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目的探讨眼底荧光血管造影(FFA)与光学相干断层扫描(OCT)在糖尿病视网膜病变临床前期的应用价值。方法回顾性分析2014年2—6月吉林市中心医院眼科收治的2型糖尿病合并糖尿病视网膜病变(DR)临床前期患者73例共146眼,病程10~15年,所有患者进行OCT及FFA检查,记录患者视盘周围视网膜神经纤维层的厚度变化和视网膜微血管异常情况,并结合糖化血红蛋白(Hb Alc)及空腹血糖(FBG)检测对OCT及FFA检查结果进行分析。结果 1OCT或FFA检查异常33例(62眼,45.2%),其中17例合并OCT检查异常(RNFL变薄)和FFA检查异常(异常荧光),11例单纯表现为OCT检查异常,5例单纯表现为FFA检查异常。2OCT共检出阳性病例27例(33眼),阳性检出率为37.0%;FFA共检出阳性病例20例(26眼),阳性检出率为27.4%,OCT的阳性检出率明显高于FFA,差异有统计学意义(P<0.05)。3OCT检查阳性者Hb Alc平均为(6.8±1.1)%,明显高于阴性者的(6.3±0.6)%,差异有统计学意义(P<0.05);OCT检查阳性者FBG平均为(7.5±1.2)mmol/L,与阴性者的(7.4±1.2)mmol/L比较,差异无统计学意义(P>0.05)。结论 OCT与FFA均为早期DR的重要检查手段,OCT的敏感度明显高于FFA,可以作为DR早期筛查与诊断的首选方法。
Objective To investigate the clinical value of fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) in the preclinical stage of diabetic retinopathy. Methods A total of 146 patients with type 2 diabetes mellitus complicated with diabetic retinopathy (DR) preliminarily treated in Department of Ophthalmology, Jilin Central Hospital from February to June 2014 were retrospectively analyzed. The course of disease was 10 to 15 years. All patients underwent OCT and FFA examinations. The change of retinal nerve fiber layer thickness and retinal microvascular abnormality were recorded and the results of OCT and FFA were analyzed with Hb Alc and fasting blood glucose (FBG). Results 33 cases (62 eyes, 45.2%) had abnormal OCT or FFA, 17 cases had OCT abnormality (RNFL thinning) and abnormal FFA (abnormal fluorescence), 11 cases showed pure OCT abnormality and 5 cases showed simple abnormality Check abnormalities for FFA. In 2 OCT, 27 cases (33 eyes) were positive and the positive rate was 37.0%. FFA detected positive in 20 cases (26 eyes), the positive rate was 27.4%. The positive rate of OCT was significantly higher In FFA, the difference was statistically significant (P <0.05). The positive rate of Hb Alc was (6.8 ± 1.1)% in patients with positive 3 OCT test and significantly higher than that of negative patients (6.3 ± 0.6)% (P <0.05). The positive rate of FBG in patients with positive OCT was (7.5 ± 1.2) ) mmol / L, compared with those in the negative (7.4 ± 1.2) mmol / L, the difference was not statistically significant (P> 0.05). Conclusions Both OCT and FFA are important means of early DR examination. The sensitivity of OCT is higher than that of FFA, which may be the first choice of screening and diagnosis of DR.