Department of Ophthalmology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, People's Republic of China.
BMC Ophthalmol. 2019 Aug 16;19(1):186. doi: 10.1186/s12886-019-1189-8.
This study aims to investigate the choroidal thickness and choroidal vascular density parameters and their correlation with severity of diabetic retinopathy (DR) in diabetes mellitus (DM) patients.
An observational cross-sectional study was conducted of 104 eyes, which were divided into 4 groups: Healthy controls (n = 38), DM with no DR eyes (n = 22), panretinal photocoagulation-untreated non-proliferative DR eyes (PRP-untreated NPDR eyes) (n = 24), PRP-untreated proliferative DR eyes (PRP-untreated PDR eyes) (n = 20). Optical coherence tomography (OCT) was performed. The total choroidal area (TCA), stromal area (SA), the luminal areas (LA) and the ratio of the luminal to choroidal area (L/C ratio) were compared. The choroidal parameters were also compared between PRP untreated and PRP-treated DR eyes.
The L/C ratio values were 0.68 ± 0.06 in controls and 0.63 ± 0.04 in DM eyes (P < 0.001). But there were no statistically significant differences in retinal nerve fiber layer (RNFL) thickness, retinal thickness and subfoveal choroidal thickness (SCT) measurements between the two groups (P = 0.407, P = 0.654 and P = 0.849; respectively). The vessel density values were significantly different in DM with no DR eyes, PRP-untreated NPDR eyes and PRP-untreated PDR eyes (P < 0.001 for SCT, TCA and SA). The L/C ratio values in the three groups were significant different (P = 0.019). There was no significant difference in SCT, TCA, LA, SA and the L/C ratio between PRP-untreated and PRP-treated DR eyes.
Eyes of patients with DM showed the L/C ratio decreased compared with normal controls. The SCT increased, but L/C ratio significantly decreased with severity of DR eyes compared with DM and normal eyes. Changes in the L/C ratio may predict DR development before they are otherwise evident clinically. Choroidal blood flow deficit can be an early pathologic change in DR.
本研究旨在探讨脉络膜厚度和脉络膜血管密度参数及其与糖尿病患者糖尿病视网膜病变（DR）严重程度的相关性。
对 104 只眼进行了一项观察性横断面研究，将其分为 4 组：健康对照组（n=38）、无 DR 的糖尿病眼（DM 无 DR 眼）（n=22）、全视网膜光凝未治疗的非增生性 DR 眼（PRP-未治疗 NPDR 眼）（n=24）、全视网膜光凝未治疗的增生性 DR 眼（PRP-未治疗 PDR 眼）（n=20）。进行光学相干断层扫描（OCT）。比较总脉络膜面积（TCA）、基质面积（SA）、管腔面积（LA）和管腔与脉络膜面积的比值（L/C 比值）。还比较了 PRP 未治疗和 PRP 治疗的 DR 眼中的脉络膜参数。
对照组的 L/C 比值为 0.68±0.06，DM 眼为 0.63±0.04（P<0.001）。但两组间视网膜神经纤维层（RNFL）厚度、视网膜厚度和中心凹下脉络膜厚度（SCT）测量值无统计学差异（P=0.407、P=0.654 和 P=0.849；分别）。DM 无 DR 眼、PRP 未治疗 NPDR 眼和 PRP 未治疗 PDR 眼中血管密度值差异有统计学意义（SCT、TCA 和 SA 的 P<0.001）。三组的 L/C 比值差异有统计学意义（P=0.019）。PRP 未治疗和 PRP 治疗的 DR 眼中 SCT、TCA、LA、SA 和 L/C 比值无差异。
DM 患者的眼与正常对照相比，L/C 比值降低。与 DM 和正常眼相比，DR 眼的 SCT 增加，但 L/C 比值显著降低，表明 DR 发展之前可能出现 L/C 比值变化。脉络膜血流不足可能是 DR 的早期病理变化。
