Influence Factors Of Macular Choroidal Thickness And Its Relationship With TCM Syndromes In Patients With DME

Objective:To explore the influencing factors of macular choroidal thickness and its relationship with TCM syndromes in DME patients.In order to improve the understanding of the influence factors of macular choroidal thickness in patients with Dr macular edema,and provide a certain basis for the clinical diagnosis and treatment of diabetic retinopathy macular edema.Methods:To apply the method of case review,according to the inclusion,The exclusion criteria collected 50 patients who were diagnosed as diabetic retinopathy macular edema group（group C）by pupil fundus examination from October 2015 to December2017 in the affiliated hospital of Chengdu University of traditional Chinese Medicine（Chengdu University of traditional Chinese Medicine）.At the same time,35 cases of diabetic retinopathy without macular edema in group B were selected.There was no history of diabetes mellitus,no history of fundus disease,no history of ocular trauma or ophthalmic surgery,no ametropia,no fundus abnormality in Oct.A total of 30normal volunteers matched with the age of the study group were measured.The macular edema thickness in SFCTC group was classified according to the measured values,and the choroidal thickness and sex,age,course of disease,intraocular pressure,pulse pressure difference,fasting blood glucose were analyzed in diabetic retinopathy patients with macular edema.The relationship between glycosylated hemoglobin and macular edema.The dialectical typing of TCM is based on Qi and Yin deficiency Syndrome,phlegm stasis Block Syndrome,spleen and Kidney deficiency Syndrome and Yin deficiency and Blood stasis Syndrome.The data collected were analyzed by SPSS20.0 software.Results:1.There were 30 cases in normal control group,including 15 males and 15females in group A,aged 4075 years（mean 57.77±10.30）years,and 35 cases in group B with diabetic retinopathy without macular edema,including 17 males and 18females in group B with an average age of 57.20±10.47 years.There were 50 cases of diabetic retinopathy macular edema in group C,including 25 males and 25 females in group C,with an average age of 60.77±10.21 years.2.The average SFCT in the A group（190.97+49.98）m,average SFCT B group（179.26±40.89）m,the two groups had no statistically significant difference（P>0.05）;the average SFCT in the C group（147.59±40.43）m,compared with A group,the difference was statistically significant（P<O.05）;B group compared with C group,the difference was statistically significant（P<0.05）.3.In 82 eyes of 50 patients with DME,18 eyes of mild macular edema group（21.9/82）,22 eyes of moderate macular edema group（26.8%）and 42 eyes of severe macular edema group（51.2%80%）;4.In 82 eyes of 4.50 patients with DME,the average SFCT of group C₁ was（196.44+26.08）m,the average SFCT of group C2 was（167.27±27.44）m,and the average SFCT of C₃ group was（147.59±43.42）mu m;the difference between 22groups was statistically significant（P<0.05）.5.50 patients with DME in 82 eyes:mean macular edema was 217.56±17.29μm in C₁ group and 323.05±37.28μm in C₂ group.The mean macular edema in C₃ group was 446.90±21.96μm.6.There was no significant correlation between mean SFCT and age,sex,course of diabetes,intraocular pressure,pulse pressure difference,fasting blood glucose and glycosylated hemoglobin in patients with diabetic retinopathy and macular edema（P>0.05）.7.Of the 85 cases of Dr,34 cases were qi and yin deficiency syndrome（40.1%）;25 cases were phlegm and stasis block（29.442）;17 cases（20.1）were spleen and kidney deficiency syndrome,9 cases were yin deficiency and stasis syndrome.TCM syndrome type of 10.4%.DR patients:Qi and yin deficiency syndrome>phlegm stasis block syndrome>spleen and kidney deficiency syndrome>yin deficiency and stasis syndrome8.There were 20 cases of deficiency of qi and yin,14 cases of phlegm and blood stasis block,11 cases of deficiency of spleen and kidney,5 cases of Yin deficiency and blood stasis.There was no significant difference in the thickness of choroid between TCM syndromes and macular regions（X²=3.176,P=0.521>0.05）.Conclusion:1.The mean SFCT of diabetic retinopathy patients with macular edema was thinner than that of normal subjects and diabetic retinopathy patients without macular edema.2.There was a negative correlation between macular edema and SFCT in diabetic retinopathy patients.3.The main syndromes of diabetic retinopathy macular edema were qi and yin deficiency syndrome,followed by phlegm and blood stasis block syndrome,spleen and kidney deficiency syndrome,yin deficiency and blood stasis syndrome.