[1]刘青,艾明.光学相干断层扫描血管成像（OCTA）和荧光素血管造影（FFA）对比观察增生型糖尿病视网膜病变（PDR）[J].眼科新进展,2017,37(1):052-55.[doi:10.13389/j.cnki.rao.2017.0014]
　LIU Qing,AI Ming.Characteristics of proliferative diabetic retinopathy observed by optical coherence tomography angiography and fundus fluorescein angiography[J].Recent Advances in Ophthalmology,2017,37(1):052-55.[doi:10.13389/j.cnki.rao.2017.0014]
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光学相干断层扫描血管成像（OCTA）和荧光素血管造影（FFA）对比观察增生型糖尿病视网膜病变（PDR）/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
37卷
期数:
2017年1期
页码:
052-55
栏目:
应用研究
出版日期:
2017-01-05

文章信息/Info

Title:
Characteristics of proliferative diabetic retinopathy observed by optical coherence tomography angiography and fundus fluorescein angiography
作者:
刘青; 艾明
430060　湖北省武汉市，武汉大学人民医院眼科中心
Author(s):
LIU Qing; AI Ming
Department of Ophthalmology，the People’s Hospital of Wuhan University，Wuhan 430060，Hubei Province,China
关键词:
光学相干断层扫描血管成像; 荧光素血管造影; 糖尿病视网膜病变
Keywords:
optical coherence tomography angiography; fundus fluorescein angiography; diabetic retinopathy
分类号:
R774.1
DOI:
10.13389/j.cnki.rao.2017.0014
文献标志码:
A
摘要:
目的　运用光学相干断层扫描血管成像（optical coherence tomography angiography,OCTA）和荧光素血管造影（fundus fluorescein angiography,FFA）对比观察增生型糖尿病视网膜病变（proliferating diabetic retinopathy,PDR）的临床特征，分析OCTA与FFA对PDR患眼眼底病变检出的一致性。方法　回顾性病例研究。选择PDR患者25例（36眼），每例患者均行OCTA和FFA检查，并且两项检查间隔时间不超过2 h。对比观察记录PDR患眼在OCTA和FFA图像中黄斑拱环结构改变、黄斑水肿、视网膜微血管瘤、视网膜新生血管、视网膜无灌注区5种眼底病变的影像学特征，并分析两种检查方法对上述眼底改变检出的一致性。结果　PDR患眼的OCTA特征主要为黄斑拱环结构改变区视网膜浅层毛细血管扩张迂曲、深层中心凹无血管区扩大，黄斑水肿区视网膜浅层血管迂曲扩张、视网膜深层片囊状弱信号，视网膜微血管瘤区浅层、深层毛细血管局部囊样扩张膨大或梭形改变，视网膜新生血管区浅层、深层不规则异常血管网状结构，视网膜无灌注区片状弱信号；PDR患眼的FFA图像特征主要为黄斑拱环结构改变区周围血管扩张弯曲，黄斑水肿区、视网膜微血管瘤区和视网膜新生血管区造影期强荧光，视网膜无灌注区表现和OCTA相似。OCTA检查发现PDR患眼黄斑拱环结构改变、黄斑水肿、视网膜微血管瘤、视网膜新生血管、视网膜无灌注区分别为26眼、26眼、25眼、13眼、30眼；FFA检查发现5种眼底病变依次为20眼、28眼、28眼、12眼、30眼；OCTA与FFA检查对PDR患眼黄斑拱环结构改变、黄斑水肿、视网膜微血管瘤检出的一致性一般（Kappa=0.416、0.705、0.646，均为P＜0.01），对视网膜新生血管、视网膜无灌注区检出的一致性较好（Kappa=0.816、0.800，均为P＜0.01）。结论　OCTA与FFA能较好地观察到PDR患眼5种眼底病变，并对PDR患眼的部分眼底病变的检出具有良好的一致性。
Abstract:
Objective　To observe the characteristics of proliferative diabetic retinopathy (PDR) by optical coherence tomography angiography (OCTA) and fundus fluorescein angiography (FFA),and assess the consistency of diagnostic results using OCTA and FFA in PDR.Methods　This was a retrospective case series of 36 eyes of 25 patients with PDR.Each patient was completed the examination of OCTA and FFA within 2 hours.The imaging features of foveal avascular zone change,macular edema,microaneurysms,retinal neovascularization and nonperfused areas of PDR in OCTA and FFA were observed,and the consistency of diagnostic results of them was assessed.Results　The primary imaging features of PDR in OCTA were as follow.The foveal avascular zone change manifested the destruction and even vanished the arch in superfacial layer,and enlarged the foveal avascular zone in deep layer.Macular edema manifested saccate low signal.Microaneurysms manifested cystoid expanding or fusiform changing of capillary.Neovascularization manifested irregular abnormal capillary network,nonperfused areas manifested low signal.However,in FFA,the expanding and bending of capillary around the foveal avascular zone were observed in the foveal avascular zone.The manifestation of macular edema,microaneurysms and neovascularization were showed as strong fluorescence in different times of FFA.Nonperfused areas were expressed low signal as similar as OCTA.Based on OCTA，foveal avascular zone change were found in 26 eyes,macular edema in 26 eyes,microaneurysms in 25 eyes,neovascularization in 13 eyes,and nonperfused areas in 30 eyes.Based on FFA,the above fundus diseases were found in 20 eyes,28 eyes,28 eyes,12 eyes,30 eyes,respectively,which indicated that the consistency was good for foveal avascular zone change,macular edema and microaneurysms (Kappa=0.416,0.705,0.646;all P＜0.01），excellent for neovascularization and nonperfused areas (Kappa=0.816,0.800;all P＜0.01).Conclusion　OCTA and FFA can preferably observe the foveal avascular zone change,macular edema,microaneurysms,retinal neovascularization and nonperfused areas in PDR patients.There is a good consistency between OCTA and FFA in the diagnosis of above-mentioned fundus lesions in PDR patients.

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更新日期/Last Update: 2017-02-15