitivity tended to be reduced. The OCT images suggested a structural disturbance of the inner retina and high-reflectivity deposition located between the outer segments of photoreceptor and the retinal pigment epithelium corresponding to the areas of capillary nonperfusion.

CONCLUSIONS

Areas of capillary nonperfusion resulting from severe nonproliferative or proliferative diabetic retinopathy show morphologic changes of the retinal structure, which may lead to a loss of sensitivity.

摘要

目的

评估糖尿病视网膜病变中毛细血管无灌注区域的光敏感性和形态学变化。

设计

前瞻性观察性横断面研究。

方法

本研究纳入了17例连续的患者(20只眼),这些患者因严重非增殖性或增殖性糖尿病视网膜病变出现毛细血管无灌注区域。所有眼睛均接受了荧光血管造影和眼底相关微视野检查。用光学相干断层扫描(OCT)对视网膜无灌注区域进行扫描。

结果

在所有20只糖尿病眼中,荧光血管造影检测到的毛细血管无灌注区域与视网膜敏感性丧失有关。在无灌注区域的边缘,视网膜敏感性往往降低。OCT图像显示内视网膜结构紊乱,在对应于毛细血管无灌注区域的光感受器外段和视网膜色素上皮之间有高反射性沉积物。

结论

严重非增殖性或增殖性糖尿病视网膜病变导致的毛细血管无灌注区域显示出视网膜结构的形态学变化,这可能导致敏感性丧失。

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