Department of Ophthalmology, Qingdao Municipal Hospital, Qingdao, China.
Dalian Medical University, Dalian, China.
Int J Clin Pract. 2022 Feb 3;2022:8775641. doi: 10.1155/2022/8775641. eCollection 2022.
We describe the clinical manifestations of supra-large range nonperfusion area (SLRNPA) in diabetic retinopathy (DR).
This was a retrospective case-control study. A total of 260 eyes of 236 patients with DR who underwent pars plana vitrectomy in the Department of Ophthalmology of Qingdao Municipal Hospital from February 2016 to June 2019 were enrolled. Fundus fluorescein angiography was performed after surgery to determine whether SLRNPA or non-SLRNPA in DR was present. All demographic and clinical data were carefully collected.
Forty-one eyes of 22 patients were diagnosed with SLRNPA in DR (15.77% of all eyes). Compared to non-SLRNPA, SLRNPA patients were more likely to be male and younger with earlier DR onset, a smoking history, other comorbidities, and a higher HbA1c level. SLRNPA in DR eyes exhibited more neovascular glaucoma (NVG) and diabetic keratopathy (DK) than did other eyes. Such eyes were more likely to require anti-VEGF therapy before surgery or a silicone oil or a gas tamponade during surgery and to suffer from persistent corneal epithelial erosion and NVG recurrence after surgery.
SLRNPA in DR is a severe status of DR. Treatment for DR patients with SLRNPA is difficult, and the prognosis is poor, so clinicians must thus pay more attention to SLRNPA in DR.
描述糖尿病视网膜病变（DR）中超大无灌注区（SLRNPA）的临床表现。
这是一项回顾性病例对照研究。纳入 2016 年 2 月至 2019 年 6 月期间在青岛市立医院眼科接受玻璃体切除术的 236 例 260 只 DR 眼。术后行眼底荧光血管造影，确定是否存在 DR 的 SLRNPA 或非 SLRNPA。仔细收集所有人口统计学和临床数据。
22 例 41 只眼诊断为 DR 的 SLRNPA（占所有眼的 15.77%）。与非 SLRNPA 相比，SLRNPA 患者更可能为男性和年轻人，DR 发病更早，有吸烟史、其他合并症和更高的糖化血红蛋白（HbA1c）水平。与其他眼相比，DR 的 SLRNPA 眼更易发生新生血管性青光眼（NVG）和糖尿病性角膜病变（DK）。此类眼在手术前更可能需要抗血管内皮生长因子（VEGF）治疗，或在手术中需要硅油或气体填充，并在手术后持续发生角膜上皮侵蚀和 NVG 复发。
DR 的 SLRNPA 是 DR 的严重状态。治疗 DR 伴 SLRNPA 的患者较为困难，预后较差，因此临床医生必须更加重视 DR 的 SLRNPA。
