| ObjectiveUsing the OCTA to scan the macular area blood flow density in diabetic patients with clinically no significant vision loss,and compared with normal people to explore the changes of retinal blood flow in macular area of fundus in early diabetic patients,so as to provide reference for early diagnosis,early prevention and intervention of diabetic retinopathy.At the same time,the changes of blood flow density in macular region of different TCM syndromes were discussed,which provided objective basis for the clinical differentiation and treatment of early DR.MethodsFrom June 2018 to December 2018,98 patients with type 2 diabetes mellitus(192 eyes)were hospitalized in the Department of Endocrinology,First Affiliated hospital of Guangzhou University of Traditional Chinese Medicine.According to the international clinical staging criteria of diabetic retinopathy,46 patients and 91 eyes were enrolled in NPDR group,52 patients and 101 eyes were enrolled in non-diabetic retinopathy group(stage 0 group),and age matching was normal.Forty-four persons and 84 eyes were enrolled in the control group.All subjects were examined by OCTA,and 3 mm X 3 mm scanning mode was selected to obtain the macular blood flow density maps in the size range of 3 mm in the macular fovea.The blood flow density in the superficial macular area and FAZ area in the macular area were automatically generated by the software.Independent sample t test(comparison of two groups)or single factor analysis of variance(comparison of multiple groups)were used to compare the blood flow density and FAZ area of subjects in different gender,age,course of diabetes,fasting blood glucose,glycosylated hemoglobin,NPDR,NDR and normal subjects.Resu t1.Macular blood flow density:The mean values of blood flow density in diabetic group and control group were 0.352±0.023 and 0.371±0.142,respectively.There were statistical differences between the two groups(p=0.000<0.05).Further two comparisons:The mean macular blood flow density in NPDR group was lower than that in phase 0 group(p=0.000<0.05);the mean values of macular blood flow density in NPDR group and 0 stage group were lower than those in control group(p=0.000<0.05,p=0.03<0.05);2.FAZ area:FAZ area of diabetic group and control group were 0.334(+0.091)and 0.270(+0.068),respectively.There was statistical difference between the two groups(p=0.000<0.05);further two comparisons:FAZ area of NPDR group was lower than that of 0 stage group(p=0.000<0.05),and FAZ area of 0 stage group had no statistical difference compared with that of control group(p=0.13>0.05).3.In this study,the macular blood flow density and FAZ area of diabetic patients with different gender,fasting blood glucose and course of disease were not related.The macular blood flow density and FAZ area of diabetic patients with different age,2-hour postprandial blood glucose and glycosylated hemoglobin levels were related to their macular blood flow density and FAZ area.4.In this study,the blood flow density and FAZ area in the macular area of diabetic patients with different TCM syndromes are different,and the change of blood flow density and FAZ area in the macular area of diabetic patients with Yin-Yang deficiency syndrome is the biggest.Conclusions1.When the central visual acuity of diabetic patients without obvious visual impairment is not affected,the macular blood flow density and FAZ area have changed significantly regardless of the change of DR in the fundus of the eye,and become worse with the progress of the disease.The quantified macular blood flow density and FAZ area by OCTA can be used as one of the indicators to monitor the progress of diabetes and the changes of visual function.2.Phlegm-dampness syndrome is the most common type of TCM syndromes in diabetic patients without obvious visual impairment.There are differences in macular blood flow density and FAZ area in different TCM syndromes of diabetic patients. |
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