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糖尿病性视网膜病变脉络膜新生血管的临床和血管造影特征。

Clinical and angiographic characterization of choroidal neovascularization in diabetic retinopathy.

机构信息

Smt. Kanuri Santhamma Centre for Vitreo Retinal Diseases, L V Prasad Eye Institute, Hyderabad, India.

Retina and Uveitis Department, L V Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, India.

出版信息

Eur J Ophthalmol. 2021 Mar;31(2):584-591. doi: 10.1177/1120672120902027. Epub 2020 Jan 27.

Abstract

BACKGROUND

To report the clinical and angiographic characteristics of choroidal neovascularization in patients with diabetic retinopathy.

METHODS

Patients of type 2 diabetes mellitus with presence of choroidal neovascularization in at least one eye were retrospectively analyzed. The study eyes were divided into three groups based on presence (active or scarred) or absence of choroidal neovascularization (fellow eyes). Imaging characteristics of active choroidal neovascularization were recorded using optical coherence tomography, fluorescein, and indocyanine angiography. Central macular thickness, subfoveal choroidal thickness, and large choroidal vessel layer thickness were compared at baseline and final visit.

RESULTS

Our study reports the prevalence rate of choroidal neovascularization in eyes with diabetic retinopathy (0.27%; 36 out of 13,382 eyes). A total of 64 eyes of 32 patients (age, mean ± standard deviation: 68.5 ± 9.3 years) with baseline visual acuity of 0.69 ± 0.69 logarithm of minimum angle of resolution (Snellen equivalent 20/100) were included. Nonproliferative diabetic retinopathy (57 eyes) comprised the majority followed by proliferative diabetic retinopathy (7 eyes). Eyes with choroidal neovascularization (36, 56.25%) included both active (25) and scarred (11) choroidal neovascularization, with bilateral choroidal neovascularization in 4 patients. Type 1 choroidal neovascularization was the most common subtype of choroidal neovascularization on optical coherence tomography. Common etiologies for active choroidal neovascularization included age-related macular degeneration (3; 12%), myopia (1; 4%), and inflammatory choroidal neovascularization secondary to chorioretinitis (1; 4%). In the remaining 20 eyes, choroidal neovascularization formation was primarily due to diabetic choroidopathy.

CONCLUSION

The prevalence of choroidal neovascularization in eyes with diabetic retinopathy is very low, with a lower prevalence of age-related macular degeneration. Diabetic choroidopathy plays a significant role in formation of choroidal neovascularization in eyes with diabetic retinopathy.

摘要

背景

报告糖尿病性视网膜病变患者脉络膜新生血管的临床和血管造影特征。

方法

回顾性分析 2 型糖尿病患者中至少一只眼存在脉络膜新生血管的患者。根据脉络膜新生血管的存在(活动或瘢痕)或不存在(对侧眼)将研究眼分为三组。使用光学相干断层扫描、荧光素和吲哚青绿血管造影记录活动期脉络膜新生血管的影像学特征。比较基线和最终随访时的中心黄斑厚度、中心下脉络膜厚度和大脉络膜血管层厚度。

结果

本研究报告了糖尿病性视网膜病变眼中脉络膜新生血管的患病率(0.27%;13382 只眼中 36 只)。共纳入 32 例患者的 64 只眼(年龄,均值±标准差:68.5±9.3 岁),基线视力为 0.69±0.69 最小角分辨率对数(Snellen 等价物 20/100)。非增生性糖尿病性视网膜病变(57 只眼)占多数,其次是增生性糖尿病性视网膜病变(7 只眼)。脉络膜新生血管(36 只眼,56.25%)包括活动期(25 只眼)和瘢痕期(11 只眼)脉络膜新生血管,4 例患者为双眼脉络膜新生血管。光学相干断层扫描上最常见的脉络膜新生血管亚型是 1 型。活动期脉络膜新生血管的常见病因包括年龄相关性黄斑变性(3;12%)、近视(1;4%)和脉络膜视网膜炎继发的炎症性脉络膜新生血管(1;4%)。在其余 20 只眼中,脉络膜新生血管的形成主要是由于糖尿病性脉络膜病变。

结论

糖尿病性视网膜病变眼中脉络膜新生血管的患病率非常低,年龄相关性黄斑变性的患病率较低。糖尿病性脉络膜病变在糖尿病性视网膜病变眼中脉络膜新生血管的形成中起重要作用。

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