[1]龚敏,徐茂晖,许长生,等.糖尿病视网膜病变患者广泛视网膜光凝术后黄斑色素光密度的变化[J].眼科新进展,2021,41(8):774-778.[doi:10.13389/j.cnki.rao.2021.0161]
　GONG Min,XU Maohui,XU Changsheng,et al.Study on the changes of macular pigment optical density in patients with diabetic retinopathy after panretinal photocoagulation[J].Recent Advances in Ophthalmology,2021,41(8):774-778.[doi:10.13389/j.cnki.rao.2021.0161]
点击复制

糖尿病视网膜病变患者广泛视网膜光凝术后黄斑色素光密度的变化/HTML
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
41卷
期数:
2021年8期
页码:
774-778
栏目:
应用研究
出版日期:
2021-08-05

文章信息/Info

Title:
Study on the changes of macular pigment optical density in patients with diabetic retinopathy after panretinal photocoagulation
作者:
龚敏; 徐茂晖; 许长生; 邵洁
620100　四川省眉山市，眉山市人民医院眼科
Author(s):
GONG Min;  XU Maohui;  XU Changsheng;  SHAO Jie
Department of Ophthalmology, Meishan People’s Hospital ，Meishan 620100，Sichuan Province, China
关键词:
糖尿病视网膜病变; 广泛视网膜光凝术; 黄斑色素光密度; 黄斑中心凹视网膜厚度; 黄斑中心凹下脉络膜厚度
Keywords:
diabetic retinopathy;  panretinal photocoagulation;  macular pigment optical density;  central retinal thickness;  subfoveal choroidal thickness
分类号:
R774
DOI:
10.13389/j.cnki.rao.2021.0161
文献标志码:
A
摘要:
目的　探讨糖尿病视网膜病变（DR）患者行广泛视网膜光凝术（PRP）后黄斑色素光密度（MPOD）的变化。方法　纳入我院2018年8月至2020年10月收治的DR患者74例（98眼），所有患者均行PRP治疗，记录PRP的激光斑点总面积、激光能量，分别在术前及术后1周、3个月、6个月检测MPOD值，包括黄斑区平均光密度（DMean）、黄斑区光密度最大值（DMax），同时检测患者的黄斑中心凹视网膜厚度（CRT）、黄斑中心凹下脉络膜厚度（SFCT）。观察患者术后MPOD与患者临床资料及CRT、SFCT的关系。结果　DR患者PRP后1周、3个月、6个月黄斑区DMean［（0.25±0.08）du、（0.20±0.08）du、（0.19±0.06）du］、DMax［（0.38±0.06）du、（0.34±0.05）du、（0.33±0.07）du］均低于术前DMean［（0.30±0.09）du］、DMax［（0.48±0.07）du］，术后1周的CRT、SFCT分别为（266.53±47.51）μm、（361.92±64.28）μm，均高于术前CRT［（240.51±43.62）μm］、SFCT［（326.49±76.43）μm］，但术后3个月、6个月的CRT［（241.92±45.89）μm、（239.84±48.82）μm］、SFCT［（328.17±70.56）μm、（325.31±68.72）μm］均低于术后1周（均为P<0.05）。年龄≥50岁、术前低密度脂蛋白胆固醇≥4.12 mmol·L-1、PRP激光能量≥283.39 mW患者术后黄斑区DMean、DMax均低于年龄＜50岁、术前低密度脂蛋白胆固醇＜4.12 mmol·L-1、PRP激光能量＜283.39 mW的患者，且术前甘油三酯≥2.17 mmol·L-1患者术后黄斑区DMax［（0.33±0.06）du］低于术前甘油三酯＜2.17 mmol·L-1患者术后DMax［（0.38±0.05）du］（P<0.05）。患者术后黄斑区DMean、DMax与激光能量均呈负相关（均为P<0.05）。结论　DR患者术后的MPOD较术前下降，MPOD变化与PRP术中激光能量密切相关，而术前血脂紊乱、患者年龄可能是混杂因素。
Abstract:
Objective　To explore the changes of macular pigment optical density (MPOD) in patients with diabetic retinopathy (DR) after panretinal photocoagulation (PRP).Methods　A total of 74 patients (98 eyes) with DR admitted to our hospital from August 2018 to October 2020 were enrolled. All patients were treated with PRP, the total laser spot area and laser energy of PRP were recorded, and MPOD before the operation, 1 week, 3 months and 6 months after the operation were obtained, including the mean macular optical density (DMean) and the maximum macular optical density (DMax). At the same time, the patients’ central retinal thickness (CRT) and subfoveal choroidal thickness (SFCT) were measured. The relationship between MPOD of patients after operation and CRT and SFCT was observed. Results　The DMean of the patients at 1 week, 3 months, and 6 months after operation are (0.25±0.08) du, (0.20±0.08) du, (0.19±0.06) du, and DMax are (0.38±0.06) du, (0.34±0.05) du, (0.33±0.07) du, all these values are lower than the preoperative DMean of (0.30±0.09) du and DMax of (0.48±0.07) du. The CRT and SFCT results of the patients at 1 week after operation are (266.53±47.51) μm and (361.92±64.28) μm, which are higher than the preoperative (240.51±43.62) μm and (326.49±76.43) μm. The CRT results of the patients at 3 and 6 months after operation are (241.92±45.89) μm and (239.84±48.82) μm, respectively, and the SFCT results are (328.17±70.56) μm and (325.31±68.72) μm, respectively, which are lower than those at 1 week after operation (P<0.05). DMean and DMax values of patients over 50 years old with preoperative LDL≥4.12 mmol·L-1 and laser energy ≥283.39 mW are lower than those of patients less than 50 years old with preoperative LDL<4.12 mmol·L-1 and laser energy< 283.39 mW. The DMax value of patients with preoperative TG≥2.17 mmol·L-1 is (0.33±0.06) du, which is lower than that of patients with preoperative TG<2.17 mmol·L-1, that is (0.38±0.05) du (P<0.05). The postoperative DMean and DMax of the patients are negatively correlated with laser energy (P<0.05).Conclusion　The MPOD value of patients with DR is lower after operation. The change of MPOD value is closely related to the laser energy during PRP. Preoperative dyslipidemia and age may be confounding factors.

参考文献/References:

［1］　WANG S Y,ANDREWS C A,HERMAN W H,GARDNER T W,STEIN J D.Incidence and risk factors for developing diabetic retinopathy among youths with type 1 or type 2 diabetes throughout the United States［J］.Ophthalmology,2017,124(4):424-430.
［2］　SAFI H,SAFI S,HAFEZI-MOGHADAM A,AHMADIEH H.Early detection of diabetic retinopathy［J］.Surv Ophthalmol,2018,63(5):601-608.
［3］　LI X,ZHANG P.Recent progress in clinical treatment of diabetic retinopathy［J］.Int Eye Sci,2019,19(1):69-72.
［4］　孙冬敏,夏丹,梁鹏.全视网膜激光光凝治疗增生型糖尿病视网膜病变患者的疗效分析［J］.中国医师杂志,2018,20(7):1056-1059.
SUN D M,XIA D,LIANG P.Analysis of the curative effect of panretinal laser photocoagulation in the treatment of proliferative diabetic retinopathy［J］.J Chin Phys,2018,20(7):1056-1059.
［5］　REDDY S V,HUSAIN D.Panretinal photocoagulation: a review of complications［J］.Semin Ophthalmol,2018,33(1):83-88.
［6］　MARTIN R M C,MOUZO M P,FERNANDEZ I,CORDERO M P.Reliability of colour perimetry to assess macular pigment optical density in age-related macular degeneration［J］.Eur J Ophthalmol,2020,30(6):1480-1486.
［7］　中华医学会糖尿病学分会视网膜病变学组.糖尿病视网膜病变防治专家共识［J］.中华糖尿病杂志,2018,10(4):241-247.
Retinopathy Group,Diabetes Branch of Chinese Medical Association.Expert consensus on the prevention and treatment of diabetic retinopathy［J］.Chin J Diabetes Mellitus,2018,10(4):241-247.
［8］　CHEUNG Y L,SABANAYAGAM C,LAW K P,KUMARI N,TING S W,TAN G,et al.Retinal vascular geometry and 6 year incidence and progression of diabetic retinopathy［J］.Diabetologia,2017,60(9):1770-1781.
［9］　温晏,王慧,于晓明,闫丽.全视网膜光凝术对糖尿病视网膜病变患者视力的影响［J］.河北医学,2017,23(9):1522-1524.
WEN Y,WANG H,YU X M,YAN L.The effect of panretinal photocoagulation on vision in patients with diabetic retinopathy［J］.Hebei Med J,2017,23(9):1522-1524.
［10］　李瑞华,张静,聂素珍,李静.糖尿病性黄斑水肿的眼底自发荧光和黄斑色素光密度成像［J］.中国药物与临床,2020,20(16):2680-2682.
LI R H,ZHANG J,NIE S Z,LI J.Fundus autofluorescence and macular pigment optical density imaging in patients with diabetic macular ede-ma［J］.Chin Remed Clin,2020,20(16):2680-2682.
［11］　李满,王冬梅,徐斌,庞久彦,寇姣姣,唐会超,等.原发性开角型青光眼患者黄斑色素密度与神经节细胞-内丛状层厚度的相关性［J］.眼科新进展,2020,40(11):1045-0148.
LI M,WANG D M,XU B,PANG J Y,KOU J J,TANG H C,et al.Correlation between macular pigment optical density and ganglion cell-inner plexiform layer in patients with primary open-angle glaucoma［J］.Rec Adv Ophthalmol,2020,40(11):1045-1048.
［12］　INAN S,POLAT O,YIGIT S,INAN U U.PASCAL laser platform produces less pain responses compared to conventional laser system during the panretinal photocoagulation:a randomized clinical trial［J］.Afr Health Sci,2018,18(4):1010-1017.
［13］　张聪,徐丽.糖化血红蛋白水平与糖尿病视网膜病变激光光凝术后黄斑水肿的相关性［J］.中国医科大学学报,2020,49(11):26-30.
ZHANG C,XU L.Correlation of glycated hemoglobin A1c and macular edema after laser photocoagulation in diabetic retinopathy［J］.J CHN Med Univ,2020,49(11):26-30.
［14］　吴建,蔡啸谷,林彩霞,王宁利.河北永年县农村成年人群黄斑区视网膜厚度的流行病学研究:邯郸眼病研究［J］.眼科,2019,28(6):44-51.
WU J,CAI X G,LIN C X,WANG N L.Epidemiological study of macular thickness in Yongnian County population: Handan Eye Study［J］.Ophthalmol CHN,2019,28(6):44-51.
［15］　CALDERON G D,JUAREZ O H,HERNANDEZ G E,PUNZO S M,DE LA CRUZ Z D.Oxidative stress and diabetic retinopathy: development and treatment［J］.Eye,2017,31(8):1122-1130.
［16］　WANG L L,SUN Y H,WEI Q P,LIAO L.The complication and prevention of laser photocoagulation in diabetic retinopathy treatment［J］.Int Eye Sci,2019,19(3):405-408.

相似文献/References:

[1]杜玮 刘子扬 周艳艳 雒雷鸣.糖尿病视网膜病变与血清胆红素水平的关系[J].眼科新进展,2012,32(5):000.
[2]范松涛 卢建民.阿司匹林与糖尿病患者玻璃体出血以及玻璃体切割术疗效的相关性研究[J].眼科新进展,2012,32(11):000.
[3]李艳 李筱荣 袁佳琴 潘斌.糖尿病大鼠视网膜中VEGF、PEDF的表达与血-视网膜屏障损伤[J].眼科新进展,2013,33(1):000.
[4]李朝晖 崔治华 胡晓英 孟丽珠 张敬维.糖尿病视网膜病变激光面积与疗效的分析[J].眼科新进展,2013,33(2):000.
[5]冯冬梅 朱鸿 施彩虹.CXC趋化因子及其受体在糖尿病视网膜病变中的作用[J].眼科新进展,2013,33(6):000.
[6]牛淑玲.糖尿病视网膜病变患者HbAlc、FPG与血小板参数的变化及危险因素分析[J].眼科新进展,2013,33(7):000.
[7]毕春潮 王睿 王建洲 雷春灵 董晓娟 王小莉 薛晓辉.Ad-PEDF对糖尿病视网膜病变大鼠视网膜新生血管的抑制作用[J].眼科新进展,2013,33(8):000.
[8]杨萍 孙书明 李晓鹏.辛伐他汀对糖尿病视网膜病变和炎症因子的影响[J].眼科新进展,2013,33(8):000.
[9]罗文婷 孙大卫.血管黏附蛋白-1在眼科疾病中的研究进展[J].眼科新进展,2013,33(8):000.
[10]李小璐 马雅玲.糖尿病视网膜病变大鼠视网膜VEGF和PEDF的动态表达[J].眼科新进展,2013,33(9):000.

备注/Memo

备注/Memo:
眉山市科学技术局科技计划项目（编号：201806）
更新日期/Last Update: 2021-08-05