基础医学与临床 ›› 2025, Vol. 45 ›› Issue (8): 1078-1082.doi: 10.16352/j.issn.1001-6325.2025.08.1078

• 临床研究 • 上一篇    下一篇

应用OCTA评估糖尿病性视网膜病变玻璃体切割术后的临床效果

乌兰, 魏畅, 李应桢, 栾春生*   

  1. 大庆油田总医院 眼科, 黑龙江 大庆 163000
  • 收稿日期:2025-03-10 修回日期:2025-05-23 出版日期:2025-08-05 发布日期:2025-07-11
  • 通讯作者: *Luanchunsheng@163.com
  • 基金资助:
    黑龙江省卫生健康委项目(20220707021087)

Evaluation the clinical efficacy of vitrectomy for diabetic retinopathy by optical coherence tomography angiography (OCTA)

Wulan, WEI Chang, LI Yingzhen, LUAN Chunsheng*   

  1. Department of Ophthalmology, Daqing Oil Field General Hospital, Daqing 163000, China
  • Received:2025-03-10 Revised:2025-05-23 Online:2025-08-05 Published:2025-07-11
  • Contact: *Luanchunsheng@163.com

摘要: 目的 应用光学相干断层扫描血管成像技术(OCTA)分析比较糖尿病性视网膜病变(DR)患者玻璃体切割术后视网膜血流的变化。方法 前瞻性分析大庆油田总医院2022年3月至2024年5月确诊的DR行玻璃体切割术患者60例(60眼)的临床资料。对患者术前、术后1 d、1周、1个月、3个月的最佳矫正视力(BCVA)、眼压与OCTA检查结果进行比较。结果 眼压在术前与术后1 d、术后1周差异有显著性(P<0.01),BCVA、黄斑中心区厚度(CMT)在术前与术后1 d、术后1周、术后1个月、术后3个月差异均有显著性(P<0.01),黄斑中央凹无血管区域(FAZ)、视盘周围放射状毛细血管(RPC)在术前与术后1周、术后1个月、术后3个月差异有显著性(P<0.01),视网膜浅层毛细血管密度(SVD)、视网膜深层毛细血管密度(DVD)、视网膜神经纤维层(RNFL)在术前与术后1个月、术后3个月差异有显著性(P<0.01)。结论 DR患者行玻璃体切割手术治疗能够明显改善视力,视力在术后1个月左右趋于稳定,这可能与术后1个月患者CMT厚度趋于稳定有关。手术能有效降低患者眼内压,术后患者黄斑区FAZ及RPC改善较早。

关键词: 糖尿病性视网膜病变, 玻璃体切割术, 光学相干断层扫描血管成像(OCTA), 视网膜浅层毛细血管密度, 黄斑中心区厚度

Abstract: Objective OCTA analysis was employed to assess the alterations in retinal microcirculation following vitrectomy in patients with diabetic retinopathy. Methods The clinical data of 60 eyes from 60 diabetic retinopathy patients who accepted vitrectomy from Mar.2022 to May.2024 in Daqing Oilfield General Hospital were analyzed prospectively.The preoperative and postoperative outcomes of best corrected visual acuity(BCVA), intraocular pressure(IOP), and optical coherence tomography angiography(OCTA) were compared at baseline, as well as at 1 day, 1 week, 1 month, and 3 months following surgery. Results There was statistically significant differences in IOP between preoperative and postoperative 1 day and 1 week (P<0.01). There were significant differences in BCVA and CMT observed prior to surgery, as well as at 1 day, 1 week, 1 month, and 3 months post-surgery (P<0.01). FAZ and RPC exhibited significant differences prior to surgery, as well as at 1 week, 1 month, and 3 months postoperatively(P<0.01).The SVD, DVD, and RNFL exhibited significant differences prior to surgery and at 1 month and 3 months postoperatively(P<0.01). Conclusions Vitrectomy can substantially enhance the visual acuity of patients with DR, and this improvement tends to stabilize approximately one month post-surgery, potentially correlating with the stability of central macular thickness(CMT)observed in patients at that time. The procedure can significantly decrease intraocular pressure in patients, and FAZ along with the radial peripapillary capillaries(RPC)in the macular region exhibited earlier improvement postoperatively.

Key words: diabetic retinopathy, vitrectomy, optical coherence tomography angiography(OCTA), vessel density of superficial capillary plexus, central macular thickness

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