Research On The Difference Of The Morphological Characteristics Of The Fundus Of Diabetic Retinopathy Based On The Three Xiaos Of Traditional Chinese Medicine

Purpose: To explore the differences between the Sanxiao in traditional Chinese medicine classification of diabetic retinopathy(DR)and fundus morphological characteristics,so as to provide help for the dialectical analysis of traditional Chinese medicine and clinical diagnosis and treatment of DR.Material and method:A prospective study was conducted to collect 153 eligible DR patients(153 eyes)from November 2018 to November 2019 in the ophthalmology and endocrinology department of Liaoning University of Traditional Chinese Medicine,according to the Sanxiao syndromes of TCM,the patients were divided into Shang xiao group,Zhong xiao group and Xia xiao group.To record the general information,the course of diabetes Mellitus(DM)and DR,TCM syndromes and the four diagnostic information,and to examine the visual acuity,fundus photography,OCT.BCVA,fundus morphology,CMT were measured and recorded.The optic disc area and fundus morphological features including microangioma(quantity),exudation(area)and hemorrhage(area)were extracted by image software,and compared with Sanxiao of TCM to analyze whether there is correlation.The frequency of vitreous hemorrhage,fibrous proliferation and traction retinal detachment in the three groups were obtained and compared by fundus photography.The CMT obtained by OCT was compared with the Sanxiao of TCM to provide reference for TCM syndrome differentiation and treatment.Results:1.There was no significant difference in age and sex among the three groups(P>0.05).2.The average duration of DM was(10.73±6.822)years in Shang xiao group,(11.90±6.638)years in Zhong xiao group,(16.60±5.594)years in Xia xiao group,the average duration of DR was(2.14±1.645)years in Shang xiao group and(3.23±2.000)years in Zhong xiao group,(3.84±2.033)years in Xia xiao group.There was significant difference between the average duration of DM and DR in three groups(P<0.05).3.The average BCVA of Shang xiao group was(0.11±0.075),Zhong xiao group was(0.12±0.065),and Xia xiao group was(0.24±0.073).There was significant difference in BCVA among the three groups(P<0.05).4.In the included cases,there was no significant difference between the two times of optic disc area obtained by image processing software(P>0.05).5.There was a certain correlation between the three groups with microhemangioma,exudate area and hemorrhage area,and the number of microhemangioma was different among the groups(P<0.05),the exudate area and hemorrhage area were significant in each group(P < 0.05).There was no significant difference in the morphological characteristics of vitreous hemorrhage,fibrous proliferation and Retinal detachment between the sanxiao of TCM(P<0.05).6.The average CMT of Shang xiao group was(247.98±22.202)μm,Zhong xiao group was(253.21±24.998)μm,and Xia xiao group was(295.67±23.037)μm.There was significant difference in CMT between the three groups(P<0.05).Conclusion:1.There was a certain difference in the course of disease in the classification of Sanxiao group,and the course of DM was longer in the Xiaxiao group.The course of DR in Shangxiao group was short.2.There was a certain difference in BCVA in the classification of Sanxiao group,and the vision of the Xiaxiao group was poor.3.There were significant differences in the morphological characteristics of the fundus in the classification of Sanxiao group.The number of microhemangiomas was more in the Shangxiao group,and the exudation and bleeding area was the smallest.The number of hemangiomas was the largest,the exudation area was the largest,and the bleeding area was large in the Zhongxiao group.The bleeding area of Xiaxiao group was the largest,the exudation area was larger,and the number of microhemangioma was the least.4.There was a certain difference in CMT in the classification of Sanxiao group.The CMT in the Xiaxiao group was the thickest,indicating that macular edema was serious.