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全视网膜光凝对重度非增殖性糖尿病视网膜病变患者脉络膜厚度和脉络膜血流的影响

EFFECTS OF PANRETINAL PHOTOCOAGULATION ON CHOROIDAL THICKNESS AND CHOROIDAL BLOOD FLOW IN PATIENTS WITH SEVERE NONPROLIFERATIVE DIABETIC RETINOPATHY.

作者信息

Okamoto Masahiro, Matsuura Toyoaki, Ogata Nahoko

机构信息

Department of Ophthalmology, Nara Medical University, Kashihara, Japan.

出版信息

Retina. 2016 Apr;36(4):805-11. doi: 10.1097/IAE.0000000000000800.

Abstract

PURPOSE

To evaluate the choroidal thickness and choroidal blood flow in the subfoveal region quantitatively after panretinal photocoagulation (PRP) in eyes with severe nonproliferative diabetic retinopathy.

METHODS

This was a prospective comparative study of 24 eyes of 24 patients with type II diabetes and severe nonproliferative diabetic retinopathy with no macula edema. The foveal retinal thickness and choroidal thickness were measured by enhanced depth imaging optical coherence tomography. The subfoveal choroidal blood flow was represented by the mean blur rate obtained by laser speckle flowgraphy. The intraocular pressure, blood pressure, pulse rate, and hemoglobin A1c level (HbA1c) were also measured before and after PRP.

RESULTS

The mean foveal retinal thickness did not change significantly during the follow-up period. The mean subfoveal choroidal thickness was reduced significantly from 327.4 μm at the baseline to 286.3 μm at 1 month and 285.0 μm at 3 months after PRP. The mean blur rate ratio decreased significantly to 87.5% at 1 month and 86.0% at 3 months of the baseline values. There was a significant correlation between the subfoveal choroidal thickness and subfoveal choroidal blood flow after PRP. After PRP, the best-corrected visual acuity, intraocular pressure, mean arterial pressure, ocular perfusion pressure, pulse rate, and HbA1c did not change significantly.

CONCLUSION

The success of PRP in treating eyes with severe nonproliferative diabetic retinopathy is probably due to the significant reduction of the subfoveal choroidal thickness and subfoveal choroidal blood flow after PRP.

摘要

目的

评估重度非增殖性糖尿病视网膜病变患者全视网膜光凝(PRP)后黄斑中心凹下区域脉络膜厚度和脉络膜血流情况。

方法

这是一项前瞻性对比研究,纳入24例2型糖尿病且患有重度非增殖性糖尿病视网膜病变且无黄斑水肿的患者的24只眼。采用增强深度成像光学相干断层扫描测量黄斑区视网膜厚度和脉络膜厚度。通过激光散斑血流图获得的平均模糊率来代表黄斑中心凹下脉络膜血流。在PRP前后还测量了眼压、血压、脉搏率和糖化血红蛋白水平(HbA1c)。

结果

随访期间平均黄斑区视网膜厚度无显著变化。PRP后,黄斑中心凹下平均脉络膜厚度从基线时的327.4μm显著降低至1个月时的286.3μm和3个月时的285.0μm。平均模糊率比值在基线值的1个月时显著降至87.5%,3个月时降至86.0%。PRP后黄斑中心凹下脉络膜厚度与黄斑中心凹下脉络膜血流之间存在显著相关性。PRP后,最佳矫正视力、眼压、平均动脉压、眼灌注压、脉搏率和HbA1c均无显著变化。

结论

PRP成功治疗重度非增殖性糖尿病视网膜病变患者的眼睛,可能是由于PRP后黄斑中心凹下脉络膜厚度和黄斑中心凹下脉络膜血流显著降低。

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