李胜 刘丁熙 纪莉莉 祁媛媛

【摘要】 目的：探讨OCT血管成像技术在糖尿病性黄斑水肿中的应用价值。方法：回顾性分析本院2017年8月-2019年8月39例（52眼）疑似黄斑水肿患者的临床资料，患者均进行眼底血管造影、OCT血管成像技术检查。比较两种检查方法对于黄斑水肿分型的结果，以及OCT血管成像技术检查诊断符合率，并计算灵敏度、特异度。结果：纳入52只眼，眼底血管造影检查结果分型：弥漫水肿型20只眼（38.46%）、无渗漏型16只眼（30.77%）、局部水肿型15只眼（28.85%）、缺血型1只眼（1.92%）;OCT血管成像技术检查结果分型：海绵样水肿型21只眼（40.38%）、黄斑囊样水肿16只眼（30.77%）、正常9只眼（17.31%）、中心凹浆液性脱离6只眼（11.54%）。OCT血管成像技术诊断符合率为82.69%，诊断灵敏度为97.22%，特异度为50.00%。有临床意义的黄斑水肿患者激光光凝术后视网膜厚度均低于治疗前（P<0.05）。结论：OCT血管成像技术在糖尿病性黄斑性水肿诊断、病情评估等方面均有重要的应用价值，为临床医师评估有临床意义的黄斑性水肿术后病情提供客观依据。

【关键词】 OCT血管成像技术 眼底血管造影 黄斑水肿

Application of OCT Angiography in Diabetic Macular Edema/LI Sheng， LIU Dingxi， JI Lili， QI Yuanyuan. //Medical Innovation of China， 2021， 18（12）： 0-043

[Abstract] Objective： To explore the application value of OCT angiography in diabetic macular edema. Method： The clinical data of 39 patients （52 eyes） with suspected macular edema in our hospital from August 2017 to August 2019 were retrospectively analyzed. All patients underwent fundus angiography and OCT angiography. The results of two methods for the classification of macular edema and the diagnostic coincidence rate of OCT angiography were compared， and the sensitivity and specificity were calculated. Result： 52 eyes were enrolled in this study， the results of fundus angiography were classified as diffuse edema type in 20 eyes （38.46%）， non-leakage type in 16 eyes （30.77%）， local edema type in 15 eyes （28.85%） and ischemic type in 1 eye （1.92%）. The results of OCT angiography were classified as spongiform edema type in 21 eyes （40.38%）， macular cystoid edema type in 16 eyes （30.77%）， normal 9 eyes （17.31%）， serous detachment of the fovea occurred in 6 eyes （11.54%）. The diagnostic accuracy， sensitivity and specificity of OCT angiography were 82.69%， 97.22% and 50.00%， respectively. The retinal thickness of macular edema patients after laser photocoagulation were lower than those before treatment （P<0.05）. Conclusion： OCT angiography has important application value in the diagnosis and evaluation of diabetic macular edema. It can provide objective basis for clinicians to evaluate the postoperative condition of clinical significance macular edema.

[Key words] OCT angiography Fundus angiography Macular edema

First-authors address： The Third Peoples Hospital of Dalian， Dalian 116033， China

doi：10.3969/j.issn.1674-4985.2021.12.009

糖尿病視网膜病变是影响劳动人口视力的主要原因之一，尤其是糖尿病黄斑水肿，危害最为显著[1]。依据我国2014年糖尿病视网膜病变临床诊疗指南，糖尿病黄斑水肿可分为局灶性黄斑水肿、弥漫性黄斑水肿和黄斑缺血三种表现形式，其中局灶性黄斑水肿，因其对视力损害明显，且激光光凝治疗效果较好，又被称为有临床意义的黄斑水肿（clinically significant macular edema，CSME）。而临床治疗弥漫性黄斑水肿，主要采用眼内注射抗新生血管药物，费用较高，需要反复多次的长期治疗[2-3]。目前临床治疗有临床意义的黄斑性水肿主要采用激光光凝、药物治疗，其中激光光凝取得显著效果，但在行激光光凝之前，需行眼底血管造影检查，评估微血管瘤的位置及渗漏情况。……